June 21, 2024 • 34 mins
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https://www.linkedin.com/in/jeffreykrepps/
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome back to building betterbusinesses in ABA with me,
Jonathan Mueller.
It's a weekly podcast about theforces reshaping our autism
services field.
Learn from successfulentrepreneurs, payers,
investors, and leaders inapplied behavior analysis.
Thank you kind listener forletting me into your world
today.
Now onto the show.
Jonathan (00:30):
My guest today is Jeffrey Kreps.
Jeffrey is a 20 plus yearexecutive in healthcare.
He has extensive experienceworking with seniors, adults
with developmental disabilities,children with autism, and people
with mental health needs.
Jeff has worked acrossoperations, strategy, outreach,
and M& A functions andorganizations.
He's currently working as ahealthcare management
consultant, as founder of AkamaiSynthesis Design, a consulting
(00:54):
firm, and as a startupentrepreneur in the psychedelic
mental healthcare space.
Jeff, welcome to the pod, dude.
Jeffrey Krepps (01:02):
Awesome, dude.
Thank you for having me.
I really appreciate this andI've been looking forward to it.
Jonathan (01:06):
Rock on.
You know, we've known eachother.
I couldn't believe this as I wasreflecting for, I think, almost
Jeffrey Krepps (01:12):
Freaking decade, dude.
Jonathan (01:14):
A decade, which means I'm not getting any younger,
man, you look younger than I, sothat's what counts.
when we first met, it was inHawaii.
You live on the big island, soI'm super peanut butter jealous,
but you live on the big island.
It was in Hawaii.
and we work closely together.
one of my former organizations,was transitioning.
It's a Hawaii operations.
to your former organization.
(01:36):
and so we went through anintense couple months working
together on, on that transitionprocess and everything came with
it.
And, uh, so yeah, let's startwith there.
Jeff, what did you learn aboutABA as you took over leading
those operations?
Jeffrey Krepps (01:48):
Yeah.
I mean, you guys were all proslike coming into the situation.
I was coming from primarily ahome care based organization,
but, you know, just the totalpassion for ABA, the, the
dedication to clinical qualitythat personnel would have.
I really learned a lot about thededication of the practitioners
themselves.
In fact, we inherited awonderful pool of talent from
(02:09):
your organization.
It allowed us to grow, to becomethe best.
And biggest organizationdelivering ABA services in
Hawaii.
And ultimately that passionitself.
And I think that that was themost tremendous impact that I
had was the understanding ofthis passion and the passion of
people would lead to, you know,many of those individuals led
efforts in order to, unfoldautism parity in the state of
(02:31):
Hawaii.
So I would say just the passionof the field, the dedication to
the science and the ability toleverage clinical talent.
IE from your prior organizationand the operational talent from
my prior organization in orderto, you know, create that PBJ,
peanut butter, jelly sandwichcombination of, maximum effect
and maximum organizationalcapacity for quality and scope.
Jonathan (02:54):
Yeah, you know, it's amazing because this is back in
what, 2013, 2014, something likethat.
like ABA services were stillgenerally pretty new, right?
And certainly getting reimbursedfor them.
And there was a combination ofboth insurance, but also the,
you know, school district work.
I mean, it's extraordinary tothink just in the last, you
know, 9, 10 years, how far thefields come.
But, and that's cool to hearthat, from a policy perspective,
(03:14):
right?
just, the greater effect of whatyou all were doing helped to,
move autism parity forward.
But one of the things that Ilearned, and actually it was
separate from this, from thisinstance, we went through, prior
to that transition, a hugeaudit, of school district
services that candidly were,like, super bogus.
And I know they're super bogusbecause we got slapped with this
audit.
from Department of Education andwe went through and said, we're
(03:36):
going to fight this and we wereable to source document and at
the end of it, they had, therewas this huge number owed and we
were able to like, fight back on98 percent of it.
And not only that, the DOE, theperson who came after ended up
getting fired and they said, Oh,you don't owe anything.
So anyway, that was like, Oh mygosh, that was an intense couple
of months.
But one of the things that Ilearned is that it's just hard
(03:58):
to do business in Hawaii asoutsider.
You know, I'm, I don't know ifthis term outsiders is a bad
word, but like, been yourexperience working in Hawaii and
how do you become an insider?
Jeffrey Krepps (04:10):
Uh, there's generally going to be a little
skepticism when people planttheir flag and say, I am now
living in Hawaii.
I'm a resident of Hawaii.
local folks many times, and I'vebeen in Hawaii for over 20 years
now.
people generally, are some ofthe best people on earth.
Love it.
Love the people here.
Love the culture.
Don't think I'm ever going tomove.
But the local vibe is that,people that come many times with
(04:34):
the best of intentions to staywill ultimately cycle through,
cycle through the localcommunity.
So people aren't.
Generally willing to invest inthose efforts unless somebody is
deeply embedded in thatcommunity.
So to me, it's all aboutcommunity and longevity.
Longevity, if you're fortunateenough to be able to make a
living in one of the mostexpensive places in the United
(04:55):
States, then great.
Longevity, just be here and behere for a while.
But secondarily, Being part ofthe community, whether that's
your professional community,whether that's your religious
community, whether that is, youknow, a not for profit board,
whether that is public serviceand volunteering, government
boards, et cetera, gettingvested in your community,
(05:16):
showing folks that you careabout community.
Show folks that you have loveand aloha for the community, and
that will reflect itself back onyou, and you'll become an
insider.
Jonathan (05:26):
I mean, I think that speaks volumes to Any community
that you're in, right?
Like that is that you get out ofa community what you put into
it.
And those, if you're justlooking to like plant that flag
and just do business in Hawaii,you're gonna be seen as that
outsider forever, but you're notgonna reap those rewards of
being part of the community.
I think it's well said.
Well, you know, as a healthcaremanagement consultant now I know
(05:49):
one of the things you're superpassionate about, you've
described to me before is.
the frameworks that you used forrunning really disciplined and
efficient organization.
and specifically references 40 Xand four disciplines of
execution.
Dude.
So Jeff, tell me more aboutthat.
Jeffrey Krepps (06:04):
there are many kind of models, and they all
have similar, similar parts anddifferent parts.
But with 40X, it's a bookwritten by, uh, McChesney,
Covey, and Euling, where they,Detail for specific disciplines
that really facilitate,execution of your goals.
But what you start with iswhat's known as a wig, which is
your wildly important goal.
(06:24):
So this is like one or twosignificant goals.
It can be a moonshot, it can belike, something very practical
and pragmatic, like in the a b,A space where it would be like,
we want to double our RBT andour BCBA talent pool.
So it can be any number ofthings, but you're not going
anywhere without, without agoal.
So you start with a wildlyimportant goal.
Secondly is the idea ofmeasurement.
(06:45):
And, uh, it's important todistinguish a lead measure from
a lag measure.
And the lead measures are what'sreally important for people in
ABA.
They're going to love theconcept of lead measure because
the lead measure is just activebehavior.
It is, what are you going to doto inflect the measure?
A lag measure, like number ofemployees on staff, that, that's
already happened.
That's past tense.
(07:05):
that is something that isultimately, not necessarily in
the now, in the present, and itcan't affect anything.
So don't focus on the lag.
Focus on the lead.
it's already happened.
You can't change it.
You can't affect it.
also number three.
So the third discipline relatesto the idea of a scorecard, like
a graphic representation ofwhere you are at.
(07:25):
against your goals.
are you hitting your goals?
Are you, or where are you at?
So I'm a visual person myselfand I like to see, whether it's
a graph or, a scorecard that islike kind of colorfully laid
out, something to get a quickglance of where you're at versus
your goal.
It's like the actuals versusyour predetermined goals.
Some people might know a versionof this by, you know, if you've
(07:47):
looked at, Uh, you know, acharity event.
They used to have telethons onTV.
There'd be like a thermometer,and the mercury would be rising.
You'd be able to see that as agraphic representation of where
somebody was at a goal.
So you have this visualrepresentation known as a
scorecard telling you whereyou're at.
Sometimes people use red,yellow, and green to determine
where Uh, am I on track?
(08:08):
Am I off track?
Am I somewhere in between?
Those types of things allowpeople without getting into the
weeds of the data to have a bigpicture understanding of on
track, off track or not.
So scorecard is important.
It's the third discipline ofexecution in 40X.
lastly, is establishing acadence of accountability.
many organizations are alreadydoing this.
you have.
(08:29):
Regular operational standupmeetings.
But occasionally you might haveto have meetings that are
designed to see where we're atwith goals.
