ISL - Behavior Intervention Services

Report
10176 Corporate Square Dr.
Suite 220
Creve Coeur, MO 63132
(p)314-395-9375
(f)314-395-9381
Hours of Operation 8am-6pm
New Hire
Onboarding
Welcome
to BIS!
Agenda for the day!
JOE DOUGLAS
9:00-9:10am
-Collect the rest of paperwork & introductions
LYNN BROOK
-First section of Orientation packet
9:10-10:30am
BERLY FORSYTHE
-Policy & Procedure
10:30-12:30pm
LUNCH
-Food
12:30-1:30pm
LYNN BROOK
-Double check all paperwork & collect
1:30-2:00pm
JAMIE KLAMERT
-ISL Orientation
-Therap Training
-WhenToWork Training
2:00-5:00pm
HERE WE GO!
The Mission
Our mission is to help each individual
we serve reach their highest potential
in life by overcoming barriers and
promoting independence,
achievement, and inclusion. We
utilize proven and positive behavior
change strategies to reach this goal,
while including all team members,
friends, and family in the process.
Defy Limits, Exceed Expectations…
What are the three most popular
services at BIS?
Individualized Supported Living (ISL)
Natural Home Personal Care Assistance
Behavior Therapy via our BCBA, BCaBA
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Other Services Health and Wellness Classes – For Clients and Staff
 Yoga, Cooking, Fun with Fitness
Social Skills Opportunities
Person Centered Strategies Consultant (PCSC)
Counseling and Support Groups
Applied Behavior Analysis (ABA)
 BIS was founded in 2004
 We have experienced substantial growth since its
beginning and have changed locations three times
 We currently hover around 130 Direct Support
Professionals (DSPs) and 190 total employees
 We are one of the largest providers of Behavior
Therapy in the state of Missouri!
Dawn Schmitt
Executive Director
 Bachelors in Psychology and Sociology
from Maryville University
 Over 20 years of experience in the field
of developmental disabilities
 Associate Executive Director for 18
years at Creative Concepts for Living
 Oversees the day-to-day operations at
BIS
Jessica Harrison,
BCBA
Asst. Agency
Director
 Bachelor in Psychology & in Political Science
from Johnson State College in Vermont
 Masters in Behavior Analysis from Southern
Illinois University
 Received her BCBA in 2004
 Specifically focused in Discrete Trial Training
and severe challenging behavior
Kimberly
Forsythe
HR Director
 Started as a full time PCA in 2006
 Promoted to Staffing Coordinator and
Human Resources in 2008
 Been in the field of developmental
disabilities since1993 & HR since 1996
 Promoted to Human Resource Director in
2011
Kim Salls,
BCBA
Chief Financial
Officer
 Bachelor in Psychology from St. Louis
University
 Masters in Applied Behavior Analysis
from University of Nevada, Reno
 Received her BCBA in 2004
 Started Behavior Intervention Services
Lynn Brook
Director of
Administration
 Started in ABA in 2004
 Came to Behavior Intervention Services
in 2006 as an ABA Implementer
 Promoted to Public Relations and Human
Resources in 2008
 Promoted to Director of Administration in
2011
 Overseas office business, plans functions,
& manages recruitment
Brittany
Thorn
Director of Natural
Home Services
 Supervises FCAs
 Assigns FCAs to client caseloads
 Performs phone screenings and
forwards Applicants to FCAs
Shannon Riemersma
BCBA
Sherrie Shannon
BCBA, LBA
Lindsay Brefeld
BCBA
Beth Munkwitz
BCBA, LBA
Melissa Atis
BCBA, LBA
Kyler Hasl-Wright
BCaBA
Maija Graudins
BCBA, LBA
Board Certified Behavior
Analyst
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Requires a minimum of a Bachelor’s degree in a
human services field and a Master in Applied
Behavioral Analysis as well as Board Certification
Makes initial contact with all potential clients
Completes interviews with client and family and
completes assessments to determine the needs of
the client
Develops a behavior plan to address all applicable
behavioral needs
Provides initial and ongoing training of all staff on
client specific behavior plan
Therapy Support Staff
BCBA –
Board Certified Behavior Analyst
BCaBA –
.
Lindsay Brefeld
BCBA
PCSC –
Board Certified Assoc. Behavior Analyst
Person Centered Strategies Consultant
DSP Trainer –
Direct Support Professional Trainer
Gina Noble
PCSC, DSP Trainer
Andrea Mazo
BCaBA
Shannon Riemersma
BCBA, DSP Trainer
Jamie Klamert
Acting ISL Director
Crystal Frost
*St. Charles ISL
*Hazelwood
Amy Gaultney
Kyle Swendig
ISL Support Specialist
QDDP
QDDP
*Hedge ISL
*Rock Hill ISL
*Turf ISL
Dana Allen
QDDP
*Fenton ISL
*Wise ISL
*King ISL
Beth Pinkley
Karen Beck
ISL Financials
QDDP
*Crestwood ISL
*Mehlville ISL
*Redbird ISL
Jessica Barfield
*O’Fallon ISL
*Ridge ISL
QDDP
Brittany
Thorn
Director of Natural
Home Services
 Supervises FCAs
 Assigns FCAs to client
caseloads
 Performs phone
screenings and forwards
Applicants to FCAs
Kristin
Robinson
Family Care
Advocate
North County,
Illinois,
West County
Brittany
Zahn
South County,
West County
Jesse
Bray
Family Care
Advocate
Family Care
Advocate
Lindy Kline
Family Care
Advocate
Central and West County
Family Care
Advocate
Jefferson County,
St. Charles County,
Central
Miranda
Pitonak
Family Care
Advocate
St. Charles County,
North County,
Central,
South County
Central,
South County,
West County,
Jefferson County
Jessica
Bartram
Theresa
Reedy
Family Care
Advocate
St. Charles County,
South County, Central
Lindsey Moore
Central
Family Care
Advocate
Family Care Advocates
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Meet with all Natural Home Families on their caseload to discuss
services and to create a schedule within allotted funding
Meet will all Natural Home DSPs to discuss client specific training
and schedules
Ensure all allotted funding is used appropriately
Work 20 hours per week of direct care or supervision shifts within
their caseload
Available for emergency coverage when necessary
Collect Daily Progress Notes from each household within their
caseload and compile these notes into summaries for DMH
Create time sheets for DSPs based on time in/time out on Daily
Progress Notes
Provide positive and constructive feedback to DSPs working within
their caseload
Work with DSPs and Families ongoing to ensure proper services are
being rendered
