Technical work.
Ethical work.
Human work.

You chose a demanding field. Behavior analysis is technical, ethical, and deeply human. Every note you write, every data point you collect, and every plan you implement touches a real person and their life. Abilities, LLC is committed to supporting you in doing this work well — with clear policies, real supervision, and ethical leadership.

This handbook applies to Registered Behavior Technicians (RBTs), Lead RBTs, BCBAs, BCaBAs, and the MANDT Instructor. It works alongside the Abilities, LLC Employee Handbook, which contains the universal policies that apply to every employee regardless of department — conduct, HIPAA, non-discrimination, corrective action, and PTO. You are expected to know and follow both documents.

If you have questions about anything in this handbook, talk to your supervising BCBA. HR is also available for questions about employment matters.

Abilities, LLC is a Missouri DMH DD Tiered Provider. Our framework comes from Positive Behavioral Interventions and Supports (PBIS). Our core belief is that most people do well with the right environment and the right supports. The driving question is not "what is wrong with the person" but "what does the person need that they aren't getting."

This code applies alongside Employee Handbook Policy 1.1. Non-discrimination, harassment, drugs, alcohol, weapons, smoking, and vaping are governed by Policy 1.1. This policy covers conduct expectations specific to Behavior Services.

Per RBT Ethics Code 2.0, Standards 1.01–1.03:

• Act honestly and ethically; follow agency policies, PCSPs, BSPs, and HCBS rules
• HIPAA — share information only with those who have a legitimate need to know
• Avoid and report conflicts of interest to your supervising BCBA
• Provide services only within your role — RBTs do not modify protocols or make independent clinical decisions
• Maintain your BACB certification, and report any change in certification status to your supervisor within 24 hours

Per Standard 2.01:

• Treat individuals with dignity, empathy, and respect at all times, regardless of behavior
• Support individual rights — privacy, autonomy, choice, and community participation
• Never engage in, condone, or ignore abuse, neglect, or exploitation — report immediately
• Use only BCBA-approved strategies; never use restrictive procedures unless documented and authorized
• Use objective, measurable, strength-based language

Per Standards 1.06, 1.07, and 1.12:

• Maintain clear professional boundaries
• No dual relationships — social friendships, business arrangements, or outside caregiving
• No gifts, tips, loans, or favors from clients or families
• No romantic or sexual relationships with current clients, stakeholders, or supervisors
• Do not share personal contact information with clients or families unless authorized by the BCBA

• Implement only BCBA-approved protocols — never freelance, improvise, or modify
• Actively seek clinical direction; do not wait for problems to escalate
• Report variables that affect the client — medication changes, illness, environmental changes
• Accept feedback and participate in supervision
• If asked to do something that conflicts with BACB ethics, agency policy, or the BSP, follow the Employee Handbook escalation pathway

• Maintain a clean, safe, therapeutic environment
• During incidents, remain calm and follow the BSP and crisis protocols exactly as trained
• Address disagreements privately — never in front of individuals
• Wear casual attire that allows movement and does not interfere with safety or dignity

• Limit personal cell-phone use during sessions — out of sight and on silent during all session time
• Use agency-approved platforms only for documentation and communication
• Never post, share, or comment on confidential information or media involving individuals on personal social media
• Take photos or videos of individuals only on agency-approved devices for agency-approved purposes

• Follow safety, infection-control, and crisis procedures as trained
• Complete incident and event reports within required timeframes
• Report injuries, misconduct, ethics, or safety concerns to HR promptly
• Complete all session documentation in SetWorks within two calendar days of service

• 4–29 minutes late = a tardy
• 30+ minutes late = a call-in
• Notify the residential home's Google Chat AND your supervisor immediately

• PTO begins accruing Day 1 and is available to use on Day 61
• Submit PTO in BambooHR with sufficient banked hours; once the maximum number of staff are approved off for a day, no more are accepted
• PTO auto-applies to cover call-ins; a call-in does not draw from future-dated approved PTO
• Cash-out up to 40 hours per calendar year after one year of employment — submit the request to the Payroll Administrator at payroll@abilitiesllc.com
• Payout at separation up to 40 hours if in good standing and you give two weeks' written notice

Paid day off at regular rate (not for PRN):

• The Executive Director or designee decides when inclement weather is activated
• When activated, all in-person RBT sessions are canceled (residential coverage takes priority)
• Employer-paid weather closure: the first 2 days = 8 paid hours/day (not PTO)
• The 3rd and later closure day uses PTO (unpaid if none is banked)
• An employee who chooses not to come in when there is no employer closure = a standard call-in

Operating outside your scope of practice is an ethics violation and a patient-safety risk. This policy defines the reporting structure and the boundaries of each role.

