History

CARD or Center for Autism and Related Disorder was founded on the basis that “early intervention using applied behavior analysis (ABA) can yield significant and meaningful clinical results for individuals with autism.”

Dr. Doreen Granpeesheh, Ph.D, BCBA-D, founded CARD in 1990. The first center was opened in Encino, California. She developed CARD’s own ABA model to “optimize individual outcome using a comprehensive treatment curriculum for individuals diagnosed with autism.”

CARD has trained thousands of behavior technicians and behavior analysts with the CARD model and has “treated” tens of thousands of autistics.

CARD has locations all over the United States and has a mission to “help families from all backgrounds obtain top-quality, evidence based treatment that results in meaningful progress for each individual.”

Everyone knows ABA is abuse and their success is based on on well a person can mask.

No Therapy Provided by CARD

CARD does not provide any therapy, interventions, diagnosis, etc. Examples of this are ABA, occupational therapy, speech therapy or physical therapy. They only connect people with services.

Privacy

According to their Gainesville, Florida location:

“Card may be considered an agency of the State of Florid and that certain records of CARD may be considered public records, which are subject to the Florida Record Law. under Florida law, e-mail addresses are public records. The mailing list shared with any other agency, individual or entity outside of Card unless required by law.”

Not all their clients information is confidential.

If this is true in Florida, it could be true in other states.

Research

CARD has been involved with ABA research. They are investigating ways to make ABA more “efficient, effective and accessible.” Nowhere does it say that they are making therapy to benefit the autistic person, just indistinguishable from their peers.

In a 2017 study, CARD researchers investigated the impact of treatment setting on clinical outcomes, finding center based services to be more “effective.”

Due to this study, CARD created their center based ABA model that is used by most ABA providers.

CARD also conducted a study in 2021 on the effectiveness of Telehealth based ABA. The study showed it was effective for all ages. They are using this to increase ABA. Now they are developing more ABA software to help with ABA.

Using this research, they developed Skills, a web based tool that provides skill assessment, individualize treatment plan design and progress tracking with automated graphs and charts.

In other words, they are responsible for the abuse and PTSD for a lot of autistic children and adults.

Mission Statement

“CARD leads the world in the effective treatment of autism, guided by science and inspired by compassion, to help people with autism and their families thrive.”

Legislation

CARD also is involved in autism related legislation such as the CARES act and Battling Autism Act. Dr. Granpeeshen has advocated for mandated coverage of ABA. Their primary goal is to increase ABA participation to have as many autistic children go through this barbaric practice as possible.

CARD Changing Hands Often

On April 13, 2018, CARD was acquired by the Blackstone Group. Granpeesheh and CARD management invested in CARD along with Blackstone, with Granpeesheh serving as CEO until December 2019.

In December 2019, Granpeesheh was replaced by Anthony Kilgore in a board role.

In February 2022, Kilgore resigned for reasons not specified and replaced by Jennifer Webster.

There was a study done on the reason for this. It is discussed later in this article.

Documentary

In 2008, CARD produced and distributed a documentary in 2008 called “Recovery: Autism Spectrum and Its Return.” It was about four children who went through ABA. They claimed that they had been “fully recovered” as a result of CARD’s program. ABA just teaches children to mask. Thats it.

The documentary was directed and edited by Michele Jaquis with Grampeeheh. They won Best Documentary Award at the 2008 Directors’ Chair Film Festival.

CARD and Their HIPAA Breach

CARD experienced a HIPAA breach when “as part of a recent update to its patient billing systems, the third party vender responsible for generating patient invoices incorrectly made a computer error which resulted in certain caregivers receiving an invoice for services for an unrelated patient.”

They did not disclose how many people were affected. They report the problem as confined to January 2023 billing statements for patient cost sharing amounts. This incident was not on the HHS’s breach tool.

Type of information involved:

• patient name
• CARD internal reference number
• payment history (insurance payments, patient payments, adjustments, account balance)
• No sensitive banking or credit card information was compromised
• No personally identifiable information was compromised (social security number, address, phone number or email address)

In The Court House

Nord v. Center for Autism and Related Disorders, LLC

On August 22, 2022, a former employee of CARD, Cade Norde filed a class action lawsuit against CARD because of the data breech. She said that her privacy was violated because of this. CARD filed a motion to compel arbitration and dismiss the case.

The judge found it able to be solved without a hearing so the court grants the motion and administratively closes this action pending the decision of the arbitrator.

Arbitration has not happened at this time.

Taryn Sacchitella et al v. Center for Autism and Related Disabilities

On May 24, 2023, Taryn Sacchitella filed a labor standard lawsuit against CARD. This case was filed in the US District Courts, California Central District Court. The judges presiding over the case is David Carter and Autumn Spaeth.

Docket Entries:

On May 24, 2023, the complaint was received and assigned receipt number ACACDC-35374622

A certificate of interested parties was filed by the plaintiffs Taryn Sacchitella and Christina Smith.

Civil cover sheet was filed by the plaintiffs.

Request for clerk to issue summons on complaint #1 filed by the plaintiffs

On May 25, 2023, A notice of assignment to the District Judge James Siena and Magistrate Judge Autumnj Spaeth.

Notice to parties of court directed ADR program filed.

Notice to counsel Re consent to proceed before a United States Magistrate judge.

21 day summons issues re complaint #1 as to deferent CARD.

Notice of pro HAC vice application due for non resident attorney.

Order returning case for reassignment by Judge Jame Selna. Case randomly reassigned to District Judge David Carter.

On May 30, 2023, application of non resident attorney Logan A Parnell to appear Pro Hac Vice on behalf of the plaintiffs.

