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Thoughts & Rants of a Behavior Scientist
In the Thoughts & Rants of a Behavior Scientist Show, Dr. Paul “Paulie” Gavoni looks at common issues or phenomena in our personal and professional lives, gives you his thoughts, sometimes rants about it, and provides you with practical solutions rooted in the science of human behavior.
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Thoughts & Rants of a Behavior Scientist
Revolutionizing ABA Clinics: Harnessing AI and Technology for Enhanced Care with Michael Gao and Christina Morales
BCBAs and RBTs enter the field to create meaningful change for learners, but more and more is being dumped on their backs, draining their energy and impacting the quality of care. This burden also sucks the life out of leaders, making it harder to retain talent and maintain high standards. But what if there was a way to ease the load while enhancing outcomes?
In this episode, Michael Gao, an innovative software developer, and my authentic friend Christina Morales, CEO of Piece of the Puzzle and founder of the IQR Group, explore how cutting-edge technology is reshaping behavior analysis.
We discuss Michael's game-changing platform, successfully piloted by Christina, that uses AI tools like Alpaca Assistant to automate administrative tasks, from session notes to intakes, allowing professionals to focus on what truly matters. Christina also shares her inspiring journey as an autism mom, driving her to create inclusive organizations like Piece of the Puzzle and Believe and Achieve. Together, we highlight the challenges of scaling ABA services and emphasize the critical role of leadership, systems, and innovation in sustaining growth while embedding values like inclusion and respect.
If you're ready to see how technology can reduce workload, improve efficiency, and help behavior analysis professionals rediscover their passion, tune in—and don't forget to check out Christina’s podcast, Know Yourself to Grow Yourself, for more leadership and personal growth insights!
About the guests:
Michael Gao is the Founder and CEO of Alpaca Health. They are developing Alpaca Assistant, the last admin hire for ABA agencies. To try Alpaca Assistant's session note-generation feature, head over to www.alpacahealth.io.
Christina Morales, an Autism mom, BCBA, and the CEO of Piece of the Puzzle Behavior Analysis, is a truly authentic leader and a dear friend. Her work is driven by her personal journey with her son, Vinny, and her unwavering dedication to supporting individuals with disabilities. Christina also founded the IQR Group, which includes impactful initiatives like Bumblebee Academy, an inclusive learning center; PACE, a life and social skills program for teens; Believe & Achieve, a nonprofit fostering acceptance and awareness; and Include & Connect, a resource hub for families. Her passion and authenticity shine through in everything she does.
Motivational Interviewing: Getting Educator Buy-In is a comprehensive online course designed to equip behavior interventionists is a goal-oriented, person-centered approach that encourages individuals to explore and resolve ambivalence toward behavioral interventions and change.
The Behavioral Toolbox equips those charged with supporting behavior change in schools with practical applications of the science of human behavior for making a positive difference in the workplace. In this case, the classroom and school!
Be sure to subscribe to Dr. Paulie's Heart & Science YouTube channel for a variety of content related to behavior science and bringing out the best in yourself and others.
Welcome to the Thoughts and Rants of a Behavior Scientist Show hosted by Wall Street Journal and USA Today, best-selling author, Dr Pauly.
Speaker 2:All right, welcome back to the Thoughts and Rants of a Behavior Scientist Show. I am your host, dr Pauly, and I am here with a couple of very cool persons. One of them is a very good friend of mine, christina Morales, and the other one is a newly emerging friend. I guess, michael, we'll see what happens with this. Michael Gao, all right, so I want to talk a little bit about how we came to have this particular show. Michael Gao is a software developer, right? Am I right in saying that, Michael? That's right.
Speaker 2:Yeah. And he reached out to me saying, hey, I would love to get on the podcast to talk about the software I have. Right, I'm not trying to push people into software unless, unless I think it's going to add value Right, Because you guys know me and I want to add value in the world. And what he told me was that there's a platform that can help BCBAs to take and organize their notes. Correct, am I saying that? Yeah, and is it also for RBTs or just BCBAs at this point?
Speaker 1:Well, with Christina, we developed a BT session of features.
Speaker 2:Amazing, wonderful, okay. So when he came to me, I said well, you know what I don't want to. I don't know about it, you know, but let's test it. I've got a good friend, you know somebody. I did some consulting with Christina, alice and I want to find out if it works right and how it goes. So let's pile it, let's test it, and so we did, and so we're going to talk a little bit about what happened here with this. Right, we're going to talk about, you know, maybe some kinks with it and you know, and what some of the outcomes are with it. But I thought that, besides making it just about the software, I want to talk a little bit about behavior, analytic organizations and some of the challenges that have occurred and what we need to do to scale things. I know one of the things that we need to do and, christine, you're in the middle of scaling things right now is we've got to make shit easy for people. We can't keep putting stuff on people's back. Right Now, we have technology that can really make things easier so we can focus on the things that are really important.