Also called the Behavior Analyst, BCBA, or Licensed Behavior Analyst (LBA). Requires BACB BCBA certification and active Missouri LBA licensure.

Exclusive, non-delegable responsibilities:

• Conducting FBAs and functional analyses
• Designing, writing, and revising BSPs and skill-acquisition plans
• All clinical decisions — treatment goals, intervention strategies, plan modifications
• Interpreting data to modify, fade, or discontinue a program
• Authorizing restrictive procedures and managing the Due Process pipeline
• Signing all clinical documentation to DMH, Medicaid, and funders

May delegate to qualified RBTs and Lead RBTs with verified competency:

• Implementing BSPs and skill programs as written
• Collecting data per the plan
• Conducting preference assessments
• Participating in FBA components — descriptive assessment, ABC data collection
• Modeling BSP implementation for residential staff when directed (demonstration only)

The Lead RBT is the agency's DBT skills coach for employees. This is provided when an employee is referred after a crisis incident, behavioral difficulty, or emotional-regulation challenge, and it covers distress tolerance, emotional regulation, and interpersonal effectiveness. DBT concepts are introduced to all new hires at orientation.

• Before any session, the Lead RBT obtains a signed consent form and submits it to HR for the personnel file
• DBT coaching is educational and supportive only — not therapy, not billable, and not documented as clinical treatment

Allowed around RBT hours only when ALL of the following are met:

• Posted and accepted in WhenToWork
• Active DSP certs (CPR, First Aid, Bloodborne Pathogens, LIMA, MANDT, Delegation where applicable)
• Signed and acknowledged all applicable DSP policies
• No conflict with RBT services, documentation, or supervision
• Lead RBT approval (discretionary, based on department needs)

A full-time Behavior Department position. Holds the MANDT Instructor certification plus an active RBT certification. This is a dual role:

• MANDT Instruction — delivers all MANDT crisis prevention and intervention training agency-wide and is the primary MANDT resource. The QAP tracks MANDT cert dates and schedules renewals.
• RBT Role — when not training, operates as a licensed RBT subject to all RBT policies, scope, and supervision

Abilities covers all MANDT Instructor costs — initial cert, renewals, recert fees, and CE.

Session time is protected.

• During a scheduled session, the RBT's only responsibility is delivering ABA services
• Residential staff direct BSP-interpretation questions to the BCBA — not to the RBT during a session
• Residential staff may not ask RBTs to do personal care, medication, household, or other residential duties during a session
• In a genuine emergency, all employees act to protect individuals regardless of department

Employees must be credentialed and onboarded before they deliver any direct services.

• FCSR criminal background check
• Employee Disqualification List (EDL) check via MO DHSS
• At least 2 professional references (at least 1 from a direct supervisor in behavioral health or direct care)
• Education verification, plus a valid Missouri driver's license with current auto insurance

RBT — already certified:

• BACB Certificant Registry verification — active status, cert number, expiration, no active ethics complaints or sanctions
• The Abilities supervising BCBA is added as supervisor in the BACB Gateway before services begin

RBT — not yet certified:

• At least 18 years old with a HS diploma or equivalent
• Employment is contingent on completing the 40-hour RBT training, competency assessment, and certification application within 90 days of hire

BCBAs / BCaBAs:

• BACB registry verification of an active BCBA or BCaBA credential
• Missouri licensure (LBA or LaBA) via the Division of Professional Registration
• BACB 8-Hour Supervision Training verification
• Active NPI for Medicaid billing

• Department structure, caseload model, and integration
• Review of the Scope, Attendance, Supervision, and Credentialing policies
• SetWorks login, note structure, and data entry
• Google Chat protocols
• Behavior Services Call-In Line — 660-225-1092
• BACB Gateway walkthrough — account access, supervisor link, cert expiration
• Distribution of the RBT Ethics Code 2.0 / Ethics Code for Behavior Analysts

The first 60-day probationary period includes heightened attendance standards (B1.2) and enhanced supervision (B3.1).