On May 31, 2023, Notice of deficiency in electronically filed pro has vice.

On July 3, 2023, an order by District Judge David Carter granting the application of a non resident attorney.

This case is still pending.

Bankruptcy

On June 12, 2023, CARD filed for Chapter 11 Bankruptcy. Judge David R. Jones presides over this case. They said that the pandemic severely hurt their business. It faced several industry wide headwinds, They had to restructure.

The bankruptcy petition:

Document History of the bankruptcy case:

On Friday October 13, 2023, Judge Christopher M. Lopez was added to the case. Judge David R. Jones was recused.

On Monday October 16, 2023, Certificate of Service (supplemental): Notice of (I) Entry of an Order Approving Debtors. Disclosure Statement and Confirming the Joint Chapter 11 Plan of Center for Autism and Related Disorders, ::C and its Debtor Affiliates and (II) Occurrences of Effective Date (Docket No, 333)

On Thursday October 19, there was a Final Application for Compensation for Quinn Emmanuel Urquhart & Sullivan, LLP, Special Counsel, Period 6/11/2023- 7/28/2023

CARD is Sold Back to Original Owner As a Result

On July 27, 2023 bankruptcy court has approved the sale of CARD. A “successful bid” of $48.5 million and two companies are included with the sale. They are Pantogran, a non profit led by CARD founder and former CEO Doreen Granpeesceh and a consortium made up of a PE firm Addax Group and its portfolio companies, including Proud Moments ABA and New Story.

It is thought that CARD will split into multiple companies. Pantogen will pay $37.4 million and control 10 CARD state markets and other business assets.

Whatever is left over is split between Audax’s portolio companies for $11.1 million.

As soon as the sale becomes finalized, the bankruptcy for CARD will continue.

How the Bankruptcy Effected the ABA Industry

When CARD’s bankruptcy has effected the ABA industry as a whole, They are the largest ABA companies.

One representative of CARD said,”I’d say the CARD transition is more indicative of where we are in the market it is of where the market is going.: Seems like they are in denial.

They said that CARD is an isolated example of a behavioral health company needing a court order restructuring because they don’t have any money.

CARD filing for chapter 11 does show several industry trends already happening.

These have strained the ABA sector:

• stagnant fee for service reimbursement rates
• along with rising inflation and interest rates.

Some companies had to make very hard decisions to cut jobs in order to stay afloat. There were others in “hyper growth mode” went to slow and steady and focusing on organic growth.

This means that deal volumes have been down during 2023.

Being a part of CARD’s banruptcy, the majority shareholder Blackstone agreed to sell its stake to Doreen Granpeesheh, the founder and former CEO, for $25 million.

CARD was valued at $700 million. Blackstone had 70% of the company.

CARD was not alone in the ABA providers that took advantage of a large investment in the market. They bit off more than they could chew. They borrowed from private investors.

In April 2023, the company’s annual earning before interest, taxes, depreciation and amortization (EBITDA) were a $22 million loss. Its net loss was $82 million, while the revenue totaled to $160 million for the same period.

They had to pay back what businesses invested in CARD, and they did not plan for it. They saw autistic kids as cash cows and could not keep up. It is encouraging to see that the volume of children has gone down this year. We can only hope it’s because autistic adults speak out about the abuse. The industry is hurting and thats what counts.

The Industry is Using Autistic Kids as Cash Cows

Autism services because a hot market for Private Equity buyouts. When health insurance for autism was widespread due to legislation requiring coverage of ABA.

The money was flowing in once the coverage was mandated.

There was a 12 private equity owned autism service chain in a study, at least 30,000 people at 1,300 locations. This study was called “Pocketing Money Meant for Kids: Private Equity in Autism Services.” Almost all private equity owners are large firms investing in anything. This can range from fossil fuels to retail stores. They have little to no experience with anything related to autism.

These investors drive rapid consolidation of small providers into large chains, and most of the time, load providers with a lot of debt that they didn’t have before.

“Parents who fought for health insurance coverage for their autistic kids expected the funds to be used to expand access to high quality treatment. They didn’t expect firms to move in, skim reimbursements to pay high salaries to executives and deliver millions to private equity partners.”

The findings of the study:

• Between 2017 and 2022, private equity firms completed 85 percent of all buyouts of autism service providers. This is a rate not found in any other industry. PE firms now dominate this market.
• One average, the 12 firms in this study, CARD included, sold their service chains to other PE firms every four years.
• After the buy out, PE owned autism service chains have less staff , training and supervision. These undermine both job quality and care quality. Some PE owners prioritize patients who can get higher billing rates or states with higher reimbursement rates. This makes care inaccessible. Not just ABA but OT, SLP, and PT as well.

While it is good that less kids are getting ABA, the companies and private equity investors are using autistic kids as cash cows, only serving profits, not kids. We as the autistic community said this was going on and no one would listen.

Sources:

https://academic-accelerator.com/encyclopedia/center-for-autism-and-related-disorders

https://dockets.justia.com/docket/california/cacdce/8:2023cv00914/885654

https://www.reuters.com/legal/litigation/autism-treatment-center-gets-us-bankruptcy-court-approval-485-mln-sale-2023-07-26/

https://www.bkalerts.com/recent-bankruptcy-cases/texas-southern-bankruptcy-court/9:23-bk-90709/bankruptcy-case-center-for-autism-and-related-disorders-llc

https://www.pacermonitor.com/public/case/49184031/Center_for_Autism_and_Related_Disorders,_LLC_and_CARD_Holdings,_LLC