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BANNOCK COUNTY COMMISSIONERS’ –
MEETING
Commissioners' Agenda
The Board of County Commissioners (BOCC) is comprised of the three elected County
Commissioners: Ernie Moser (District 1), Jeff Hough (District 2, Chair), and Ken Bullock (District
3). The BOCC generally meets twice weekly: Tuesdays & Thursdays at 9:00 a.m. Unless otherwise
noted, meetings are generally held in the Commissioner's Chambers at 624 E Center, Room 212,
Pocatello, Idaho. During these public meetings, the BOCC may approve contracts, expend funds,
hear testimony, make decisions on land use cases, and take care of other County matters.
Times are subject to change within 15 minutes of the stated time.
Tuesday, August 11, 2026
9:00 AM Work Session and Claims Meeting (action items)
Agenda:
Indigent Business may require an Executive Session pursuant to Idaho Code §74-206(1)(d) to
consider records exempt from public disclosure (action item)
BOARD OF AMBULANCE DISTRICT
Kristy Pincock, City of Pocatello Fire, requesting approval to write-off balance due on Deceased
patients; 28 accounts totaling $8025.36 (requested 5 minutes) (action item)
Shane Grow, Ambulance District, requesting signature on a proposal to purchase two (2)
ambulances (requested 5 minutes) (action item)
BOARD OF COUNTY COMMISSIONERS
Matthew Phillips, HR & Risk Management, requesting ratification on special event policy with liquor
liability endorsement quote for a concert (requested 5 minutes) (action item)
Todd Mauger, Juvenile Probation Director, requesting a signature on an affiliation agreement with
Idaho State University for the Community Health Worker Training Program (requested 5 minutes)
(action item)
1
BOARD OF BANNOCK COUNTY COMMISSIONERS
Tuesday, August 11, 2026
CONSENT AGENDA (action items):
· Manual Checks
· Alcohol Licenses and Catering Permits
· Certificate of Residency Approval
· Personnel Actions with potential Executive Session under Idaho Code §74-206(1)(a),(b)&(d)
for personnel actions or personnel records exempt from disclosure with potential action following
adjournment of Executive Session
· Mileage and Travel Approvals
· Minutes:
2
BOARD OF BANNOCK COUNTY COMMISSIONERS
Tuesday, August 11, 2026
3 BOARD OF BA\ Tuesday, August 11, 2026
—————————— -
BANNOCK CouNTy COMMISSIONERS
624 E. Center, Pocatello, ID 83201
Phone: (208) 246-7210 ¢ Fax: (208) 232-7363
Ernie Moser Jerr HoucGH ‘Terre N. Tovey
Comrnissioner Commissioner Commisstoner
Ist District 2nd District 3rd District
AGENDA REQUEST FORM
The Board of Bannock County Commissioners business meetings are generally held on Tuesday
in the Commissioners’ Chambers in the Bannock County Courthouse, 624 E. Center, Room 212,
Pocatello, Idaho, or as noticed 48 hours prior to the meeting at
hittps:/Avww.bannockcounty.us/commissioners/. Agenda times are subject to change within 15
minutes of scheduled time. Any person(s) needing special accommodations to participate in public
meetings should contact the Commissioner’s Office at 208-236-7210, three to five working days
before the meeting.
E-mail this completed form and any supporting documents to agendarequest@bannockcounty.us by
NOON on the Thursday prior to the scheduled meeting.
Name/Department:
Kristy Pincock / Bannock County Ambulance District
Item to be considered/background:
Request approval to write-off balance due on Deceased patients; 21 accounts totaling
$5363.58
How much time will be needed?
5 minutes
Does this item involve a contract, agreement, external funding application or award
acceptance?
YES [| NO
Have all supporting documents been included with this form?
YES NO [
List of attendees:
Kristy Pincock
Please include any supporting documents with your Work Session Request Form.
Commissioner Office Only:
. Date: Time:
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
Bannock County Ambulance District
Billing and Collections
408 E. Whitman
Pocatello, ID 83201
208-234-6200
Date: August 5, 2026
To: Board of County Commissioners
Re: Request to Write-off Balance on Deceased Patient Accounts
The Bannock County Ambulance District would like to present the
following list of accounts for deceased patients to request the Board’s
permission to write-off the remaining balance due.
Number of Accounts: 28
Total Balance Due: $ 8,025.36
All patients on the attached list are deceased and no others means of
payment for the Emergency Medical Services received have been identified.
Collection efforts by the Bannock County Ambulance District have been
exhausted.
{
Phone: ¢
raph.
enter, Pocatello, ID 8Syaot
(i-7210 © Fax: (208) 252-7963
BOARD OF Tuesday, August 11, 2026
BANNOCK CouNTY COMMISSIONERS te \ Ernie Moser Jere HouGH — Ken BuLLock
Commission: Commissions Clonnissiones
Ist District 2nd District Srd District
AGENDA REQUEST FORM
The Board of Bannock County Commissioners business meetings are generally held on
Tuesday at 9:00 AM in the Commissioners’ Chambers in the Bannock County Courthouse, 624
E. Center, Room 212, Pocatello, Idaho, or as noticed 48 hours prior to
the __ meeting _at__https://www.bannockcounty.us/commissioners/, Agenda _ times are
subject to change within 15 minutes of scheduled time. Any person(s) needing special
meetings should contact the Commissioner's Office at 208-236-7210, three to five working days
before the meeting.