Help families receive additional resources for services when
necessary
Lynn
Brook
Matt
Thielemier
Director of
Administration
Coordinator of
Client Services
Debby Schaefer
Payroll
Kim”Berly”
Forsythe
Joe
Douglas
Lisa Arnett
Human Resources
Director
Human Resources
Assistant
Receptionist
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…will be contacted by the FCA to discuss scheduling, initial training dates, and
shadowing of current DSP staff
…are responsible for carrying out activities or programs set forth by the clientspecific behavior plan, treatment plan, or individual support plan. Programs and
activities differ depending on your clients ability level and living situation but
may include living skills, personal hygiene, socialization etc..
…attend scheduled team meetings and required trainings to maintain current
agency and state certifications
…are responsible for taking data per BIS and state guidelines, communicating
with the family and team in a communication log, and reporting any incidents to
supervisory staff (FCA or behavior support professional)
…will report directly to their client’s BT and FCA
…will be scheduled for hours based on the availability provided upon hire and
client needs, and must provide two weeks’ notice for change in availability
…will keep all clients within line of sight unless otherwise dictated in the client’s
BSP
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…will be contacted by the ISL Staffing Coordinator to discuss training shift.
…will be contacted by their supervising QDDP or BCBA for BSP and ISP training
before initial worked shift.
…are responsible for carrying out activities or programs set forth by the clientspecific Behavior Support Plan (BSP).
•
…will attend monthly team meetings as planned by the QDDP.
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…will keep all clients within line of sight unless otherwise dictated in the client’s BSP.
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…will maintain required trainings to satisfy current agency and state certifications.
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…are responsible for taking data per BIS and state guidelines, communicating with
team in the house communication log, and reporting any incidents to the QDDP.
…will be scheduled within the availability they provided upon hire and must provide
two weeks notice to change that availability
•
…will report directly to Lead Staff and QDDP.
•
…will treat their clients with respect.
•
…will nominate their coworkers for Employee of the Week to recognize a job well
done!
First Steps, ABA Implementer,
or Tier 2 DSP - Natural Home
…must
have a Bachelor's degree or 60 credit hours in a Human
Services Field
…must
attend Discreet Trial Training (DTT)
…will
be responsible for working under the assigned ABA consultant
to implement discreet trial programs as well as any other programming
set forth by the consultant
…must
Please
pass an FBI fingerprint background check
speak with Family Care Advocates about possible openings
From the Desk of Human
Resources…
Policy and
Procedures overview
Where do I fit in?
Residential
Supervisory
staff
Direct
Support
Professionals
Natural
Homes
Office
Team
Funding Sources
How they effect YOU
New Hire Probationary Period
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Every employee’s first 90 days is considered a
probationary period during which at any time BIS can
retract it’s original offer of employment.
Part-time employees will be scheduled between 10-29
hours per week on average.
Full-time employees must meet comply with all
requirements to set a full time start date.
Employees may at times be asked to work over the 29 hour per
week part time maximum but that does not make them full-time
staff. You must submit your intent to move to a full-time position
in order to start the process of moving to a full-time position if you
were not hired in at full time.
Trainings
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Pre-Hire Requirements – Congratulations! - Unpaid Prerequisites
CPR/First Aid – Two year certification if taken at BIS
Mandt – Annual certification
Annual training forms: A & N, BBP, Confidentiality, HIPAA, ORR, Seizure training
Orientation – Day 1 typically 9a-5p -Paid on first paycheck, min. wage
Agency Policy and Procedure
ISL Policy and Procedure training
Trainings/
Certification
Payment Policy
Orientation – Day 2 typically 9a-5p- Paid on first paycheck at min. wage
Behavior Management #1 & #2
Orientation Wrap-Up
Must complete within 30 days of hire date
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Medication Administration Level 1 - 2-day course, 9a-5p each day, paid at minimum wage
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Not required for all employees
Please make sure to turn in a timesheet for this class in order to be compensated!
Must complete within 60 days of hire date
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Behavior Management #3 & #4 - typically 9a-4:30p, paid at minimum wage
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Mandatory For Tier 2 DSPs Only, But Open To All
Discreet Trial Training (DTT) – typically 9a-5p, unpaid training
If your last name begins with
A-M, these items are
Required each January of employment
If your last name begins with
N-Z, these items are
Required every June of employment
Abuse & Neglect (A & N)
Abuse & Neglect (A & N)
Blood Borne pathogens (BBP)
Blood Borne pathogens (BBP)
Confidentiality agreement
Confidentiality agreement
HIPAA test
HIPAA test
Observe, Record and Report test
(ORR)
Observe, Record and Report test
(ORR)
Seizure training acknowledgement
Seizure training acknowledgement
All BIS Employees are
Mandated Reporters
This will be covered more thoroughly in Abuse and
Neglect
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Anyone holding any of these positions is considered by the state of Missouri to
be a Mandated Reporter. As a Mandated Reporter it is your responsibility, in
good faith, to report any allegation of abuse or neglect of a client to an
immediate supervisor who will in turn report this allegation to the Department