Speaker 2:I use AI all the time. Right, I use it with my writing all the time People are like you shouldn't do this. I note it on. I'm like are you kidding me? It's like mixing the paint for me. So now I can focus on what's really important sequencing my stuff and telling a story that's important to engage them.
Speaker 2:Right, and I'm not embarrassed about it. I've written books for years without any of that stuff. Now I can like wow, I can really get into some really important details with it. So I find it very useful and I think we really need to embrace AI as we move forward and think about how we can make things better for our learners, better for our employees and such and such. So, christina, just give a little introduction to yourself, right? And, of course, your company, right, and then we'll let Michael just introduce yourself and your company. And then we'll let Michael just introduce yourself and your company and then we'll dive into some of the challenges that are going on organizations right now yeah, so I am the founder and CEO of the IQR group, which consists of several organizations all centered around providing services to individuals with disabilities.
Speaker 3:We have, piece of the puzzle, behavior analysis, which is what Ali came in and consulted with me on. It's's, you know, obviously providing that ABA services and the community homes, schools. And then I like kind of saw this gap in the education system and I opened a school that's individualized education for individuals with disabilities and we have a preschool and elementary program Disabilities and we have a preschool and elementary program. And I have a teen group called PACE stands for Prepare, achieve, create and Evolve and that is a life and social skills group. Right now it's a small after-school program. I do have big plans for that, but one thing at a time.
Speaker 3:And then I also have a nonprofit organization called Believe and Achieve and really my mission with Believe and Achieve is to create more inclusion, acceptance and awareness in the community and just allow these families to be able to access more things for their, for their kids and for them, because I am also an autism mom and a behavior analyst and you know, as an autism mom with my son was younger, he's now 17.
Speaker 3:I isolated a lot and it was a scary thing Like and I know what these parents are going through when they're first experiencing, you know, hearing from a doctor that their child has autism, and doctors, unfortunately, are still saying to parents that their child may never talk, they could be institutionalized, and it's sad, it's scary. As a parent, it changes your whole world in the blink of an eye. And so, you know, with the nonprofit, it's really allowing me to channel that side of my passion when it comes to this field and be able to provide more extracurricular activities to families with the support of having ABA therapists come in, so when these learners are going into these new environments, they're set up for success. And we also have I'm doing like a whole family support side of it as well, where I'm doing coffee meetups where parents can pick my brain, share wins. You know, like we just need to be able to share that. And I plan to do some parent support like training, virtual, so more families can access that support because, as we all know, wait lists are very long.
Speaker 2:Yeah, and let me say this about Christina, that she is a very authentic and valued person and she reached out to me many years ago about getting leadership training for herself and for people in there, and this is where I got to connect with her. I'm like, wow, I wish more CEOs in an organization had this kind of value, because I feel like when that value is in place, when you care about the people, because we're going to bring out the best in learners If you guys have heard me say this a bunch you got to bring out the best in employees. And she really wanted to create a culture like this and she was very reflective on her own behavior because, as we all know, it's not about intent, it's about impact. And so Anika Costa and I came in and started doing some work with her and man, her and her team would take and she has a wonderful, amazing leadership team and I love these ladies Um, they would, we would meet and we'd go over some stuff and they would just take the ball and they'd run with it and they'd come back with stuff.
Speaker 2:I'm like, oh my gosh, it'd be like you know, like I can imagine, like a doctor, right, but writing, you know, giving some sort of plan to a patient and the patient just coming back and just going way above and beyond with everything. You're like, oh my gosh man, you just want to keep treating them, you know, because it's so great to see progress happen and see outcomes happening. So it's been really wonderful and I think we'll get into a little bit of that journey in just a bit. So. But, michael, now, if you can kind of, you know, talk a little bit about yourself and how you came into what you're doing and how you connected it with the field of behavior analysis.
Speaker 1:Yeah, yeah, absolutely so. My background was in education. Before this, I started an online tutoring organization. We worked with all kinds of students, but it became pretty obvious that kiddos with special needs in pull-out programs had the most needs that weren't being fulfilled by the school system in many cases today.
Speaker 1:And so earlier this year, dug a little bit deeper, learned more on the clinical side of ABA, went to ABAI and met a whole bunch of clinicians where it seemed like when I asked them what they didn't like to do in their weeks, the biggest thing they said was some form of documentation, whether it's writing session notes, whether it's reviewing BT session notes, writing treatment plans, retreatment plans and all that not so fun stuff of behavior analyst jobs.