So more of a tactical meeting,like it's a tactical meeting
cadence, whereby you're meetingto discuss where you at with
like maybe initiatives,strategies, or things that are
outside the normal day to day ofwhat's going on.
Where are we at with scheduling,billing, collections, other
(08:50):
functions that you frankly takeup a lot of operational time,
but setting out time to meetwith others that are on your
team to kind of pressure testeach other and say, where are we
at with our goals?
Team members should besupportive in this case.
They should be, helping eachother.
It should feel like teambuilding, camaraderie, and we
all leave the meeting comingback with goals for the next
(09:11):
week and then ready to reportout when we convene again in the
following week.
So typically you might want todo this weekly or monthly.
Jonathan (09:18):
I, so full disclosure, I am a huge fan of 40 X and the
4 disciplines.
In fact, at element, we've gotour wig and the scoreboards like
we measure just a couple ofthings.
Got to reflect on like this ideaof lead versus lag is so
important.
Right?
And, and I've always thought ofleading indicators are those
that are number one, predictiveof the outcome.
(09:40):
And number two are actuallyinfluenceable, right?
To your point, like you canchange behavior now and affect
them.
And that's really importantbecause looking in, like you
mentioned a lag indicator, likenumber of staff, right?
Or, or if you look at a PNL,right?
A financial statement, that's alagging indicator.
That's what happened in thepast, right?
Is it important to know?
Sure.
Absolutely.
But what are the things, whatare the inputs?
What are those predictive leadmeasures That are shaping those,
(10:01):
but that cadence ofaccountability and like the
weekly wig lag meeting, as wecall it, dude, because we like
to say 80 percent of the workthat, that we do, at least I
guess most organizations, it'sjust the whirlwind.
It's the stuff that comes up.
That's like, gotta be done, butit's like whack a mole.
And are you really moving theorganization forward?
No.
So we have to specifically carveout time to look at the
(10:22):
scoreboard and look at that 20percent of like, how we can use.
our most valuable time that willmost bend the needle and move
the organization forward towardour goals.
And without doing that, it'sjust so easy to get caught up in
the whirlwind, isn't it?
Jeffrey Krepps (10:36):
It sure is.
I'm glad you mentioned that too,because that's an important
concept of 40x as well.
This idea that we're caught upin a whirlwind and whether it's,
work or day to day life, thewhirlwind is all around us,
right?
And if we don't take time tostep outside of that, we're just
going through the motions oflife with, without being
conscious or meditative aboutwhat it is that we're doing.
So that's 40X, stepping out ofthe whirlwind is you know,
(10:57):
taking your deep breath andmaybe hitting, um, a little bit
of meditation, yoga or somethingto get your head straight, to
think about what you need to do.
Jonathan (11:05):
I do that.
You know, I'm a big fan of theapp Headspace.
Now you mentioned meditation.
Um, I don't know, I've got likeseven or 8, 000 minutes
meditated over the last coupleof few years, but I think that's
another good example ofdiscipline.
Number three, the scorecard,right?
Like we want to know how are wedoing better for worse as human
beings, but how are we doing?
Are we winning or not?
And, uh, I don't know, we seethat everywhere, especially with
all the gamification, right?
(11:27):
Well, hey, I'm going to put youon the spot, Jeff.
give me an example of how you'veused this framework in your own
career at your ownorganizations.
Jeffrey Krepps (11:34):
You know, I'll be honest with you, John.
I tend to use a variant of astrategic execution model that
is similar, but a little bitdifferent.
So I don't know what the namefor this is.
I picked it up many, many yearsago, but there are definitely
analogies.
with the 40X model, but itreally is more based upon, I
guess for maybe some of thelisteners coming from the
(11:55):
clinical space, based morearound a clinical treatment
model of assess, plan,implement, and review.
Like, there's always acontinuous process of, looking
at where are we at with ourproblem, what is our, plan for
addressing the problem?
How are we going to executethat?
And how are we going to reviewthat?
So you have goals in assessmentafter an assessment, you're
gonna have goals.
So there's a wildly importantgoal when you're planning,
(12:17):
you're ultimately saying whatyou're going to do.
And when you're executing your,your, involved in, the creation
of a lead measure.
the review happens at a tacticalmeeting at the, at the weekly
lag meeting.
So it's similar, but a littlebit difference.
and I always think of it as likea clinical model that is,
refabricated for organizationalthinking.
Jonathan (12:39):
Yeah.
And I think what's importantabout what you've described,
this assess, plan, implement,review is like, that's an
ongoing process.
You you do it once, right?
And come back in a year or fiveyears or something.
It's always going.
Were there any.
Big challenges that you facethat you found that this, this,
framework lent itself to andthat you were able to solve
because of it.
Jeffrey Krepps (12:57):
Yeah.
almost every single activity asa.
Strategic advisor as a strategicconsultant.
rests upon some sort of, ideawhere there's a goal, there's a
challenge, there's a problem,you're attempting to solve it,
and you execute interventionsthat are designed to affect
change in the organization.
So I could call out any numberof things that I've worked on,
(13:20):
but it's almost, I would sayeverything that I do is based on
that model.
Everything outside of, I have,I'll be honest, I haven't been
in operations, pure operations,And maybe seven or eight years.
So this is all I do.
This is what I do all the time.
Jonathan (13:35):
It's, yeah, you're right.
there's like a universalapplication of this to any
challenge that, that you face.
And I think back at Ascend, um,when we had this challenge of,
you know, we were getting thislow acceptance rate, on, uh,
BCBA offer letters think we'regetting a 50 percent acceptance
rate.
And we looked at this, we'relike, what are we doing wrong in
the process?
And we had to first step backand like assess.
(13:56):
And we figured out we weren'tlike, we were like speedily
going through the process, butwe weren't helping candidates
contact our values,organizational values.
So, you know, the plan we cameup with was sort of modeled on a
much harder interview processwhere they got to meet more
people in the organization,where they contacted our values.
We implemented it right.
Like.
Teed up the metrics we wanted tosee and whether it's gonna be
successful.
And then it was like thisconstant review and we actually
(14:18):
got it up to, and we've stayedabove 80 percent acceptance rate
ever since like four or fiveyears ago.
So, but I think this is, that'sa really important idea is like
you're constantly revisiting andworking through those four
stages.
Well, You mentioned that youhaven't been in, in operations
for, for seven or eight years,but like at your heart, I know
you love strategy.
I love strategy too.
Huge strategy I love likestepping up to the 10, 000 foot
(14:40):
level and looking at, you know,where an organization fits
within its competitiveenvironment in the field.
but tell me, how does strategyin your mind, Jeff differ from
execution?
Yeah.
Jeffrey Krepps (14:50):
Well, kind of put it in a way, like when you,
when you think about it, or whenI think about it, I think of it
as they're, they're essentiallyalmost poles of the same thing,
or they're essentially maybe theyin and yang of business
development.
They are, one without the otheris sort of like.
It's nonsense.
It's it doesn't make any senseto have half of a yin and miss
the yang or half the yang andmiss the ying.
(15:12):
And so to execute withoutstrategy is like going into a
wilderness without a map.
and that's back to thewhirlwind.
It's like, okay, you're justspinning around.
What are you, what are you evendoing with yourself day in and
day out?
Don't know.
I'm just too busy executing.
To strategize without executionis just.
One of the biggest waste oftimes that you could ever do.
It's the, you know, you putforth all of this money, you put
(15:33):
forth all of the team getstogether, you start drafting
strategies and plans, maybe evenpay a consultant and then you
never do anything with it.
Like, you know, why even gothrough the process?
You might as well just enter thewhirlwind and not think about
it, but to have, to have both ofthem prevents you from wasting
your energy.
Creating a document that isperhaps, destined for the scrap
(15:54):
heap of ideas and wasted effort.
And ultimately, just being ableto put them together as
strategic execution, I think isa more helpful way to kind of
look at the, the paradigm.
Um, there is also the science,the nuance, the magic between
the yin and the yang there.
And that's tactical execution.
Like it's helpful to havesomebody on your team that's
(16:16):
able to be able to say, let'stake these ideas.
We'll put them in the operator'shands and we'll be able to make
this magic happen.
Because sometimes with the bestof intent, you can have the
strategy there.
You can have the execution, butthere's this whole tactical
middle ground that has to happento convert one set of ideas
into, into practice.
Jonathan (16:34):
I love that imagery that you did in the end.
It's so true.
One of those like is without theother is functionally useless.
You know, I'll be honest.
Like, I'll make a big confessionwhen I started my career first
couple of years, I was amanagement consultant and I
didn't work in healthcare.
