In 2020, Derek Bullard once again felt called to help autistic children.
As CEO and founder of Already Autism Heath in Georgia, Bullard has watched his newest company grow rapidly since its launch four years ago, expanding its initial service to three additional states.
But running a new healthcare company focused on autism wasn’t something Bullard had in mind. After running the successful behavioral health company Access Family Services for 15 years, he sold it and planned to take early retirement in 2014.
Only when he had some time to think did he realize that he was not ready to give up everything.
“I really hit a bit of a low point,” Bullard told Autism Business News. “I was kind of depressed and I missed old coworkers and my old company. I missed the camaraderie we had, the challenges, the ups and downs and everything that came with it.”
Between 2014 and 2020, Bullard founded a non-medical senior care company called Already HomeCare and became CEO of the 70-year-old nonprofit Siskin Children’s Institute, which provides developmental pediatric services for children.
Then, in 2020, before COVID, Bullard and his former colleagues at Access Family Services had a momentous reunion.
“We just decided that we would all work together again and advocate for children with autism,” Bullard said.
Bringing the band back together
For Bullard, starting a new company with experienced employees right from the start is a big advantage.
“I was very fortunate to bring my entire leadership team back together from Access Family Services,” said Bullard. “Coming back with a group of people who all have more than 20 years of experience in mental health and autism gave us a real competitive advantage. I think it would be difficult to find a leadership team that has the experience of our team. We also care about each other. We trust each other and we love the work we do.”
Already Autism Services began in 2020 with a commitment to providing comprehensive and individualized, evidence-based home and community-based treatment for autistic children and their families in Savannah, Georgia.
Over the next four years, the company expanded into North Carolina, South Carolina, and Virginia, and increasingly evolved into a balanced model that offers both home- and clinic-based services. Autism already uses telehealth in some areas where clinical staff is difficult to find.
The company is on track to serve just over 3,000 children this calendar year.
“Right now we’re 70% home and probably 30% clinic, but that’s changing,” Bullard said. “We have four clinics opening in 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 spectrum and a hybrid model for those kids who need a more structured environment in a clinic setting. We hope to be half clinic and half home next year.”
In addition to treatment, the company offers comprehensive autism assessments in four markets to help children who are on a waiting list for a diagnosis.
Autism Health already employs 452 people, including the company’s C-suite team and 18 administrative support staff working in a variety of departments, from human resources to revenue cycle management to compliance.
Already Autism also has an extensive compliance program with over 55 BCBAs who are master’s degree clinicians. The rest of the staff is made up of registered behavior technicians who work either in-home or at one of the clinics.
The company’s services are largely funded by Medicaid.
“We are about 80% Medicaid and 20% privately insured, meaning all private,” Bullard said. “We are also expanding our private insurance offerings. We want to be able to provide comprehensive care to more children and families who need these services. We are in the approval process with a handful of other private payers in the markets where we operate.”
Growing period
In parallel with Already Autism’s rapid market expansion, the company is also growing internally.
“I am very proud that several of our clinical staff, and even staff who only started with us a year or two ago, have been promoted to clinical leadership positions – positions they may not have even imagined themselves,” added Bullard.
Over the past three months, Already Autism has launched a nine-month internal leadership development program that includes mentoring, classroom-based training and job sharing.
“Hopefully, at the end of these nine months, they will have gained a really comprehensive insight into all aspects of what we do,” Bullard said. “I hope that by spring of next year, we will have four to six people who will be ready to take on leadership roles.”
Ready for what comes next
As Already Autism grows and employees move up the career ladder, the company faces several challenges in the coming years.
Bullard said the biggest operational obstacle is recruiting and retaining qualified employees in a very competitive market. He said Already Autism is addressing this issue by providing a supportive and rewarding work environment, developing new training programs, offering benefits and health insurance, and promoting from within.
Bullard sees another major operational challenge as keeping up with rapid regulatory changes in the healthcare industry.
“It requires constant vigilance. You have to keep an eye on what the payers want as well as keep an eye on changes in the field and adapt accordingly,” Bullard said.
Bullard said it is also important to stay up to date with innovations such as AI, assistive technologies, diagnostic technologies and advances in analytics and documentation.
Already Autism is currently collaborating with Jade Health on the National Autism Data Registry (NADR), a comprehensive data analytics 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 and great things happening across the country on the diagnostic and treatment side,” Bullard said. “So it’s about how we can implement these things in a way that saves our staff time and effort and reflects the essence of what we do. Just trying to keep track of it is an operational challenge, but I also think on the other side it’s a potential opportunity.”
Over the next five years, Bullard said Already Autism Health will focus on providing excellent services. As the company continues to grow, he believes it is critical to provide consistent and visible, high-quality, evidence-based care across all locations.
“We really want to expand our geographic presence and our reputation as a compassionate, trusted partner to the families and children we serve, as well as to our payers and partners,” Bullard said.
For Bullard himself, the call to help autistic children has never been stronger.
“I say I never want to fully retire because I enjoy the work we do and the people I work with,” he told Autism Business News. “I feel very lucky and blessed to be in an environment where I look forward to going to work every day.”