Speaker 1:And so I studied computer science in school, thought there were some interesting tools that we could create, really with the mission to help clinicians do clinical work period Like it sounds incredibly obvious that you went to a two years master's program you should do the work that you went to the master's program for, but that doesn't seem to be happening in the field today because of all these insurance requirements that we hope to alleviate using technology. And so now we work with mostly smaller scale-ups in the ABA world. Organizations were just getting started. Organizations were on the verge of growth, ready to open. The second, the third, the fourth location to think about how you can use new technologies like AI to make things easier for your team, your parents, your clients and really set them up for the next phase of growth.
Speaker 2:I've got your perfect hashtag, Just hashtag. We make shit easier.
Speaker 1:Honestly.
Speaker 2:Yeah, that is the whole point. Man who doesn't want their job to be easier, you know. So you can really focus on what's important, especially taking care of some of those things oh gosh, man, there's. You know, we come into the field of human services because we really want to help people and there's these things that we just don't want to have to do, but we have to because it's part of the deal, and so if we can make those things as easy as possible in a way that doesn't compromise the integrity of the treatment that we're providing in fact, that enhances it because we can put more time to that I think that's amazing.
Speaker 2:So, christina, I want to shift back to you now, and because I know that you know you had some struggles and your struggles are very common, right in organizations, and I like to call it, when we don't have good systems. I believe that the two key components in organizations are systems, leadership, right, and if you, you can't have one without the other, uh and but you did have. What you did have were people, including yourself, with high values. So so you had strong will, right, and I believe, higher will over skill. That's really important because we can embed the skill and we can help develop the systems.
Speaker 2:But without a system it's like again people are outgrowing their drawers, they just get too big and you can't scale. So talk a little bit about some of the struggles that you've had before. I don't want to provide the solutions yet. Just say what you were doing right and what was occurring as a result of that right, what you were intending to do, what was occurring, and then we'll get to what we really need to do to make those things better. As you're doing it, talk a little bit about even the technology side of it right, how things were kind of screwed up, because then we can kind of hand it back over to michael in a little bit to find out, like you know, what he's seen in companies and how these solutions can make a difference yeah.
Speaker 3:So when I started piece of the puzzle I was the only bcba in the company so I was doing all the direct services, getting credentialing done, doing all the billing, all the intake. Like I look back and I'm like not sure I did that, but I figured it out and made it happen and I really, as I continued to grow, I realized I can't keep providing direct services if I'm going to scale and grow, and that happens very quickly. And I think that when BCBEs have this idea to start their own organization, they all have good intent, right Like. They maybe see that I want to do things differently than what I'm experiencing, whatever it is, but they don't realize how quickly you will grow in that you can no longer be the one providing the direct services.
Speaker 3:We were small, I had great culture, I was the only leader really and I started building that is anybody that is a CEO knows you have to have a very strong lie and purpose in your organization and I really lost sight of that and that was when things just started to fall apart. Honestly, they really did. My culture started to get toxic and I Polly knows like I freely talk about all the like cringy things that were. And, polly, you've said it before and I it's such a good like metaphor of like, when you start to feel this spiral on your team leaders often get louder and, you know, get more like stern, and they think that that's going to change the behavior. Well, like, maybe I'm being too nice, so I need to get louder and get more, put more punishment in place and all this. Well, all that does people just exit your company and go elsewhere.
Speaker 3:So you know, as, as far as the technology side of it goes, like let's tie that in it.
Speaker 3:It is so important to have. That's all part of systems, right? So if you don't have good technology that is making your systems flow, response effort can be very high. Nothing is automated, so it's a lot of manual which is going to lead to a lot of errors, because at the end of the day, you're human and nobody is going to be programmed to never make errors. So that was definitely a huge learning curve and one that we're still truly honestly, still working through, and why I've really enjoyed starting to work with Michael, because we do need to automate more and streamline, because that's all going to lower response effort and, like you said, polly, to me before, like this is one of the biggest things that you said when you started consulting with me is like you have to remember when you give somebody a new task, you need to figure out how to offload something, and when you have good technologies and systems, then you're going to just automatically be able to kind of take that workload off of them.
Speaker 2:Yeah, and what you I mean what you experienced is so common. There's a, there's a book called the e-myth. It's the entrepreneurial myth, and that is you can be like an amazing clinician, right, and you want to make you're like, you know what I want to make a difference at scale. And you know I want to have my own organization. So we get some people to go. But just because you're good clinician doesn't mean you have the skills to be an entrepreneur. It doesn't mean you can't gain them right.
