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Who we are
Our Mission and Work
Not Putting on a Shirt (NPOAS) is a patient-led, all-volunteer 501(c)(3) nonprofit organization advocating for optimal surgical outcomes for women who choose to go flat after mastectomy.
Our organization maintains an informational website and social media platforms which provide the public with free medically reviewed information, publications, and tools to advocate for themselves and for others. We provide information on going flat at initial mastectomy, revision surgery, going flat after explant, and flat denial. We curate a searchable database of flat closure surgeons. We also moderate a private Facebook support group for victims of flat denial.
Additional initiatives include stakeholder and public outreach, legislative and regulatory actions, and original research in order to effect cultural and institutional change to protect the interests of women who choose to go flat after mastectomy.
Our contact information:
Our website address is: https://notputtingonashirt.org.
Charity ID# 84-3021062
Kimberly Bowles, President
Christy Avila, Vice President
Devorah Vester Borenstein, Secretary
Shana Whitehead, Treasurer
Electronic Communications With Us
We do not share confidential information with third parties. All electronic communications with NPOAS are assumed to be confidential and we will never share your confidential information unless you give us explicit permission in writing. Every agent of NPOAS is required to sign a confidentiality agreement that prohibits sharing of any personal information obtained during the course of their service with the organization, prior to such service. NPOAS preserves all electronic communications on our secure Google Drive in accordance with our document retention policy.
Surgeons Directory Submissions (and Gallery)
Your privacy and ongoing consent are of utmost importance to us. Persons who have submitted identifying personal information or photos may withdraw their consent for NPOAS to use or retain such information or images at any time by notifying NPOAS in writing. We will review your request within one months’ time.
NPOAS anonymizes submitted mastectomy photos by cropping out identifying information. The cropped image files are then saved with an encoded filename on NPOAS’ secure Google Drive. Your name and contact information (email, etc.) is the only identifying personal information we retain, and it is only linked to your image file(s) via a single secure, restricted access spreadsheet. Before obtaining access to any Drive files, NPOAS volunteers must sign a confidentiality agreement which explicitly protects the privacy of all confidential information.
WordPress Blog and Website
If you leave a comment on our site you may opt-in to saving your name, email address and website in cookies. These are for your convenience so that you do not have to fill in your details again when you leave another comment. These cookies will last for one year.
We do not share data with third parties. Visitor comments to the WordPress blog may be checked through an automated spam detection service. If you leave a comment, the comment and its metadata are retained indefinitely. This is so we can recognize and approve any follow-up comments automatically instead of holding them in a moderation queue.
If you have left blog comments, you can request to receive an exported file of the personal data we hold about you, including any data you have provided to us. You can also request that we erase any personal data we hold about you. This does not include any data we are obliged to keep for administrative, legal, or security purposes. Contact our administrators at firstname.lastname@example.org.
Online Media Comments Management Policy
The purpose of this policy is to provide clarity and transparency to the public, and specifically to our supporters, about how we manage public comments (“comments”) on our online media platforms. This policy contains clear guidelines that Not Putting on a Shirt, Inc. (“NPOAS”) has historically followed and commits to follow moving forward, including prohibited comments and redress, and how NPOAS manages comments, including guidelines for conflict prevention and resolution.
Online media, as it pertains to this policy, is defined as any NPOAS website, application or other virtual platform that allows end-user interaction, and includes, but is not limited to, blogs, websites, social networking websites (such as Twitter, Facebook, Instagram, etc.) online forums, podcasts, message boards, chat rooms and interactive web or mobile applications.
[II] Online Media and Our Mission & Core Values
NPOAS online media channels – including our website, blog, and social media – are curated with the intent to educate stakeholders and the public, and in particular women facing mastectomy, about aesthetic flat closure as a legitimate option and about the injustice of flat denial, and to engage these people in a way that inspires them to participate in our work both online and offline. All of our online media interactions aim to further our organization’s mission in accordance with our core values of clear language, full disclosure, and accountability:
Our mission is to advocate for satisfactory cosmetic outcomes – as agreed upon by the mastectomy patient and surgeon(s) – for those who choose to go flat. We inform and support patients, demand increased accountability for medical professionals and institutions, and collaborate with patients and the surgeons who care for them to establish resources and protocols that will make a difference.