E-mail this completed form and any supporting documents to agendarequest@bannockcounty.us by
NOON on the Thursday prior to the scheduled meeting.
Name/Department:
BCAD
Item to be considered/background:
PSS Ambulance Pricing and Proposal for two Horton Ambulances
How much time will be needed? Meeeting date requested:
5 min 8/11/26
Does this item involve a contract, agreement, external funding application or award
acceptance?
YES [/] no[ ]
Have all supporting documents been included with this form?
YES NO []
List of attendees:
Chief Grow
Please include any supporting documents with your Agenda Session Request Form.
Sere rater TEST
Commissioner Office Only:
Date: Time:
POE ET STEEL RTI ELIS 9S BPE A
BOARD OF BAN STE] COMMISSIONERS Tuesday, August 11, 2026
Om EPARr Se
Cet “e470
408 EAST WHITMAN
POCATELLO, ID 83201
208.234.6201
FAX: 208.233.4043
© “4
wy wx
WeNock cova’
LANCE DIS
Ryan O'Hearn - Fire Chief
TO: BANNOCK COUNTY COMMISSIONERS
FROM: DEAN BULLOCK
SUBJECT: CAPITAL PURCHASE —- AMBULANCE
DATE: AUGUST 11, 2026
CC: KRISTI DAVENPORT, ISRISTI KLAUSER, SHANE GROW, AUTUMN BAKER
The Bannock County Ambulance District requests approval to enter into an agreement with Professional Sales
& Service, L.C. (PSS) for the purchase of two Horton ambulances. The attached agreement will put us on the
production list and establish our place in line. The funding for these ambulances was requested in the FY2027
capital budget. It is estimated that at least one of the ambulances will be completed and delivered in FY2027,
and the second may come in the beginning of FY2028. If that delay occurs, we will request that the remaining
funding for that second ambulance be approved to move from the FY27 budget into the FY28 budget during
that budget build cycle.
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
P AY AY PROFESSIONAL SALES
AND SERVICE, L.C.
Quality Emergency Vehicles Since 1974
August 7, 2026
Bannock County Ambulance District
624 E Center St, Room 104
Pocatello, ID 83201
To Whom It May Concern:
Professional Sales and Service, LC respectfully provides the Bannock County Ambulance
District the following proposal for a new ambulance vehicle. We appreciate the opportunity to
work with you now and look forward to helping you with your ambulance needs in the future.
The following proposal reflects New Type I ambulances the proposal is as follows:
Two 2027 Horton 603 Type I 4x4 Custom Ambulances
Mounted on 2027 Ford F-550 4x4 Diesel Chassis
The module body will be 167” long and have an interior height of 74” inches. It will be mounted
on a 2027 Ford F-550 4X4 with a Diesel Motor dual rear wheel cab/chassis. This proposal
includes Horton’s electrical system: The most advanced electrical system available which
incorporates solid-state electronics with Multiplexing technology. It also includes weight saving
all-aluminum module body, NO-wood construction, aluminum cabinetry, electrical system
diagnostic testing, digital computer consoles, privacy windows, LED lighting package and much
more. Full specification attached.
Take a look at Horton Emergency Vehicles (HEV) and you will see why they are so well
regarded in the ambulance industry and among the finest available anywhere. A Horton
emergency vehicle is BUILT TO WITHSTAND the rigors of ambulance service. Horton
ambulances are tested and engineered to be incredibly structurally sound which provides the
EMS crew and patient with aSAFER WORKING ENVIRONMENT. They are currently the
only manufacturer with an ongoing crash simulation testing program to test things like cabinet
mounting stability, door structure & latching strength, and body mounting solidity.
ALUMINUM CABINETS SAVE PAYLOAD and are much more DURABLE than wood. An
ambulance built to a higher quality standard will provide REDUCED OPERATING COSTS over
the many years the vehicle is in service!! When it comes to quality, durability, customization,
and safety, Horton continues to be a leader in the ambulance manufacturing industry.
PSS SHowROOM
1720 Indiana Ave, Salt Lake City, UT 84104
(801) 977-3961 Phone <> (801) 977-3969 Fax
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
P Ss AY PROFESSIONAL SALES
AND SERVICE, L.C.
Quality Emergency Vehicles Since 1974
PRICING PAGE
PROPOSAL CONDITIONS
F.O.B. POINT: Pocatello, ID 83201
DELIVERY: Do to current and ongoing national supply chain issues specifically in
regard to chassis availability. We will be providing estimated delivery
times only. Currently Horton standard lead time is approximately 24-28
months (pending chassis).Please note all delivery times are quoted barring
any delays due to strikes, availability of component parts (including
chassis), or acts of God
SERVICE: Professional Sales & Service has been selling and servicing ambulances
since 1975. We have factory trained technicians and a large inventory of
parts, so you know that in the unlikely event of a problem we are only a
phone call away.
