Amber Nelms 0:03

Well, welcome, Shannon. We are so excited to have you on the podcast today. And you are the owner and managing director of Living Soul of New York. You're a licensed behavior analyst, and you are nationally certified school psychologist as well, with over 15 years of experience. Wow. You've worked across schools, homes, community, and you're passionate about expanding access to high-quality ABA services and advocating for the families that you serve. Well, thank you for what you do. And I would love to know what you got you started in the industry.

Shannon Carr 0:41

I started as a school psychologist, and then I ended up working for a school that specializes in kids with autism and multiple disabilities, and they specialized in ABA. So they provide a lot of ABA services. So I got into that side of things. And I liked that more because a lot of times in school psychology, I would just test kids and then send them on their way. There wasn't a lot of follow-up, but with ABA, I was able to actively work with the kids, work with staff, and make changes that I could see. So the real life changes. And I that appealed to me a lot more. Also, being an ABA, you're never bored. It's never the same thing twice. That is true. Yeah. And that really appealed to me. So I went on to get my BCBA and then licensed in New York. And I've been doing that since. So yeah. So I started doing that. And then I got into the insurance side of things because then I was able to work more in like clinic settings. And I've been in the insurance side of things for a while. And then I noticed that being on the insurance side of things for Medicaid, we had to turn on a lot of Medicaid applicants for the service. And I felt like that. Oh no, why is that? A lot of I can't speak for every place, but at least where we are in New York, the insurance companies weren't covering it. And then they finally started. I mean, Medicaid wasn't covering it. And then Medicaid finally covered it with over the past a few years. So it's relatively new that they started covering. So I was finally able to, when I started my own company, accept all those Medicaid families that were waiting so long for this critical service.

Amber Nelms 2:16

So well, you know, it's funny. That was it's not on our list of questions, but I was super curious. I'm, of course, in all those Facebook groups of people that run ABA companies. And I've heard that New York is pretty challenging and new laws have even come into effect for Medicaid. In NC, we've just had some new changes. So I was curious just what your journey has been like with that. What is the specifications that you guys have to go through in New York?

Shannon Carr 2:40

Yeah, New York, they had more specifications in place previously. They're starting to take some of it away thanks to some advocacy. Like we Oh, good. We go to Albany and tell them like we're the only state in this entire country that has these crazy rules in place. So they actually are listening, though. They did reel some of it back. So it's a little more, there's more opportunities for more individuals. So that's been good. So we're headed in the right direction. But yes, it was pretty challenging for a while. And then as of right now, I was just in Albany last week actually uh advocating for Medicaid coverage because Medicaid is finally covered, but now they're cutting the rates of Medicaid, only Medicaid. So again, that's not fair to families. So we're advocating for cuts not happening to only ABA because we finally got the service for the individuals and now it's being cut back. So, or the reimbursement rates are going to be lower, which will cut back our ability to fund the service.

Amber Nelms 3:36

Very frustrating. Well, I'm really excited to know you then. Please stay in touch because I'm trying to learn more and more about how to do that. And I'm so glad you already have experience, and I'm glad you're making a difference for those families while running a practice. That's not easy to do.

Shannon Carr 3:51

Oh, thank you. I appreciate it.

Amber Nelms 3:53

Yeah. You worked across a variety of settings. What have those different environments taught you about what truly drives meaningful progress for clients?

Shannon Carr 4:03

Yeah. I mean, each setting presents its own challenges and its own strengths. But generally, the kids are the most successful just across the board or experience the most success. They have collaboration between all settings. So there's a lot of breakup between what happens at the clinic, what happens in the homes, what happens in the schools. So what we really strive for is making sure that we are communicating with the schools, we're communicating with the parents, everybody's on the same page to the best of their abilities. I know what we can do in the clinic is different from school and different from home, but we try to be on the same page, at least with functions of behavior and addressing those behaviors in the ways that we can to try to make meaningful progress in some of the goals that the kids have and the families have. Really, I think the most important thing for progress, and that I've learned from working in all these different places, is that the biggest key is that collaboration. And if it's too compartmentalized, it's going to be a lot more challenging to make that progress, at least generalize the progress.

Amber Nelms 5:01

That's true. Very true. Well, we already talked about this. You've been deeply involved in advocacy, especially around protecting access to ABA services. What do you think leaders in this space need to prioritize right now to ensure families need to receive the care they need? I mean, that's kind of asked a little bit differently. Is there anything you could challenge people to be considering in their different states?

Shannon Carr 5:20

And I think that just getting the parents involved, because yeah, it's important. Like when I go in and I talk to senators or assembly members or their secretaries, when I go in and I speak with them, sometimes they don't know what ABA is or don't fully understand ABA. So educating them is important. But also I always bring, like I meet with the senators and assembly members that represent my districts, and I bring to them actual families and actual stories for how their choices are impacting them directly. So I think that getting the families involved is really important because the families are the citizens and they are the ones that are needing the services. And I think that sometimes they might not always see everything that's happening at that level. So I want to make sure the families are involved and that their voices are heard. So we've been really advocating for families to make their voices heard as well. And I've had families reach out and send me videos. I've tagged different assembly members and senators and the governor in.