• Monthly BCBA review of the BACB Certificant Registry for all Behavior Department employees
• Annual full credentialing audit
• Employees must self-report within 24 hours any change in BACB cert status, ethics complaint, or Missouri licensure

All employees complete all DMH, BACB, and agency training within the required timelines. Records are kept in BambooHR.

• At least 5% of total behavior-analytic service hours each calendar month
• At least 2 face-to-face contacts per month
• At least 1 individual meeting and 1 direct observation
• By an active BCBA or BCaBA who completed the BACB 8-hour supervision training

• RBTs: those completing their 2026 renewal transition to a two-year recertification cycle and must earn 12 PDUs (including at least 1 ethics PDU) per two-year cycle, logged in BACB Gateway
• BCBAs: 32 CEUs per 2-year cycle (at least 4 ethics, at least 3 supervision)
• BCaBAs: 20 CEUs per 2-year cycle (at least 4 ethics)
• Each individual tracks their own progress and meets BACB deadlines

The agency maintains a designated MANDT Instructor for trauma-informed crisis prevention and intervention training agency-wide. Abilities pays all initial cert, renewal, and CE costs.

• Attend all training in full
• Calling in to scheduled training = the same consequences as a session call-in (B1.2)
• Arriving more than 15 minutes late = sent home and rescheduled (counts as a call-in)
• For BACB training, partial attendance earns no PDU or CEU credit
• Failure to complete required training within timelines may result in removal from direct client contact until met

• Initial competency assessment within the first 2 weeks (BACB RBT Initial Competency Assessment form)
• Direct observation at least 2× per month during the first 90 days
• Written supervision agreement within the first 2 weeks
• At least 1 face-to-face within the first 2 weeks of the supervisory relationship

• Monthly group supervision (at least 1/month) — clinical topics, ethics review, case discussion
• The BCBA may schedule additional individual sessions, check-ins, competency reviews, or performance conversations

• Clinical performance — BSP fidelity checks, data review and analysis, skill-program updates, behavior-reduction strategies
• Ethics & professional conduct — review the RBT Ethics Code 2.0 at least every 6 months, boundary review, scope discussion
• Administrative & compliance — documentation accuracy and timeliness, supervision-hour tracking, cert status

• Complete the BACB 8-hour supervision training before supervising
• Register each RBT in the BACB Gateway before supervision begins
• Conduct the initial competency assessment within the first 2 weeks
• Ensure the 5% minimum plus at least 2 face-to-face contacts
• Conduct quarterly competency reviews and maintain documentation for at least 7 years
• Monitor each RBT's cert status, recert deadlines, and PDUs

• Attend all supervision (a missed session is an attendance event per B1.2)
• Implement feedback in subsequent sessions
• Accurately track service hours and alert the BCBA if minimums are at risk
• Keep personal copies of supervision documentation for at least 7 years
• Notify the BCBA immediately of cert changes or an approaching expiration
• Review the RBT Ethics Code 2.0 and RBT Handbook with the supervisor at least every 6 months

Each contact documents the date and start/end time, the format (individual, group, or direct observation), topics covered, corrective feedback given, and the RBT and supervisor signatures. It is completed and shared with the RBT within 7 days.

Document the deficiency and reason, then develop a remediation plan (which may add sessions). The BCBA and RBT review whether the RBT must self-report to the BACB. If the cause is agency-level, the Behavior Analyst notifies the Executive Director.

This policy applies to Behavior Analysis Trainees — graduate students and trainees pursuing the BCBA or BCaBA credential.

• Enrollment in a BACB-Verified University Program (written documentation)
• Active employment in an eligible role — hours count only during active paid employment
• Active RBT certification, or concurrent pursuit with a documented plan
• Completed pre-hire credentialing (B2.1)
• A university-approved fieldwork site agreement if required
• An executed BACB Supervision Contract
• BACB Gateway registration with an active supervisor link

• The same structural requirements as B3.1 plus BCBA-level content
• At least 5% of total fieldwork hours
• Content includes BCBA-level activities beyond RBT implementation
• All contacts documented in writing (the trainee maintains their own per BACB)
• The Abilities BCBA may end fieldwork supervision at any time if the trainee fails performance, ethical, or credentialing requirements

RBT scheduling is driven entirely by the needs of the individuals served. Session times are set by clinical priorities and client availability, not RBT preferences. The BCBA builds the schedule in coordination with the Director of Residential Operations.