PSS. SHOWROOM
1720 Indiana Ave, Salt Lake City, UT 84104
(801) 977-3961 Phone <> (801) 977-3969 Fax
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
P y y PROFESSIONAL SALES
AND SERVICE, L.C.
Quality Emergency Vehicles Since 1974
PAYMENT TERMS: Payment due upon delivery and acceptance of vehicle by the Bannock
County Ambulance District.
** Pre-Payment discounts available upon request.
WARRANTY: Horton Emergency Vehicles feature one of the most progressive, no-
nonsense warranties around. Horton does not pro rate their warranties so
there are no surprises should you ever need it.
Unless accepted within Sixty (60) days from the above date, the right to withdraw this proposal
is reserved. If there are any additions/deletions to our bid, please contact me for pricing details
or credits.
We are confident you will be completely satisfied with the quality Horton ambulance and the
service which PSS provides.
Respectfully Submitted,
Professional Sales and Service, LC
Fragen 7. Petirsen
Braxton T. Peterson, General Manger
Bannock County Ambulance District agrees to purchase the vehicle detailed in this proposal,
from Professional Sales and Service, L.C. and understands and agrees with the terms specified
within these documents.
Authorized by (Print name) Signed Date
Please let us know if you have any questions regarding this proposal. We are happy to assist you
in any way that we can.
PSS SHOWROOM
1720 Indiana Ave, Salt Lake City, UT 84104
(801) 977-3961 Phone <> (801) 977-3969 Fax
10
OMMISSIONERS Tuesday, August 11, 2026
BANNOCK County COMMISSIONERS Zz : —_ \ Ernie Moser = Jere HouGu KEN BULLOCK
G2, FB,
Phone: (208) 25
(
fi-7210 © Fax: (208)
er, Pocatello, 1D Bya0)
AGENDA REQUEST FORM
The Board of Bannock County Commissioners meetings are generally held on Tuesdays and Thursdays at 9:00 AM in the
Commissioners' Chambers in the Bannock County Courthouse, 624 E. Center St. Room 119, Pocatello, Idaho, or as noticed 48
hours prior to the meeting at https:/www.bannockcounty.gov/commissioners. Agenda times are subject to change withing 15
minutes of scheduled time. Any person(s) needing special meeting accommodations should contact the Commissioners' Office at
208-236-7210, five working days before the meeting.
Email this completed form and any supporting documents to: agendarequest@bannockcounty.gov
Meeting Date Requested: 98/11/2026
Requestor Name: Matthew K. Phillips Department: HR & Risk Management
Item to be considered/background:
Requesting ratification on special event policy with liquor liability endorsement quote for
08/13/26 Jason Bonhams' Led Zepplin Evening concert.
Action Requested: Decision Amount of Time Requested: 5 Minutes
Financial Impact (Total Cost/Funding Source):
$766.00 for special event liability and $393.00 liquor liability from BC events line item for
concerts.
Does this item involve a contract, agreement, external funding application, or award
acceptance?
P Contract
Has the item been reviewed by Risk Management? [vlvEs NO [INA
Are all supporting documents included? | y [YES NO [INA
Has the item been reviewed by Auditing? Ly |YES NO
List of additional attendees:
Has the item been submitted to/reviewed by Legal? | y YES ~
Please include any supporting documents with your Agenda Session Request Form.
Commissioner Office Only:
Date: Time:
Commissioner Comirissiones Clonpmnissioner
Ist District 2nd District 3rd District
11 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
P HILADELPHIA One Bala Plaza, Suite 100
ar , Bala Cynwyd, Pennsylvania 19004
eatin INSURANGE COMPANIES 610.617.7900 Fax 610.617.7940
A Sauber of the Tukia Marine Gros PHLY.com
PROPOSAL FOR INSURANCE
Proposal Number:4183266 Proposal Date: 07/29/2026
Named Insurad and Mailing Address: Producer: Mutual insurance
Bannock Caunty dba Portneuf Health Trust Amphithaatre 1875 Baldy
624 E Center Street Rm 214 Pocatello, ID 83201
Pocatello, ID 83201 : Contact: Jayson Meline
: Agency Number; 28790
Phone: 208-2379696
Insurer: Philadelphia Indemnity insurance Company Underwriter: Jaclyn St. Galals
Policy Period From: 08/13/2026 To: 08/14/2026
Proposal Valid Untit 08/12/2026 at 12:01 A.M, Standard Time al your malling address shown above
Product: Special Events Submission Type; New Business
Commission 10%
IN RETURN FOR THE PAYMENT: OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE
AGREE WITH YOU TO EXTEND INSURANCE AS STATED IN THIS-PROPOSAL. THIS PROPOSAL CONSISTS OF THE
FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM [8 INDIGATED. THIS PREMIUM MAY BE SUBJECT TO
ADJUSTMENT, PREMIUM
Commercial General Liability Coverage Part — - woe vies $766.00. -
The Total Premium includes Federal Terrorism Risk Insurance Act Premium in the amount of $0.00
TOTAL $766.00
12 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
P HILADELPHIA One Bala Plaza, Suite 100
" ; " Bala Cynwyd, Pennsylvania 19004
Gehan INSURANCE COMPANIES 610.617.7900 Fax 610.617.7940
AMeasbur ab she Tokia Marie Grenays PHLY.com
Proposal Date: 07/29/2026
Proposal Number: 4183266
The producer placing this policy may receive commission and additional underwriting profit share Incentives. These Incentlves are
based on the undenwtiting performance of this producer's book of business, Any questions about the nature of this compensation
should be directed to the producer:
In order to complete the underwriting process, we require that you send us the additional information requested In the “conditlons”
section of this proposal. We are not required to bind coverage prior lo our receipt, review and underwriting approval, of said
additional information, However, if wa do bind coverage, it shall be for a temporary period of not more than 30 days: Such
temporary binding of coverage shall be vold ab Initio ("trom the baginning’) If we have not received, reviewed and approved In
writing such materials within 15 days from the effective date of the temporary binder. This 30 day temporary conditional binder may
be extended only in writing signed:by the Insurer, Payment of premium shall not operate to extend the binding period or nullify the
automatic voiding as described above.
