A glimpse into the success of an ABA organization built on strong company culture, strategic technology, and genuine passion for working with the autistic community.
CentralReach was lucky enough to interview Licensed Behavior Analyst, Executive Director, and founder of ABA Insight Autism Services, Angie Fuqua. Angie detailed her experience starting up an ABA organization, including ways in which her initial implementation of key technologies helped the practice not only stay afloat, but thrive, during the COVID-19 pandemic — a time of widespread global devastation for many businesses.
Angie spoke about the practice’s utilization of telehealth to serve clients during social distancing, techniques and strategies used to remain profitable and debt-free during a global pandemic, and what she hopes the future will hold for ABA Insight. She even offers advice to those thinking of starting their own ABA businesses.
We hope ABA business owners, clinicians, those in the field, and aspiring ABA practice owners garner value and inspiration from our interview with Angie.
About ABA Insight.
ABA Insight offers therapy for children, teens and adults with Autism Spectrum Disorder (ASD). Their mission is to empower, equip and inspire success through collaboration with other professionals, families and clients. They strive to create effective and meaningful treatment programs that result in socially significant changes and improve individuals’ quality of life.
Since opening in 2018, the ABA Insight has won a number of awards and accolades — they won the 2020 Greater Washtenaw Region Best Small Business award; were recognized as one of the 2020 Michigan 50 Companies to Watch; landed a spot on the 2020 Michigan Best Small Business list; and even earned a 2-year BHCOE reaccreditation, receiving national recognition for commitment to quality improvement.
ABA Insight is now operating in five counties across Michigan, expanding two of its facilities, and has not permanently laid off a single employee even throughout the COVID-19 pandemic.
Starting a business is not something you decide on a rainy day. What made you decide to open an ABA practice in Michigan?
There was definitely a need out there to help a lot of families. Instead of doing private consulting and only helping 5-6 families at a time, I knew starting a business would allow us to expand our services and help many people across many counties, so that was really important to me, [having] greater outreach [as well as] more analysts and more one-on-one behavior technicians.
I absolutely knew the therapy of applied behavior analysis, and was practicing [it] across many different populations, other than just autism. And the other big part for me was, I have an emphasis in my education in organizational behavior management. So I love systems, I love processes, I love putting one small part of something together to create a bigger picture. So having that skillset and knowledge definitely helped me [determine] what I needed to do to have a solid business plan.
How has technology strengthened what you’re doing in terms of running your business and providing services?
It’s funny you ask that. I just had a [new] staff person [that came] from another different provider say to me, “I’m so thankful to you that you’ve put the investment into technology, because having the right tools and resources at our fingertips is what makes us that much more efficient and effective.”
And that’s exactly what I wanted to do for staff. There was this big trend of using paper-based binders and they were just so cumbersome and such a mess. So moving to electronic data collection is a perfect example of how much our productivity can increase, [as well as] our efficiencies. I think the fact that [our business is] all electronic in what we do has made a huge impact on our systems’ effectiveness, for sure.
Has it helped you grow? Do you think it’s because you’ve had the infrastructure in place early on?
I absolutely do. I think it’s been key in [our] scalability. [In terms] of CentralReach, I had been in business with many placeholders to try and get the scheduling, the billing, accounts receivables, using different Microsoft Office tools – information was in so many different places. [Finding] a tool that was all-in-one was so important to me, that had scheduling, billing, reports, and data at your fingertips.
Most of our billing is under 30 days in AR outstanding. So that’s huge for us. CentralReach has been wonderful – everyone loves it. Even from our clinical implementation side, which is obviously very important, I firmly feel it’s allowed us to get our second accreditation from the Behavioral Health Center of Excellence (BHCOE). We got a 2 year accreditation this time – and it was so easy for us to present our progress with our clients [and] their goals. All of our clinical implementation was so accessible to show them because of CentralReach.
Let’s take a quick step back – in the beginning, what were some of the early challenges you faced? Were there any challenges in getting systems set up or marketing your business? What were some of the stepping stones?
Working capital for a new business is always the worrisome piece, for sure. And then, you know, knowing that this technology is going to be so important, and these tools are going to be so important, you have to be able to be willing to take that risk to build it and invest in it – knowing that the return is going to be there by doing [making] that investment.
But, that risk does cause a burden on [your] ability to scale at first, because you have to watch the numbers so closely. We provide our services before we get the reimbursement, so constantly having to watch those numbers – knowing our break-evens, knowing how we’re scaling to be able to have those working funds there to maintain the business, was difficult. And then when you do get these new tools, you have to put so much time into learning them, and then training other staff on how to use them, and then working through the kinks of – you know, it’s usually not the tool, it’s the user error – but, working through those kinks together caused a lot of indirect time for us that’s not reimbursable.