of Mental Health.
As a Mandated Reporter, if you negligently or intentionally fail to report you
could be found guilty of a misdemeanor and be liable for damages caused by
your failure to report.
As a Mandated Reporter, if you intentionally file a false report you could be
liable in a civil suit for any damages suffered by the accused or the report
facility
No BIS employee will be retaliated against for submitting a good faith report.
Full-Time Employee Benefits
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Must work at least 37-40 hours per week
Accrued paid vacation accrued after one year of
full-time employment
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After one year of full-time employment, 5 days of vacation
are available
After two years of full-time employment, 10 days of vacation
are available
Retirement Plan (available to all employees) which
matches up to 3% of employee contribution after 90
days from full time start date
Vision and dental insurance 30 days after full time
start date at a premium of $4.00 per pay period or $8
per month.
Healthcare benefits 90 days after full time start date
at a premium of $60 per pay period or $120 per
month
Steps to move to a full-time position:
Full-time positions are offered based on merit,
performance and agency need. If there is a need for
additional full-time staff, employees may apply for a
position by following these steps (in the order listed):
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Submit a letter of intent to move to full time stating
why you would be a good candidate for full time.
Have a current BIS supervisor write a letter of
recommendation for you, supporting your request for
full time
Secure a work schedule that is conducive to
maintaining a minimum work week of 37 hours.
Schedule a meeting time with HR to set a full time start
date, discuss and sign up for any full-time benefits, sign
a change in status form and discuss any additional
questions at that time. (This will be scheduled after the
first 3 items have been completed).
Failure to maintain a minimum of 37 hours for
each ongoing work week will result in the
following:
• Immediate demotion to a part-time status
• Decrease in pay rate
• Limitation on hours to no more than 29 per
week
• Loss of all accrued PTO time
• Loss of all benefits (if applicable) after last paid
through date
• Inability to seek a full-time position for a
minimum of six months
Liability
Agreement for
Personally
Owned Vehicles
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Relationship with Families
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Sexual Harassment
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Smoking
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Rate of pay
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Cell phone use
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Med Administration
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Dress code
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Client’s Siblings / own children
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Drug and alcohol use
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Name Badge
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Confidentiality/HIPAA
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Client Transportation
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Respect
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Seatbelt
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Line of Sight
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Class E
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Arms length
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Insurance
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Supporting a client vs. the
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Agitated State
appearance of Sleep
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NO TEXTING/TALKING on phone
WHILE DRIVING
Non-Transport
Release Form
1:1 Staffing
Agreement and
Responsibilities
as a PCA
How do I request time off?
(RTO requests)
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Make sure you are not
scheduled for any shifts for the
day you wish to take off
Log into the W2W system
Click on “Request Time Off (Full
or Partial day)
Choose either full day or Partial
Day or Repeating Days off
Comment as necessary
Receive approved or rejected
based on previous
stipulations/requirements
 If
you know of any
days that you need
off currently (within
the next 4 months),
please enter them
into W2W as soon
as you receive your
log in information!
Holidays in the ISL
Time and a half for
hours worked on the
following Holidays:
•New Year’s Day
•Easter
•Thanksgiving
•Christmas
ISL Holiday
Guidelines
Holidays in the Natural Home
• New Year’s Day
• Easter
• Thanksgiving
• Christmas
• Memorial Day
• Independence Day
• Labor Day
Natural Home
Communicate
DSPs are not
with your clients
paid above their
ahead of time
hourly rate to
and relay your
work on the
plans!
listed Holidays
Timesheets, W2W,
DPN’s and Pay:
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Please clock in and out on the master timesheet located in the
client binder in each home. Do not clock in before your scheduled
shift time and do not clock out on the sheet until you leave your
shift.
Time in and out must match your client’s Daily Progress Note (DPN)
as well as your W2W shift assigned to you.
Any deviations or problems with any forms may result in a lack of
pay for the shift.
DPN’s (in home only) are used as your weekly timesheets.
2 ways to receive pay:
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Via mail or direct deposit – individual issues will be handled on a case
by case basis.
Time must be reported in 15 min increments – do not clock into shift
before your scheduled time!
DO NOT FALSIFY A TIME SHEET or a DPN – Medicaid/Insurance Fraud
Mileage logs are to be turned in at the same time as your
timesheets
Mileage logs and guidelines
To claim mileage with a Natural Home
client, you must do the following:
*Have a shift that is at least 3.5 hours long