This quotation is strictly conditioned upon no material change in the risk occurring betwean the date of this proposal and the
Inception date of the proposed polley (including any claim or notice of ciroumstances that which may reasonably expected to give
rise to. a claim under any policy of which the polley being proposed by this letter is a renewal or replacement). In the event of such
change in risk, the Irisurer may in its sole discretion, whether or not this quotation has been already ‘accepted by the Insured, modify
and/or withdraw this quotation.
Subject to the tars and conditions outlined above and prior to the quote expiration date, this quote may be bound by signing and
dating below and by inifialing, on the previous page, the option to be bound. This form wilt then act as the binder of coverage for 30
days from the date signed and may be distinguished by the Quotation number on page 1. This binder is only valid for 30 days.
No coverage is afforded or implied unless shown in this proposal.
This proposal does not constitute a binder of insurance.
This proposal is strictly limited to the terms and conditions herein. Any other coverage
extensions, deletions or changes requested in the submission are hereby rejected.
Signature of Authorized Insurance Representative Date
13 BOARD OF BANNOCK COUNTY COMMISSIONERS
Philadelphia Indemnity Insurance Company
Locations Schedule
‘ Proposal Number: 4183266
Frems. Bldg.
No, No, Address
ono 0004 2375 Olympus Drive,
Pocatello, ID 63201
Page 1 of 4
Tuesday, August 11, 2026
14 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
Philadelphia Indemnity Insurance Company
Form Schedule — Policy
Proposal Number: 4483266
Forms and Endorsements applying to this Coverage Part and made a part of this
policy at time of issue:
Form Edition
BIPL9O1 1298
PP2020 0220
CPDPIC 0614
Location Schedule 0100
PICME1 1009
1L00241 0908
ILO017 1198
1L0204 0908
Description
Commercial Lines Policy Jacket
Privacy Poticy Notice
Common Policy Declarations
Location Schedule
Crisis Management Enhancement Endorsement
Nucleer Energy Liability Exclusion Endorsement
Commion Policy Conditions
Idaho Changes ~ Cancellation and Nonrénewal
Page 1 of 1
15
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
Philadelphia Indemnity Insurance Company
Form Schedule ~ General Liability
Proposal Number: 4183266
Forms and Endorsements applying to this Coverage Part and made a part of this policy at
time of issue:
Form Edition Description
Gen Liab Dec 1004 Commercial General Liabillty Coverage Part Dectaration
ean bap 0100 General Liability Schedule
CGo001 0413 Commercial General Liability Coverage Form
CG2100 0798 &xclusion - All Hazards in Connection With Designated Premises
CG2101 1185 ~~ Exclusion - Athletic ar Sports Participants
CG2106 0s14 Exclusion ~ Access or Disclosure of Confidential or Personal Information and Data-Related Liability
With Limited Bodlly Injury Exception
CG2109 0615 Exclusion - Unmanned Afreraft
CG2116 0413 = Exclusion - Dasignated Professional Services
CG2132 0509 Communicable Disease Exclusion
CG2133 1185 ~—- Exclusion - Designated Products
€G2135 1001 ‘Exclusion - Coverage C ~ Medical Payments
€62144 0417 Limitation of Coverage to Designated Premises, Project or Oparation
CG2147 1207 Employmant-Related Practices Exclusion
CG2153 0196 = Exclusion - Designated Ongolng Operations
CG2167 1204 = Fung! or Bacterla Exclusion
CG2173 O115 Exclusion of Certifled Acts of Terrorism
CG2404 0509 = Waiver of Transfer of Rights of Recovery Against Others to Us
PIACLOOL 0120 =©Absolute Cyber Liabillty and Electronic Exclusion
PIASOOS 4113 Limitation of Coverage to a Specified Event and Event Date
PIASOUG 0404 = Exclusion - Pyrotechnicians/Fireworks
PIASOO? 0404 Exclusion ~ Performer(s)
Additional Insured: Qwners and/or L r i
PIASO10 aaoa AO arena ns 2wners and/or Lessors of Premises, Lessors of Leased Equipment, Sponsors
PIASOIZ3 0404 ~— Exclusion ~ Miscellaneous Activities and Devices
PIASO14 0404 — Earned Premium Endorsement (Fully Earned Premium)
-PIGLOO1 0894 = Exclusion - Lead Liability
PIGLO02 0894 ~=Exclusion - Asbastos Liability
PIGLO18 0536 Absolute Liquor Liabitity Exclusion
PISAMO06 0117 Abuse or Molestation Exclusion
PISEOOS 1111 Exetusion » Assault or Battery
PISE0O7 1111 Additional Insured Primary and Non-Contributory Insurance
Page 1 of 1
16 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
Philadelphia indemnity Insurance Company
COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS
Proposal Number: 4183266
Agent # 28790
See Supplemental Schedule .
