How COVID-19 Flexibilities Will Strengthen Hopebridge Autism Therapy Centers Long-Term

Like most behavioral health providers, Hopebridge Autism Therapy Centers expected 2020 to pan out differently.

The coronavirus threw a wrench in many of the Indianapolis-based company’s plans, forcing it to scale back its growth goals and temporarily close all of its locations.

On a more positive, equally unexpected note, 2020 also prompted Hopebridge to roll out new telehealth and home-based care offerings to maintain continuity of care, according to Hopebridge founder and Chief Clinical Officer Kim Strunk.


In a recent interview with Behavioral Health Business, Strunk likened the new capabilities to muscles, which will ultimately help make the company stronger and more flexible in the long run.

You can read about all that and more in the conversation below, edited for length and clarity.

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BHB: The last time we spoke, Hopebridge had just announced it planned to add 20 new centers across Colorado and Minnesota by mid-2021. Is that trajectory still on track?

Strunk: COVID put a little bit of a wrinkle in things.

Although we were not able to launch the 20 we had planned, we have still been able to successfully launch new centers. We adjusted our number down a bit, just for that time when everything was shut down.

But we have opened a new center in Indiana, a new center in Arizona and we are getting ready to launch in the state of Colorado in the next week.

By the end of the month, we will have 54 centers total.

The coronavirus has complicated things for every behavioral health company, especially autism treatment providers. Social distancing and masks are hard enough for anyone, let alone children on the spectrum. What have been the biggest challenges for Hopebridge?

Initially, the biggest challenge was that children’s routines and therapy services were completely disrupted for a brief period of time.

Then there was a shift in how we provided support to families. We pivoted to more of a telehealth model, which then put a lot of burden on families to execute treatment in the home with just virtual support. That was challenging for a lot of people.

As we’ve reopened, we have some new protocols and procedures in place. Obviously, social distancing has played a part in how the children interact with each other and their access to different things within the center. For example, we have pretend play areas and gross motor areas. Those areas are still in use, but they’re in use in a much more limited way.

The biggest challenge today is social skills, social interaction and social communication. The coronavirus has made it challenging for kids to navigate learning habitats and still learn those skills effectively.

Then, couple that with the requirement of the face coverings. For children on the spectrum, the inability to see people’s faces affects their ability to read and process social cues, which is already a challenge for them. And as you’re working on language development, when you can’t see someone’s mouth, imitation becomes very, very challenging for them.

Then, many of these kids have sensory sensitivities, and now you’re asking them to put something on their face, which is foreign to them and doesn’t necessarily feel good.

How are you dealing with those challenges?

We’ve had to reduce the capacity of how many children we can serve in our centers. We’ve restructured the physical space to accommodate social distancing but to still allow for some type of interaction between children.

For the imitation, we have a variety of different facial coverings, from clear masks to face shields, that allow the mouth to be seen. Then we incorporate mask wearing protocols into the child’s therapeutic program.

You mentioned that your centers closed down for a period of time. Can you walk me through that decision and how you provided services during that time?

Around March 20, we closed our doors, and we were closed until about the end of April.

That gave us an opportunity to do some restructuring of the physical environment to accommodate for social distancing and to do some deep sanitizing in our centers. It also gave us an opportunity to make sure we had in place appropriate protocols.

In the interim, however, we quickly pivoted to a telehealth platform in order to support our families. We did so very successfully.

While we weren’t necessarily able to provide the same level of intensity of services to the children — for example, for kids that had been coming for 35 hours a week, we were not providing 35 hours a week via telehealth — we were providing whatever they could tolerate.

We were providing intensive parent training and parent consultation during that time in order to support the family and child during the transition.

In addition, we were able to provide our occupational therapy and speech therapy services to the families.

At the end of April, we reopened in a phasic approach. We opened a block of six to 10 centers one week, and then the following week we would open another six to 10 centers, until we finally got everybody back.

When it comes to reducing the number of kids at each center, have you had to turn anyone away? Or how are you managing that?

We’ve not turned anybody away.

We did lose a few families who weren’t comfortable returning yet. It really was only a handful of families. We continue to support them through telehealth, and then everybody else is back.

It was a lot of restructuring in how we utilize our space.

Rooms that had previously been conference rooms or offices, we converted in order to allow for spacing. Then we went to block scheduling, so any of our common areas are really limited in the number of kids that are in there at a time.

We do offer and can support a center that may be at physical capacity by sending our therapists in the home until a spot opens up in the center. We have done this in a number of our centers.

While this pandemic has been life-changing and disruptive in so many ways, it has really stretched our ability and our creativity in how we support and serve these families. It opened up some new doors that we hadn’t previously been through before.

Will those home-based and telehealth offerings remain long-term options for your clients?

Hopebridge is a center-based model. That’s who we are. However, I do feel like there is opportunity to support these families and meet them where they are.

Whether it be because of the pandemic or space or transitions to school, I think we need to be open to providing some additional support for children in their home.

But, at its core, Hopebridge will always remain a center-based model, just with the muscle built now to also support families via telehealth and in the home on an interim basis.

Another challenge that a lot of providers in the autism space are dealing with is financing. You guys are in a special situation because you have PE backing from Arsenal Capital Partners. A lot of those providers who aren’t PE-backed are struggling, which I imagine means Hopebridge could have its pick of acquisition targets. Is that something you’re thinking about?

We’ve always had a de novo growth strategy. At this point, that’s where I see us continuing to grow. Our strategy hasn’t changed.

Got it. Are there any long-term changes the coronavirus has prompted for Hopebridge?

I always try to find the silver linings. I think, long term, it’s going to make us better clinicians. It’s going to make us a better provider. It’s going to make us more in tune with patient and family needs. And it’s going to provide us the opportunity to be very creative and thoughtful about how we support and provide services.