Amber Nelms 0:00

Well, welcome today, Anna, for being on with Accelerate with Amber's podcast. It's so exciting to have you. You are the founder of Alinea Autism Services. She is an advocate and a leader in the autism space who successfully helped pass. Oh, this is cool. Ava's law to expand access to therapy across Georgia. Thank you so much for your work in that. That's awesome. We need people like you doing the work with over 15 years of experience in policy, payer relations, and behavioral health. She is dedicated to creating patient-centered care and increasing access to services for families nationwide. Wow. I'm so glad to meet you. I do not have that as an experience in my pocket. So knowing someone like you is fantastic. How did you even learn about doing that to start with the law change?

Anna Williams - Bullard 0:56

Oh, well, I didn't know. So that's it, that's the beauty of it. So my my daughter was diagnosed with autism in 2006. And so we were headed down this path. She needs therapy. The medical professionals recommended all these things. And then we learned that in Georgia there was no coverage. Insurance excluded autism therapies, Medicaid didn't cover it. It kind of unfolded this challenging world that people with autism were living in. Yeah. And so that was where I really started realizing there was disparity and really discrimination against all those that to again, autism is something people are born with. So it was to no fault of their own. And then there was no healthcare coverage for it.

Amber Nelms 1:46

Man, that was not on our set of lists of questions. So thank you so much for being willing to pivot. But I have always dreamed about meeting someone like you because I was reading the history of ABA and the very first coverage for kids on the spectrum, and I think it was in the state of California, came from a parent. And look at that. Seeing how much maybe I'll point some of our parents to listen to this podcast to be like, listen, I know it's really hard as you're going through services right now and helping your child, but parents are the ones that push really hard and change the world for other parents. So thank you so much for helping your kid and helping many more families because you were willing to get into that fight and do that. That's awesome. Thank you. Thank you.

Anna Williams - Bullard 2:32

It was hard. It was very hard. And to your point, because it was not an area where I had expertise. I'm not an attorney or anything like that. But yeah, it was worth it. I would do it all again. And I still, that is what I do every day is continue to advocate for families with children with autism.

Amber Nelms 2:50

That's fantastic. Does your families know that about you? Are you kind of more like a humble person that don't even share that? Um a lot of people don't know that about me. Oh my goodness. We need to shout it from the rooftop. Sorry. To me, that's just huge. And that's why I try to encourage our families. Like, stay in the work, help your child and do all the things. But guess what? As you come through this, it's like that's my story too. I wouldn't have gotten to the field had my child not been diagnosed. But that was a part of why I'm so passionate because I saw it help. And so I think that is what really does empower a very strong why when you have that. And I get so thankful. I have several of my BCPAs that have kids on the spectrum. It's so fun to work together with people that like have strong whys. Yeah, agree. It is, it's very cool. How long did it take you? Sorry, this was not on the list, but I'm just so interested. How long did it take you to get that law passed? It took seven years. Seven years, and you did not give up.

Anna Williams - Bullard 3:52

Yeah, it took seven years, and that was a surprise because I thought that this would be something that was very obvious. What I did not appreciate, I didn't have the, I guess, the kind of understanding of the intricacies of how when you're passing legislation that's going to change everyone's health insurance across the entire state. And so obviously there were a lot of concerns around the implication of cost. And so years of trying to get to the truth of the true cost. And so, and in Georgia, they are not really inclined to pass mandates. And then with Medicaid, we had with Medicaid coverage, you actually have to get the legislature to put those millions of dollars in the budget because it's state funded. So when you're going to add a benefit to Medicaid, that $90 million that they are estimating it's going to cost, you have to get them to put that in the budget. So we actually passed Davis Law for commercial health insurance in 2015 first, yes. And then continued to work and did not get the Medicaid benefit until 2018. I'm sorry.

Amber Nelms 5:14

We just have I have to this is not what we play, but I'm just like, what in the world?