[III] Prohibited Comments
Every social media forum has its share of users that surface from time to time with unproductive and/or malicious intent. NPOAS will maintain vigilance on this front in order to maintain respectful discourse and protect the community that we serve. Comments that meet any of the following criteria are prohibited and will be deleted immediately:
- Contain spam (irrelevant content that adds no value to and/or distracts from the discourse) or inappropriate advertising of products or services
- Be off-topic, irrelevant or unintelligible
- Give medical or legal advice
- Contain confidential information about any person or entity
- Be defamatory of any person
- Be deceitful, misleading, or intended to provide or support factually incorrect misinformation
- Promote discrimination based on race, sex, religion, nationality, disability, sexual orientation, gender identity, or age
- Be obscene, degrading or disparaging of any person, threatening, abusive, or hateful
- Promote violence
- Breach any of the terms of any of the social media platforms themselves
Furthermore, trolls, bots, and individuals who are clearly data mining or engaged in other egregiously malicious or unethical behaviors will be identified and dealt with promptly (blocked and reported as necessary).
Trolls are imposters – real people who obscure their identity – whose sole purpose in the social media forum is to cause discord, insult people, data mine, or otherwise cause damage to the organization, its leadership, or its community.
Bots are algorithms generating interactions that falsely appear to be from a person.
Data mining is the gathering of private information without disclosure and/or consent of all parties.
[IV] Comments Management Code of Conduct
NPOAS adheres to a strict code of conduct with respect to online media interactions, including responding to comments, removal of prohibited comments, and removal or blocking of persons who repeatedly and/or intentionally post prohibited comments.
Tone. NPOAS will maintain a respectful, professional tone in all interactions with the communities we serve. We will always demonstrate respect for others’ points of view, even when they’re not offering the same in return.
Prudence. When dealing with comments that may be objectionable or inflammatory but do not clearly meet any of the criteria for prohibited comments, NPOAS will extend the benefit of the doubt to the commenter and will use prudence and good judgment in responding or otherwise managing the comment.
Sensitive Topics. NPOAS will be sensitive to topics that may commonly be considered objectionable or inflammatory, such as partisan politics or comments that could be interpreted as disparaging of either aesthetic flat closure or of conventional breast mound reconstruction. Comments about personal experience with post-mastectomy reconstruction are permitted; comments that disparage or condemn any post-mastectomy reconstructive option are generally not permitted.
Conflict Resolution. NPOAS appreciates that some of our supporters and readership have had negative experiences with conventional breast mound reconstruction, and it is our policy to engage respectfully on this and other sensitive topics rather than to immediately remove these comments. NPOAS will not remove non-prohibited comments, nor remove comments on sensitive topics, without prior transparent and respectful engagement.
Removal/Blocking. Persons who post comment(s) that intentionally and/or repeatedly and clearly violate this policy are subject to removal and/or blocking from NPOAS platforms. NPOAS will not remove or block persons for any other reason other than violation of this policy.
Appeal. Commenters who feel that their comment was removed in error may contact NPOAS to appeal the removal. NPOAS will conduct a timely, fair and transparent review of the comment and the manner in which it was removed and make its determination either:
- in favor of restoring the comment, if we find that the comment was removed in error, or
- confirming the comment removal, if we find that the comment was removed in accordance with this policy.
Contacting NPOAS. Please contact NPOAS directly via email at email@example.com for appeals or inquiries about this policy.
This policy has been duly adopted by the NPOAS Board of Directors and may be amended as needed pursuant to NPOAS internal guidelines.
Code of Conduct Policy
Includes Core Values, Code of Ethics, Non-Discrimination, Anti-Bullying, and Conflict of Interest
Not Putting on a Shirt (NPOAS) is a patient-led, all-volunteer 501(c)(3) nonprofit organization advocating for optimal surgical outcomes for women who choose to go flat after mastectomy, and for full and fair disclosure of all options post-mastectomy, including flat closure and the risks of all reconstructive options.
