In 2020, Derek Bullard felt a calling to help children with autism again.
As CEO and founder of Already Autism Heath in Georgia, Bullard has watched his latest company grow rapidly since it began four years ago, expanding its initial service to three additional states.
But running a new health care company focused on autism wasn’t something Bullard planned on. After 15 years of shepherding the successful behavioral health services company, Access Family Services, he sold it and was set to semi-retire in 2014.
It wasn’t until he had some time to reflect that he realized he wasn’t quite ready to hang it up.
“I really kind of went through a little bit of a funk,” Bullard told Autism Business News. “I found myself kind of depressed and missing old colleagues, and my old company. I missed the camaraderie we had, the challenges, the ups and downs, and all the things that went with it.”
Between 2014 and 2020, Bullard founded a non-medical care company for seniors called Already HomeCare and became CEO of 70-year-old nonprofit, Siskin Children’s Institute, which provides developmental pediatric services for children.
Then in 2020, prior to COVID, Bullard and his former Access Family Services colleagues had a momentous reunion.
“We just decided we were going to all work together again, and we were going to serve children with autism,” Bullard said.
Getting the band back together
Beginning a new company with seasoned collaborators is something Bullard sees as a major asset right out of the gate.
“I was very fortunate to reassemble my entire senior leadership team from Access Family Services,” Bullard said. Coming back together with a group of folks who all have well over 20 years of experience in behavioral health, and in the autism segment, really gave us a competitive advantage. I think you’d be hard pressed to find a leadership team that has the experience that our team does. We also care about each other. We trust each other and we love the work that we do.”
Already Autism Services began in 2020 with a commitment to provide comprehensive and individualized, evidence-based in-home and community treatment for children with autism and their families in Savannah, Georgia.
Over the next four years, the company expanded into North Carolina, South Carolina and Virginia, and it has been progressively moving toward a balanced model that offers both in-home and clinic-based services. Already Autism also uses telehealth in some areas where it has a hard time finding clinical staff.
The company is on track to serve a little over 3,000 children this calendar year.
“Right now, we’re about 70% home-based and probably 30% clinic-based, and that’s changing,” Bullard said. “We’ve got four clinics that will open over the next three weeks, one in the Raleigh, North Carolina, area, two in Charlotte, and one in Fayetteville, North Carolina. We want to offer a broader continuum and more of a hybrid model for those children that need more of a structured setting in a clinic-based environment. We’re hoping in the next year to be half clinic and half home-based.”
In addition to treatment, the company offers comprehensive autism assessments in four markets to help children who are on a waitlist to get a diagnosis.
Already Autism Health has 452 employees. That includes the company’s C-suite team, plus 18 administrative support employees that work in different departments – from HR, to revenue cycle management, to compliance.
Already Autism also has an extensive compliance program with over 55 BCBAs, who are master’s-level clinicians. The remainder of the staff are registered behavior technicians that either work in the home or in one of the clinics.
The company’s services are primarily funded by Medicaid.
“We’re about 80% Medicaid and 20% commercial insurance, private insurance across the board,” Bullard said. “We are expanding our commercial insurance offerings as well. We want to be able to broadly serve more children and families that need the services. We’re in the credentialing process with a handful of additional commercial payers in the markets we’re in.”
Growing season
Along with Already Autism’s rapid market expansion, the company is growing internally.
“I’m very proud of the fact that several of our clinical staff, and staff that started with us even as recently as a year or two ago, have been promoted into clinical leadership positions – and positions they may not have even envisioned for themselves,” Bullard added.
In the last three months, Already Autism launched a nine-month, internal leadership development program that involves mentorship, classroom-based training and job sharing.
“At the end of that nine months, hopefully they will have had really broad exposure to all aspects of what we do,” Bullard said. “I’m hoping that we have four to six folks who come out of that in the spring of next year, prepared to move into a leadership role.”
Ready for what’s next
As Already Autism grows and staff move up the ladder, there are several challenges the company must face in the coming years.
Bullard said the main operational obstacle is recruiting and retaining qualified staff in a very competitive market. He said Already Autism is tackling that issue by providing a supportive and rewarding work environment, creating new training programs, offering benefits and health care, and promoting from within.
Another big operational challenge Bullard sees is keeping up with the rapid regulatory changes in health care.
“It requires constant vigilance. Keeping your eyes on both what payers are looking for, and what’s changing in the field and adapting to it,” Bullard said.
Bullard said staying current on innovations like AI, assistive technologies, diagnosing technology, and advancements in analytics and documentation is also vital.
Already Autism is currently partnering with Jade Health on the National Autism Data Registry (NADR), a comprehensive data analysis platform developed in collaboration with a network of applied behavior analysis (ABA) clinics and therapists. The NADR helps organizations measure and improve the quality of the autism care they provide, Bullard said.
“There are tools out there, and some great things happening across the country on the diagnosing side and also on the treatment side,” Bullard said. “So, it’s a matter of how we can implement those things in a way that saves time and effort on behalf of our staff that captures the essence of what we do. Just trying to stay on top of it is an operational challenge, but I also think on the flip side it’s also a potential opportunity.”
Over the next five years, Bullard said Already Autism Health will be focused on providing great services. As the company continues to grow, he believes it will be crucial to deliver consistent and visible high-quality evidence-based care across all locations.
“We really want to expand our geographic footprint and our reputation as being a compassionate, trusted partner for the families and children we serve, and for our payers and partners,” Bullard stated.
For Bullard himself, the call to help children with autism has never been stronger.
“I say I don’t ever want to retire fully because I enjoy the work that we do and the folks that I work with,” he told Autism Business News. “I feel very fortunate, very blessed, to be in an environment where I look forward to going to work every day.”
