The current study combined a management technique termed "Service Review" with performance scorecards to enhance staff and consumer behavior in a human service setting consisting of 11 supervisors and 56 front-line staff working with 9 adult consumers with challenging behaviors. Results of our intervention showed that service review and scorecards produced significant staff behavior changes that were maintained over time. Positive consumer outcomes were also correlated with staff performance changes. The behavioral package of training, clinical consultation, service review, biweekly manager meetings, scorecards, and public posting has the potential to reduce the need for monetary staff incentives. (Contains 3 figures.)