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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 d ay!. JOE DOUGLAS 9:00-9:10am -Collect the rest of paperwork & introductions

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New hire onboarding

10176 Corporate Square Dr.

Suite 220

Creve Coeur, MO 63132



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 9:10-10:30am

-First section of Orientation packet

BERLY FORSYTHE 10:30-12:30pm

-Policy & Procedure

LUNCH 12:30-1:30pm


LYNN BROOK 1:30-2:00pm

-Double check all paperwork & collect

JAMIE KLAMERT 2:00-5:00pm

-ISL Orientation

-Therap Training

-WhenToWork Training


The mission


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
What are the three most popular services at BIS?

  • Individualized Supported Living (ISL)

  • Natural Home Personal Care Assistance

  • 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)

  • Behavior Therapy via our BCBA, BCaBA



  • 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!

BIS Directors

  • 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

  • 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

Coming soon!

  • 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

  • Oversees office business, plans functions, & manages recruitment

  • 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

  • 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

  • Supervises FCAs

  • Assigns FCAs to client caseloads

  • Performs phone screenings and forwards Applicants to FCAs

  • Graduated from University of Dayton with BA In Psychology; Started at BIS in August 2011 as DSP

  • Became Home Supervisor in January 2012-May 2012

  • Held Position of QDDP from May 2012-November 2012

  • Became ISL Assistant Director in November 2012-Novemeber 2013; Became ISL Director November 2013

Board Certified behavior analysts

Sherrie Shannon


Shannon Riemersma


Kyler Hasl-Wright


Andrea Mazo


Lindsay Brefeld


Beth Munkwitz


Melissa Atis


Maija Graudins


Lindsay Brefeld


Board certified behavior analyst
Board Certified Behavior Analyst

  • 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


Board Certified Behavior Analyst


Board Certified Assoc. Behavior Analyst


Person Centered Strategies Consultant

DSP Trainer

Direct Support Professional Trainer

Gina Noble

PCSC, DSP Trainer

ISL Leads

*St. Charles ISL


*Hedge ISL

*Rock Hill ISL

*Turf ISL

*Fenton ISL

*Wise ISL

*King ISL

Coming soon!

*Crestwood ISL

*Mehlville ISL

*Redbird ISL

*O’Fallon ISL

*Ridge ISL


  • Supervises FCAs

  • Assigns FCAs to client

  • caseloads

  • Performs phone

  • screenings and forwards

  • Applicants to FCAs

South County,

West County

North County,


West County

St. Charles County,

North County,


South County


South County,

West County, Jefferson County

Central and West County

Jefferson County,

St. Charles County, Central


St. Charles County,

South County, Central

Family care advocates
Family Care Advocates

  • 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

Natural home dsps
Natural Home DSPs

  • …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 client-specific 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

Isl dsps

  • …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 client-specific Behavior Support Plan (BSP).

  • …will attend monthly team meetings as planned by the QDDP.

  • …will keep all clients within line of sight unless otherwise dictated in the client’s BSP.

  • …will maintain required trainings to satisfy current agency and state certifications.

  • …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

NH Tier 2

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 pass an FBI fingerprint background check

  • Please speak with Family Care Advocates about possible openings

From the Desk of Human Resources…

Policy and Procedures overview

Kim “Berly” Forsythe

Funding Sources

How they effect YOU

New hire probationary period
New Hire Probationary Period

  • 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.



Certification Payment Policy

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

    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

  • Medication Administration Level 1 - 2-day course, 9a-5p each day, paid at minimum wage

    • 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

  • Behavior Management #3 & #4 - typically 9a-4:30p, paid at minimum wage

    Mandatory For Tier 2 DSPs Only, But Open To All

  • Discreet Trial Training (DTT) – typically 9a-5p, unpaid training

Required every June of employment

Required each January of employment

  • Blood Borne pathogens (BBP)

  • Confidentiality agreement

  • HIPAA test

  • Observe, Record and Report test (ORR)

  • Seizure training acknowledgement

All bis employees are mandated reporters this will be covered more thoroughly in abuse and neglect
All BIS Employees areMandated ReportersThis will be covered more thoroughly in Abuse and Neglect

  • 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
Full-Time Employee Benefits

  • Must work at least 37-40 hours per week

  • Accrued paid vacationaccrued after one year of full-time employment

    • 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 dentalinsurance 30 days after full time start date at a premium of $4.00 per pay period or $8 per month.

  • Healthcare benefits90 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
    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):

    • 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

    • Sexual Harassment

    • Rate of pay

    • Med Administration

    • Client’s Siblings / own children

    • Name Badge

    • Client Transportation

      • Seatbelt

      • Class E

      • Insurance

      • Agitated State


    • Relationship with Families

    • Smoking

    • Cell phone use

    • Dress code

    • Drug and alcohol use

    • Confidentiality/HIPAA

    • Respect

    • Line of Sight

    • Arms length

    • Supporting a client vs. the appearance of Sleep

    Non-Transport Release Form

    1:1 Staffing Agreement and Responsibilities as a PCA

    How do i request time off rto requests
    How do I request time off? (RTO requests)

    • 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!