But, it was an investment so we were definitely willing to do that. Just before March, we were at the peak of what our business was doing. We hadn’t had to market [ourselves], we had [a] wait list, we had people calling us just from word of mouth, and we were going into the summer, which is our busiest season. And then obviously COVID hit. [Then] it… felt like we were just trying to keep our head above water as a newer, smaller, company, to maintain what we put into all of this. So that was really hard, but obviously we got through it, and we’re looking really good right now!
Obviously, COVID threw life into a whirlwind no one expected. Do you have a vision of where you want to see your business in the next 4-5 years, or are you just trying to make it through the next couple months with everything going on with the pandemic?
No, actually, what a blessing… We are pretty close to being back at the numbers we were at pre-COVID. Our projections for the rest of the year – even our highest level goals for the company for this year – we are very optimistic that we are going to be able to meet those [goals]. We were saved, for sure, by the Paycheck Protection Program (PPP) loan. That was phenomenal for us, we are very grateful for that. At this point, with the help of that PPP loan and the level that we’re back [at] in terms of capacity [to] take on even more clients, we are definitely above [where we thought we’d be] in the profitability level.
[With COVID], it was a constant analysis of numbers over that whole [time period] — you know, how to be smart about what we’re doing, how to [curb] expenses, and really make sure that when those doors open, we [will] be strong for our customers. So it was a lot of analyzing.
Did having the technology and infrastructure in place help you pivot?
Absolutely, yeah. And Insight has a fabulous, extraordinary culture of staff. In our accreditation scores, they were like, “Wow, you guys have really great culture scores!” That really means a lot to me, and it does because of these kinds of things that can happen – these risks that can impact a company. We all came together, wanted to achieve the same mission of keeping this business open, and getting back [to where we could] be [a] backbone for our families – and we did that. We really stuck together.
“Insight has a fabulous, extraordinary culture of staff… We all came together [and] wanted to achieve the same mission of keeping this business open.”-Angie Fuqua, M.A., BCBA, Founder of ABA Insight
It’s hard – the burnout, the stress, and the amount of work that it takes to do this job. Having a company culture that is so strong is hugely important for success.
I definitely felt that, for sure, [during] that time. But what was great, again, about the technology piece is that [our] analysts were still able to [get] paid their full salary while working from home. They had great telehealth sessions, they… had all of their materials they needed with them at their fingertips, between the learning trees, and the schedules… everything we needed was just so [accessible] out of the office.
In [terms of] telehealth, did you have any struggles or challenges getting the families on board? What was it like from the client side for you?
Unfortunately, I think the families at first were extremely overwhelmed. They were trying to coordinate their own day to figure out, how am I even going to be here [during sessions]?
Before, at least the children were at school for a while. So, they were navigating that so much that at first, we didn’t get a lot of buy-in. But as things started to calm down, and they experienced what telehealth was, they actually became very excited about the fact that they could be in their home, they didn’t have to get childcare for siblings, [and] it was… a lot more efficient for them as well.
We also started a parent group. We got parents on the line together, some weren’t clients anymore, but needed to hear from other parents [who were also] going through this COVID stuff, and what they were doing for activities. So we got all these parents together and just had a really organic conversation with a special topic, and I think they felt very supported through that modality as well.
Do you think you’ll continue to do telehealth and those types of support groups post-COVID? Will it become an option for things like inclement weather, or will it be based on the payors and what they decide?
Yes, we would love to be able to continue it, and still are, because we are allowed to as long as the payors continue to approve it. We are trying to, as a field, advocate for all the advantages and positive outcomes that the families had by utilizing it. So we’re definitely wanting it and hoping that it will be allowed, but it’s just a matter of waiting to see what the funding sources say. But as I said, it allows for so many more efficiencies – both on our side, and for the families.
There are a lot of people out there considering opening an ABA practice. What kind of advice would you give to someone that’s saying, “I want to start an ABA business.”
I would definitely say that you have to dig deep [and] ask yourself, why you are saying that. [In] this field, it’s not about the “business profitability for my own personal interest” – it’s more about, “I’m willing to put such an investment into this – sweat, energy, and tears,” to help these families… feel comfortable and have a trusted partner for their child, which is a precious gift to them.
I think you have to make sure you know why you want to do it, and [then] do it in an ethical way and a quality way, over quantity. And, there’s that double-edged sword – you say you want the business, but you’re talking about a child. You have to be able to balance why you’re doing it and remain ethical. And if you’re in it for that intense purpose of what it should be, I would say, make sure you have a good business plan. Make sure you’ve analyzed all the strengths and weaknesses, and that you’re aligned from that step forward to support [the] plan.
We are truly proud to have ABA Insight as a CentralReach partner and commend them on their success, hard work, and unwavering commitment to the clients and families they serve in the autistic community.
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