I worked in a whole bunch ofdifferent fields, but, we would
walk it.
I, I worked with Canada post.
Uh, so the, the Canadianequivalent of the U.
S.
Postal Service and I was inOttawa for, for many, many weeks
(16:56):
and we, um, we were tasked, Ithink, with looking at the
replacement future forecast andthe future replacement rate of
emails, or I'm sorry, ofphysical mail getting replaced
by fax, email, and other things.
So anyway, there's thisbeautiful, like deck that
resulted, this great strategy Irecommend about how they like,
afforded that.
And then guess what?
I'm sure it went on a shelf.
(17:17):
And like, we left it up tosomeone else to execute.
It's like, seriously, dude, likego, go execute on that thing.
Don't just tell me what to do.
Anyone has good right?
And you can say what to do.
So I think it's so true, man.
Jeffrey Krepps (17:29):
Yeah.
I mean, wouldn't that be great?
just, if you're not going to usethe plan anyway, How about just
paying me the money and I'll goto the beach and we'll just kind
of scribble a few notes on apiece of paper and you can have
that, but yeah, that's a goodexample.
It's
Jonathan (17:43):
Um, I, as I understand it, like you are like looking
out over the beach now, like inKona on the big Island.
I am super jealous.
That's like pretty sweet, dude.
I don't know how you get
Jeffrey Krepps (17:54):
hard to concentrate.
Jonathan (17:57):
Um, well, let me follow up on my question about
strategy.
Like what does it take for anorganization?
To be great at strategy.
Jeffrey Krepps (18:05):
Um, a couple of things, and I think like there's
so many, I think of so manyanalogies between what does it
take to be, a great individualand what does it take to be a
great organization?
And there, there, there are alot of parallels.
So one is being honest, beinghonest with yourself about the
organization, being honest aboutwhere you're at in time and
being able to have difficultconversations about areas of
(18:26):
improvement.
So that honesty really goes along way in Knowing yourself and
knowing your company and knowingwhat you do.
there has to be this,existential acknowledgment of
who we are and being honestabout who we are.
it's a prerequisite to anything,like, you're not going to go
anywhere if you're deludingyourself.
Or if you're, you're senseless.
have some misrepresentation ofwho you are, what you can do.
(18:48):
So number one, it's the realismof having on honesty with
yourself in order to, have thebest knowledge set about your
company.
Um, so otherwise you're lost.
but.
Then I would say, okay, so thoseprerequisites being said, then
you got to work it backwards.
Like, I'm a fan of like visionboards, visualizations, etc.
(19:09):
So the team having a realconcrete idea in mind in terms
of what is it that, that happenswhen we hit these wildly
important goals or What does itlook like when we're at the tail
end of that?
and it helps sometimes if youmentioned gamification earlier,
but if you gamify something, orif you have a big party at the
end of it, but what is, what'sthis end point going to look
(19:29):
like, you know, close your eyes,feel it, taste it, touch it,
smell it.
Like make sure you know where itis that you're going.
And start thinking about how ifI were to take steps backwards,
how could I get to the startingpoint?
So you can work it from thefront end.
You can work it from the backend, but it's a whole lot of
tactical objectives to get frompoint A to point B.
So you kind of subsect thesubheadings, work through the
(19:49):
subheadings.
If there are sub objectivesthrough there, work through
those, but you then line up thetasks, have a task analysis and
just line it up.
It's kind of like projectmanagement principles.
Um, but then, The other thing Iwould say is becoming an expert
is also know your expertise.
But also your teams, the peoplethat you work with have so much
(20:09):
knowledge.
They have got so much to say,they've got so much to give so
that, this being great atstrategy, it's not a one person
operation or it shouldn't be.
It should be a collectiveenterprise where people are
distilling all of the inputsthat they can into a.
Particular puzzle or aparticular goal that people are
working on and then ultimately,working to distill that down
(20:31):
into a functional plan to get tothat end point, that wildly
important goal, thatdestination.
So those are some things I thinkthat, you know, off the top of
my head, I would think arereally important for great
strategy.
be humble, work with others,know your destination.
Jonathan (20:48):
Well, you're now a consultant with your own
practice.
tell me more about the differentkinds of consulting services you
provide.
Jeffrey Krepps (20:54):
there's several buckets.
there's vision and strategywork, of course.
So, with strategic planning, Iwork on annual and three year
goals.
Typically, um, I do vision andvalues work, framing and
reframing those for teams, go tomarket strategies and de novo
planning for people that areentering new markets or
delivering new services.
a second bucket of work that Ido is in business and corporate
(21:14):
development.
So a whole litany of.
Market analysis, competitiveanalysis, market research
projects, outreach, growth,growth initiatives, cross
functional facilitation andproject management, M& A
support.
So that's sourcing and advisingbuy and sell side, of the
equation, due diligence andintegrations there.
(21:35):
I've recently started doingsome, not for profit corporate
structuring.
So starting up not for profitsfor people, doing some grant
proposals there.
and also, lastly, with businessdevelopment and corporate
development, partnerships,alliances, and joint ventures,
and working with people in waysto collaborate, in order to, uh,
more effectively servecommunities.
Ideally, that's like a goodcommunity, a good way for
(21:57):
individuals to more effectivelyserve communities cooperatively
rather than competing.
and then I guess the last bucketis along organization building.
So doing organizationalassessments.
If people don't know who theyare.
As an organization, I can helppull that mirror up and show
organizations who they are, dosome executive coaching and team
building.
and then, lastly, um, someinterim work.
So I can do interim fractionalexecutive, temp CEO, temp COO,
(22:21):
or temp chief, chief growthofficer.
I've done a few of those beforeas well.
Jonathan (22:26):
Wow, dude, that is a, an extraordinarily broad range
of what's really fun work, atleast in my mind.
That's like some super fun workthat you get to do.
I want you to harness like allof your expertise in autism
services, broader behavioralhealth, and take out your
crystal ball, Jeff.
what's the next five years goingto bring to the ABA field?
Jeffrey Krepps (22:47):
Okay.
And I can't say with the firstthing on my list, it's, it
doesn't take a crystal ball to,to realize this.
if you have been alive in ABA inthe last.
I'd say three to five years.
You've heard about value basedcare and you know that it's
coming down the pike Soultimately, as more, insurance
providers, funders, et cetera,are looking at the total volume
spend of these services.
(23:08):
They're going to be looking at,payment methodologies that
resemble other fields that I'vebeen previously, such as,
Medicare based services thathave capitated care.
They have moved to value basedcare.
And, essentially, companies.
will need to show value in termsof the services that they're
offering.
And primarily, at a minimum,that should be related to
(23:29):
clinical outcomes and access tocare.
if that's that no crystal ballnecessary, like you're asleep if
you don't know that one.
Some others, they're a littlebit, deeper back.
Another one that's emergent isthe increase in an engraved care
model so that, you would havenot just ABA, but ABA partnered
with neurology.
I mean, OTPT speech has beenthere for a while, but you may
(23:50):
see some pediatric mental healthpartnerships with ABA companies,
pediatric, pediatric home care,pediatric, Maybe even pediatric
primary care at some point, butyou can see, the integration of
the overarching healthcaresystem to acknowledge ABA as a
subsector of the healthcaresystem.
And, no, as no person is anisland, no intervention is an
(24:11):
island in the Americanhealthcare system.
Eventually, everything folds andcomes together.
another one would be, aregionalization, which would be,
say, a market density approachfor, companies looking to expand
versus a national approach, youwould see that as market
breadth.
So I think we're going to seeless of the days where the
highly funded invested companiesare going for a pin in every
(24:35):
state of the map.
And they're going to look atwhere are the markets that we
can most concentrate in and beable to most effectively serve
the most individuals in thatparticular market.
So it may be looking at moreregional versus national
markets.
seeing some effects of it.
God knows how long this willlast, but the effects of, higher
interest rates.
So there's all kinds of financerelated challenges and issues
(24:58):
related to tighter lending.
So you can see lower valuationsin terms of, offerings in the M&
A space.
More difficult access to loans.
So if you need a bridge loan orsomething, there may be more of
a risk at, failure or,involuntary exits, that are out
there, which in itself then, Iguess lowers valuations, but,
that expensive debt is going tolimit growth and improvement
(25:20):
initiatives.
So, you know, the moneyeventually.
Um, and then lastly, this one Imentioned joint ventures and
partnerships before, but I feelthat there's a lot of
opportunity for mom and pop andsmaller providers to be able to,
Be competitive in markets wherethere are more well heeled, more
(25:41):
heavily funded organizations outthere.