    Timesheets w2w dpn s and pay
    Timesheets, W2W, DPN’s and Pay:

    • 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.

    • 2ways to receive pay:

      • 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
    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

    *Failure to turn in mileage logs on time, will result in non-payment.

    *Mileage logs must be turned in according to pay cycle. Please refer to Pay Cycle doc for dates**

    *receive $4 per shift as a mileage stipend

    401 Timekeeping & Mileage Logs


    If you are going to miss a shift with a client in the natural home setting you must….

    Natural Home:

    Call In/Shift Coverage Procedures

    Attendance and punctuality policy call in shift coverage

    Call In/Shift Coverage Procedures

    Attendance and Punctuality Policy Call in/shift coverage

    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.

    • 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).

    • 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.

    • Employees that have three call offs of any nature during a six-month period (unless excused by a physician's note) will be terminated.

    • 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:

    • Verbal Feedback

    • Written Feedback

    • Action plan/suspension (Final notice for improvement) *disqualified for annual increase or pay rate for that calendar year

    • Termination –

      • Training repayment policy enforced

      • Recovery of any agency/client items

      • HIPAA and confidentiality agreements invoked

    Call In/Shift Coverage Procedures

    Workers compensation
    Workers Compensation

    Worker’s Compensation and Policy Procedures

    All employees will sign a copy of the Workers Compensation policy stating that they understand it’s contents

    • 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

    • All Workers Compensation claims will begin with a drug test

      • 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.

    • 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.

    • All paperwork acquired must be presented to BIS for submission to the Insurance company

    • 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

    Community event report forms cerf medical event report forms merf
    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.

    • 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

    HR Wrap-Up



    ISL Policy & Procedures

    With 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
    Medication Administration

    Medication Administration waiver

    • Must be Med Certified to pass any medication to a consumer (this includes creams and treatments)

      • 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

    • Label and Storage of medications

    • Controlled Substances must be double locked!

      • All staff (med certified or not) must count controlled substances every shift

    • If you are not med certified:

      • It is a Direct Support Professional’s responsibility to ensure that a consumer receives their medication

    • Always check the MAR when entering the ISL.

      • 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 Administration Continued…

    • Medication Errors

      • The importance of the “Triple Check”

      • Reporting a Medication Error:

        1) Inform the QDDP immediately

        2) Leave medication in the bubble pack

        3) Fill out specific Med Error ERF

    Restraints time outs
    Restraints & Time Outs

    • MANDT

    • Last Resort

    • Keeping you and your client safe

    • Cannot be used as a punishment

    • Must be the choice of the consumer

    • Time out =No

      Break = Yes

    Consumer rights
    Consumer Rights

    • 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

    • 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

    What’s Wrong with this Report?!

    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

    • 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!


    • 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

    Consumer funds continued
    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
    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.


    • 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.


    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

    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

    People express their own persona identity

    People have control of their daily lives

    People have the opportunity to advocate for themselves, for others, and for causes they believe in

    People’s plans reflect how they want to live their lives, the supports they wants, and how they want them to be provided

    People live with dignity

    People feel safe and experience emotional well being

    People are supported to attain physical wellness

    People are actively supported throughout the process of making major lifestyle changes

    People are supported in managing their home

    Paperwork in isl
    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
    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

    • 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 well-being

  • 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

  • Timesheets

    • 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

    Mileage Logs

    • Every ISL consumer is allotted a budget for a certain number of miles for the DSP staff to receive reimbursement.

    • Mileage logs can be found in ISL

    • The amount of miles allotted to each consumer varies

    • Mileage is paid out at .45 cents per mile. If over miles, payout is recalculated to stay within budget.

      • E.g. Consumer budget = 400 miles/month equaling $180.

      • If 450 miles that month, new payout = .40 cents/mile to stay within $180 budget.

    • Mileage Logs are turned in bi-weekly with timesheets and will be paid out according to the dates on the Pay Cycle Document

      • Mileage Logs must be filled out legibly, accurately, and completely

      • Each consumer requires different mileage logs; DO NOT combine



    401 Timekeeping & Mileage Logs

    Home Supervisors

    • 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

    Who do you call?

    • 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…

    Scheduling of clients
    Scheduling of Clients

    Timesheets need to match DPNs

    • 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.

    • 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

    Anyone working in an isl must
    Anyone working in an ISL must..

    Call In/Shift Coverage Procedures

    • THERAPis 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

      • Create a T-log summary

      • Create a T-note

      • Check and create S-comms (messaging system)

    Reward programs
    Reward Programs

    • Employee of the Week and Month

    • Family Feedback Bonus

    • Applicant Referral Bonus

    Perks for All Employees!!!

    (After 30 days employment)

    Scheduling System

    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

    • 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

    Like us on facebook
    Like us on Facebook!

    • 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
    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