• Generally Monday–Friday; overnights and weekends are not standard
• Session times shift week to week
• Documentation time (non-billable) is scheduled between sessions
• Supervision meetings are grouped on a designated day or week
• Department meetings are mandatory; training takes precedence

Because many clients attend community Day Programs, assignments may be conditional. The BCBA communicates conditional scheduling in advance. When a client is unexpectedly unavailable, the RBT is reassigned to another client or approved task.

• Session swaps require Lead RBT approval — no independent trading
• No unauthorized session drops — a session remains your obligation until the Lead RBT approves a change
• Time-off requests go in BambooHR at least 2 weeks before the schedule is published; the Lead RBT approves them
• Availability changes require an in-person meeting with HR

• At most 40 hours/week in the RBT role
• Combined hours with residential shifts cannot exceed legal or policy limits
• The same 18-consecutive-hour limit as residential staff applies when working across departments in the same period

Universal Policies 5.3 (Individual Rights), 5.4 (Due Process), and 5.5 (Non-Discrimination in Services) apply to all employees. This supplement explains how those rights apply to ABA practice.

Clinical questions go to your supervising BCBA. Grievances and rights concerns go to HR or the grievance process (Employee Handbook Policy 5.1).

Tools of Choice is an evidence-based universal positive-practice program adopted by Missouri DMH across the state's DD system. It teaches a defined set of skills any staff member can use with any individual in any setting at any time. Each skill is broken into observable, measurable steps learned through instruction, demonstration, and practice with feedback until competency is verified.

• About Behavior and Avoid Coercion — why behavior happens and why coercion is not useful; this frames everything else
• Stay Close — build connection and presence through positioning, tone, empathy, encouragement, and active listening
• Use Positive Consequences and Pivot — reinforce desired behavior and redirect attention away from non-target behavior without escalating
• Set Expectations — state expectations clearly and positively, including consequences for earning and not earning, and confirm understanding

It meets every requirement of a Tier 1 universal positive practice — it is evidence-based, delivered to every staff member regardless of role or department, and applies to every individual in every setting at every time. It requires no diagnosis, referral, plan, or clinical decision.

RBTs are expert and fluent in Tools of Choice language. They teach and coach caregivers in Tools of Choice and how to use it across daily interactions in the home.

• Online modules — once at hire
• 16-hour in-person course at hire
• 4-hour annual refresher
• Owned and delivered by the Department of Culture & Experience — the DCE is a certified Tools of Choice Instructor and the in-house owner
• Tracked in BambooHR

No individual receives behavior services until intake is complete. Referrals come from internal staff, the Support Coordinator, a guardian or family, or DMH. The BCBA reviews all referrals and determines acceptance within 5 business days.

All communicated before signing:

• Purpose of services
• Expected time commitment and procedures
• Right to decline or withdraw without penalty
• Potential benefits, risks, and adverse effects (including temporary behavior increases during extinction)
• Limits to confidentiality
• Contact for questions (the supervising BCBA)
• Opportunity to ask questions without being rushed
• Incentives disclosed

• Re-consent at least annually
• New consent on any substantial change to the BSP, service model, or intensity
• On withdrawal, services discontinue per B8.3 — the BCBA documents and initiates discharge
• Intake docs are retained in SetWorks for at least 7 years

The FBA is a standardized process grounded in BACB ethics and DMH requirements.

No BSP is developed or implemented until this meeting is held and documented. Required attendees: the individual/LAR, the Support Coordinator, a residential staff representative, and the BCBA.

A functional analysis is not required for every FBA. It involves systematic experimental manipulation of environmental variables. The decision must be clinically justified by the BCBA, documented in the FBA report, and disclosed to the LAR in informed consent (a temporary increase in the target behavior is possible).

All BSPs are grounded in a completed FBA and meet BACB, DMH, and Abilities standards.