*Travel a minimum of 20 miles with that client within that shift
*Complete mileage logs with starting and
ending mileage and destinations
*Mileage logs must be turned in
according to pay cycle. Please
refer to Pay Cycle doc for dates**
*Failure to turn in mileage
logs on time, will result in
non-payment.
*receive $4 per shift
as a mileage stipend
401 Timekeeping
& Mileage Logs
CLIENTS DEPEND
ON US!!
If you are going to miss a shift
with a client in the natural home
setting you must….
Natural Home:
Call all
team
members
• With as much advanced notice as
possible to see if anyone can cover your
shift
Call In/Shift
Coverage
Procedures
• Contact the team’s Family Care Advocate and
immediate supervisor regarding whom you have
Call the
contacted and what, if any, resolution has been
office and
made
the BT
Call the
family
•If coverage was found, let the family & FCA know who will be working
that shift so that changes can be entered into W2W.
•If coverage was not found, a discussion must take place with the
family regarding make up hours before the end of the service month.
Changes should be reported to the Family Care Advocate.
Attendance and Punctuality Policy
Call in/shift coverage
Call In/Shift
Coverage
Procedures
To maintain a safe and productive work environment, BIS expects employees to be reliable and to be punctual in
reporting for scheduled work. Absenteeism and tardiness place a burden on other employees and on BIS and will
not be tolerated.
In the rare instances when employees cannot avoid being late to work or are unable to work as scheduled, they
should notify their supervisor as soon as possible in advance of the anticipated tardiness or absence and their start
time should reflect the late start time as discussed in the Time Keeping and Mileage Log policy (401).
Changes to the scheduled start and/or end time of any publish schedule must be submitted to the Staffing
Coordinator of that client within 24 hours of the changes so that it may be reflected in the employee's published
schedule.
Unreported and undocumented changes to a published schedule will result in disciplinary action. Failure to follow
the agency's call off/shift coverage policies will subject the employee to disciplinary action.
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Employees that call off to a scheduled shift during the hours of Friday at 3pm to Monday at 8am will receive a
first and final disciplinary action (DAF).
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Employees that call off to a second shift during the hours of Friday at 3pm to Monday at 8am during a six
month period will be terminated.
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Employees that have three call offs of any nature during a six-month period (unless excused by a physician's
note) will be terminated.
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Employees that are late to three scheduled shifts in a 6 month period will receive a first and final disciplinary
action (DAF). Employees that are late to an additional shift in a 6 month period and have already received a
first and final warning regarding tardiness will be subject to termination.
Poor attendance and excessive tardiness are disruptive. Either may lead to disciplinary action, up to and
including termination of employment.
Any BIS employee found to be in violation of these or any
policies/ procedures will be subject to disciplinary action
up to and including termination.
Progressive Disciplinary Action:
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Verbal Feedback
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Written Feedback
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Action plan/suspension (Final notice for
Call In/Shift
Coverage
Procedures
improvement) *disqualified for annual increase or pay rate
for that calendar year
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Termination –
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Training repayment policy enforced
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Recovery of any agency/client items
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HIPAA and confidentiality agreements invoked
BIS Grievance Procedure
Express grievance verbally to your
immediate supervisor. If resolution has not
been reached within one week then…
Put the grievance in writing and submit it
again to your immediate supervisor. If issue
is not resolved with in a reasonable amount
of time then….
Contact the office to request a hearing with
a Behavior Intervention Services BCBA. All
parties will state their case and the BCBA will
provide a resolution.
Workers Compensation
All employees will sign a copy of the Workers Compensation policy
stating that they understand it’s contents
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If you are injured during billable time with a client you must call your
immediate supervisor to start the Workers Comp process. You will be
asked a series of questions and a treatment determination will be
made
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All Workers Compensation claims will begin with a drug test
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This test must be completed within 24 hours of the incident. Workers
Compensation will not cover an injury if the drug test is outside of these
parameters. Should you decline to take a drug test, you must sign a
waiver form or your refusal will be deemed a positive drug test and you
will be terminated.
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We ask that all employees visit a Walgreen’s Take Care clinic or
Urgent Care facility when possible. Emergency rooms will only be
approved when the injury is classified as a catastrophic event:
broken bone, large laceration to a vital area, etc.
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All paperwork acquired must be presented to BIS for submission to
the Insurance company
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An injured employee will not be permitted to return to active duty
until a letter from a health care professional has been received
permitting the individual to return to work