LIMITS OF INSURANGE
$ 4,000,000 General Aggragate Limit (Other Than Products — Completed Operations)
$ 4,000,000 Products/Completed Operations Aggregate Limit (Any One Person Or Organization)
$ 2,000,900 Personal and Advertising Injury Limit
$ 2,000,000 Each Occurrence Limit
$ 300,000 Rented To You Limit
$ 0 Medical Expense Limit (Any One Person)
FORM OF BUSINESS: Other
Business Description: Special Events
Location of All Premises You Own, Rent ar Occupy: SEE SCHEDULE ATTACHED
AUDIT PERIOD, ANNUAL. UNLESS OTHERWISE STATED: This policy is not subject to premium audit.
nescence enemas eames
Raton ~~ Advanced Premiums
Clasalfleations Code Na. Premium Basls Prem./Gps. ProdJGomp. Prom./Ops P row ‘ comp.
— _ :
TOTAL PREMIUM FOR THIS COVERAGE PART:
RETROACTIVE DATE (CG 00 02 ONLY)
This insurance does not apply to “Bodily Injury’, “Property Damage", or ’Personat and Advertising Injury” which occurs before-the
retroactive date, if any, shown below,
Retroactive Date:
=. .FORM{§) AND ENDORSEMENT (S) APPLICABLE TO THIS COVERAGE PART: o Forms Schedul
BSLV Data
17 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
ENDORSEMENT #1
This endorsement, issued by Mount Vernon Fire Insurance Company
to BANNOCK COUNTY forms a part of
Policy Number SE 2036411 effective on 8/13/2026 (MO, DAY YR.) at 12:01 A.M.
Add Event
In consideration of an additional fully earned premium of $385 it is hereby agreed and understood that
coverage for the location(s), event(s), and date(s) is
Description GL Class Code Liq. Class Code = Start Date End Date
Concerts - Alternative Rock (applicant is the host of the event) 00402 08/13/2026 08/13/2026
Additional Locations
TOTAL CHARGES:
Additional Premium: $385.00
Surplus Lines Tax $6.00
Stamping Fee $2.00
Total: $393.00
Subject to the terms and conditions of this policy, coverage is provided for a maximum of twenty-four
(24) hours after the scheduled end date of an event shown above.
if the end date shown above exceeds the current policy period, the policy period is amended to expire
twenty-four (24) hours after the scheduled end date of an event shown above.
All other terms and conditions of this Policy remain unchanged.
Wiles Alyy 8 6 (2036
AP) () 0
BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
In the Matter of AUTHORIZING THE ) R.S. No. 2026-30
DELEGATION OF AUTHORITY ) May 12, 2026
TO THE RISK MANAGEMENT )
DIRECTOR TO BIND INSURANCE )
POLICIES AS NEEDED )
RESOLUTION
WHEREAS, the Amphitheater, Portneuf Wellness Complex, and Event Center hold many
events throughout the year, such as community events, Independence Day Celebration, or concerts;
and
WHEREAS, some events have contractual and risk requirements that require adequate
alcohol and/or special event liability insurance that, from time to time, have accelerated deadlines,
late quotes, or other timing factors that prevent seeking Board approval before the event; and
WHEREAS, pursuant to Idaho Code §31-602, due to the nature of the business for events,
the Board of County Commissioners desires to delegate the authority to bind insurance policies
for events to Matthew Phillips, HR/Risk Management Director; and
WHEREAS, after binding of policies by the Risk Management Director, the insurance
policies should be sent for ratification by the Board, with consideration under executive session if
needed, and a copy remitted to the Bannock County Auditing office upon submission and approval;
NOW, THEREFORE, BE IT RESOLVED that Matthew Phillips, HR/Risk Management
Director, is delegated the authority to bind insurance policies necessary to ensure adequate alcohol
and special event liability insurance as needed, and forwarded for ratification and copied to
Auditing. The delegation of authority must be reviewed and redelegated annually. This authority
is effective through May 12, 2027.