• A completed FBA with a written report and identified function(s)
• An FBA Review Meeting with documented attendance
• BCBA clinical judgment that services are indicated

• Identifying info, FBA summary, and function statement(s)
• Target behavior definitions (operationally defined and measurable)
• Replacement behavior definitions (functionally equivalent)
• Preventative/antecedent strategies, teaching/skill-acquisition strategies, and consequence strategies
• Reactive strategies and crisis procedures
• Restrictive procedure documentation if applicable — procedure, due-process requirements, restoration goals
• Data-collection procedures (how, when, by whom)
• Monitoring and review schedule and staff-training requirements
• Signature block (BCBA, guardian/LAR, Support Coordinator) and version log

No BSP is implemented until all 3 signatures are obtained.

Per 9 CSR 45-3.090(2) & (5), restrictive interventions are any procedure restricting movement, access, or freedom for behavioral purposes. Before implementing, ALL of the following are required:

• PCSP justification — documented assessed need, positive interventions tried first, less-intrusive alternatives documented insufficient
• RBSC review — the BSP is submitted to the Regional Behavior Supports Committee before the procedure begins
• Separate consent — specific written guardian/LAR consent per procedure
• Time-limited authorization — established time limits, reviewed each BSP cycle

When in doubt, treat it as substantial.

• Monthly Summary (DMH requirement) — the BCBA completes one for every individual with an active BSP; signed by the BCBA, Support Coordinator, and RPM; due by the 15th of the following month via BoldSign
• Annual BSP review — with the PCSP annual review or on the BSP anniversary; updated signatures and in-person training if content changes

This policy requires real-time, accurate, complete data every session.

• Collect data in real time every session for every target and replacement behavior in the BSP
• Enter session notes in SetWorks within 2 calendar days (best practice: same-day)
• Complete data sheets exactly as trained — never estimate, guess, or fill from memory
• Contact the BCBA immediately if procedures are unclear or cannot be completed
• Report data irregularities, unusual patterns, and changes

• Design feasible data systems
• Train staff before implementation
• Review raw data at least monthly and generate graphs per target behavior
• Base clinical decisions on data, not anecdote
• Address data-quality concerns via supervision

The method is specified in the BSP. RBTs may not choose or change methods without BCBA authorization.

• Real-time only
• No backfilling (unless reviewing recorded paper data with BCBA approval)
• No rounding or approximating — exact counts, durations, percentages, and times
• Document deviations
• No over- or under-reporting

All clinical decisions — modify a BSP, discontinue an intervention, change a replacement behavior, adjust goals — are grounded in objective data analysis by the BCBA.

RBTs complete accurate, timely, complete session documentation in SetWorks every session.

• Date of service
• Actual session start and end times (not scheduled)
• Correct CPT code and modifier (from the BCBA or billing at setup)
• Individual's name, Medicaid ID, and service location / ISL home
• Session narrative — what occurred, interventions implemented, how the individual responded
• Behavioral data summary per target and replacement behavior
• Significant events — behavioral incident, physical altercation, injury, medical concern, BSP deviation
• Staff present
• Procedure fidelity note — was the BSP implemented as written? If not, document the deviation and reason

Never select a CPT code that does not reflect the service delivered. Ask the BCBA if unsure.

• Describe this specific session on this specific date (not what typically or should happen)
• Avoid copy/paste and templated narratives
• Use observable, measurable language — "Michael hit his left forearm with a closed fist 3 times during the transition," not "Michael was aggressive"
• Include relevant environmental context
• Document any BSP deviation and reason
• Document significant events per Employee Handbook Policy 6.1 in a separate incident report

• Within the 2-day window — correct directly in SetWorks, resubmit to the BCBA/QAP, notify the BCBA of material corrections, and never alter a note to hide an error
• After the 2-day lock-out — use the Session Record Exception form in BambooHR only (complete all fields; it auto-routes to the BCBA, QAP, and Director)

Late documentation is noted in performance reviews. Chronic late documentation may result in corrective action.

The BCBA ensures each BSP includes identified antecedent triggers, antecedent modification strategies, reinforcement-based de-escalation techniques, and a specific crisis protocol appropriate to the individual.

