Hiring and Managing In-Person Staff at Your New Location

You likely already have RBTs delivering telehealth. A physical site needs in-person staff, and supervision dynamics shift.

Step 1: Decide who transitions vs. who’s new. Some telehealth RBTs may want to move to in-person work; others may prefer to stay remote. Treat this as a real conversation.

Step 2: Confirm background-check requirements for the physical workplace. These are state-level and may differ from what you needed for telehealth-only staff — confirm whether working in-person with children triggers additional fingerprinting/registry checks.

Step 3: Rebuild your supervision rhythm for in-person work. The BACB ratios don’t change (a BCBA can typically supervise up to ~10 RBTs, 5% of monthly hours directly supervised, two face-to-face contacts a month). What changes physically: a BCBA walking room to room, not reviewing recordings remotely.

Step 4: Plan for a different labor market. In-person RBT roles compete with local retail/service jobs in a way remote roles don’t — build ongoing local recruiting into your plan.

• RBT staff at a clinic might be working at or closer to full-time hours. If so, you may need to consider what FTE benefits you need to provide to your staff (e.g., health insurance, PTO, etc.)

NOTE: Confirm with each payer whether individual clinicians need to be separately listed at each service location, not just the organization.

WARNING: Don’t over-hire for the new site ahead of confirmed payer-location enrollment (“Enrolling a New Physical Location With Payers”) — you’ll have staff on payroll before you can bill for their in-person work.