ATTEST:
19 BOARD OF OMMISSIONERS Tuesday, August 11, 2026
BANNOCK County COMMISSIONERS ag - _ Ernte Moser Jerk Houcu — Ken Buttock
Gay FE, Center, Pocatello, ID Syaat i Commissioner Cotimmissiones Cotimissic
Phone: (208) 2yfi-y210 © Fax: (
mies
Ist District 2nd Distriet 3rd District
AGENDA REQUEST FORM
The Board of Bannock County Commissioners business meetings are generally held on
Tuesday at 9:00 AM in the Commissioners’ Chambers in the Bannock County Courthouse, 624
E. Center, Room 119 Pocatello, Idaho, or as noticed 48 hours prior to the meeting at
https://www.bannockcounty.gov/commissioners. Agenda times are subject to change within 15
minutes of scheduled time. Any person(s) needing special meeting accommodations should
contact the Commissioner's Office at 208-236-7210, five working days before the meeting.
E-mail this completed form and any supporting documents to agendarequest@bannockcounty.gov
Meeting Date Requested: 08/11/2026
Requestor Name: Todd Mauger Department: Bannock County Juvenile Jt
Item to be considered/background:
Idaho State University, Community Health Worker Training Program Affiliation Agreement
Action Requested: Signature Only Amount of Time Requested: 5 Minutes
Financial Impact (Total Cost/Funding Source):
There is no financial impact
Does this item involve a contract, agreement, external funding application, or award
acceptance?
. Agreement
Has the item been submitted to/reviewed by Legal? Has the item been co
Has the item been reviewed by Risk Management? reviewed by Auditing?
Are all supporting documents included?
List of additional attendees: Jacia Snyder, Matthew Phillips
Please include any supporting documents with your Agenda Session Request Form.
Commissioner Office Only:
Date: Time:
Docusign Envelope ID: 14CC9D4D-0ACF-8319-8108-D01CC01CDO0E
20 BOARD OF BANNOCK COUNTY COMMISSIONERS Tuesday, August 11, 2026
Idaho State
University
AFFILIATION AGREEMENT
This Affiliation Agreement (“Agreement”) between Idaho State University, on behalf of its Community Health
Worker Training Program, located at 1291 E Terry Street Pocatello, ID 83209 (the "Program") and Bannock County
located at 345 North 5" Street Pocatello ID 83201 (the "Facility") (each individually, a “Party,” and collectively, (the
“Parties’), takes effect on 8/4/2026 (“Effective Date’).
Background
Program is a higher education institution having enrolled students (whether singular or plural, “Student”) who have
need for clinical education experiences (whether singular or plural, “Experience”).
The Parties desire each Program-selected Student to obtain clinical education experiences at the Facility.
Agreement
1. Mutual Responsibilities and Coordination.
1.1. Exchange and Review. Each Party retains a privilege to exchange visits and review materials relevant to a
Student's Experience.
1.2. Non-discrimination. The parties agree that no part of this Agreement shall be performed in a manner
which illegally discriminates against any person on the basis of race, sex, sexual orientation, gender
identity, color, national origin, religion, age, mental or physical disability, veteran status, or any other
protected class under applicable law.
1.3. Organization. The Parties must cause the ACCE (defined below) to cooperate with Facility’s clinical
coordinator (or other designee) in arranging each Experience’s schedule, content, objectives and goals.
2. Definitions.
2.1. “HIPAA” means CFR parts 160 and 164 and HITECH (Title XIII of the American Recovery and
Reinvestment Act of 2009) as amended.
2.2. “ACCE” means Program’s academic coordinator of clinical education
3. Program Responsibilities.
3.1. Provide a statement to the Facility that describes the philosophy, goals, objectives, and schedule of:
3.1.1. The Program’s curriculum generally; and
3.1.2.Each Experience in particular;
3.2. Ensure that each Student appropriately is assigned to the Experience, including:
3.2.1.Evaluating the Student’s competence and knowledge before the Experience begins;
3.2.2.Assessing Student's health before Experience begins; and
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3.2.3.Requiring the Student to carry appropriate general and professional liability insurance;
3.3. Ensure that the Student is knowledgeable concerning and has prepared for:
3.3.1. Transportation needed to fulfill responsibilities at the Facility;
3.3.2.Room and board concurrently with the Experience; and
3.3.3.Scheduling arrival at and departure from the Facility;
3.4. Ensure Students are made aware of and are directed to comply with Facility’s applicable rules,
regulations, policies, procedures, and requirements during their Experiences;
3.5. Ensure that the Student has been made aware of each Program requirement and regulation for clinical
education, including professional practice standards;
3.6. Facilitate communication between the Parties, including:
3.6.1.Appointing a member of Program's faculty to serve as ACCE;
3.6.2.Notifying the Facility in writing of the identity of the ACCE and any Program-designated Program
director;
3.6.3.Notifying the Facility annually of each then-current academic year's clinical education schedule;
3.6.4. Notifying the Facility of each specific Student assignment no later than ten working days before the
Student's arrival, subject to the arrangement set forth below in Sections 5.2 and 5.3; and
3.6.5.Describing to the Facility specific Student outcome objectives for each assigned Student's
Experience;
_~ 3.7. Direct Students to comply with and participate in all of Facility’s required trainings and orientations
--~ segarding Facility’s policies and procedures governing any use or disclosure of individually identifiable
_ health information under federal law, specifically including HIPAA; and
3.8. Ensure at Facility’s request that each Student signs and delivers to Facility before the Experience begins
a copy of a Confidentiality Understanding (attached and incorporated into this Agreement as Attachment A).