Speaker 2:But a lot of people think because they're good at this, they're going to be good at that or they can just do it right, but it requires skills. It's a completely different skill set, as you've learned, and that's why you've gotten these pieces of the puzzle to put in. And I think the other piece of it and my listeners have heard me say this before and, of course, christina, you have is the importance of having a good system that's easy to navigate, that cannot be complex, because complexity is an enemy of execution, sustainability and scalability. So it's got to be very simple. And, just for anybody listening, remember that every time you drive in the roads that you're getting to work on, this is a system that guides your behavior, brings your behavior for our behavior analysts generates rule. Government behavior brings your behavior. Understand this control. Essentially, it tells your behavior what to do. Nobody has to come out there and manage it right. So it helps to maintain behavior and there's contingencies in place that keep your behavior going in the right direction and there's lots of reinforcement because you're getting to the places safely and effectively and efficiently and all this stuff. But there's also corrections in place and a good system is going to leverage positive reinforcement for value-added behavior.
Speaker 2:And, christina, I know you guys took a lot of time and effort to build your system on values. It's what I know, anika, and I got you guys going on it and you took the ball and ran with it right and real value. You took your values and you unpacked it that way, right. And what were your three values? Again, I know it was a Inclusion, quality and respect Right. Inclusion, quality and respect right. And so I think that clearly to me that you can. The quality piece of it we have things that make it easier to automate in this area. It allows us to focus more on the quality of aspects of it. So we'll talk about how like these values are that they're functional response classes, right, they're like buckets, as Anik like to say that we put behaviors in, and I love that.
Speaker 2:And so I think that you know, by by by, looking to reduce effort on people, because that's a huge thing the more effort goes up, the more positive reinforcement you need to have. Right, if you don't have enough positive reinforcement to match the effort, you're going to get escape behavior. And now escape behavior might not mean immediately quitting the job, which we have a huge issue with people leaving the job and immediately quitting the job, which we have a huge issue with people leaving the job. And, christina, you recently shared with me that your retention is up and I love that so much, because we can't help the learners if we don't support our employees and if there's a constant cycle of turnaround. That's not good for anybody, including you as a CEO.
Speaker 2:So I know that with a good system where response effort is minimized and there's, you know, good positive reinforcement for these value-added behaviors, because you've unpacked it across the performance chain, as we did and worked with you on it that makes a big, big difference, huge, yes. So, michael, why don't you come on over here and just talk a little bit. Come on over here, man, talk a little bit about like I. You know you did this and I think I'm pretty sure that what I said must resonate with you, because you probably saw there's a lot of problems out there. First, talk about some of the problems that you've seen out there an organization that you've experienced, right, because that gives us the reason why you wanted to solve this problem and, uh, kind of what, what your software does to solve that yeah, when we were building alpaca health, we still were building Alpaca Health.
Speaker 1:we still are building Alpaca Health. There's a lot more to do. We've spoken to at this point probably over 100, 120 BCBAs about what their days look like, what their weeks look like, what they like most about their jobs, what they liked least out of their jobs and a lot of this conversation of it's very human. It's very manual. The systems aren't there. I have technology but I'm somehow still doing stuff in spreadsheets or manually or on pen and paper.
Speaker 1:That was really the core theme that we heard from clinicians and when I think about the kind of burden that adds to staff, it really comes from how you see clinicians, like spending potentially 7am to 7pm, with an hour lunch break, in the clinic doing hard, difficult, emotionally taxing clinical work. I mean, you guys know this more than me. I spent a couple of sessions as a BT and I don't know if I could honestly do that Five, seven days a week for 50 weeks a year. Honestly, I don't know if I personally have the emotional muscle and stamina needed. And then you ask them to do session notes and figure out your schedule and do some texting of parents to make sure that they know to get to their sessions on time. The next day and we talked to clinicians who were falling asleep on their computers doing their session notes, who were like quickly making dinner for their kiddos and then put the kiddos in front of the TV and then getting.
Speaker 2:Was that Stephanie? I did talk to Stephanie. She's talking about falling asleep on her computer.
Speaker 1:Yeah, yeah, it's pretty, it's not just Stephanie.
Speaker 1:A lot of clinicians say that, oh yeah, I'm sure, and also not something sustainable. And having kind of watched and listened to a lot of clinicians, it's understandable why folks are leaving the field or thinking about other options besides direct clinical work, are turning over, at the very least, from organizations to try to find one that has less of this manual work, to try to find one that has less of this manual work. And so I guess, when I think about it from a technology perspective, kind of what are the challenges with existing tools? It's, I guess, that they add complexity.
Speaker 1:In many ways it's almost like the introduction of a new system. It adds a person who manages that system right. I saw a LinkedIn post from someone who's starting an ABA clinic who was saying hey, is there anybody who's very well versed in insert big competitor here that can help me set it up and train my staff? And so it's almost like you bought a system and then now you hire a person to manage the system that you just paid for and then as you grow, you have to incrementally grow the number of people that uses that system as your organization grows. And I guess from the start our thinking was how could we build a tool that actually takes Lyft away from agencies, away from clinicians, instead of adding to it.
Speaker 2:Man, I got to think. People are on the edge right now wanting to hear right.
