- Caseload: You will be assigned a caseload of about 15+ clients. The number of clients is dependent on you reaching billable units per month and is NOT based on your competence, resources and or availability. - Billable Units: You will need to achieve roughly 115 and some change on billable hours every month. It was very close to impossible to reach that number monthly and you will be repeatedly reminded to hit your billable units. Which became annoying and added unnecessary pressure on the BCBA especially when some of the cases didn’t have technicians, scheduling mishaps etc. - Flexible Schedule: During the interview process it was discussed that Kyo has flexibility in their scheduling because they offer remote supervision. Most clients you will receive are within their most popular timeframe (Block 3), which is anywhere between 3-7PM. They advertise full days of hours but truthfully, they have VERY VERY limited morning clients so do not count on reaching your billables with just morning clients, you will be working till late into the night. Furthermore, although Kyo offers remote supervision – caregivers and technicians highly preferred the BCBA to be present more in person, which would lead to some unsatisfied caregivers and underprepared technicians. - Technician Turn Over: The technician turns over at Kyo is extremely high. It was very hard to maintain technicians and truthfully the newer technicians coming out were severely underprepared. They are not trained and are mass produced and thrown into this field without much knowledge. They needed someone to hold their hands during this process but with higher caseloads and billable units to achieve it was very hard to prepare them. Which leads to them leaving abruptly without much notice. - Drive Time: Kyo has these percentage of 25/75 which they advertise as 25% in person (which comes out to once a month – roughly) and 75% remote. 25% in person is a stretch because the BCBA’s are required to be in person for one contact per RBT to fulfill their credentials (if you have a client that has 3 different RBT you will need to fulfill all 3 RBT requirements), the BCBA must be in person for all new RBT overlaps, BCBA has to be in person for certain insurances to complete treatment plans and or assessments. Truthfully you will be doing the same amount of in person to remote so it’s more like 50/50 (on a good day). Furthermore, clients are not given to you based on your location, they are given to you based on you reaching billable units. I had clients anywhere between 30 minutes to and hour out from me. This put a lot of strain on my car, and it made it difficult to book more than 2 clients a day because you need to account for traffic and client scheduling. - Responsibilities: Your responsibilities in Kyo are not just that of a BCBA, you are primarily the face of the company, and most caregivers will go to YOU for answers. Caregivers wanted a face to talk to and it became very overwhelming and stressful when you had to take on other responsibilities like scheduling, client services, trainer, etc. to get an answer to caregivers. The company’s moto to relieve this was to relay caregivers to appropriate departments but in turn the BCBA ended up being the bad guy or the bearer of bad news in the eyes of the caregivers, losing the rapport you already gained. - Mentorship: Kyo offers mentorship meetings about once a week, anywhere between 30 minutes to an hour. At these meetings you can supposedly talk about clients and any questions you may have. After a change in management my meetings became more around billable units and reaching them, with VERY surface level advice on clinical questions about clients. I would need to reach out to other BCBA in surrounding regions to ask for help or guidance as I was not receiving that from higher ups. Conclusion: It honestly ended up being more important for the company to achieve billable units instead of prioritizing the clients, caregivers, technicians and even BCBA needs. There was very little support from upper managements, and I needed to depend on other BCBA for support which was not idle as they also have their own caseloads, caregivers, and technicians to worry about. Your concerns are not relatively heard and there are no concrete solutions to any clinical question you may have. There was no sense of collaboration, and you were essentially left to figure it out on your own most of the time.