I think it only makes sense forthose providers to start
partnering up and looking atways they can help each other in
certain markets.
So that's what I got in terms ofmy crystal ball.
Jonathan (25:54):
Wow, if you had asked me that question about next 5
years in a priori, what I'vesaid, I I think I would have
said exactly all things justdescribed.
And I think it's so true.
in fact, to that last point, Iwas at a conference.
Actually, both of us wererecently at, I was talking to
some sharp folks in the fieldwho said, look, if In these
times, in these harder times ina field like ABA, there will be
(26:17):
non traditional mergers thathappens.
Call it a couple different,regional providers maybe that
come together who are valuesaligned and meet certain
criteria.
And there's a way to accretevalue that way.
that's different fromtraditional MNA.
So I think it's so true.
I want to talk about integratedcare, cause I am so passionate
about this is one of the thingswe built into ascends DNA from,
the get six years ago when westarted, that it's having ABA
(26:39):
company by family mental healthsupport, LCSWs and diagnostics
psychologists and a really smartdude in Silicon Valley recently,
I was at a dinner and he said,Jonathan, there's value in.
Bundling and unbundling.
And he was describing, not, justABA, he was describing like
generally any type oforganization as you're thinking
(27:00):
about how you create value foryour consumers.
And just give a, for instance onthis, think about, Microsoft and
how it bundles, right?
you buy a Microsoft, like thesuite, and then they introduce
like You know, MS Teams,Microsoft Teams, and that
automatically, is competing apotential consumer out of a Zoom
or somewhere they sneak it in.
So there's this value inbundling, right?
(27:21):
There's also a value inunbundling and just look at 20
years ago.
Cable companies existed and youhad to spend a couple hundred,
300 bucks a month and you had toget literally like thousands of
channels.
Like you couldn't decide.
And now you've got Netflix orHBO max, whatever the
subscriptions are, there's valuein unbundling.
And I think that's part of whatwe're going to see to your
point, there is value inbundling these different and
(27:43):
integrating different autismrelated evidence based services.
Guess why?
Because the consumer.
Ultimately, that's autismbenefits because they're going
to be getting speech or OT, orthey need a diagnosis.
they need maybe access to apediatrician.
So I think you're spot on withthat, that's part of the future
of our field.
Jeffrey Krepps (28:00):
to that point, like when you talk about that,
it reminds me of like the ideathat, we should be client
centered and individual focused.
And that's very true coming fromthe service side.
But that In the kind of likeproduct development, maybe in
tech space, we might considerthat consumer experience and in
some regards, they're the samething, right?
So we're carving out this piecethat this one person wants as a
(28:22):
micro data point and creatingthat experience for them.
Jonathan (28:26):
Yeah, well said.
Jeffrey, what's one thing everyABA business owner should start
doing and one thing to stopdoing?
Jeffrey Krepps (28:32):
Okay.
Assuming they're not doing it.
It's like, um, I guess.
Just empower your teams.
you hire your teams for areason.
no exec, no founder can doeverything.
So empower your teams toactualize on your wildly
important goals that you've setout and incentivize, and even
vest if you can your teams whenpossible so that they're part of
it.
They know they're entrenched.
They are part of the DNA.
(28:53):
So I think that's, that, thatis.
The most essential thing.
You need a team.
Nobody can do it themselves.
Empower the team.
Jonathan (29:01):
stop?
Jeffrey Krepps (29:04):
This may be a personal bias.
People may disagree, but I'd saylisten more than you speak, just
generally, you know, always be amagnet for information.
Always have your antenna up,listen more.
you know, the expertise iscloser than you think.
And it may be from that quietperson in the corner of the
room.
So just always be prepared tolisten more than speak.
Jonathan (29:26):
Such words of wisdom.
And before we wrap up, I got toask you, cause how did you get
interested in, in thepsychedelic mental healthcare
space?
I think there's some reallyinteresting research going on
right now about that.
Jeffrey Krepps (29:37):
Uh, yeah, certainly, There, I mean, I'm a
lifelong aficionado of, um,psychedelics as transformative,
substances for people, in the, Iguess, You know, long term, when
you look at it from anethnological perspective, these
substances have been used inshamanic experiences.
They have been used as, naturalhealing remedies for thousands
(29:59):
of years.
You know, it's, it's undeniable.
There's a history of this beinga medicine that's out there.
Personally, I had the mosttraumatic experience in my life
many, many years ago, well, 10or 11 years ago.
And, I had undergone, MDMA, selftreatment for that trauma.
And I would say that that'sfundamentally, it altered my
(30:20):
neurons in order to, it, youknow, it stopped my brain from
battling with itself, feelingsof guilt, feelings of.
The inability to, have done theright thing at the right
situation.
So it's going to sound nebulousto the audience, but trust me,
this is, this was a painfulexperience and still is, but the
medicine allowed me to walkforth in a nonjudgmental way,
(30:42):
assume the best of the situationand allow my, Cognitive rational
side of my mind to communicatewith my feeling and emotive side
of the mind in ways that talktherapy alone will never do.
It will never, ever do that.
So I have a passion for it.
It's personal.
And I look forward to Expandingaccess to this type of medicine.
Jonathan (31:03):
Uh, Jeffrey, you give me goosebumps, dude, that
emotion and your voice as youdescribe that.
Promise me when you were readyto come back on the pod to talk
more about psychedelics.
I cannot wait, to do more ofthat, sir.
Well, hey, Jeffrey, where canpeople find you online?
Jeffrey Krepps (31:17):
Um, you can find me, um, www.
asd.
earth.
That's for Akamai SynthesisDesign, www.
asd.
earth.
I'm also, LinkedIn.
you can find me there.
And personally, I'm always openfor networking calls.
You can reach out to me atjkreps.
That's jkrepps@asd.earth.
Jonathan (31:38):
And I know from firsthand experience how much
you are a knowledge sharer, andyou're trying to help to put
good knowledge and wisdom out inthe world.
So I appreciate that about you,Jeffrey.
All right.
You ready for the hot takequestions, dude?
Jeffrey Krepps (31:49):
Let's hit it.
Jonathan (31:51):
All right, you're on your deathbed.
What's the one thing you want tobe remembered for?
Jeffrey Krepps (31:54):
I want to be remembered as somebody that gave
more than they take, they'vetaken.
I want to be known as a kindperson.
I want people to know that I hada good heart and I gave more
than I took.
Jonathan (32:05):
What's your most important self care practice?
Jeffrey Krepps (32:07):
Uh, digging in the dirt, gardening, planning
things, being in nature.
Jonathan (32:12):
Well, hey, that's the jcreps at asd.
earth.
I did not even know thatextension existed.
So you've learned me somethingnew today,
Jeffrey Krepps (32:19):
You got it.
Jonathan (32:20):
Um, Hey, do you have a favorite song and or music
genre?
Jeffrey Krepps (32:23):
Um, millions, more than maybe not millions.
I'm exaggerating.
There's hundreds of favoritesongs.
I cannot, and it's not fair toask a music lover that question.
But, in terms of genre, like, Iguess, summertime I listen to a
lot of reggae.
Like, I like reggae in thesummertime.
I have a little seasonal affect,so in the wintertime it becomes
darker.
Sometimes I listen to stonermetal or like dark EDM, but, you
(32:45):
know, it varies depend,depending on my mood.
Jonathan (32:48):
I love it.
What's the one thing you'd tellyour 18 year old self?
Oh,
Jeffrey Krepps (32:52):
Um, chill out, dude.
don't rush to the destination.
The experience is right there infront of you.
know that your ego, althoughpart of the team, your ego is
really not the driver.
It's an illusion and it's tryingto take control.
Very important, valuable memberof the team, but not the
captain.
let the ego step aside and letthe true self shine through.
Jonathan (33:10):
that is deep AF.
Wow.
Um, You could only wear onestyle of footwear.
What would it be?
Jeffrey Krepps (33:17):
Okay.
This is kind of, it's an easyone.
after the last few, I live inHawaii and we wear slippahs
bra'.
That's flip flops to you peopleon the mainland.
Jonathan (33:27):
Slippers, bro.
Well, bra, it has been sick fun.
Thank you so much for coming onthe pod.
I've loved our conversation,Jeffrey.
Jeffrey Krepps (33:34):
I appreciate it too, man.
You have, you have a good one.
Hey, kind listener, thanks fortuning in.
If you like this episode, canyou do me a favor?
Give me a rating on yourfavorite podcast channel.