Speaker 2:People are like, well, I want you. This is great, right, I'm wanting to hear right. So now let's go back, let's continue the story. So you know, chris, I connected you guys with this right Because we wanted to test it out, just like any good behaviorist. We want to test it out right, and I know you guys will be authentic about it, right Cause I know, like you said, you're still. You know there was some kinks or whatever, and that's fine, that's great. But talk about the initial introduction to Michael, christina, and what you guys began doing at first, uh, just some of the challenge with it, what you learned along the way and where it's at right now.
Speaker 3:Yeah. So I have absolutely loved working with Michael. He loved working with Michael. He's actually been joining our executive level meetings and, like my team loves him he is. You know from my experience in the past with other software providers and you know you meet with somebody and it's, I'll be honest, I feel like there's been times I've had like a smoke and mirror show. You know they're selling you something and I get it. You want to like make the sale whatever, but you know you're selling you something and I get it. You want to like make the sale whatever, but you know you're kind of promised something and then you go to use it and then start using it or it's not working the way that they said it would. And here's the deal. That's going to happen too. But what I love about Michael and his business partner Bao, they are so receptive to the feedback. I mean, paul, you know me, I'm a high energy person and I just kind of like say whatever is on my mind and sometimes I'm like Michael, sorry, like you're very authentic.
Speaker 2:I love it.
Speaker 3:I'm very authentic, yes, and you know, but they have been so receptive. So when we started meeting what? What last Michael mentioned in the beginning like or you did, polly, but it started off as BCBAs right, and of course I want to make my BCBAs jobs easier as well. I'm not saying that my BCBAs don't matter. As far as you know, initial assessment interviews with parents Of course we want to make those shorter. Insurance doesn't reimburse a lot for that, especially when you have state Medicaid. A lot for that, especially when you have state Medicaid. It's very little hours that these BCBAs get and then they're expected to write these detailed reports that take so long and you know. So I want to make that response effort for them shorter, like easier on them, but also give them more time so that they're actually getting those billable hours, which is everybody that works in the field knows that that's like a buzzword. Billable hours, which is everybody that works in the field knows that that's like a buzzword. Billable hours how many billable hours am I going to get to complete this? So that piece I loved. And then the supervision AI note session and the parent training. Those are the three things, michael, right? Yeah, those are the three things we started off with Well. So I had some BCBAs probe it out. We proved it out with the initial assessment. It was great. Um, it was funny because my BCBA Shauna said she's like, honestly, like it would have been better. I was like kind of in my head at first about it because, like I'm like, okay, this is recording me, remember, michael? She was kind of like overthinking it, but she's like, but I couldn't believe when it so.
Speaker 3:So when you're doing the parent interview, we all know parents are overwhelmed. Like you're going in, they're overwhelmed and I know at first hand I was overwhelmed too. But they they sometimes can get off on topic where I mean, here's the deal. You want to build a relationship with these parents when you're going in and doing these initial interviews. So there is going to be some kind of small talk and that's very necessary in those initial interactions. So you're building those positive relationships rates, exactly what you need for your initial assessment that insurance is looking for. And to further like that's just kind of that's just like their regular template can do that. But what's really cool about it is that Michael and Val can further customize it to what your company's template is. So it's going to take.
Speaker 3:When we talk about response effort, that's even less response effort because, paul, you know you said you use AI. You have to shape AI, you know. But this is almost shaping it for you because you're talking, you're interviewing the parent for this initial assessment and then it's spitting it out into the sections of your initial assessment template, which is very cool because it's less time of editing things. And then, if you did need to reference the actual transcript of, you know, the conversation with the parent, it also records the transcript as well. So you do have the exact conversation that's happening on top of what AI is formulating for you. Polly, do you have any questions on that? Because there's more. I can keep going.
Speaker 2:No, keep. Well, Michael, do you want to interject anything from?
Speaker 1:what she?
Speaker 2:said so far.
Speaker 1:I think this is a great description of a lot of the things that we worked on, because Christina has been an instrumental part in making some of these things happen, especially the BT session notes piece, even making the templates right, very well organized Maybe.
Speaker 1:Just like on your first comment around, sometimes software is a smoke and mirror show.
Speaker 1:This is my biggest thing too, because when I ran a tutoring company, I had to buy scheduling software not sort of central region EHR software, but stuff to get my tutors on time to sessions, not sort of central reach and EHR software, but stuff to get my tutors on time to sessions. And it was so hard to actually find technology because nobody would actually let me try it out before I signed something that committed me to X number of months and when I went into this new venture I didn't want to do that anymore. I just wanted to say, like, try it for yourself and if you like it, we can talk about how we can make it better for your organization. If you, you know, let's not waste any of our times, right, that's totally okay, right, and so that's why we really believe in show. Don't tell, right, just go on the website, try it out, let us know how it is and we can work together. Awesome, if not? No, no sweat on either of our backs.
