IMPACT OF DRIVING FOR PROFITABILITY

I think BHCOE (under 500 companies) and CASP (under 300 members) do great work. Organizations that seek credentialing are seeking to establish better business practices but better business practices don’t always align with fair treatment of staff and ethical decision-making. For many companies, those two objectives don’t align.

Many BHCOE organizations are owned by PE-backed companies. It would be fair to say that the most egregious ethics violations in terms of HR and business practices – unpaid nonbillable hours; minimal breaks; unpaid training; unpaid driving time, bait and switch hiring tactics, lack of training and support for BTs/RBTs, inadequate supervision, cherry-picking easy clients, establishing arbitrary minimum billing requirements, firing “difficult” clients, etc. – are being perpetrated by these organizations because the primary objectives of these businesses are to increase profits. Often at all costs.

A profit-seeking company will always find ways to maximize profits. A short-term-oriented profit-seeking company will do so without regard to the damage it is doing to clients, staff, and the health and sustainability of the business because they’re playing a short game.

As PE-backed companies always have a short-term investment horizon of 5 to 7 years, you can understand their motivation to extract immediate gains during their investment horizon.

As a general rule of thumb…

Private Equity-backed companies will ALWAYS seek to exit their investment. The typical investment horizon (time to flip) is 5 to 7 years. Their primary objective will always be to maximize profits because profits equal enterprise value. And enterprise value equals how much money they will get at the time of exit.

BUT not all PE-backed companies are evil. Some are ethical.

Independent ABA agencies, particularly those owned by BCBAs, often have a longer investment horizon (especially since most don’t even have exit strategies) and focus primarily on helping clients. Some are smart enough to know that in order to help clients, they have to have committed, dedicated staff.

We spent over 2 years creating a national database of ABA organizations. Although this number is constantly in a state of flux because there are so many new agencies being created by disenchanted BCBAs and those going out of business because of the inability to compete against PE-backed companies (M&A activity has slowed down considerably), our database stands at around 3,500.

Through the Ethics Standards Board of ABA Providers (ESBAP), an organization that we created to establish ethical business standards for ABA provider organizations, we will be publishing this database in late March / early April.

Our goal is to use data that we collect from parents, RBTs, BTs, BCBAs, funding sources, and others with a vested interest in protecting the field of ABA – it may not be objective, but it will be actionable data – to drive behavior change.

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Being an RBT for me was extremely fun because where were you going to find a place where you can be completely silly without having to worry what people thought about you? This was the only job that made me feel like I could make a dramatic difference while being myself.

I also liked to be surrounded by people that had the same goals of wanting to help kids and the teamwork made the job much easier and more enjoyable.

Change and progress was the ultimate goal for our kiddos. The early intervention program was seriously only a miracle because I saw changes in the kiddos that from day one, you wouldn’t even recognize who they were.

Changes from being able to utter 3-4 words where they can only make a syllable from when they started, the behavior decreases in which kiddo that used to engage in 30-40 0 self-harm to only half, learning how to wait during games, table work where they use to swipe and drop to the floor if they had to.

My favorite was when the parents would tell us what amazing progress they were making at home. I used to tear up and felt for these parents so much because it was already difficult for them and now, they can trust and rely on ABA and the therapists knowing their goal was ours.

By Emma Rogers, BA, RBT

Mother Child
Special Learning’s Free Hotline

This is an independent SL Hotline that is part of our VCAT service. This hotline has no connection with any other association or membership group.

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