It helps more values alignedpeople like you find the pod.
Till next time, peace.
Welcome back to building betterbusinesses in ABA with me,
Jonathan Mueller.
It's a weekly podcast about theforces reshaping our autism
services field.
Learn from successfulentrepreneurs, payers,
investors, and leaders inapplied behavior analysis.
Thank you kind listener forletting me into your world
today.
Now onto the show.
Jonathan (00:30):
My guest today is Jeffrey Kreps.
Jeffrey is a 20 plus yearexecutive in healthcare.
He has extensive experienceworking with seniors, adults
with developmental disabilities,children with autism, and people
with mental health needs.
Jeff has worked acrossoperations, strategy, outreach,
and M& A functions andorganizations.
He's currently working as ahealthcare management
consultant, as founder of AkamaiSynthesis Design, a consulting
(00:54):
firm, and as a startupentrepreneur in the psychedelic
mental healthcare space.
Jeff, welcome to the pod, dude.
Jeffrey Krepps (01:02):
Awesome, dude.
Thank you for having me.
I really appreciate this andI've been looking forward to it.
Jonathan (01:06):
Rock on.
You know, we've known eachother.
I couldn't believe this as I wasreflecting for, I think, almost
Jeffrey Krepps (01:12):
Freaking decade, dude.
Jonathan (01:14):
A decade, which means I'm not getting any younger,
man, you look younger than I, sothat's what counts.
when we first met, it was inHawaii.
You live on the big island, soI'm super peanut butter jealous,
but you live on the big island.
It was in Hawaii.
and we work closely together.
one of my former organizations,was transitioning.
It's a Hawaii operations.
to your former organization.
(01:36):
and so we went through anintense couple months working
together on, on that transitionprocess and everything came with
it.
And, uh, so yeah, let's startwith there.
Jeff, what did you learn aboutABA as you took over leading
those operations?
Jeffrey Krepps (01:48):
Yeah.
I mean, you guys were all proslike coming into the situation.
I was coming from primarily ahome care based organization,
but, you know, just the totalpassion for ABA, the, the
dedication to clinical qualitythat personnel would have.
I really learned a lot about thededication of the practitioners
themselves.
In fact, we inherited awonderful pool of talent from
(02:09):
your organization.
It allowed us to grow, to becomethe best.
And biggest organizationdelivering ABA services in
Hawaii.
And ultimately that passionitself.
And I think that that was themost tremendous impact that I
had was the understanding ofthis passion and the passion of
people would lead to, you know,many of those individuals led
efforts in order to, unfoldautism parity in the state of
(02:31):
Hawaii.
So I would say just the passionof the field, the dedication to
the science and the ability toleverage clinical talent.
IE from your prior organizationand the operational talent from
my prior organization in orderto, you know, create that PBJ,
peanut butter, jelly sandwichcombination of, maximum effect
and maximum organizationalcapacity for quality and scope.
Jonathan (02:54):
Yeah, you know, it's amazing because this is back in
what, 2013, 2014, something likethat.
like ABA services were stillgenerally pretty new, right?
And certainly getting reimbursedfor them.
And there was a combination ofboth insurance, but also the,
you know, school district work.
I mean, it's extraordinary tothink just in the last, you
know, 9, 10 years, how far thefields come.
But, and that's cool to hearthat, from a policy perspective,
(03:14):
right?
just, the greater effect of whatyou all were doing helped to,
move autism parity forward.
But one of the things that Ilearned, and actually it was
separate from this, from thisinstance, we went through, prior
to that transition, a hugeaudit, of school district
services that candidly were,like, super bogus.
And I know they're super bogusbecause we got slapped with this
audit.
from Department of Education andwe went through and said, we're
(03:36):
going to fight this and we wereable to source document and at
the end of it, they had, therewas this huge number owed and we
were able to like, fight back on98 percent of it.
And not only that, the DOE, theperson who came after ended up
getting fired and they said, Oh,you don't owe anything.
So anyway, that was like, Oh mygosh, that was an intense couple
of months.
But one of the things that Ilearned is that it's just hard
(03:58):
to do business in Hawaii asoutsider.
You know, I'm, I don't know ifthis term outsiders is a bad
word, but like, been yourexperience working in Hawaii and
how do you become an insider?
Jeffrey Krepps (04:10):
Uh, there's generally going to be a little
skepticism when people planttheir flag and say, I am now
living in Hawaii.
I'm a resident of Hawaii.
local folks many times, and I'vebeen in Hawaii for over 20 years
now.
people generally, are some ofthe best people on earth.
Love it.
Love the people here.
Love the culture.
Don't think I'm ever going tomove.
But the local vibe is that,people that come many times with
(04:34):
the best of intentions to staywill ultimately cycle through,
cycle through the localcommunity.
So people aren't.
Generally willing to invest inthose efforts unless somebody is
deeply embedded in thatcommunity.
So to me, it's all aboutcommunity and longevity.
Longevity, if you're fortunateenough to be able to make a
living in one of the mostexpensive places in the United
(04:55):
States, then great.
Longevity, just be here and behere for a while.
But secondarily, Being part ofthe community, whether that's
your professional community,whether that's your religious
community, whether that is, youknow, a not for profit board,
whether that is public serviceand volunteering, government
boards, et cetera, gettingvested in your community,
(05:16):
showing folks that you careabout community.
Show folks that you have loveand aloha for the community, and
that will reflect itself back onyou, and you'll become an
insider.
Jonathan (05:26):
I mean, I think that speaks volumes to Any community
that you're in, right?
Like that is that you get out ofa community what you put into
it.
And those, if you're justlooking to like plant that flag
and just do business in Hawaii,you're gonna be seen as that
outsider forever, but you're notgonna reap those rewards of
being part of the community.
I think it's well said.
Well, you know, as a healthcaremanagement consultant now I know
(05:49):
one of the things you're superpassionate about, you've
described to me before is.
the frameworks that you used forrunning really disciplined and
efficient organization.
and specifically references 40 Xand four disciplines of
execution.
Dude.
So Jeff, tell me more aboutthat.
Jeffrey Krepps (06:04):
there are many kind of models, and they all
have similar, similar parts anddifferent parts.
But with 40X, it's a bookwritten by, uh, McChesney,
Covey, and Euling, where they,Detail for specific disciplines
that really facilitate,execution of your goals.
But what you start with iswhat's known as a wig, which is
your wildly important goal.
(06:24):
So this is like one or twosignificant goals.
It can be a moonshot, it can belike, something very practical
and pragmatic, like in the a b,A space where it would be like,
we want to double our RBT andour BCBA talent pool.
So it can be any number ofthings, but you're not going
anywhere without, without agoal.
So you start with a wildlyimportant goal.
Secondly is the idea ofmeasurement.
(06:45):
And, uh, it's important todistinguish a lead measure from
a lag measure.
And the lead measures are what'sreally important for people in
ABA.
They're going to love theconcept of lead measure because
the lead measure is just activebehavior.
It is, what are you going to doto inflect the measure?
A lag measure, like number ofemployees on staff, that, that's
already happened.
That's past tense.
(07:05):
that is something that isultimately, not necessarily in
the now, in the present, and itcan't affect anything.
So don't focus on the lag.
Focus on the lead.
it's already happened.
You can't change it.
You can't affect it.
also number three.
So the third discipline relatesto the idea of a scorecard, like
a graphic representation ofwhere you are at.
(07:25):
against your goals.
are you hitting your goals?
Are you, or where are you at?
So I'm a visual person myselfand I like to see, whether it's
a graph or, a scorecard that islike kind of colorfully laid
out, something to get a quickglance of where you're at versus
your goal.
It's like the actuals versusyour predetermined goals.
Some people might know a versionof this by, you know, if you've
(07:47):
looked at, Uh, you know, acharity event.
They used to have telethons onTV.
There'd be like a thermometer,and the mercury would be rising.
You'd be able to see that as agraphic representation of where
somebody was at a goal.
So you have this visualrepresentation known as a
scorecard telling you whereyou're at.
Sometimes people use red,yellow, and green to determine
where Uh, am I on track?
(08:08):
Am I off track?
Am I somewhere in between?
Those types of things allowpeople without getting into the
weeds of the data to have a bigpicture understanding of on
track, off track or not.
So scorecard is important.
It's the third discipline ofexecution in 40X.
lastly, is establishing acadence of accountability.
many organizations are alreadydoing this.
you have.
(08:29):
Regular operational standupmeetings.
But occasionally you might haveto have meetings that are
designed to see where we're atwith goals.