4. Facility Responsibilities.
4.1. Accept a mutually agreed upon number of Students which the Program has selected for an Experience
period;
4.2. Provide any applicable annually updated information that is necessary to complete Program’s Clinical
Education Center Information form;
4.3. Notify the Program - no later than fifteen working days before a clinical assignment - of any change in
Facility's ability to accept the Student;
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4.4, Provide the Student a clinical schedule averaging no more than forty (40) hours per week;
4.5. Complete and return each Student evaluation according to the Program’s guidelines and schedule;
4.6. Recognize the right of Student’s to work and earn in an environment free from sexual harassment and
agree that sexual harassment will not be tolerated in the Facility.
4.7. Inform and train the Student regarding Facility’s applicable rules, regulations, policies, procedures, and
schedules, including HIPAA-related policies and practices;
4.8. Facilitate communication between the Parties, including appointing a member from Facility to serve as
clinical coordinator and notifying the Program of the member's identity;
4.9. Certify itis either a hospital as defined by the Idaho No Public Funds for Abortion Act or is otherwise not
an abortion provider and disclose if it or an affiliate is or becomes an abortion provider per Idaho Code §
18-8701 et seq.
5. Student Experience Characteristics.
5.1. No Employment relationship to Either Party, unless previously specified.
5.1.1.1n General. Facility’s rules and regulations apply to each Student which Program assigns to an
Experience.
5.1.2.Liability. The Student is not considered an officer, employee, agent, representative, or volunteer of
either Party for any purpose, including, but not limited to, liability, but instead is a Student engaged
in educational Experiences as a part of the Program’s curriculum.
5.1.2.1. In the event the student is employed by Facility prior to the educational experience, 5.1.2, and
5.1.3 does not apply, and is considered an employee of Facility.
> 5.1.3.HIPAA: The Student specifically is not and must not be considered to be Facility’s employee. But the
~= -§tudent is considered to be a member of the Facility’s workforce, when engaged in any Agreement
activity:
5.1.3.1. Solely for the purpose under HIPAA to define the Student's role in relation to using and
disclosing Facility’s protected health information; and
5.1.3.2. As workforce is defined under 45 CFR 160.103.
5.2. Short-Notice Assignment. In an emergency circumstance, Program has a right to assign a Student to an
Experience upon less than ten days’ notice to Facility. The Facility reserves a right to accept or reject that
assignment.
5.3. Short-Notice Cancellation. Program retains a right to cancel a Student’s Experience assignment for
academic or other good cause upon less than ten days’ notice to Facility, with no duty to designate
another Student as a replacement.
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5.4. Assignment Refusal. Facility retains a right for good cause to refuse any clinical assignment upon less
than fifteen working days’ notice.
5.5. Withdrawal. Each Party is entitled at any time to withdraw the Student from the Facility after assignment
for any of the following reasons that the Party must document:
5.5.1.The Student’s unprofessional or unethical behavior;
5.5.2. The Facility’s staff's unprofessional or unethical behavior that directly affects the Student's
Experience;
5.5.3. The Student's failure to meet Program’s prerequisite academic requirements; or
5.5.4.Any good cause, including but not limited to, any medical emergency.
6. Effective Duration.
6.1. Term. The Agreement's term begins on Effective Date and is continuous with automatic one-year
renewals on each successive anniversary of the Effective Date.
6.2. Termination. Each Party has a right at any time to terminate the Agreement upon no later than sixty (60)
days’ advance written notice to the other Party.
6.3. In the event of termination of this Agreement by either party, Students currently assigned to clinical
experiences at Facility at the time of notice of termination will be given the opportunity to complete their
Experience at Facility, unless withdrawn as set forth in Student Experience Characteristics Withdrawal
Section above.
7. Liability.
7.1, Program Commitment.
7.1 1.dnsurance. Program at its own expense shall provide adequate liability insurance and/or self-funded
coverage for its officers, employees, and agents. Program must ensure that its liability insurance
has an claims-made form. Program, at Facility’s request, will deliver a certificate of financial!
responsibility to Facility.