We maintain an informational website and social media platforms which provide the public with free information, publications, tools and support to advocate for themselves and for others. We provide medically reviewed, accurate, and up to date information on going flat at initial mastectomy, revision surgery, or after explant, and flat denial. We curate a searchable database of flat closure surgeons that we and our volunteers are continuously validating and updating.
We also conduct stakeholder and general public education and outreach, as well as legislative and regulatory advocacy initiatives, and support original research on flat closure and flat denial in order to effect cultural and institutional change to protect the interests of women who choose to go flat.
Our Core Values
Aesthetic flat closure (flat closure) is reconstruction of the chest wall contour.
Flat denial is when a surgeon disregards the patient’s consent and fails to perform the agreed upon flat closure.
Doctors and surgeons must give women full and accurate information about ALL of their reconstructive options, including aesthetic flat closure.
“Shared” Decision Making
The decision making process must center the patient’s values and priorities from start to finish for optimal surgical outcomes.
An optimal, evidence-based standard of care must be developed for aesthetic flat closure in order to ensure that women consistently receive acceptable surgical outcomes.
Respect for a woman’s informed consent is non-negotiable. Surgeons who intentionally disregard a woman’s reconstructive choice must be held accountable.
Surgeons deserve to be fairly reimbursed for aesthetic flat closure and revision services, as flat closure is a truly reconstructive, NOT cosmetic, procedure.
Achieving parity for flat closure requires legislative and regulatory change. Both the NCI [update: NCI has added “aesthetic flat closure” to their Dictionary of Cancer Terms!] and WHCRA’s definitions of “breast reconstruction” as well as the NAPBC’s reconstructive consult protocol must all be amended to explicitly include aesthetic flat closure.
Code of Ethics
To be effective as an advocacy organization and ensure our mission is carried out, our work is guided by a strong and unifying code of ethics. We believe in:
- Acting with care and respect for the communities we work with and serve.
- Treating every individual fairly, with dignity and respect.
- Acting honestly, truthfully and with integrity in all of our transactions and dealings.
- Being responsible, transparent and accountable for our words and actions.
- Acknowledging the limitations of our own expertise and seeking appropriate professional advice when indicated.
- Continuous review and validation of all of the information we provide for factual, scientific and medical accuracy.
- Appropriately handling actual or apparent conflicts of interest in our relationships.
- Being a good corporate citizen – complying with both the spirit and the letter of the law.
Purpose. Not Putting on a Shirt (“NPOAS”) believes that all Directors, volunteers, and other associates should be treated with dignity and respect. NPOAS does not and shall not discriminate on the basis of age, sex, color, race, creed, national origin, religious persuasion, marital status, sexual orientation, gender identity, political belief, disability, health status, or any other characteristic protected under applicable federal or state law (herein called “protected categories”), in any of its activities or operations. NPOAS is committed to providing an inclusive and welcoming environment for all of our associates. This anti-discrimination policy will help us achieve the following organizational goals:
- Promote a culture of diversity and inclusiveness;
- Improve recruitment and retention;
- Avoid illegal discrimination; and
- Take action against any associate who does not uphold NPOAS’ principles.
Definitions. Unlawful discrimination occurs when a person is harassed or treated arbitrarily or differently because of the person’s real or implied membership in a protected category.
- Discrimination. In the nonprofit advocacy context, discrimination may begin with an adverse work action, which is something a Director, Volunteer Coordinator, or other management agent, has done that is unfair to a volunteer or other associate. Some examples of adverse work action are: terminating an associate’s service, not selecting him/her/them for promotion within the organization, harassing the associate, or denying the associate’s request for a reasonable accommodation.
- Non-Discriminatory Harassment or Bullying. Personality differences or conflicts, general mistreatment not based on the above protected categories, or a response to poor performance are usually not discrimination matters; however, they may be covered under another policy, such as the Anti-Bullying policy.
Responsible Party. The Responsible Party (“RP”) – the NPOAS designated person for issues concerning this anti-discrimination policy – is the President of NPOAS. The RP is responsible for ensuring that discrimination complaints are resolved appropriately, and may not delegate this authority to any other agent unless incapacitated. If the President is incapacitated, the Vice President will serve as the temporary RP.