Worker’s
Compensation
and Policy
Procedures
Community Event Report Forms
(CERF) & Medical Event Report Forms
(MERF)
What is considered a “Community Event” for one client may be a
daily occurrence for another. Please make sure to speak with
your clients Behavior Therapist or DSP Trainer to better understand
your particular clients and when a CERF may be necessary.
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Forms will be located in your clients home in the data binder
 All CERFs must be turned in within 24 hours of the event
 All CERFS must be legible and precise
 If you are uncertain as to whether an CERF should be
completed, please call your Supervisor for clarification
Questions?
With Assistant ISL Director Melissa Hutson
Assistant ISL Director Jamie Klamert
ISL Support Kyle Swendig
What is an ISL?
-Individualized Supported Living
-Requires staff to be committed, reliable, and enthusiastic about the
Direct Support Professional position
-Residential living with around the clock support staff
-able to provide safe environment for our consumers
-provide 24 hours behavior intervention
-promotes independence and a quality lifestyle for individuals
-There are specific policy and procedures of Direct Support
Professionals within the ISL Department.
Medication Administration
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Must be Med Certified to pass
any medication to a consumer
(this includes creams and
treatments)
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Must complete DMH Med
Level 1 Certification Class
before passing meds
Must have Supervised
Medication Administration
Sign-off Signed before passing
meds at any ISL
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Label and Storage of
medications
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Controlled Substances must be
double locked!
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All staff (med certified or not)
must count controlled
substances every shift
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If you are not med
Medication
certified:
Administration
It is a Direct Support
waiver
Professional’s
responsibility to ensure
that a consumer receives
their medication
Always check the MAR
when entering the ISL.
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This will inform you what
time the consumer takes
their medication
You must notify your
QDDP that you will need
someone to pass meds
for your consumer
Medication Administration
Continued…
 Medication
Errors
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The importance of the “Triple Check”
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Reporting a Medication Error:
1) Inform the QDDP immediately
2) Leave medication in the bubble pack
3) Fill out specific Med Error ERF
Restraints
 MANDT
 Last
Resort
 Keeping
you and
your client safe
&
Time Outs
 Cannot
be used as
a punishment
 Must
be the choice
of the consumer
 Time
out =No
Break = Yes
Consumer Rights
Treatment of Client:
• Do not say “NO!”—The use of
positive talk
• Consumer Rights
• Consumer Rights/ Limitations
• HIPPA
• Role of Parents/Guardians
• Rights of Parents/guardians
ERF and State Documentation
language:
• The importance of positive
language on state
documents
• Eliminating the words
“must” “have” “don’t”
“can’t” “no” “stop” from
your vocabulary
Please find your Report Worksheet!
At 5:50pm I prompted SP that she needed to take one bite of food in the next five
minutes or she would not have her snack tonight. I prompted SP every minute
explaining how many minutes she had left to take one bite. SP refused to take any
bites. After the five minutes were over I explained to SP that we would sit at the table
until it was time to take her bath and go to bed. SP continued to sit and look. SP
began to rest her head on her hand as if she was going to sleep. At 7:00pm, her room
mate began to eat her dinner, Subway. SP began pointing to her roommate's plate
saying she was hungry. I gave SP her meds and prompted her to eat her food. SP
responded by scratching staff, ripping her shirt and punching her body. She was
prompted to have nice hands. At 7:15 SP threw her spoon at roommate and was
removed to her bedroom where she sat with nice hands. At 7:30, SP chose her
clothes for the next day, her night clothes and began her bath routine. She required
help washing her hair and verbal prompts to wash her body. SP independently
dressed herself, brushed her teeth and went to bed at 8:30pm. Overall SP had an
okay day with the exception of several target behaviors and refusals.
Consumer Funds
Each consumer within an ISL receives funding from
the state. Some consumers may receive additional
funding from additional sources At the start and end
of each shift, you will be responsible for checking
and recording consumer funds
Personal Funds
Each consumer receives a set allowance from the
state each month.
• These funds are used for activities in the
community, as well as, personalized items (i.e.
hair products, soap, OTC medications, hygiene
products)
• These funds are tracked on a financial tracking
sheet in the ISL
• Set monthly amount varies per consumer
Pocket Money
This funding comes from parents, guardians, family
members
• Can be spent on activities in the community,
personal items, food, whatever the client might
want or need
• Amount varies per consumer
• These funds are tracked on a financial tracking
sheet in the ISL
Chaperone Funds
• These funds are for staff to use when
doing activities in the community
• These funds are tracked on a
financial tracking sheet in the ISL
• The set monthly amount for each
consumer is $30.
• These funds can ONLY be used with
Personal Funds
• Must have a personal fund receipt to
match chaperone receipt
Household funds
• All consumers receive a set $30
monthly allowance for household
items
• Includes all cleaning products
• Paper towels, toilet paper, hand
soap, laundry detergent
• These funds are tracked by the
QDDP
• Must use these items sparingly
• Once the house hold is out of
money, THAT’s IT!
MUST KEEP ALL RECEIPTS NO
MATTER WHAT FUND IS USED!!
Consumer Funds Continued…
Buying consumers gifts