Speaker 3:Yeah, yeah, so the what I want to hop to. So again, this is all great for behavior analysts, right, and that's what we initially met with. But I said to Michael, I said, listen, I need to make my RBTs jobs as easy as possible. Like you said, michael, you can't imagine doing that job, you know, and at the end of the day, behavior analysts do get a break from the direct services. It's not. You know, and as I should.
Speaker 3:We've worked very hard to get there, you know, but the RBTs deserve as much of a break as we can give them to, and Polly knows that. You know I am a very compassionate person by nature and I just I care so deeply about my team and I know how hard they work and I value everything they do each and every day for our learners, everything they do each and every day for our learners. It really is incredible work that's happening at my school, you know in the other schools and you know homes, everything, but the session notes is the biggest thing that RBTs are always like oh my gosh, my notes. And any business owner in this field knows getting everybody to get session notes done on time is a total shaping process and if you can lower that response effort for RBTs. That to me is like major value added. You know, it just really is.
Speaker 3:Because now it is also a great thing in interviewing to be able to say, hey, you know, if you have an existing RBT who's worked other places, like, hey, we have this capability where you can just rattle off what your session note was and, like Michael said, he's taking our session note template and customizing it to the AI. So it is just coming out exactly what our template is and they just copy paste, boom, convert and central reach and it's done. So you know that's. And, michael, I know that I'm sure you're going to talk about it is you know we're venturing, like talking further, michael, is Bauer building out other capabilities where potentially, you know, down the road we could not have central reach and be doing all the things that central reach does in Alpaca, and then there's not even going to be the copy paste into another software, whether you know it's rethink whatever it is that you're using. You're just converting your note, you talk in, it's done, submit and you're done. Right, michael, that's basically where your vision is, with everything Exactly, exactly.
Speaker 1:Yeah, done right michael, that's basically where your vision is with everything, exactly, exactly, yeah, um, and, and I guess on the bt piece, um, it really is like when you say rattle off, it really is a bt just riffing about the session, right, like they, they, they intentionally, do not have to be structured with it, they don't have to think about what should the first sentence be and how does this narrative flow.
Speaker 1:They just like literally rattle off. Oh, the child seemed really angry today and our system will recognize that you don't want to put angry in a session note, since that is not objective. You want to say the evidence-based facts. So when the BT says oh well, you know, the kid cried multiple times and even kicked me during the session, that's the specific elements that you want to add into a session note. So in the same way that it knows what pieces to keep in a parent training, it also can figure out the pieces to take out of a BT just rattling things off. And I think that's probably the best way to have BTs operate right, like BTs are not meant to be highly trained, master's levels, clinicians that know the difference between subjective and objective. They're not trained to know every little piece of behavior analytic vocabulary, like BCBAs are, and so why not give an assistant to BTs so that they can just do the work they love, which is working with children, instead of thinking about how to write those in a scientific friendly, insurance-friendly kind of way?
Speaker 2:I think it's like the bowling alley, where the things come down so you bowl, your ball doesn't go off into the side lanes or whatever.
Speaker 1:Like they need-.
Speaker 2:Yeah, guardrails, they need guardrails. I can't remember yeah they need guardrails.
Speaker 2:I'm going to steal that For the behavior? Absolutely right, because we just want them to get a strike. You know we want them to in terms of the performance and I bet so I got to think that anybody. That's because I used to hate doing notes when I was a therapist. God man, I dreaded that stuff. I'd get backed up on them. All this stuff Then you're trying to recall it was miserable. I kind of think that any BT or BCBA that's been out there that's been doing notes in another organization comes to your organization like oh, this is kind of good, right. So I have to think that's a nice little perk to add to say we know you care about the learners, right. We know you want to work with them and we're doing our best to minimize response effort here. And guess what? This isn't the only place. This is what we always want to do. We always want to make things you know as practical and as simple as possible for you. Are you experiencing that, christina?
Speaker 3:Yeah, and you know we definitely are. And, paula, you know like I like to rule out change. This is again something you you help me with slowly. You know we, we are making sure that we're doing it in kind of our little coaching cohorts.
Speaker 2:that we have. Yeah, you test it out.
Speaker 3:And getting that feedback and then we're able to give Michael about that feedback. But on top of this whole idea, of course, we I care so much about my team and lowering the response effort because, again, that ties to so many more things that you can give them another task to do instead. Whatever it is, but it's also as a CEO. Insurance auditing can be a scary thing. Like I'm a Paula, you know, I'm such an ethical legal business owner, I do everything by the book, but it's still going to make you like a little like, oh goodness, I have an insurance audit coming up. And the thing for me that makes me nervous about an insurance audit it's not about I. I I'm not worried about fraud, I'm not worried about that. That doesn't make me nervous, it's them.