So more of a tactical meeting,like it's a tactical meeting
cadence, whereby you're meetingto discuss where you at with
like maybe initiatives,strategies, or things that are
outside the normal day to day ofwhat's going on.
Where are we at with scheduling,billing, collections, other
(08:50):
functions that you frankly takeup a lot of operational time,
but setting out time to meetwith others that are on your
team to kind of pressure testeach other and say, where are we
at with our goals?
Team members should besupportive in this case.
They should be, helping eachother.
It should feel like teambuilding, camaraderie, and we
all leave the meeting comingback with goals for the next
(09:11):
week and then ready to reportout when we convene again in the
following week.
So typically you might want todo this weekly or monthly.
Jonathan (09:18):
I, so full disclosure, I am a huge fan of 40 X and the
4 disciplines.
In fact, at element, we've gotour wig and the scoreboards like
we measure just a couple ofthings.
Got to reflect on like this ideaof lead versus lag is so
important.
Right?
And, and I've always thought ofleading indicators are those
that are number one, predictiveof the outcome.
(09:40):
And number two are actuallyinfluenceable, right?
To your point, like you canchange behavior now and affect
them.
And that's really importantbecause looking in, like you
mentioned a lag indicator, likenumber of staff, right?
Or, or if you look at a PNL,right?
A financial statement, that's alagging indicator.
That's what happened in thepast, right?
Is it important to know?
Sure.
Absolutely.
But what are the things, whatare the inputs?
What are those predictive leadmeasures That are shaping those,
(10:01):
but that cadence ofaccountability and like the
weekly wig lag meeting, as wecall it, dude, because we like
to say 80 percent of the workthat, that we do, at least I
guess most organizations, it'sjust the whirlwind.
It's the stuff that comes up.
That's like, gotta be done, butit's like whack a mole.
And are you really moving theorganization forward?
No.
So we have to specifically carveout time to look at the
(10:22):
scoreboard and look at that 20percent of like, how we can use.
our most valuable time that willmost bend the needle and move
the organization forward towardour goals.
And without doing that, it'sjust so easy to get caught up in
the whirlwind, isn't it?
Jeffrey Krepps (10:36):
It sure is.
I'm glad you mentioned that too,because that's an important
concept of 40x as well.
This idea that we're caught upin a whirlwind and whether it's,
work or day to day life, thewhirlwind is all around us,
right?
And if we don't take time tostep outside of that, we're just
going through the motions oflife with, without being
conscious or meditative aboutwhat it is that we're doing.
So that's 40X, stepping out ofthe whirlwind is you know,
(10:57):
taking your deep breath andmaybe hitting, um, a little bit
of meditation, yoga or somethingto get your head straight, to
think about what you need to do.
Jonathan (11:05):
I do that.
You know, I'm a big fan of theapp Headspace.
Now you mentioned meditation.
Um, I don't know, I've got likeseven or 8, 000 minutes
meditated over the last coupleof few years, but I think that's
another good example ofdiscipline.
Number three, the scorecard,right?
Like we want to know how are wedoing better for worse as human
beings, but how are we doing?
Are we winning or not?
And, uh, I don't know, we seethat everywhere, especially with
all the gamification, right?
(11:27):
Well, hey, I'm going to put youon the spot, Jeff.
give me an example of how you'veused this framework in your own
career at your ownorganizations.
Jeffrey Krepps (11:34):
You know, I'll be honest with you, John.
I tend to use a variant of astrategic execution model that
is similar, but a little bitdifferent.
So I don't know what the namefor this is.
I picked it up many, many yearsago, but there are definitely
analogies.
with the 40X model, but itreally is more based upon, I
guess for maybe some of thelisteners coming from the
(11:55):
clinical space, based morearound a clinical treatment
model of assess, plan,implement, and review.
Like, there's always acontinuous process of, looking
at where are we at with ourproblem, what is our, plan for
addressing the problem?
How are we going to executethat?
And how are we going to reviewthat?
So you have goals in assessmentafter an assessment, you're
gonna have goals.
So there's a wildly importantgoal when you're planning,
(12:17):
you're ultimately saying whatyou're going to do.
And when you're executing your,your, involved in, the creation
of a lead measure.
the review happens at a tacticalmeeting at the, at the weekly
lag meeting.
So it's similar, but a littlebit difference.
and I always think of it as likea clinical model that is,
refabricated for organizationalthinking.
Jonathan (12:39):
Yeah.
And I think what's importantabout what you've described,
this assess, plan, implement,review is like, that's an
ongoing process.
You you do it once, right?
And come back in a year or fiveyears or something.
It's always going.
Were there any.
Big challenges that you facethat you found that this, this,
framework lent itself to andthat you were able to solve
because of it.
Jeffrey Krepps (12:57):
Yeah.
almost every single activity asa.
Strategic advisor as a strategicconsultant.
rests upon some sort of, ideawhere there's a goal, there's a
challenge, there's a problem,you're attempting to solve it,
and you execute interventionsthat are designed to affect
change in the organization.
So I could call out any numberof things that I've worked on,
(13:20):
but it's almost, I would sayeverything that I do is based on
that model.
Everything outside of, I have,I'll be honest, I haven't been
in operations, pure operations,And maybe seven or eight years.
So this is all I do.
This is what I do all the time.
Jonathan (13:35):
It's, yeah, you're right.
there's like a universalapplication of this to any
challenge that, that you face.
And I think back at Ascend, um,when we had this challenge of,
you know, we were getting thislow acceptance rate, on, uh,
BCBA offer letters think we'regetting a 50 percent acceptance
rate.
And we looked at this, we'relike, what are we doing wrong in
the process?
And we had to first step backand like assess.
(13:56):
And we figured out we weren'tlike, we were like speedily
going through the process, butwe weren't helping candidates
contact our values,organizational values.
So, you know, the plan we cameup with was sort of modeled on a
much harder interview processwhere they got to meet more
people in the organization,where they contacted our values.
We implemented it right.
Like.
Teed up the metrics we wanted tosee and whether it's gonna be
successful.
And then it was like thisconstant review and we actually
(14:18):
got it up to, and we've stayedabove 80 percent acceptance rate
ever since like four or fiveyears ago.
So, but I think this is, that'sa really important idea is like
you're constantly revisiting andworking through those four
stages.
Well, You mentioned that youhaven't been in, in operations
for, for seven or eight years,but like at your heart, I know
you love strategy.
I love strategy too.
Huge strategy I love likestepping up to the 10, 000 foot
(14:40):
level and looking at, you know,where an organization fits
within its competitiveenvironment in the field.
but tell me, how does strategyin your mind, Jeff differ from
execution?
Yeah.
Jeffrey Krepps (14:50):
Well, kind of put it in a way, like when you,
when you think about it, or whenI think about it, I think of it
as they're, they're essentiallyalmost poles of the same thing,
or they're essentially maybe theyin and yang of business
development.
They are, one without the otheris sort of like.
It's nonsense.
It's it doesn't make any senseto have half of a yin and miss
the yang or half the yang andmiss the ying.
(15:12):
And so to execute withoutstrategy is like going into a
wilderness without a map.
and that's back to thewhirlwind.
It's like, okay, you're justspinning around.
What are you, what are you evendoing with yourself day in and
day out?
Don't know.
I'm just too busy executing.
To strategize without executionis just.
One of the biggest waste oftimes that you could ever do.
It's the, you know, you putforth all of this money, you put
(15:33):
forth all of the team getstogether, you start drafting
strategies and plans, maybe evenpay a consultant and then you
never do anything with it.
Like, you know, why even gothrough the process?
You might as well just enter thewhirlwind and not think about
it, but to have, to have both ofthem prevents you from wasting
your energy.
Creating a document that isperhaps, destined for the scrap
(15:54):
heap of ideas and wasted effort.
And ultimately, just being ableto put them together as
strategic execution, I think isa more helpful way to kind of
look at the, the paradigm.
Um, there is also the science,the nuance, the magic between
the yin and the yang there.
And that's tactical execution.
Like it's helpful to havesomebody on your team that's
(16:16):
able to be able to say, let'stake these ideas.
We'll put them in the operator'shands and we'll be able to make
this magic happen.
Because sometimes with the bestof intent, you can have the
strategy there.
You can have the execution, butthere's this whole tactical
middle ground that has to happento convert one set of ideas
into, into practice.
Jonathan (16:34):
I love that imagery that you did in the end.
It's so true.
One of those like is without theother is functionally useless.
You know, I'll be honest.
Like, I'll make a big confessionwhen I started my career first
couple of years, I was amanagement consultant and I
didn't work in healthcare.
