The services cliff
ends here.
Medicaid-first, culturally affirming ABA therapy and adult autism transition services for the families the system left behind.
The system isn't overwhelmed.
It was never designed for them.
Three programs. One mission. The families others turned away.
Adult Autism Transition
The moment a young autistic person turns 22, their federal entitlement to services ends. We catch them before the cliff. Our adult transition program delivers life skills coaching, supported employment, vocational readiness, and independent living support — designed specifically for the 50,000 autistic youth who age out every year into a system with nothing for them.
BIPOC-Focused Pediatric Care
Black children receive their autism diagnosis 42 months after parents first raise concerns. Hispanic children are 65% less likely to be diagnosed than white peers. We're building a pediatric ABA program that prioritizes these families — delivered in their preferred language, by providers who reflect their communities, accepted on Medicaid. Culturally affirming isn't a marketing word for us. It's the service requirement.
Medicaid-First Access
Most ABA providers prefer commercial insurance. Medicaid reimbursement is lower, paperwork is higher, and families on Medicaid get deprioritized. We're building our entire business model around Medicaid. Our caregiver-mediated model reduces session time by 75% — making Medicaid rates sustainable and allowing us to accept referrals other providers won't touch. Five days from referral to first session is the target.
Structurally committed.
Not just mission-stated.
Every healthcare company says they care about underserved communities. Most of them mean it when they say it. We built our structure so it can't be taken away.
Delaware Public Benefit Corporation
Our charter legally requires us to balance profit with public benefit. Shareholder interests cannot override the mission. That's not a policy — it's the corporate structure. PBC status survives leadership change, investor pressure, and acquisition attempts.
Sister 501(c)(3) for Advocacy
A portion of our financial success flows directly to a sister nonprofit. That organization funds policy advocacy, community organizing, caregiver training grants, and direct services for families who fall through every other crack. We're building the market and working to change the rules at the same time.
<5 Day Referral-to-First-Session
The average time from autism diagnosis to first ABA session is 6–18 months. We're targeting under 5 days. Our caregiver-mediated model means sessions can start without a full BCBA caseload in place — caregivers learn to deliver the program while the BCBA supervises. Speed is an equity issue, not a branding claim.
Caregiver-Mediated + BCBA-Supervised
Traditional ABA requires 30–40 hours per week of direct therapy. Families rearrange their lives around it. Our model is 4–5 hours of BCBA-supervised sessions, with caregivers trained to deliver evidence-based strategies between sessions. Same outcomes. 75% lower cost for payers. Families remain agents in their children's care — not just recipients of it.
Founder, Elevate ABA
Built from the inside.
Brian Gutierrez spent 3.5 years as a Registered Behavior Technician before founding Elevate ABA — not because the career path pointed there, but because the gap he was asked to step over every day became impossible to ignore. He watched families on Medicaid wait for slots that never opened. He worked with autistic adults who had aged out of every program that existed and were now invisible to a system that had promised to serve them.
He has lived experience with autism in his own family. The services cliff isn't abstract to him — it's the phone call that doesn't get returned, the referral that sits in a queue for eight months, the young adult who has everything he needs to work a job and live independently except someone to help him learn how. Elevate ABA exists because Brian has been on both sides of that gap.
Brian is building Elevate ABA as a Delaware Public Benefit Corporation, pursuing fellowship support from Echoing Green, Camelback Ventures, and Halcyon, and looking for a BCBA co-founder who shares the conviction that the current system isn't an accident — it's a design choice, and different choices are possible.
Read the white paper.
"The Services Cliff" documents the data behind what we're building: waitlist data, employment statistics, the care desert map, the financial case for a Medicaid-first model. It's the foundation everything else rests on.
Download: The Services Cliff →We need a BCBA who's done watching the gap get wider.
If you're a Board Certified Behavior Analyst who has spent years delivering care to families the system keeps underserving — and you've been building a picture in your head of how it should work instead — we should talk.
This is a co-founder role, not a clinical director hire. You'd own the clinical model, shape the training framework, and build something that could reach the families who currently have nothing. Equity. Mission alignment. The hard work of getting there.