Any additional purchase made outside of the
provided consumer funding, must be approved
by the QDDP for each consumer

This is to prevent perceived gift/purchase
entitlement of the consumer


Set-up expectations that all staff should buy them
something
Staff cannot bribe clients…


If you do/stop that…then I will buy you…
“Be a good girl today, and I will take you to
McDonald’s”
Behavioral Crisis Procedure

In the event that a behavioral crisis or injury to staff occurs at the
time of a shift change or while on shift that places the safety of our
consumers and/or staff at risk, it is expected that staff is not to leave
the ISL prior to the following procedure:





the QDDP and/or Behavior Therapist for the team has been contacted
The Event Report Form has been filled out and faxed to the BIS office
the staff relieving you on shift has arrived
the situation has deescalated
a supervisor (QDDP, BT, ISL director) gives permission to leave
Failing to remain with the consumer before these steps have been taken will
constitute consumer neglect and job abandonment, and employment with
BIS will be terminated. The situation will also be submitted to the state for
investigation.
ISL Holiday Guidelines




Please turn to pg. 3 of the ISL
Policy and Procedure packet
Holidays in the ISL:
 New Year’s Day, Easter
Sunday, Thanksgiving,
Christmas Day
 These holidays are paid at
Time and a half
Holiday staff is required since
we cannot leave consumers
unstaffed
Holiday shifts are broken
down into 3 or 4 hour shifts for
the following dates:
 New Year’s Day, Easter,
Memorial Day,
Independence Day,
Labor Day, Thanksgiving
Day, Christmas Eve,
Christmas Day
 Each member on the
team will be required to
work a small portion of
each holiday
•
Time off requests will not be
approved for the any of the
afore mentioned holidays
•
DSP members will be given at
least one month’s notice of their
time slots for holidays
•
If a DSP member wants a
holiday off you must follow
proper protocol of finding
coverage and informing the
QDDP and ISL Staffing
Coordinator of any changes
•
For any improper Call-off that
does not follow the policy
guidelines will result in
disciplinary action
•
•
•
First infraction
Second infraction
Third Infraction
Individualized Support Plan
What is the person centered approach?
According to DMH, person centered planning is a process
directed by the individual, with assistance as need from a
represented. This process allows the individual to access supports
that will allow him/her to achieve personally defined outcomes and
the training, supports, therapies, treatments, and other services to
become part of the plan.
• All consumer’s within the ISL will have an ISP. Each staff member is
required to receive ISP training (and BSP training if applicable)
before working their first shift with any consumer
• It is important to remember that the Individualized Support Plan is
the document that drives all that we do with our consumers.
• ALL STAFF MUST FOLLOW THE ISP AT ALL TIMES
Individualized Support Plan
What information is in the ISP?
•
•
•
•
•
•
•
•
•
•
•
•
The individual’s demographic information
Contributors to the plan
Who is important to the individual
What is important to the individual
What do you need to know to appropriately support the individual
What supports are needed for health, if any?
What support are needed for safety, if any?
Requirements of family of minor child or guardian
How the person communicates (i.e. verbal vs. non-verbal)
Issues to be resolved/ concerns
Action plans toward meeting outcomes
Legal Issues
• Some homes require locks on doors, cabinets, refrigerators
• Any restriction put in place in the home must be approved
by the Human Right Committee
Missouri Quality Outcomes
1)
2)
3)
4)
5)
6)
7)
People belong to their community
People have a variety of personal relationships
People have valued roles in their family and in their community
People are connected with their past
People’s communication is understood and receives a response
People are provided behavioral supports in positive ways
Prepare are provided with support in a manner that creates positive
image
8) People express their own persona identity
9) People have control of their daily lives
10) People have the opportunity to advocate for themselves, for others,
and for causes they believe in
11) People’s plans reflect how they want to live their lives, the supports
they wants, and how they want them to be provided
12) People live with dignity
13) People feel safe and experience emotional well being
14) People are supported to attain physical wellness
15) People are actively supported throughout the process of making
major lifestyle changes
16) People are supported in managing their home
Paperwork in ISL
 We
are going to touch on a few of the
aspects of daily paperwork. There may
be more or less depending on the
consumers you work with. You will learn
more about client-specific paperwork
during your training shift with the Lead
Staff. It seems like a lot at first, but once
you get used to it, it’s a breeze!
Daily Progress Notes (DPN)
 DPNs
track the progress of consumers