I worked in a whole bunch ofdifferent fields, but, we would
walk it.
I, I worked with Canada post.
Uh, so the, the Canadianequivalent of the U.
S.
Postal Service and I was inOttawa for, for many, many weeks
(16:56):
and we, um, we were tasked, Ithink, with looking at the
replacement future forecast andthe future replacement rate of
emails, or I'm sorry, ofphysical mail getting replaced
by fax, email, and other things.
So anyway, there's thisbeautiful, like deck that
resulted, this great strategy Irecommend about how they like,
afforded that.
And then guess what?
I'm sure it went on a shelf.
(17:17):
And like, we left it up tosomeone else to execute.
It's like, seriously, dude, likego, go execute on that thing.
Don't just tell me what to do.
Anyone has good right?
And you can say what to do.
So I think it's so true, man.
Jeffrey Krepps (17:29):
Yeah.
I mean, wouldn't that be great?
just, if you're not going to usethe plan anyway, How about just
paying me the money and I'll goto the beach and we'll just kind
of scribble a few notes on apiece of paper and you can have
that, but yeah, that's a goodexample.
It's
Jonathan (17:43):
Um, I, as I understand it, like you are like looking
out over the beach now, like inKona on the big Island.
I am super jealous.
That's like pretty sweet, dude.
I don't know how you get
Jeffrey Krepps (17:54):
hard to concentrate.
Jonathan (17:57):
Um, well, let me follow up on my question about
strategy.
Like what does it take for anorganization?
To be great at strategy.
Jeffrey Krepps (18:05):
Um, a couple of things, and I think like there's
so many, I think of so manyanalogies between what does it
take to be, a great individualand what does it take to be a
great organization?
And there, there, there are alot of parallels.
So one is being honest, beinghonest with yourself about the
organization, being honest aboutwhere you're at in time and
being able to have difficultconversations about areas of
(18:26):
improvement.
So that honesty really goes along way in Knowing yourself and
knowing your company and knowingwhat you do.
there has to be this,existential acknowledgment of
who we are and being honestabout who we are.
it's a prerequisite to anything,like, you're not going to go
anywhere if you're deludingyourself.
Or if you're, you're senseless.
have some misrepresentation ofwho you are, what you can do.
(18:48):
So number one, it's the realismof having on honesty with
yourself in order to, have thebest knowledge set about your
company.
Um, so otherwise you're lost.
but.
Then I would say, okay, so thoseprerequisites being said, then
you got to work it backwards.
Like, I'm a fan of like visionboards, visualizations, etc.
(19:09):
So the team having a realconcrete idea in mind in terms
of what is it that, that happenswhen we hit these wildly
important goals or What does itlook like when we're at the tail
end of that?
and it helps sometimes if youmentioned gamification earlier,
but if you gamify something, orif you have a big party at the
end of it, but what is, what'sthis end point going to look
(19:29):
like, you know, close your eyes,feel it, taste it, touch it,
smell it.
Like make sure you know where itis that you're going.
And start thinking about how ifI were to take steps backwards,
how could I get to the startingpoint?
So you can work it from thefront end.
You can work it from the backend, but it's a whole lot of
tactical objectives to get frompoint A to point B.
So you kind of subsect thesubheadings, work through the
(19:49):
subheadings.
If there are sub objectivesthrough there, work through
those, but you then line up thetasks, have a task analysis and
just line it up.
It's kind of like projectmanagement principles.
Um, but then, The other thing Iwould say is becoming an expert
is also know your expertise.
But also your teams, the peoplethat you work with have so much
(20:09):
knowledge.
They have got so much to say,they've got so much to give so
that, this being great atstrategy, it's not a one person
operation or it shouldn't be.
It should be a collectiveenterprise where people are
distilling all of the inputsthat they can into a.
Particular puzzle or aparticular goal that people are
working on and then ultimately,working to distill that down
(20:31):
into a functional plan to get tothat end point, that wildly
important goal, thatdestination.
So those are some things I thinkthat, you know, off the top of
my head, I would think arereally important for great
strategy.
be humble, work with others,know your destination.
Jonathan (20:48):
Well, you're now a consultant with your own
practice.
tell me more about the differentkinds of consulting services you
provide.
Jeffrey Krepps (20:54):
there's several buckets.
there's vision and strategywork, of course.
So, with strategic planning, Iwork on annual and three year
goals.
Typically, um, I do vision andvalues work, framing and
reframing those for teams, go tomarket strategies and de novo
planning for people that areentering new markets or
delivering new services.
a second bucket of work that Ido is in business and corporate
(21:14):
development.
So a whole litany of.
Market analysis, competitiveanalysis, market research
projects, outreach, growth,growth initiatives, cross
functional facilitation andproject management, M& A
support.
So that's sourcing and advisingbuy and sell side, of the
equation, due diligence andintegrations there.
(21:35):
I've recently started doingsome, not for profit corporate
structuring.
So starting up not for profitsfor people, doing some grant
proposals there.
and also, lastly, with businessdevelopment and corporate
development, partnerships,alliances, and joint ventures,
and working with people in waysto collaborate, in order to, uh,
more effectively servecommunities.
Ideally, that's like a goodcommunity, a good way for
(21:57):
individuals to more effectivelyserve communities cooperatively
rather than competing.
and then I guess the last bucketis along organization building.
So doing organizationalassessments.
If people don't know who theyare.
As an organization, I can helppull that mirror up and show
organizations who they are, dosome executive coaching and team
building.
and then, lastly, um, someinterim work.
So I can do interim fractionalexecutive, temp CEO, temp COO,
(22:21):
or temp chief, chief growthofficer.
I've done a few of those beforeas well.
Jonathan (22:26):
Wow, dude, that is a, an extraordinarily broad range
of what's really fun work, atleast in my mind.
That's like some super fun workthat you get to do.
I want you to harness like allof your expertise in autism
services, broader behavioralhealth, and take out your
crystal ball, Jeff.
what's the next five years goingto bring to the ABA field?
Jeffrey Krepps (22:47):
Okay.
And I can't say with the firstthing on my list, it's, it
doesn't take a crystal ball to,to realize this.
if you have been alive in ABA inthe last.
I'd say three to five years.
You've heard about value basedcare and you know that it's
coming down the pike Soultimately, as more, insurance
providers, funders, et cetera,are looking at the total volume
spend of these services.
(23:08):
They're going to be looking at,payment methodologies that
resemble other fields that I'vebeen previously, such as,
Medicare based services thathave capitated care.
They have moved to value basedcare.
And, essentially, companies.
will need to show value in termsof the services that they're
offering.
And primarily, at a minimum,that should be related to
(23:29):
clinical outcomes and access tocare.
if that's that no crystal ballnecessary, like you're asleep if
you don't know that one.
Some others, they're a littlebit, deeper back.
Another one that's emergent isthe increase in an engraved care
model so that, you would havenot just ABA, but ABA partnered
with neurology.
I mean, OTPT speech has beenthere for a while, but you may
(23:50):
see some pediatric mental healthpartnerships with ABA companies,
pediatric, pediatric home care,pediatric, Maybe even pediatric
primary care at some point, butyou can see, the integration of
the overarching healthcaresystem to acknowledge ABA as a
subsector of the healthcaresystem.
And, no, as no person is anisland, no intervention is an
(24:11):
island in the Americanhealthcare system.
Eventually, everything folds andcomes together.
another one would be, aregionalization, which would be,
say, a market density approachfor, companies looking to expand
versus a national approach, youwould see that as market
breadth.
So I think we're going to seeless of the days where the
highly funded invested companiesare going for a pin in every
(24:35):
state of the map.
And they're going to look atwhere are the markets that we
can most concentrate in and beable to most effectively serve
the most individuals in thatparticular market.
So it may be looking at moreregional versus national
markets.
seeing some effects of it.
God knows how long this willlast, but the effects of, higher
interest rates.
So there's all kinds of financerelated challenges and issues
(24:58):
related to tighter lending.
So you can see lower valuationsin terms of, offerings in the M&
A space.
More difficult access to loans.
So if you need a bridge loan orsomething, there may be more of
a risk at, failure or,involuntary exits, that are out
there, which in itself then, Iguess lowers valuations, but,
that expensive debt is going tolimit growth and improvement
(25:20):
initiatives.
So, you know, the moneyeventually.
Um, and then lastly, this one Imentioned joint ventures and
partnerships before, but I feelthat there's a lot of
opportunity for mom and pop andsmaller providers to be able to,
Be competitive in markets wherethere are more well heeled, more
(25:41):
heavily funded organizations outthere.