7.1.2.Program Responsibility:
7.1.2.1, To the extent permitted by applicable law, including, but not limited to, the Idaho Tort Claims
Act (1.C. § 6-901 et seq.), Program will be responsible for damage to persons or property
resulting from the negligence on the part of itself, its officers, employees, or agents. Neither
party will be considered the agent of the other and neither party assumes responsibility to the
other party for the consequences of any act or omission of any person, firm, or corporation not
a party to this Agreement. Program shall not be responsible for the acts or omissions of
Facility its officers, employees, or agents. The Program will provide Workers Compensation
coverage for, and be responsible for injuries or illness timely reported by Students that are
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incurred in the course of their authorized assignment(s) at the Facility, except for instances
when the Student is also employed by the Facility during their practicum assignment and then
the obligation for Worker's Compensation coverage will be the responsibility of the Facility.
7.1.2.2. Any claim which involves a Student shall be the responsibility of the Student insurance
carrier.
7.2. Facility Commitment.
7.2.1.Insurance, Facility at its own expense shall provide adequate liability insurance coverage for its
officers, employees, and agents. Facility, at Program's request, will deliver a certificate of insurance
to Program.
7.2.2.Facility Responsibility.
7.2.2.1, To the extent of Facility’s preceding insurance coverage and permitted by applicable law, the
Facility will be responsible for damage to persons or property resulting from the negligence on
the part of itself, its officers, employees, or agents. Neither party will be considered the agent
of the other and neither party assumes responsibility to the other party for the consequences
of any act or omission of any person, firm, or corporation not a party to this Agreement.
Facility shall not be responsible for the acts or omissions of Program.
7.3. Student Insurance.
7.3.1.Student Requirement. Student is required to have general and professional liability insurance with
limits of liability of $1,000,000 per occurrence and $3,000,000 aggregate before the Student begins
the assignment, and to remain-in-force for the entire time period of their assignment at the Facility..
7.3.2.Program Duty. The Program ensures that the 7.3.1 general and professional liability insurance
coverage for any Student assigned to the Facility has been obtained before Program has assigned
the Student. The Program, at Facility’s request, will deliver a certificate of insurance to the Facility
listing the Facility on the certificate along with Program.
7.3.3,.Auto Insurance. An intern may only be covered under the Facility's automobile liability insurance
when given prior authorization and permission by the County to drive its vehicles, and within the
course and scope of the Student's assigned duties, but no coverage is represented or provided for
unauthorized vehicle use, operation outside of assigned duties, or for physical damage to a County
vehicle except as expressly provided by the applicable County insurance policy.
8. Immunities. The Parties agree Program shall retain all of its governmental immunities and protections under
applicable law, including, but not limited to, the Idaho Tort Claims Act (I.C. § 6-901 et seq.), which shall apply
to the terms of this Agreement and any claims brought against Program. If Facility is a governmental entity,
Facility shall atso retain all of its governmental immunities and protections under applicable law.
9. Confidentiality. The Facility agrees to treat Student records as confidential and shall not disclose any Student
records to a third-party without the prior express written consent of Student, unless such disclosure is
otherwise required or permitted by applicable law.
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10. Amendment. Any change to this arrangement requires a written amendment executed by both Parties,
11. Notices. Each Party must send any notice under this agreement in writing either hand-delivered or mailed by
certified mai! to the addresses set forth below.
12. Binding Authority. Each Party has authorized an undersigned individual to sign this Agreement on behalf of that
Party.
To express the parties’ intent to be bound by the terms of this Agreement they have executed this document on
the dates set forth below. Signature page to follow.
Program Notification Address: Facility Notification Address:
Idaho State Universit Matthew K. Phillips
General Counsel HR and Risk Director
921 S. 8" Ave., Stop 8410 624 E. Center, Ste #214
Pocatello, ID 83209-8410 Pocatello, ID 83201
Idaho State University Bannock County
exiSignodiby:
By;
Rex Force Jeff Hough
~~ Title: VP DHS - Title: Bannock County Commissioner Chairman
pate: 12026 Date: _
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ATTACHMENT A
Confidentiality Understanding
By signing and dating this Confidentiality Understanding, the undersigned Student indicates an understanding of,
and agrees to be bound by, a certain Affiliation Agreement between_____ (“Facility”) and
Idaho State University, on behalf of its Community Health Worker Training Program (“Program”).
As a material part of any consideration that Student provides to Facility in exchange for Facility allowing the
Student's clinical education at Facility, Student confirms that any patient information acquired during the clinical
education is confidential, and Student at all times must maintain the confidentiality of and not disclose this
information, whether during the clinical education or after it has ended.
Student further must abide by the applicable rules and policies of both Facility and Program while at Facility.
Student understands that, in addition to other available remedies, Facility immediately may remove the Student
and terminate the Student’s clinical education if Facility considers the Student to endanger any patient, breach
patient confidentiality, disrupt Facility’s operation, or not to comply with any request by Facility including its
supervisory staff.
| have read and understand the Affiliation Agreement, and | agree to abide by this Confidentiality Understanding.
Student's Signature Date
Student's Name (Print)
SU's Program Witness (Signature) | Date
ISU's Program Witness Name and Title (Print)
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Text is extracted by machine from the official file linked on each page; the official file is the record. Sentinel Media, LLC.