360 Human Services is an applied behavioral analysis clinic that is serving a behavioral healthcare service desert in San Bernardino, California. There’s especially limited access to centers to support individuals with autism spectrum disorder, and related intellectual and developmental disorders.

THE PROBLEM

The clinic provides daycare, day services and applied behavioral analysis services. The organization serves adults with autism spectrum disorder and related intellectual and developmental disorders to accomplish goals related to pre-employment, job readiness, independent living and community engagement.

A behavioral healthcare service desert can occur in either rural or urban areas where resources for individuals with mental and behavioral health needs are scarce, and 360 operates in both settings.

To access such services, individuals must travel miles away from their homes, oftentimes without sufficient public transportation, to access these services. One study from the Centers for Medicare and Medicaid Services indicates 75% of rural counties across the country have no mental or behavioral health service providers, including essential services for individuals with autism.

Behavioral healthcare service deserts face issues with staffing and staff retention, which is unfortunately quite common for the healthcare industry. Staffing challenges cause radiating impacts and can ultimately affect the quality of care an individual with autism spectrum disorder or intellectual and developmental disorders receives.

PROPOSAL

Health IT vendor CentralReach was proposed to support billing, scheduling, payroll, data collection, human resource-related tasks and more.

"When we first learned about the vendor, our team was immediately impressed," said CEO Harry Jackson. "So often, small therapy providers are using disparate platforms to manage multiple tasks and workflows. Some even currently use spreadsheets and pen-and-paper to manually track things like billing or an applied behavioral analysis client’s progress.

"CentralReach was positioned to us as an all-in-one practice and clinical management solution designed with the specific challenges of startup and small applied behavioral analysis therapy practices in mind," he added.

MEETING THE CHALLENGE

Day to day, 360 Human Services' administrative staff, registered behavior technicians and board-certified behavioral analysts use CentralReach for billing, scheduling, payroll, data collection, tracking staff credentials and managing teams, document encryption, and following up with caregivers to individuals with autism spectrum disorder and intellectual and developmental disorders.

"Staff retention and turnover are our biggest challenges. As such, maintaining sustainable workloads for our staff is a top priority for us," Jackson explained. "The role of technology, specifically an all-in-one tool, is integral for increasing efficiency and sustainability in applied behavioral analysis therapy clinics and enabling registered behavior technicians and board-certified behavioral analysts more time for direct care.

"By using such technology, registered behavior technicians and board-certified behavioral analysts can offload administrative tasks, allowing therapists to spend more time working with their clients," he added.

360's three locations operate in rural and urban behavioral health services deserts, making scheduling a constant stressor. At the rural location in Apple Valley, California, community members are spread out throughout the town, making getting to the health center a challenge.

The same goes for the more urban centers: poverty and crime can stand in the way of clients and staff safely and comfortably arriving at the health centers. Cancellations, late arrivals and reschedules are the reality at 360.

"CentralReach’s calendar manages restrictions, wait lists and insurance coverage eligibility," Jackson noted. "It helps us alleviate bottlenecks that are reducing the productivity of staff. Additionally, our team has found the data that we have been able to collect using the tool has been imperative to furthering the success of our clients.

"The software easily integrates with our learning trees and goals set for our clients, so at the start of every therapy session the expectation and progress are clearly laid out for our therapists," he continued.

In addition to the vendor's practice management software, 360 is using CentralReach’s avail, a remote support software that helps therapists meet their client’s goals related to pre-employment, job readiness, independent living and community engagement.

"The software is person-centered software, tailored to each individual, making it easy for our staff to use," Jackson said. "The software simplifies task analysis and provides remote support with step-by-step digital prompts and reminders to help individuals master work-related and day-to-day living tasks.

"With the avail app, our therapists have access to their clients' instructions on their phones and tablets to use wherever they are in the community with their clients. But it also has the capability to operate offline, which is essential in areas where WiFi is unreliable," he continued. "It’s helped us expand staff capacity and minimize the need for limited one-on-one support."

RESULTS

Using the software, 360 Human Services has achieved several measurable outcomes that demonstrate the effectiveness of the tool in the organization. Two key success metrics include increased client progress and enhanced staff efficiency, Jackson explained:

• Increased Client Progress – With the comprehensive data collection and analysis tools, staff members have been able to monitor and evaluate the progress of clients more effectively. This has enabled staff to tailor individualized treatment plans and interventions for each client, leading to significant improvements in their skill acquisition and behavioral outcomes. The real-time data visualization has also allowed staff to promptly identify and address any barriers to progress, ensuring that clients continue to make steady advancements toward their goals.
• Enhanced Staff Efficiency – The avail digital platform has provided staff with easy access to a vast library of evidence-based resources, including video modeling and interactive lessons, which has improved the quality and consistency of services. The platform's easy interface has streamlined communication and collaboration among team members, reducing the time spent on administrative tasks and allowing staff to focus more on direct client support. This has contributed to a higher level of job satisfaction among employees and resulted in better overall client outcomes.

"By achieving these successes, we have been able to optimize our service delivery, ultimately leading to a higher quality of care for our clients and a more efficient, cohesive team," he said.

ADVICE FOR OTHERS

"When considering using assistive technology, a good place to start is analyzing organizational workflow and determining which tasks are taking your clinicians the most time to complete," Jackson advised.

"Identifying bottlenecks in workflows can be time-consuming, especially when time feels so scarce in a busy applied behavioral analysis therapy clinic environment, yet understanding where this congestion is happening is imperative, and requires organizations to dedicate time to see where their team needs more support."

Having a pulse on the technological landscape and conversing with other applied behavioral analysis therapists and small therapy practice owners can help a team understand issues more efficiently and help them acquire solutions that effectively address the issues a clinic is facing, he added.

"Further, you want your technology to work for you, and not vice versa," he commented. "For staff, implementing new technology can occasionally be met with pushback, as it feels like one more thing has been added to their to-do list.

"Finding a vendor that facilitates constant touchpoints with your staff, even after implementation, has helped our team continue to grow with the technology they are using," he concluded. "There are other tools out there on the market that all aim to do similar things, but what makes a vendor stand out is a person-centered design and approach that amplifies the human touch in healthcare."

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