toward their ISP goals and Missouri Quality
Outcomes
 These DPNs must have your accurate time
in/time out, date, printed name, signature
 DPNs must be fully filled out—do not leave
anything blank! Circle or write in N/A if
that particular task was not completed
 DPNs are different for each consumer
Daily Progress Notes (DPN)
What information is included on a DPN?
• Progress made towards outcomes
• Any doctor’s appointments attended
• Any medications that have been given
• Any new medical information specific to the consumer (i.e. illness,
new medication order, etc.)
• Any visitors to the home
• Any pertinent phone conversations
• Any unusual incidents
• Behavior Incidents
• The emergence of any new behavior concerns
• Emergency Situations
• Community Outings
• Any new skills that have been mastered
Behavior Data Sheets
 Behavior
Data Sheets collect information
that is needed for Behavior Therapy. Not
all ISL consumers have Behavior Data
Sheets separate from DPNs, but they are
just as important! These sheets help you
and the Behavior Therapist track the
behavioral progress that the consumer is
making and help justify their need for
services.
Intake, Sleep, and BM Logs
These logs are very simple to complete, but it is important to
keep track of Intake (what the consumer eats/drinks),
sleep (times that the consumer is sleeping),
and BM (times that the consumer has a Bowel Movement) to
maintain communication in the house and to monitor the
consumer’s health.
• These Medical Data sheets must be completed every shift
• If any consumer has not had a BM in 3 days you MUST notify
the QDDP immediately
• Some consumers require their blood pressure, weight, fluid
intake, or temperature to be recorded everyday, these are
important medical records that must be kept up with
accurately to ensure the quality of our consumer’s health
Monthly Nursing Reviews
The Community RN looks for signs and trends that may be medically,
behaviorally, and mentally intertwined and affecting the clients
behavior or well-being
• Intake, Sleep, and BM logs are also reviewed by the BIS Community
RN who does monthly visits to each ISL with every individual
consumer
• Many people don’t realize that physical and physiological
symptoms can all effect our behavior, the monthly RN visit are
essential to maintaining our consumers health and over all wellbeing
• It’s important for staff to familiarize themselves with why medical
data is being taken and who to notify if abnormal observations are
made
• Always notify the QDDP if there are any abnormal medical
changes or medication concerns
• The QDDP contacts the Nurse for further instructions
•
•
•
•
•
•
•
•
ISL time sheets are due every other
Monday after the Sunday overnight
(9am)
All time sheets will be faxed to the
Office at (314) 395-9381 from the ISL
by whomever works Sunday
overnights
One time sheet per HOME
Only use 15-minute increments when
signing in and out
Time sheet times MUST match Daily
Progress Notes (DPN)
Do NOT falsify the time sheet. This is
Medicaid fraud! Sign in and out
ACCURATELY!
Mileage logs are turned in with time
sheets.
ANY questions regarding time sheets
may be directed to Staffing
Coordinator or Financial Officer
Debby! (Time sheets are completely
different in Natural Home settings—
please get clarification before
working any Natural Home shifts.)
401 Timekeeping &
Mileage Logs
Behavior Intervention Services, LLC
Direct Care Staff Time Sheet Log
ISL Name (Clients’ name(s)): ___________________________________________
Please keep track of your hours worked on this log. Hours not logged will not be paid.
Pay Cycle Dates: ______________________________________________________
Date
PCA Name
Mileage
for this
shift:
On Call
Client’s
Initials:
Time
In
Time
Out
Hours
Worked
TIMESHEETS ARE FAXED TO THE BIS OFFICE EVERY TWO WEEKS AFTER
THE SUNDAY OVERNIGHT. SEND THEM TO FAX # 314-395-9381.
FAXED IN BY:________________________________________ ON:__________________
(Staff Name)
(Date)
o
Every ISL consumer is allotted a budget for a certain number of miles for
the DSP staff to receive reimbursement.
o
Mileage logs can be found in ISL
o
The amount of miles allotted to each consumer varies
o
Mileage is paid out at .45 cents per mile. If over miles, payout is
recalculated to stay within budget.
o E.g. Consumer budget = 400 miles/month equaling $180.
o If 450 miles that month, new payout = .40 cents/mile to stay within
$180 budget.
o
Mileage Logs are turned in bi-weekly with timesheets and will be paid out
according to the dates on the Pay Cycle Document
o Mileage Logs must be filled out legibly, accurately, and completely
o Each consumer requires different mileage logs; DO NOT combine
STAFF ARE NOT ALLOWED TO USE THEIR PHONE AT
ANY TIME WHEN TRANSPORTING CONSUMERS!
401
Timekeeping
& Mileage
Logs
Home Supervisors
QDDPs







Direct Supervisor when
in the ISL
Provide Verbal
feedback
Can be contacted
about general
household questions or
concerns
Conduct in-home
training and training
shifts
Report to QDDP at least
twice week
Collaborate and work
side by side with the
QDDP during staffing
and behavioral
difficulties





