Starting an ABA practice involves five areas of activity.
1. Planning. Some people have an idea and jump at it with their wallet and both feet. That’s their plan; they figure they’ll learn the rest as they go. Others want to plan everything to the last detail before beginning.
Both extremes have their pros and cons. Wisdom is about discerning the most appropriate target spot on the spectrum between planning and action—architect and building contractor.
You can effectively start building the house before every last detail of the architectural work is complete, but only if you are intricately aware of where flexibility exists or doesn’t, where risks are high or low, what the likely timeframes are for each aspect of the building process, how long it takes to acquire each of the necessary materials, how to manage the cost of capital tied up in the project, etc.
In short, the more you want to take action while still developing the plans, the more complex the effort becomes and the more mathematics and highly developed expertise are required.
2. Credentialing. There are self-pay clients and those with PPO insurance policies for whom a licensed BCBA can offer services without the lengthy credentialing process (often 2-6 months) generally applicable to Medicaid and in-network insurer relationships. But most practices depend primarily upon Medicaid/in-network contracts. And many new practices engage in magical thinking—imagining that their credentialing will happen faster than it does. Wishing does not make it so.
3. Training. Whether you are a novice or expert, a franchisee or independent practice, opening a large clinic or starting tiny, you must allocate time and resources toward training and staff/team development. Team cohesion requires dedicated time regularly invested to create strong, healthy lines of communication and mutual understanding. Expect key employees to require at least 12-24 months to come up to speed, and plan accordingly.
4. Recruiting. Yes, you can start recruiting before credentialing is complete. New techs take time to interview and select and can then easily require another 30-60 days to finish a 40-hour course and become ready for clients. But manage expectations! Watch your timelines. Give them a realistic projection for when they will likely begin work so that you don’t find yourself under pressure from staff for client assignments before you have all the other pieces in place.
5. Accepting Clients. The new practice is naturally sensitive to any potential clients which may happen along. In some geographic areas, 6-12-month waitlists are common. You may well be able to let prospects know that you anticipate readiness to offer services within, say, 30-60 days. But again—manage expectations. And remember that industry ethics rules forbid utilizing a waitlist when alternative adequate services are available from another provider.
Balance resource allocation between all five areas from the beginning, prioritizing them in the order listed.