Amber Nelms 6:14

So that's really good. That's a really good insight of like there's so many ways you could ask the families to be involved. It could include going there, videos. There's a wow, that's fantastic.

Shannon Carr 6:25

One of the families is very creative. She sent a video of what her son is doing now to show the progress, like how he's responding when there's like a fire alarm going off. So very cool. Yeah. So I think that's important for them to see to show that this is a valuable service.

Amber Nelms 6:41

Fantastic. Now to shift gears a little bit because I'm very passionate about making the user experience for people running or the user experience for the clients, because if we were even going to get them into treatment, how do we want that experience to be? Do we want it to be clunky and difficult or do we want it to be seamless? And just asking the questions like where is our tech stack at in the ABA industry? Where do you think we're under-leveraging technology to make it more seamless?

Shannon Carr 7:09

Yeah. So I would say that sometimes what we're doing is a little clunky, I admit. But I I have looked into all different types of programs that might be a little smoother. Central Reach, for example. And while I think that they are the full package, I also think that this is just a personal problem, very expensive. So as a small business and someone without, you know, private equity backing or any kind of grant funding or anything, I'm just kind of doing it on my own. Some of the services offered are very expensive and I would have to take away from staff or the clinic to afford them. So in my mind, I would rather be a little clunkier, so long as everything gets done, and make sure that I'm being smart with where the money goes. So I might explore some of those options down the road, but right now that's where I'm at. I think that it is under-leverage because I think that it could be a lot smoother if we had more of an all-inclusive system. But a lot of systems that are popping up are you bill with this service, and then your clearinghouse is over here, and your scheduling is over here, and all your clinicals are in this section, HR is over here. And a lot of different companies are trying to jump on and include more, but they're not including everything. So you still have to go to different platforms to get all your needs met.

Amber Nelms 8:22

Yeah, I think that's the common problem. And then the ones that claim they have all the things are so expensive that they don't really have all the things. That's my take on a lot of stuff. It's people are like, oh, well, I can do scheduling and sensory. No company really does that. Actually, they always have an outside spreadsheet or a thing if they're scheduling. They don't really truly do that. If you're gonna scale at all, you really can't. So, and then the software is super expensive. Yeah, that is unfortunately what I have seen. It's frustrating. And I really love that you brought up that price point. I think you that's why I love doing these interviews. People bring up a different consideration every single time where my brain, I'm really trying to analyze what the field needs when it comes to technology, what are the hindrances? How do we help clinicians that own companies really be able to scale with the right tools and the right setup, or even ask the questions of what they actually need? Because as BCBAs or psychologists, like that's not what we studied, right? So that is one thing that has been very important for me of being asked the right questions to be like, wait a minute, I don't even know what that is. And I better know what that is if I'm going to grow this thing in a sustainable way.

Shannon Carr 9:32

Right. That's my thing. I tell everyone I'm not a perfect business owner because I didn't get into this to be a business owner. I'm a clinician first. I'm still a clinician first. I make business mistakes. So yeah, I don't know all of the platforms or how they could all work together, but the ones that I have explored, regardless what they claim to offer, are expensive. And I just can't afford that on top of like a clinic and paying my staff well. So yeah, so those decisions had to be made.

Amber Nelms 10:01

I understand. Well, talking about that, is there a separate scheduling tool you use for scheduling or CRM or anything like that? Or you just use your typical EHR, like essential reach, to do those things then?

Shannon Carr 10:17

So I this is where like again it's a little clunky. Well, it's kind of like split up. So we do use one system where a lot of our clinicals are, which makes sense. So we keep all of our clinicals in one section. Parents actually have access to their child's programs and data so they can see all the their progress the child is making, and that's been really valuable for a lot of families. And then we have our scheduling in another Google Suites. So Yeah, you have that.

Amber Nelms 10:42

I was just curious. Yeah. Yeah. That's how a lot of people have to do it. Yeah.

Shannon Carr 10:46

So we just have I have a scheduler, so she does like all of her scheduling, and everyone has access to basically everything, not some HR. HR is something I only handle, but and I do that through paychecks. But like a lot of our staff have access to a lot of the scheduling, onboarding, and we have a team approach. Like everybody owns something, but if someone else needs to jump in, we have the access. So I always praise my team and I speak very highly of them. I have a fantastic team, and it's helping cover some of those gaps that there are systematically. So they're all jumping in as needed, and they've been fantastic.

Amber Nelms 11:22

Well, that's the sign of a good business owner. Can you build a strong team? So I don't know. I know you call yourself the clinician, but that's the sign of a real business owner. Do you have a strong team? Sounds like you do. So that's awesome. Well, thank you, Shannon, for being on the podcast today. Thank you for bringing your insights. Thanks for bringing where you're at, and thanks for challenging us to continue to think through how we do need to advocate within our states to help families. That reminded me again like it's something I want to grow in. So if you can stay connected with me on that, I want to.

Shannon Carr 11:52

Yeah, I would love to. Thank you so much. Okay, absolutely.