Supervise all DSP staff
within the ISL
Manage 2-3 ISLs
Provide additional staff
training and written
feedback
Must be contacted any
time a med error occurs,
injury to consumer,
behavioral crisis, or an
ERF/med error occurs
Must be contacted for
approval before using
any PRN medication
Provides
communication
between day programs,
schools, case managers,
family/guardians, and
DSP staff
Exercise….
•
You notice you’re running low on paper towels…
•
You’re giving your consumer a bath when you
notice a bruise on their lower back…
•
While out in the community you consumer
requests to buy a soda, but you forgot their
personal funds…
•
You’re realize you’re going to be 15 minutes late
picking up your consumer from their day
program…
•
When filling out Ernie’s BM log you realize that a 0
has been put for the last 4 days…
•
You are working an overnight one night and you
discover you’re out of floor cleaner
You’re taking Joey’s blood pressure and receive
a reading of 80/40; the parameters for Joey’s
blood pressure are:
Systolic:
if this number is greater than 200 or less than 90
Diastolic:
if this number is over 100 or less than 50
•
•
On your first shift from 3pm-11pm, you go
to the MAR and see that Charlie has
5pm meds, you are the only staff
member in the house and you are not
med certified…
•
You have a question about how to fill
out the Daily Progress Note…
•
You’re in the community with your
consumer when suddenly they begin
having a behavioral crisis and are
refusing to leave, the store manager has
already asked you one time to leave the
store…
•
While out for a walk Sally trips and scraps
her knee. The cut requires minor First Aid
including her PRN Neosporin…
•
Jimmy wants to go out to eat, but his ISP
states that he can only go out to eat
once a week, you notice that his chart
does not indicate whether or not he’s
been out to eat for the week…
Timesheets need to match DPNs
Scheduling of Clients

Will be scheduled for hours
based on the availability
provided upon hire, and must
provide two weeks notice for
change in availability
•
Hours are specific to the
individual needs of clients or their
parents or guardians
•
Unassigned shifts are assigned to
staff using inverse seniority
•
Flexible scheduling available if
requests are made in a timely
fashion & needs are met for
families
•
All schedules will be posted on
the When to Work websites.
Requests for time off will also be
made and approved or denied
using this system
•
Any ongoing change to a schedule,
be it for personal reasons or at the
request of a parent/guardian, must
be reported and approved by the
staffing coordinator and the BT or
QDDP
•
It is the responsibility of all employees
to update their preferences on
When2Work
•
Anytime there is a shift
addition/change that is outside of
your normal schedule will be
followed up by an email from the ISL
staffing coordinator
•
All employees (especially DSPs)
should be checking WhenToWork at
least twice per week.
Anyone working in
an ISL must..
Call all
other team
members
Call Staffing
Coordinator
• With as much advanced notice as
possible to see if anyone can
cover your shift
Call In/Shift
Coverage
Procedures
• With as much advanced notice as
possible to make them aware of
who will be working the shift
• Contact your QDDP, Lead Staff member,
and Staffing Coordinator so that an
appropriate Floater DSP may be
Contact
contacted
THERAP is an Online Software System for Providers Supporting
People with Developmental Disabilities for Effective and Efficient
Documentation, Reporting and Communication.
Currently every DSP and ISL staff member is responsible for
medication administration, T-logs (daily summaries), and some
health tracking on THERAP every shift.
Each ISL has a laptop and a jetpack (wireless internet provider)
which is kept in the locked med closet
 Laptops are not allowed out around consumers
 Laptops are to be used for work related repurposes ONLY
 Sites like YouTube, Pandora, and Netflix are strictly
prohibited
 Lead Supervisor, QDDP, and ISL Assistant Director track
data usage and web history for each laptop within the ISL
www.therapservices.net
 How





to…
Log in
Sign-off on the THERAP MAR
Create a T-log summary
Create a T-note
Check and create S-comms (messaging
system)
Reward Programs
 Employee
 Family
of the Week and Month
Feedback Bonus
 Applicant
Referral Bonus
Perks for All Employees!!!
(After 30 days employment)
Corporate
Wellness
•Club Fitness
•$10/month
•Minimum of
8 visits per
month
•Concierge
Wellness is
also
available to
all
employees!
Discounted
Phone Service
• Verizon
Wireless
• 8% discount
on monthly
services
• Bring your
check stub to
the nearest
Verizon store!
Legal Shield
• Prepaid
Lawyer
Services
• Credit
Monitoring
• Identity Theft
protection
• $15.95-$22.24
per month
Supplemental
Insurance
Reinforcement
Programs
• AFLAC
• Short Term
Disability,
Cancer
Screening,
Wellness
Plans, etc.
• SIMPLE IRA
retirement
plan
• Available to
all
employees
whom have
earned
$5000
• BIS will
match up to
3% of
contribution
• Employee of
the Week
• Employee of
the Month
• Employee of
the Year
• Applicant
Referral Bonus
• $25 at 90
days
• Family
Feedback
Bonus
• $10 and 1
per quarter
Scheduling System







Individual user id and
password
24/7 access to schedules,
team member contact info,
intranet email system
Request Time Off (RTO)
abilities
Scheduling preferences
Urgent text alerts
Employee Bulletin Board
Trade Board
BIS Agency Website




Upcoming events and
trainings
BIS Buzz
Employee Nominations
Staff-only section to
access Annual
forms/trainings due:
 January for A-M
 June for N-Z
Like us on Facebook!
https://www.facebook.com/behaviorinterventionservices
Facebook is a great place to find out:
•
•
•
•
Upcoming events
Client function updates
EoW and EoM winners
About your co-workers and other members of the agency
Any Questions?
 Please
complete all new hire
packet forms with signatures and
dates
 Please turn in any additional items
that are needed for your file
 Verify your next training date and
time of that class
 Turn in all items to your moderator
for HR

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