Anna Williams - Bullard 5:20

That's very intense. It's an interesting part of my life that sometimes I do stop and just remember how hard it was. Because as a mom, I was very excited to be a mom and wanted to be a mom. I was a young mom, actually. I had my kids very young. And so when Ava got diagnosed, I knew nothing. It just changed everything about my life's journey and just who I have become. Some of it, I would say, it and all the families and everything I've gotten to do in such a positive way. And then in some ways, you do get pretty cynical, honestly, of just how hard it is and how hard it still is for families who have children with autism. Yeah, that is very true. How is your daughter doing now, if you want to share? Yeah, yeah, sure. I mean, so Ava, I always like to tell Ava's beginning because for any parent who it gives hope to, but I wanted her to get ABA because I could I read the research and felt like it had the best science behind it. And so we pushed really hard. She was nonverbal at three, couldn't feed herself, had a lot of fine gross motor, a lot of stemming, could not really go anywhere because of all her sensory issues. We started ABA. And I mean, even when I think about like she couldn't follow a one-step direction, like Ava, touch her nose, wave bye-bye, nothing. And so I had kind of chalked it up to she's probably not gonna speak because she just couldn't. Like she had no verbal sounds, she was pretty silent. So we did two years of really intense ABA, 30 hours a week. She responded immediately, like responded, like she started following instructions, being able to learn from her natural environment. So by the time she was four, she was up to saying two, three words. And she just progressed. Like she wanted it. She wanted to be able, like you could just tell, like she wanted to be able to talk, she wanted to be able to do things, and she was such a fighter and fought her way through really those formative years of getting ABA, I know is what changed her life. And then I have two other daughters, one older and one younger than Ava. And so she was forced into constant socialization that I think she otherwise, I really think that also formed her abilities to be able to socialize. So she went on to graduate high school. She went to the University of Georgia.

Amber Nelms 8:08

That's awesome! Congrats!

Anna Williams - Bullard 8:10

It's a it's such an amazing story. Now, you know, and Ava always likes people to know. So she graduated from UGA last December with a biology degree.

Amber Nelms 8:20

I really want to know this, Ava. Sorry. You should.

Anna Williams - Bullard 8:22

She's really the rock star, actually.

Amber Nelms 8:24

She's really No, you are too, though. You helped her get to that point. This is what I wish more people knew about ABA. And I wish new parents that have kids that are newly diagnosed, because they read and see all these crazy things on the internet. And I'm like, they need to hear the story of Ava. They need to hear the story of my kid. Like, I know he's gonna go to college and do all the things. And I wish that message could get out to more families to be like, please take it seriously. I know not everybody's gonna have the story like our two kids did, but a lot of more families would.

Anna Williams - Bullard 8:57

Yes, and you have and just to understand the challenging part of those the first two, maybe to four years, they can be the hardest because that's when you have to dig in and just steady the course.

Amber Nelms 9:14

We need it. I'm sorry, this might if you're okay with it, this podcast might actually go out to some of our families because I want other people to know I'm not the only one that had this story. And now, does this also make you super passionate to own an ABA company because that is what you want for your families?

Anna Williams - Bullard 9:31

Yeah, so interestingly enough, I always did say I don't want to own an ABA company because Oh, that's hilarious. I know. And I've worked for large ABA companies where I did a lot of their family advocacy and payer relations to really be the patient advocate for them. And so I've spent my career, and then four years ago, maybe three or four years ago, my nephew was diagnosed with autism. And he presented just like Ava did. You could tell he was in there. Really, his symptoms were very similar to Ava's, but even after all the work I've done, they're still not access for a lot of communities. So we live in a very rural area outside of Savannah in a small town called Vidalia, Georgia, where the onions grow. So people may know that, but still it's very rural. And I knew that he was headed just down a path where, just like Ava, he would probably not speak unless he got ABA. And so I knew I had to get him ABA. And so I was like, you know what, this is it. I'm just gonna, I know how to do all the stuff because I do this for other people all the time. So I was like, I'm just gonna get contracts with payers, get a BCBA, hire an RBT, and like just serve a couple kids. Like, I was just like, that's all I needed to do. And it grew like crazy, didn't it? It did, because you have a strong line. And he his story is incredible. I mean, he started ABA again, similar, non-verbal. He had like gave up a lot of sensory issues where he could not leave the house, did not want to put shoes on, all the things. And he is just yesterday started kindergarten. He's fully verbal.

Amber Nelms 11:24

Congrats! Oh my goodness, can I come see your center someday? You can't so excited for you. It's just so cool to to meet people that stay in it and really have that like knowing, like I'm just gonna fight to make this happen. Congrats. That's so awesome.