Physical intervention may be used when:

• The individual presents an imminent danger of self-injury or harming others
• De-escalation and verbal intervention have not been effective
• The staff member is current in MANDT certification

When the reactive-strategy threshold is met (5+ uses that qualify as restrictive interventions within a calendar month), the BCBA initiates the RBSC referral process (B8.2).

After every crisis where physical intervention was used or warranted, the BCBA debriefs all present — what triggered the crisis, whether the BSP was followed, de-escalation effectiveness, safety concerns, and whether the BSP needs modification.

• Prior to implementing any restrictive intervention — RBSC review is required before implementation
• Reactive-strategy threshold — 5+ reactive-strategy uses qualifying as restrictive interventions within a single calendar month
• RBSC-directed referral — the DMH Regional Office or RBSC directs it

• If approved — the updated BSP with modifications is executed with all signatures, in-person staff training occurs before implementation, and it is filed in SetWorks
• If denied — it may not be implemented; the BCBA reviews the rationale and develops an alternative using positive supports

• RBSC approval is time-limited and renewed via the annual BSP review
• The Monthly Summary documents each use of the restrictive procedure
• If a procedure is consistently ineffective, the BCBA brings it to the RBSC
• Per BACB Ethics Code Std 2.15, all restrictive procedures have a fading or discontinuation plan based on clinical data

Discharge and discontinuation are handled to prioritize safety and continuity of care.

• Clinically appropriate — goals met / graduation, transition to a better-suited provider, LAR withdraws consent, Medicaid authorization ends
• Non-voluntary (requires due process) — safety concerns that cannot be adequately managed, inability to provide services consistent with BACB ethics, chronic disruption preventing service delivery, insufficient staff capacity

• Identifying info — name, DOB, Medicaid ID, guardian/LAR, period of services
• Summary of target behaviors at discharge (operational definitions + final data trends)
• Summary of BSP interventions (tried, worked, didn't)
• Summary of skills gained (replacement behaviors + skill outcomes)
• Recommendations for continuation (triggers + early warning signs for the incoming team)
• Crisis / safety notes
• BCBA signature and date
• Recipients — guardian/LAR, Support Coordinator, incoming provider (with consent)

Records are retained for at least 7 years (BACB Std 2.05).

• The outgoing BCBA completes a written clinical handoff summary and participates in a live handoff meeting
• All current BSP versions, data, graphs, and notes are transferred
• The incoming BCBA introduces themselves to the guardian/LAR and support team within 5 business days

Abilibucks is an agency-wide token economy for individuals with I/DD. It is created, managed, designed, and supervised by Behavior Services.

A token economy means tokens are earned contingent on target behaviors and exchanged for backup reinforcers. It is clinically designed to increase adaptive and functional behaviors across all homes.

• Design and produce the Abilibuck currency (physical or digital)
• Create and maintain the Abilibuck Store — curate items, set exchange rates, restock, ensure preferred backup reinforcers
• Develop and distribute individual tracking sheets — target behaviors, exchange rates, reinforcement schedules
• Conduct individual preference assessments
• Collect completed tracking sheets from homes on a regular schedule
• Enter and maintain tracking data
• Analyze effectiveness data and report trends to the BCBA and Director
• Train residential staff on Abilibuck delivery, tracking, and store procedures
• Review and update the program at least annually (sooner if data show it is losing effectiveness)

Under BCBA clinical direction, the Lead RBT:

• Manages store inventory and purchases items within the Finance Director-approved budget
• Updates item availability and prices
• Maintains data-collection sheets and ensures accurate, current data
• Collects completed tracking sheets on schedule
• Clarifies caregiver questions

The Lead RBT does NOT independently change exchange rates, modify program rules, or alter the budget. Program design, exchange-rate decisions, and effectiveness review remain with the BCBA.

A token economy is only as effective as its backup reinforcers. Conduct formal preference assessments at intake, at least annually, and whenever engagement decreases. Rotate store items regularly.

• The BCBA reviews tracking data monthly — participation and engagement
• Identifies individuals for whom the program has lost value and adjusts the backup-reinforcer menu
• Program-wide trends are reported to leadership at least quarterly
• An annual formal program review is conducted

Full residential implementation — House Manager and DSP responsibilities, tracking-sheet procedures, and modification rules — is in the Residential Services Handbook Policy R9.1.