Speaker 2:looking at the content of the notes finding an error and then, like you know, hey, we got. Yeah, that is a huge thing.
Speaker 3:And here's the thing like you said, michael, rbts aren't trained, they're not master level with the. They don't understand all the. You know behavior, analytic lingo and objective versus subjective, and you're just trying to get the learners to get the outcomes that, like you're, it's hard to shape all of that and you don't want to overwhelm them. So to know, as a business owner, that you, that they are using a system that is going to ensure that their session note is high quality and everything that insurance company is looking for because the insurance companies don't care about all these little things of how hard it is for them, and then that you know they it's hard to train subjective versus objective. They don't care. They're going to say this wasn't written properly, you owe us back this money. So that's a huge piece of it too when you look at it from, you know, a CEO perspective as well it too when you look at it from, you know, a CEO perspective as well.
Speaker 1:Yeah, yeah, I mean I that's. I think what got me so interested in note writing too is, I think one of the first conversations we had with an agency owner. He said he had a $300,000 clawback from an insurance company. Oh, my goodness, because bt was copy and copy and pasting.
Speaker 1:yes, the same exact note, session after session after session and literally not changing anything and so stuff like that happens when you don't have folly to take the language guardrails right to right, ease from doing crazy stuff and and obviously, like the, the BT shouldn't have done that. But if you put yourself in the BT shoes, you've just come off a four hours of a kid kicking, screaming, biting you and you're stressed out and you're ready to cry and you just want to go home and watch Netflix. I, I don't think they should have done that. I don't think she had a copy and pasted session notes, but I also can't blame them if that makes sense.
Speaker 2:Well, I mean, you really can't. And now I would say this that a good system would have prevented that from happening, you know, because we have to have quality assurance, right. But now here's the thing, again, that requires effort on everybody's part, right. And so now again you are taking because you only have X amount of resources, and it's about where are you going to put those resources? Christina, you and I were talking about and we're going to go back, but we had a chat with a well-known person in the field where we're talking about onboarding and doing simulations and stuff like that, and they said well, we should hire actors to play kids. Well, that sounds really wonderful to be able to do that.
Speaker 2:Know, do you understand the resources that would be involved in doing something like that? And you have to work with the resource that you have, and so in this case, certainly you can check the quality of notes on a regular basis and prevent that from occurring, but that comes at a cost. It's a resource and you should still do it right, probably with the ai, until you're certain that things are good for a while, but you still want to have maintenance of it right To reinforce, but I imagine that reduces the response effort across the board. But, more importantly, that person that's doing that can now focus on coaching, you know, or you know doing their own clinical you know stuff. So yeah, I could just just just so many benefits of doing this kind of stuff. And that's just to me, just one example of how, you know, reducing response effort has this kind of, you know, ripple effect.
Speaker 1:Yeah, yeah, I guess like here's how we've seen organizations solve the problem before us or without us, right To your point one there's usually hiring a human quality assurance, BCBA, and that's very expensive and that's all non-billable.
Speaker 1:Or it's them doing monthly trainings to BTs about how session notes work and saying the same thing over and over again and nagging people, and that's not good for team morale, it's not a good use of your time, it's also not that effective and so sort of like. The third option, the one that we're trying to build, is just get session notes right in the get-go. If you need to change your session notes, what goes into the notes, what goes into each paragraph, what goes into each checkbox you just tell one place, tell Alpaca Assistant, and that has the change implemented throughout the entire organization. So instead of oh, I have to add a new paragraph, you have to sit down every BT and tell them about this new paragraph and what goes in this new paragraph and what's the definition of quality when writing for this new field in the session note, instead of having to do all of that change management to get your note to a new place that a new payer needs to get to or you that you need to get to for a new contract. You just tell alpaca assistant.
Speaker 1:One time in one place.
Speaker 2:Okay, but this is beautiful, I think, all right. So tell me a little bit, what are your, what are your next steps? Right With this and like cause, let's just start to wrap this up here and then I'm going to let you. You know, both you guys just talk about how folks can reach out to you and stuff, because you're both great and I got to say, if you've heard me, I always talk about how great Christine is. Michael, I'm hearing from both you and Stephanie Walden.
Speaker 2:They both said the same thing separately about you, about the quality of your person, and so, once again, folks that are listening to this, I have no tie into this. I'm not making any money Michael's not sponsoring me, right but I see something that has potential to help organizations and you know I I'm excited about the potential for this and we're starting to see it. So go ahead. You know, what do you guys think the next steps are and where do you see things in? You know, a month or two.