- The current President is: Kimberly Bowles (firstname.lastname@example.org)
- The current Vice President is: Christy Avila (email@example.com)
Process and Procedures. When NPOAS receives such a discrimination complaint, it will be forwarded to the RP, who will contact the associate(s) who felt harmed to see if they want to resolve the matter informally or formally.
- Informal Action. The RP will use good business judgment to investigate the complaint and take appropriate informal action to resolve the matter to the satisfaction of all parties.
- Formal Action. The RP will conduct a fact-finding investigation to determine whether or not the associate’s membership in a protected category was the reason for the adverse action, and take appropriate corrective action.
Duties and Responsibilities of NPOAS Agents
- Duty to Report. Directors, Volunteer Coordinators, and other management agents of NPOAS are required by law to promptly report any allegations of discrimination and/or harassment based on protected categories and other forms of sexual misconduct that they observe or learn about in the course of their service with NPOAS, to the RP. Failure to report a known or suspected incident of discrimination or harassment to the RP may result in disciplinary action up to and including termination of service with NPOAS.
- Duty to Cooperate. All agents of NPOAS must cooperate fully with the RP’s investigations concerning allegations of discrimination or harassment. Refusal to cooperate with an investigation may result in disciplinary action up to and including termination of service with NPOAS.
- No Retaliation. Any agent or associate of NPOAS has the right to raise concerns or make a complaint regarding discrimination or harassment under this policy without fear of retaliation. It is a violation of NPOAS policy to retaliate against an individual for filing a complaint of discrimination or harassment or for cooperating in an investigation of alleged discrimination or harassment. Any person at NPOAS found in violation of this policy is subject to disciplinary action up to and including termination of service with NPOAS.
- Confidentiality. NPOAS and the RP will respect the privacy and confidentiality of individuals involved in an investigation to the fullest extent possible. NPOAS recognizes the importance of confidentiality and understands that some individuals filing complaints of harassment/discrimination or who are otherwise involved in an investigation may want their identity to remain anonymous and/or confidential. The RP has the power of discretion to shield the reporter’s identity when reviewing a matter or conducting an investigation. In all cases, issues of confidentiality must be balanced against NPOAS’ need to investigate and take appropriate action.
NPOAS considers workplace bullying unacceptable and will not tolerate it under any circumstances. Workplace bullying is behavior that harms, intimidates, offends, degrades or humiliates any person (or “target”) in the course of their work, possibly in front of other persons.
Examples of workplace bullying behaviors:
- Unwarranted or invalid criticism
- Blame without factual justification
- Being treated differently than the rest of your work group
- Being sworn at, shouted at, or other expressions of direct hostility
- Exclusion or social isolation
- Excessive monitoring or micro-managing
- Withholding of resources necessary for the target to carry out their duties
Mobbing is a subset of workplace bullying behavior where the instigator enlists bystanders and other agents to bully the target. Workplace bullying and mobbing in particular may cause the loss of trained and talented volunteers, reduce productivity and morale and create legal risks. NPOAS believes all people deserve to work in an environment of respect, trust and open communication that is free of bullying.
Persons in position of authority over others at NPOAS, including Directors and Volunteer Coordinators, are responsible for creating an atmosphere of respect and open communication to ensure that members of their team are not subjected to bullying. Any reports of workplace bullying at NPOAS will be treated seriously and investigated promptly, confidentially and impartially.
NPOAS encourages all agents of NPOAS to report workplace bullying, whether or not they themselves were targeted. Mobbing in particular is only possible when bystanders do not speak up. Directors and Volunteer Coordinators must ensure that individuals who make complaints, whether targets or witnesses, do not experience retaliation for doing the right thing.
Disciplinary action will be taken against anyone who is determined to have engaged in bullying in the course of their service at NPOAS. Discipline may involve a warning, counseling, and/or demotion or dismissal.