Anna Williams - Bullard 11:44

Thank you, thank you. Yeah, so that's why I started the company, and then I just ended up saying, you know, my community is what I there's so many kids here that there is some telehealth services, but nothing beats in-person services. I mean, oh yes, yes. So you have one center there. I do. I have one center, and we're serving about 24 kids, 25 kids, and my family is such a huge support for me. I mean, they are they're really how I was able to do everything that I've done. My mom and dad live here, and my sister, whose son has autism, she lives here, my brother and his family, my husband is a huge support. So my dad came to me and said, let's build a center. Like, let's build a truly incredible center where you can put 80 kids. Because I mean, I have so many kids on the wait list. So that's what our next step is. We've broken ground. We're gonna build a nice big place where we can have all these kids get services.

Amber Nelms 12:51

That's fantastic. Well, we never even talked about the tech art. This is actually supposed to be a tech podcast talking about the tech stack. What are you using right now for your EHR? Do you have a good CRM? What's your CRM you're using?

Anna Williams - Bullard 13:06

So we are using Hierasmus for our EMR. And I think because the great thing about it is I love it when someone really decides we're gonna do something and do something we know and do it well and not try to do everything. I feel like that is Hierasmus to me.

Amber Nelms 13:25

He's a parent of a child of us on the spectrum. You know that I know, isn't that great? It's great. You can feel the energy on how he created the parent training platform and all the things. Yeah.

Anna Williams - Bullard 13:36

Yes, you definitely feel that from the work that they put into being able to provide a product that clinicians can really benefit from. And then we pair that with Boost on the R RCM side. And Boost is a newer platform. Yes. I haven't heard of that one.

Amber Nelms 13:55

That's your RCM.

Anna Williams - Bullard 13:56

Okay. I've been very pleased their team is extremely knowledgeable. That's good. Yeah. And so coming from someone like me who knows a lot about payer contracting, fee schedules, credentialing, that's been my world, really advocating on that side of things. I've been, I know when someone doesn't know what they're talking about. I just do. And I've been on those calls where people are talking and you're like, you definitely do not know ABA. But they do. They do. So it's uh it's great.

Amber Nelms 14:32

Okay. Well, that's great. I'm glad to hear that. What about a CRM? Do you have one or do you just use Google Sheets or something? We use Google Sheets for it's fine. A lot of people do. I was just curious. Yeah. You only have 24 kids right now, so that probably works. And you have a wait list, and it's just not the different locations and different areas need different things. In the area that I'm at, and I think that's one thing I've noticed a lot on Facebook groups for people that own ABA companies. Like, people will make all sorts of comments. Like, oh, we have no problem, we have just a long wait list. I'm like, Well, you're not also in a certain city, yeah. I think you cannot compare apples to apples. Everybody has a different needs and stuff, depending on how much demand there is and where they're at. And it'll make or break your company if you have the wrong tech stack, though, too.

Anna Williams - Bullard 15:19

100%. And that's why we moved to Hierasmus and Boost. So because we were smaller, we were on CR Essentials, not the enterprise version, because you have to be of a certain size, and it just was not working for us. You know, it's interesting because with Hierasmus and Boost, we're getting what a company with a thousand kids would get. There's not like levels, it's not like, oh, you're small. So, I mean, we're getting all the incredible reports and AI and opportunity, and really we're not paying the way that they're structured for your payment is really beneficial, honestly, to small practices. So I get the same robust technology as anyone else would.

Amber Nelms 16:08

Well, thank you so much for sharing. I know you're gonna help a lot of people. Thank you. You inspired me today. You made me excited. Oh, good. To hear you and what you've done and how you've helped. You just made my day. Oh, thanks.

Anna Williams - Bullard 16:24

I needed that because we're dealing with some issues here in Georgia, and I'm having to advocate again in a way that I'm having to like remember, like make myself be like, huh, because sometimes you put yourself out there over and over, and it's hard. And you these large companies, they're multi-million billion dollar companies, healthcare payers, up against like a parent, it can be scary sometimes. I know.

Amber Nelms 16:51

I can only imagine. So thank you for taking your time out of your busy life to come be on this podcast. And I hope a lot of people listen to it and get inspiration. And I think it was a good variety of like telling about your journey, but then also we did talk about the tech stuff. And I know the other business owners that's gonna find that very helpful. So thank you so much for being on today. Awesome. Thank you, Amber.