Speaker 3:Yeah, so Michael has already started to kind of review other things that they're working on. The next thing that me as a business owner and planning to take on is intake, and they have AI, has a system that calls for you, answers the phone. I don't even understand the depths when it comes to insurance, but like you think about when you have like somebody in the office calling insurance, you're on hold for a really long time, you're transferred a bunch of times and they're building out a system for that, which I think is really cool. It's funny because when Michael showed it us, the intake stuff, I was like again me being honest, I'm like well, michael, you know I get really annoyed when I get a bot that answers the phone. I like I start yelling at the bot sometimes and everything, but then at the same time I'm like but you have to look at things from a scaling perspective and like you can't, it doesn't mean that a parent is never going to be able to talk to a human and and that was what we talked through is like the system can have where you know if you can flag that the parent really wants to talk to a human, then you call that parent, but it helps like if it is a phone call that doesn't necessarily need a human to be on.
Speaker 3:It takes all the information for you in that intake process, because intake is when you do it right and you're, you know, getting everything you need. It can be a back and forth thing for a while with families. There's a lot of documentation that's needed to get ABA services going. So I think that that piece of it is great and, michael, you go ahead and talk on, because I have a contract right now with the software company that I'm bound to. So we're like we're going to basically be very systematic in how we bring on things and, plus, michael's still building things, and that is what I love about him and Val. They are very transparent about where they're at in the process. They're not trying to bring on agencies and have them be their guinea pigs. They are like test this first, give us feedback, and they're shaping it and taking all the feedback as as we go with it.
Speaker 1:Yeah.
Speaker 2:Michael.
Speaker 1:Exactly, yeah. So that's a great description of intake is, instead of waiting on insurance or trying to ping parents who never get back to you, let alpaca assistant do it for you. Trying to ping parents who never get back to you, let Alpaca Assistant do it for you. Scheduling we are working on a scheduling optimizer so instead of you spending the first two hours of your Sunday planning the next week's schedules, let Alpaca Assistant do it for you. We will input your staff schedules, your block schedule, their availability, clients availability and shift around schedules. And if there's any last minute changes like a cancellation comes up, a BT call out comes up, we'll automatically send the messages to the right people if we can't get another BT to staff that shift otherwise. And so all this sort of manual puzzle piecing that it seems like right now it's master's level BCBAs who train to be clinicians doing we want our alpaca assistant to do.
Speaker 1:And the last piece of the puzzle is kind of bringing everything together and actually billing insurance. So submitting claims, doing denial management, all things that we can do more efficiently with our technology than you know, like one person who's already stressed out doing a bunch of things can do themselves. So really the vision is to be the back office partner, the admin partner for growing ABA clinics is you want to grow your team, you want to serve more clients and families, you want to open that new location, expand into that next state. You know to do that you have to hire your scheduler, your intake person, you have to think about the processes to bring new people on, and we just want to be the partner that says, hey, no, let us handle that with you so that you can focus on, I think, what really matters, which is how do we deliver the best, highest quality clinical services to the most vulnerable families and kids?
Speaker 2:But this is awesome and this is exciting and how would, how would, and we'll make sure we drop this in the description for anybody. But how would folks reach out to you best?
Speaker 1:Yeah, so my name is Michael Gao GAO. I'm very active on LinkedIn maybe too active, so connect with me there. Or you can go to our website, alpacahealthio alpacahealthio, and if you search alpacahealth ABA, we should be the first ones on Google too.
Speaker 2:Christina.
Speaker 3:Yeah, so I know I listed out like a bunch of different organizations. We have one landing page for them. It's iqrgroupflcom, which stands for values, inclusion, quality and respect, so you can go there and you can choose which organization you're interested in learning more about. There's an email to contact. If you do want to contact me directly, you can find me on LinkedIn. I'm also on Instagram and Facebook, so are all my organizations.
Speaker 2:And Christina has her own podcast too. Just drop. Yeah, Talk about your podcast.
Speaker 3:I have a podcast. It's sometimes I talk about leadership stuff and autism because it's I. This is what I say to people. All things Christina Morales. I am very, very big into personal growth and healing and the podcast is called Know Yourself to Grow Yourself. You can find me on Instagram and if you want to listen in, you can find me on Apple and Spotify. So, and my son, vinny, has been coming on and doing episodes, so for anybody, I know I've had family, other autism moms that have really enjoyed listening to those episodes.
Speaker 3:So definitely share it as a resource to other families and everything. He's such a great kid. I may be biased, but he's a great kid.
Speaker 2:He's the best. I love Vinny. Shout out to Vinny. All right guys, thanks for coming on and sharing your experiences with us. Maybe we'll have you back on. I'm going to have a new season of this podcast is going to be about leadership, but certainly this all ties in leadership. If your life's being sucked away from doing this stuff, how are you going to be a leader, right? So maybe we'll have you back on in a few months just to see how things are going.
Speaker 1:So thank you, guys, and you guys have a great day. Okay, thanks for having us.