The contact person for bullying at this workplace is:
Kimberly Bowles, President
Conflict of Interest
We are committed to clear policies that protect the integrity of our work. We acknowledge that our Board members and volunteers have broad interests and participate in many community, charitable and business activities. Often, the broader the individual’s experience, the more valuable the individual is to our organization. From time to time, however, situations may arise where an individual’s business or personal interests may be affected by a Board decision. In all such cases, NPOAS understands that the potential for conflict of interest needs to be recognized and disclosed, and appropriate steps taken to prevent influence or favoritism. To that end, Board members and volunteers annually complete a conflict of interest disclosure agreement.
Whistleblower Protection Policy
Not Putting on a Shirt (NPOAS) requires directors, officers and volunteers to observe high standards of business and personal ethics in the conduct of their duties and responsibilities. As representatives of NPOAS, we must practice honesty and integrity in fulfilling our responsibilities and comply with all applicable laws and regulations.
This Whistleblower Policy is intended to encourage and enable employees and others to raise serious concerns internally so that NPOAS can address and correct inappropriate conduct and actions. It is the responsibility of all board members, officers, and volunteers to report concerns about violations of NPOAS’s code of ethics or suspected violations of law or regulations that govern NPOAS’s operations.
It is contrary to the values of NPOAS for anyone to retaliate against any board member, officer, or volunteer who in good faith reports an ethics violation, or a suspected violation of law, such as a complaint of discrimination, or suspected fraud, or suspected violation of any regulation governing the operations of NPOAS. An agent of NPOAS who retaliates against someone who has reported a violation in good faith is subject to discipline up to and including termination of service with NPOAS.
NPOAS has an open door policy and suggests that volunteers share their questions, concerns, suggestions or complaints with their Volunteer Coordinator. If you are not comfortable speaking with your Volunteer Coordinator or you are not satisfied with your Volunteer Coordinator’s response, you are encouraged to speak with a member of the Executive Committee. Volunteer Coordinators are required to report complaints or concerns about suspected ethical and legal violations in writing to NPOAS’s Secretary, who has the responsibility to investigate all reported complaints.
The Secretary is responsible for ensuring that all complaints about unethical or illegal conduct are investigated and resolved. The Secretary will advise the Executive Committee of all complaints and their resolution and will report at least annually to the Treasurer on compliance activity relating to accounting or alleged financial improprieties.
Accounting and Auditing Matters
The Secretary shall immediately notify the Finance Committee of any concerns or complaints regarding corporate accounting practices, internal controls or auditing and work with the committee until the matter is resolved.
Acting in Good Faith
Anyone filing a written complaint concerning a violation or suspected violation must be acting in good faith and have reasonable grounds for believing the information disclosed indicates a violation. Any allegations that prove not to be substantiated and which prove to have been made maliciously or knowingly to be false will be viewed as a serious disciplinary offense.
Violations or suspected violations may be submitted on a confidential basis by the complainant by mailing a letter to NPOAS’ corporate office. Reports of violations or suspected violations will be kept confidential to the extent possible, consistent with the need to conduct an adequate investigation.
Handling of Reported Violations
The Secretary will notify the person who submitted a complaint and acknowledge receipt of the reported violation or suspected violation. All reports will be promptly investigated and appropriate corrective action will be taken if warranted by the investigation.
Devorah Vester Borenstein
Secretary of NPOAS
NPOAS believes in transparency and accountability to the public. Therefore, we make available information on certain key policies and documents, governance structure, and financial statements. We also comply in full with the IRS’s tax record disclosure requirements. Please contact us at firstname.lastname@example.org with any questions or to request further information.
Charity ID# 84-3021062
By Request with Board Approval: Bylaws, Board Meeting Minutes
REGISTERED CHARITY ID# 84-3021062
FAIR USE STATEMENT
This site contains copyrighted material. Not Putting on a Shirt’s educational materials and resources on this site are freely available for “fair use” (Title 17 U.S.C. Section 107) in accordance with our mission to advocate for optimal outcomes for those who choose to go flat after mastectomy. The copyrighted material on this site is distributed for educational purposes without profit – all donations to Not Putting on a Shirt directly fund our advocacy work. If you wish to use copyrighted material from this site for purposes that go beyond “fair use”, you must first obtain explicit permission from the copyright owner. Please direct requests or questions to email@example.com.