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Autism services have a very specific purpose. They are meant to impart language and skills that open up access to new worlds. Worlds of learning. Worlds of fun. Worlds of independence. Worlds upon worlds.


But Autism services are facing something of a crisis. Outside investors have found their way into our industry and the results are becoming quite scary. I want to tell you about the looming dangers of outside investing, or “equity-based financing,” for autism service providers. There are three big ones.


Danger #1: Expansion and Sustainability


First, we have to talk about expansion and sustainability. An expanding business isn’t always a bad thing. Sometimes, it can even be good for the consumer, such as when the number of services are expanded. But when businesses expand too quickly, it often means that they don’t have time to do it right. They just don't have time to put the systems in place to keep the organization running in the long run. In other words, they’re not sustainable. So sure, in the short term they might expand the company from 50 to 500 employees. But in the long term, they’ll be down to zero.


Danger #2: Boosting Revenues


Building off Danger #1, investors often don't care about sustainability. Their focus is on increasing the dollar value of their share of the company. This is done by getting as many clients as quickly as possible (a type of expansion). It makes it looks like everything is going really well even if the company is actually losing money in the process. When that happens, the investors can sell their stake in the company to other smaller, less informed investors just before everything goes belly-up.


Danger #3. Maximizing Billable Hours


Every state in the US (not including Puerto Rico) has a law that requires health insurance to cover the cost of autism services. Once investors found out about this, they started getting really excited. The investors started pouring money into these companies and demanding they start maximizing their revenues. In our field, this is done by cutting costs like employee training and teaching resources. It also means making therapists work back-to-back-to-back sessions, which really burns them out.


You can imagine the effect this has on the quality of services.


So where do we go from here?


To stem the tide of greedy investors, vote with your wallet, as they say. We find that many families simply aren’t aware of the power they have when it comes to choosing a service provider for their child. Too often, they take the first option given to them, unaware they’re entitled find a provider that works for them. After all, would you stick with a doctor you didn’t like? A mechanic? Therapist? Dentist? Of course not. So why should autism services be any different?


If someone were to ask me where they should go for ABA services, I think it’s obvious I’m biased toward Behavioral Connections. It’s a service founded the principles of highly trained staff, language development over ‘problem behavior’ reduction, and just making an environment the kids genuinely want to be a part of. But I meant it when I said the choice was up to you and there are many small providers that share our commitment to treatment integrity over inflated revenues. And this wave of integrity is only growing stronger, as more and more of us become fed up with a system that values investors over clients.


And now it’s your turn to be part of that wave. The choice is yours.


-Dr V

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