Butte Schools Self-Funded Programs
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  • DOT Testing Consortium
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Claims submitted under BSSP's self-funded property and liability coverage are administered by the Executive Director and and a contracted claims administrator, Erik J. Knak of Knak and Associates.
Erik J. Knak, Claims Administrator
Phone:  (530) 247-1049
Email:  ejknak@jett.net
Request a Certificate of Liability Insurance
Request a Certificate of Property Insurance
eRisk

Claims

Claims Manual
Auto Accident Claim Form
Liability Claim Form
Cyber Claim Form
Property Claim Form

Activities Subject To High Risk Deductible

Waivers

Other Forms

Field Trip - Date Specific
​Field Trip - Date Specific Spanish
Field Trip - Annual
Field Trip - Annual Spanish
Voluntary Sports/Activity - All Grades
Voluntary Sports/Activity - All Grades Spanish
Voluntary Sports/Activity - Grades 8 and Below
Voluntary Sports/Activity - Grades 8 and Below  Spanish
COVID Waiver: HTS Transportation
COVID Waiver: HTS Trans - Spanish
COVID Waiver: Vol Participation
​COVID Waiver: Vol Participation - Spanish
COVID Waiver: SPEC Assessment
COVID Waiver: SPED Spanish
​COVID Waiver: EE Child
COVID Waiver: Facility Use
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 CIF Pre-Participation Physical Evaluation and Examination
CIF Concussion Information Sheet

COVID-19 Asymptomatic / Surveillance Testing

FAQ's re COVID-19 Surveillance Testing of Asyymptomatic Employees for COVID-19 

Quest COVID-19 Test Directions

Trainings

BASIC / Bickmore Risk Services streaming video trainings
The Hartford - Claim
The Hartford - Enrollment
The Hartford - Portability vs. Conversion
As a service to its member districts, the Butte Schools Self-Funded Programs operates a consortium for required random alcohol and drug testing under the US Department of Transportation's (DOT) Omnibus Transportation Employee Testing Act of 1991 (OTETA) and the Code of Federal Regulations DOT-FMCSA, 49 CFR part 382.   

The consortium covers approximately 200 safety-sensitive positions for certain K-12 districts in Butte County as well as the Butte County Office of Education and Butte-Glenn Community College District.

Under the OTETA, each year 10% of the consortium participants must be randomly selected for being under the influence of alcohol while performing a safety-sensitive position and 50% of the participants must be similarly tested for the influence of drugs. 

Who is affected?  Any person who holds a commercial drivers license is considered to have consented to such testing as is required by an state or jurisdiction as well as any safety-sensitive function (mechanic, etc.). 

BSSP's consortium is administered by Healthstat.

Additional Resources

Random Testing Brochure
US DOT Office of Drug & Alcohol Policy & Compliance website
FMCSA Drug & Alcohol Clearinghouse
Authorization for DOT Services
​American Substance Abuse Professionals (ASAP)  888-792-2727
Authorization for TB
Authorization for Hepatitis A/B
Authorization for Occupational Medicine Services - Preschools and Child Care Centers
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