I think it only makes sense forthose providers to start
partnering up and looking atways they can help each other in
certain markets.
So that's what I got in terms ofmy crystal ball.
Jonathan (25:54):
Wow, if you had asked me that question about next 5
years in a priori, what I'vesaid, I I think I would have
said exactly all things justdescribed.
And I think it's so true.
in fact, to that last point, Iwas at a conference.
Actually, both of us wererecently at, I was talking to
some sharp folks in the fieldwho said, look, if In these
times, in these harder times ina field like ABA, there will be
(26:17):
non traditional mergers thathappens.
Call it a couple different,regional providers maybe that
come together who are valuesaligned and meet certain
criteria.
And there's a way to accretevalue that way.
that's different fromtraditional MNA.
So I think it's so true.
I want to talk about integratedcare, cause I am so passionate
about this is one of the thingswe built into ascends DNA from,
the get six years ago when westarted, that it's having ABA
(26:39):
company by family mental healthsupport, LCSWs and diagnostics
psychologists and a really smartdude in Silicon Valley recently,
I was at a dinner and he said,Jonathan, there's value in.
Bundling and unbundling.
And he was describing, not, justABA, he was describing like
generally any type oforganization as you're thinking
(27:00):
about how you create value foryour consumers.
And just give a, for instance onthis, think about, Microsoft and
how it bundles, right?
you buy a Microsoft, like thesuite, and then they introduce
like You know, MS Teams,Microsoft Teams, and that
automatically, is competing apotential consumer out of a Zoom
or somewhere they sneak it in.
So there's this value inbundling, right?
(27:21):
There's also a value inunbundling and just look at 20
years ago.
Cable companies existed and youhad to spend a couple hundred,
300 bucks a month and you had toget literally like thousands of
channels.
Like you couldn't decide.
And now you've got Netflix orHBO max, whatever the
subscriptions are, there's valuein unbundling.
And I think that's part of whatwe're going to see to your
point, there is value inbundling these different and
(27:43):
integrating different autismrelated evidence based services.
Guess why?
Because the consumer.
Ultimately, that's autismbenefits because they're going
to be getting speech or OT, orthey need a diagnosis.
they need maybe access to apediatrician.
So I think you're spot on withthat, that's part of the future
of our field.
Jeffrey Krepps (28:00):
to that point, like when you talk about that,
it reminds me of like the ideathat, we should be client
centered and individual focused.
And that's very true coming fromthe service side.
But that In the kind of likeproduct development, maybe in
tech space, we might considerthat consumer experience and in
some regards, they're the samething, right?
So we're carving out this piecethat this one person wants as a
(28:22):
micro data point and creatingthat experience for them.
Jonathan (28:26):
Yeah, well said.
Jeffrey, what's one thing everyABA business owner should start
doing and one thing to stopdoing?
Jeffrey Krepps (28:32):
Okay.
Assuming they're not doing it.
It's like, um, I guess.
Just empower your teams.
you hire your teams for areason.
no exec, no founder can doeverything.
So empower your teams toactualize on your wildly
important goals that you've setout and incentivize, and even
vest if you can your teams whenpossible so that they're part of
it.
They know they're entrenched.
They are part of the DNA.
(28:53):
So I think that's, that, thatis.
The most essential thing.
You need a team.
Nobody can do it themselves.
Empower the team.
Jonathan (29:01):
stop?
Jeffrey Krepps (29:04):
This may be a personal bias.
People may disagree, but I'd saylisten more than you speak, just
generally, you know, always be amagnet for information.
Always have your antenna up,listen more.
you know, the expertise iscloser than you think.
And it may be from that quietperson in the corner of the
room.
So just always be prepared tolisten more than speak.
Jonathan (29:26):
Such words of wisdom.
And before we wrap up, I got toask you, cause how did you get
interested in, in thepsychedelic mental healthcare
space?
I think there's some reallyinteresting research going on
right now about that.
Jeffrey Krepps (29:37):
Uh, yeah, certainly, There, I mean, I'm a
lifelong aficionado of, um,psychedelics as transformative,
substances for people, in the, Iguess, You know, long term, when
you look at it from anethnological perspective, these
substances have been used inshamanic experiences.
They have been used as, naturalhealing remedies for thousands
(29:59):
of years.
You know, it's, it's undeniable.
There's a history of this beinga medicine that's out there.
Personally, I had the mosttraumatic experience in my life
many, many years ago, well, 10or 11 years ago.
And, I had undergone, MDMA, selftreatment for that trauma.
And I would say that that'sfundamentally, it altered my
(30:20):
neurons in order to, it, youknow, it stopped my brain from
battling with itself, feelingsof guilt, feelings of.
The inability to, have done theright thing at the right
situation.
So it's going to sound nebulousto the audience, but trust me,
this is, this was a painfulexperience and still is, but the
medicine allowed me to walkforth in a nonjudgmental way,
(30:42):
assume the best of the situationand allow my, Cognitive rational
side of my mind to communicatewith my feeling and emotive side
of the mind in ways that talktherapy alone will never do.
It will never, ever do that.
So I have a passion for it.
It's personal.
And I look forward to Expandingaccess to this type of medicine.
Jonathan (31:03):
Uh, Jeffrey, you give me goosebumps, dude, that
emotion and your voice as youdescribe that.
Promise me when you were readyto come back on the pod to talk
more about psychedelics.
I cannot wait, to do more ofthat, sir.
Well, hey, Jeffrey, where canpeople find you online?
Jeffrey Krepps (31:17):
Um, you can find me, um, www.
asd.
earth.
That's for Akamai SynthesisDesign, www.
asd.
earth.
I'm also, LinkedIn.
you can find me there.
And personally, I'm always openfor networking calls.
You can reach out to me atjkreps.
That's jkrepps@asd.earth.
Jonathan (31:38):
And I know from firsthand experience how much
you are a knowledge sharer, andyou're trying to help to put
good knowledge and wisdom out inthe world.
So I appreciate that about you,Jeffrey.
All right.
You ready for the hot takequestions, dude?
Jeffrey Krepps (31:49):
Let's hit it.
Jonathan (31:51):
All right, you're on your deathbed.
What's the one thing you want tobe remembered for?
Jeffrey Krepps (31:54):
I want to be remembered as somebody that gave
more than they take, they'vetaken.
I want to be known as a kindperson.
I want people to know that I hada good heart and I gave more
than I took.
Jonathan (32:05):
What's your most important self care practice?
Jeffrey Krepps (32:07):
Uh, digging in the dirt, gardening, planning
things, being in nature.
Jonathan (32:12):
Well, hey, that's the jcreps at asd.
earth.
I did not even know thatextension existed.
So you've learned me somethingnew today,
Jeffrey Krepps (32:19):
You got it.
Jonathan (32:20):
Um, Hey, do you have a favorite song and or music
genre?
Jeffrey Krepps (32:23):
Um, millions, more than maybe not millions.
I'm exaggerating.
There's hundreds of favoritesongs.
I cannot, and it's not fair toask a music lover that question.
But, in terms of genre, like, Iguess, summertime I listen to a
lot of reggae.
Like, I like reggae in thesummertime.
I have a little seasonal affect,so in the wintertime it becomes
darker.
Sometimes I listen to stonermetal or like dark EDM, but, you
(32:45):
know, it varies depend,depending on my mood.
Jonathan (32:48):
I love it.
What's the one thing you'd tellyour 18 year old self?
Oh,
Jeffrey Krepps (32:52):
Um, chill out, dude.
don't rush to the destination.
The experience is right there infront of you.
know that your ego, althoughpart of the team, your ego is
really not the driver.
It's an illusion and it's tryingto take control.
Very important, valuable memberof the team, but not the
captain.
let the ego step aside and letthe true self shine through.
Jonathan (33:10):
that is deep AF.
Wow.
Um, You could only wear onestyle of footwear.
What would it be?
Jeffrey Krepps (33:17):
Okay.
This is kind of, it's an easyone.
after the last few, I live inHawaii and we wear slippahs
bra'.
That's flip flops to you peopleon the mainland.
Jonathan (33:27):
Slippers, bro.
Well, bra, it has been sick fun.
Thank you so much for coming onthe pod.
I've loved our conversation,Jeffrey.
Jeffrey Krepps (33:34):
I appreciate it too, man.
You have, you have a good one.
Hey, kind listener, thanks fortuning in.
If you like this episode, canyou do me a favor?
Give me a rating on yourfavorite podcast channel.
It helps more values alignedpeople like you find the pod.
Till next time, peace.
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