BrainSTEPS Consulting Team Member Application

EMAIL your COMPLETE application packet that must include the Supervisor Sign Off Form to Dr. Brenda Eagan-Johnson, CBIST, BrainSTEPS Program Coordinator

Email: [email protected]

Team Member Model & Responsibilities

We ask for an initial commitment of two years for all new members of the Brain Injury Consulting Team.

Participation in the Brain Injury Consulting Team New Team Member training is essential for new team members. Once you complete the requirements for the new team member training, you will be assigned student cases by your team leader.

The time commitment for consultation activities is dependent on the type of request for BrainSTEPS services. Specific hours are flexible, however, and can vary according to the individual team member's work schedule and needs of the team.

Training Requirements First Year

BrainSTEPS Team Training Schedule

If you CANNOT commit to these requirements, please do not apply.

5.5 hour online Return to Learn Concussion Management training

Full Day (7-10.5 hour) In Person or Online New BrainSTEPS

Team Member Training (varies)

Annually, you will participate in Additional Capacity Building Training-(either in person or online)

BrainSTEPS Team Member Commitment

Team Membership includes the following. Please read and discuss with your supervisor prior to submitting your application Submission of your signed application demonstrates your commitment to the following:

BrainSTEPS expects a time commitment from all team members. Please think about your potential role before applying. Participation in the initial BrainSTEPS New Team Member training sessions as well as additional day-long trainings that are scheduled each year.

REQUIRED - please review because if you cannot commit to the requirements, you will not be able to remain on the team.

The time commitment for consultation activities is dependent on the type of request for team services. Specific hours are flexible, however, and will vary according to the individual team member's work schedule.
We only accept active team members who agree and are willing to take the time to work on student referrals on a rotating basis for their team. Our teams are working teams.
You must secure your supervisor’s approval (attached form), because the BrainSTEPS work takes place during work hours.
Team members who apply must commit to attending all mandatory trainings to remain on the BrainSTEPS Team.
Team members must log ALL student consultation activity data performed each month in the ORBS database.
Team members must attend regularly held meetings (monthly) that are scheduled by their BrainSTEPS team leader to discuss program updates and student specific cases.
All BrainSTEPS team members must participate actively by being involved with student referrals made to the team. This can mean any/all of the following:

Regular Team Member Student Consultation includes variations of the following:

Communication with family
Communication with school
Consultation activities
Information sharing among team
Observation/evaluation of student
Consultation with Medical Professionals
Records Review/Report writing
IEP Meeting attendance
Training of educators and support staff
504 meeting attendance
Intervention Demonstration
Classroom and peer education
Consultation: Educational Plan
Consultation: Modification of instruction method
Consultation: Teaching child compensatory strategies
Consultation: Use of assistive technology
Consultation: Modification of curricular content
Consultation: Use of behavioral strategies
Consultation: Student’s environment modification

TEAM TASKS

1. Training & staff development activities for team members provided by BrainSTEPS staff and guest faculty.

2. Student, District, Family consultation (See list of specific consultation activities that team members track below)

3. Team development

4. Evaluation activities (See list of specific consultation activities that team members track below)

5. REGULARLY SCHEDULED MANDATORY Team Meetings that the regional team leader schedules. This is an extremely important part of the BrainSTEPS Teaming process.

AVERAGE TIME COMMITMENT

Equivalent to 1-3 day sessions in each school year (Additionally, Team Leaders of each team typically attend 1 Fall and 1 Spring Workshop)

8-10 hours per month (will vary depending upon # of districts in an IU region and the number of team members)

Ongoing & formal, as designed by individual teams (e.g., email, phone calls, person-to-person team meetings)

Approximately 1.5-2 hours per month of record keeping (ORBS Database) (i.e., track team member individual student consultation activities in database)

1.5-2 hours per month (at least).

Team Member Application

PERSONAL INFORMATION

Name

Profession

Home Address

Address Line 1

City

State

Home Telephone #

Home Email

EMPLOYMENT INFORMATION

Job Title:

School District/Organization

Work Address

Address Line 1

City

State

Work Telephone #

Work Email Address (REQUIRED) *

Job Responsibilities

Experience Working with Students with TBI:

Which BrainSTEPS Team Are You Joining?

Summarize previous training experiences in Brain Injury (note: no previous training required to qualify for team membership.)

SUPERVISORS (Please provide the following information for each of your supervisors)

Name

Address

Title

Phone

Please write a brief statement of your interest in serving on a BrainSTEPS Consulting Team and HOW you plan to become an ACTIVE team member. Please refer to the BrainSTEPS Best Practices Document for more details.

The BrainSTEPS Program will review your application and if chosen, you will receive an email with notification of the New Team Training

All Documents Must Be Submitted via Email At One Time.

Please write "New Team Member Application" in the subject of your email.

Please return to:[email protected]

Applications only accepted via email. All pages must be included.

Pennsylvania BrainSTEPS Team Member Supervisor Support for Staff Participation

Applicant Name:

Dear Supervisor,

The Supervisor's support of our BrainSTEPS Consulting Team Member is critical for successful participation in educational and consulting activities. Selection for joining a team requires a 2 year minimum commitment. Required trainings for all team members are broken down into an initial new team member trainings (approximately 2 days either in person or online), followed by an annual 1-2 day training IN PERSON or online each year. There may also be additional required webinars/trainings throughout the year. Please see the attached documents which detail the time involved for BrainSTEPS team membership. Please indicate your consent by completing this form and returning it to the applicant, so s/he can submit this application. If you have any questions, please do not hesitate to contact me:

Dr. Brenda Eagan-Johnson, Program Coordinator Email: [email protected] or Phone: 724-944-6542 To find out more about BrainSTEPS, visit: www.brainsteps.net

An Explanation of Costs Associated with Team Training & Consultation:

Project funds are limited. The priority of funds is to underwrite the costs of the training program for team members (including honorarium and travel expenses for guest faculty, training materials/resource libraries for participants, and facilities). At times, there may be travel costs associated with participation in the BrainSTEPS trainings. To date, these costs have been covered by the employing district or Intermediate Unit as an in-kind contribution to the training provided through the project. Please indicate your approval for the above-named staff person's participation as a member of the Pennsylvania BrainSTEPS Consulting Team. (Please check one of the options below.)

Yes. I have reviewed the attached Team Member Application Packet, I understand the task and time commitments required for team membership, and I approve of his/her participation.
No. At this time I am unable to approve his/her participation.

Supervisor (please print your name)

(Supervisor signature & date)