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Welcome to Real Talk with Tina and Anne.
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I am Anne and today we have Shawn Menvel on.
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She is the founder of Achievement Center for Therapy in California and Las Vegas.
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From what I understand, you know I really personally, you know this meant a lot to me for you to even reach out and want to be on, because, with having three kids with disabilities and autism and you know, it really hit home for me what exactly you guys do.
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But I would love for you to tell our listeners what exactly the Achievement Center for Therapy is.
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Great Thank you, and thank you for having me on this is a real pleasure and honor to be on here.
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So thank you.
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Achievement Center for Therapy is a pediatric feeding therapy center and it started as one in Camarillo, california, and that's in Ventura County.
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I started as one in Camarillo, california, and that's in Ventura County.
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That's my headquarters, and then added on Las Vegas, nevada, and the reason why is who I serve are military families predominantly, and from doing my work I kept getting recruited, if you will, from a doctor on Nellis Air Force Base to keep coming out to assist with some questions that they had about pediatric feeding, which is my specialty.
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So I kept going out to Nellis, to the Air Force Base, and then they said, well, why don't you just start a practice here?
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You're here an awful lot, and I thought you know what?
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That's not a bad idea.
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So I Did you talk more about what the feeding therapy is, because I'm not even aware of what that is.
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Oh yeah, so pediatric feeding therapy is actually what looks like for a lot of people, including, sadly, our pediatricians.
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A lot of times I go and I was teaching them the differences because there's kind of a fine line between the two.
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So a lot of times they get dismissed as they're a picky eater but it's not necessarily picky eating when it crosses a certain threshold.
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So my job and mission was that I would teach doctors, school psychologists, psychologists, nurses, everyone what that difference really is and what it looks like.
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All right, so that's how you got started, I got started, and then I added one last location just recently, in the last three years, which is in San Diego, again catering to my military.
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But you do a lot more than that.
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I mean, from what I understand, there's speech therapy and occupational therapy and ABA, advanced intensive therapy and independent education evaluation, you know.
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I mean you have a list of things that you do, so somehow along the line, you just kind of kept expanding.
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I did right so as a speech language pathologist myself and I was an expert witness for doing helping families with IEEs, which is the IEP.
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If you, um don't agree with that, that would go get that level.
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So, um, I do that as well.
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And then I'm also um the pediatric feeding specialist and and I think that came from just loving giving a voice to, um, children and people but then I started realizing I'm like, well, wait a minute, if you don't have your health or your nutrition, you don't have your health, and then those other things are just going to be a bigger challenge.
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We're going to be kind of like spinning our wheels.
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So I just I really got into pediatric feeding so that I just overall get to help the entire body and kids flourish with their development.
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Yeah, on your website you do talk about reaching helping each child reach their full developmental potential for communication and enabling them to increase their independence and everyday activities, increase interaction and participation with their families and improve the overall quality of their lives.
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I just want to quickly say that you know, we had people come into our home when my littles were really little and my four-year-old was nonverbal when I adopted him made by having all these tools and people in our lives early in order to help them reach what I consider their full potential right now.
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You know we've worked really hard, so what you're doing is really incredible and I really would encourage all of our listeners to.
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You know, for a program like this, it is so important to get kids that are having difficulties communicate their needs and their wants.
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I mean things that are just basic things.
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It's so important for us to understand.
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I mean, I've got kids, my kids, especially my one.
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I mean he still, when he gets sick, it's really like you know what is exactly wrong with you and we don't know what is exactly wrong with him.
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So we really have to, you know, try to use the language and try to learn their language and try to get them to learn how to communicate with us Exactly.
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Yeah it's, there's a lot to it.
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And then there's that hierarchy that we as the speech pathologists see, that we want to try to go make happen and that's our specialty where we come in.
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But then we also have to have that bond with the child so that then they even trust you and then can start basically their healing process and their rehabilitation.
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That's everything.
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I mean trust is everything.
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So I mean you have a process, I'm sure, of start to finish, of how you get introduced to the child, to where you get them, to where they need to be, where you can, because my one son, I kept taking him to different therapies.
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It just wasn't working.
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I mean there was nothing that was connecting with him.
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So getting that connection, I would think that very initial connection is really important.
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Yeah, the rapport building is definitely where we have to start with everybody and it's essential to get that piece.
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And then some it's on an individual basis, so some kids might take to a therapist a little bit easier and quicker and then sometimes it takes them a little bit longer.
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But, like to your point, there's sometimes where it just isn't going to happen.
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There's just a barrier.
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You know whether it's personal needs or something, maybe just a comfort or that trust like you mentioned.
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And that's where, knowing that and recognizing it and my expansion of not just having one therapy center, that's where all this teletherapy has come in and doing masterpieces and stuff like that.
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Because our outreach has to be bigger.
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Because what if you are remote and you only have one person in town to choose from and you tried it and it just didn't work out.
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So this opens up the doors so that people in remote areas and all over can actually go get exceptional care that works for them and their child.
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What is the age range that you work with.
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Directly one-on-one.
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We can work with babies right out of a NICU because we are pediatric feeding specialists.
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So that's happened multiple times that you know the parents need support after leaving the hospital, because that's a big, scary step right.
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You have this whole team of people at that hospital and then you go home and it's just you and your spouse.
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Then we work up to about pre-teens and that's because we work with a lot of children with autism and those social skills are really creating a barrier.
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So we find that that age range is when it's really essential to go after social skills critical to get them when they're as young as possible.
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Those younger years are absolutely key.
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So when you get a child and you've made the connection you've got, you're going now.
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I mean, what are some of the things that you might do with a child to help them get to becoming their best self?
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A lot of it is a systematic approach or it's a systematic desensitization.
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So a lot of times I think the secret to what differs from us being the speech language pathologist and expert and then parents, because a lot of times parents come in and be like I tried that I can't believe that's what you're doing and it's working for you.
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But the subtle little thing that's missing and not everyone catches it, is that we know if you're performing here, we just got to make sure that the child is performing just below here when we ask them to do things.
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Because if we ask too high of a level, which is a lot of times, what's happening with the parents?
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Because they're not speech language pathologists, they don't know that order, the developmental hierarchy, that sometimes you come in just slightly too high and then the child won't perform for you.
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So then we can identify that we bring them down to a level where they're very comfortable and that they're functioning at successfully.
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And then from there, once we got that trust and the rapport, we start building on that little bit by little bit and we just keep adding to their ability level.
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And there's different parts of language too, right.
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So there's the articulation of it, the phonology of it semantics in your vocabulary, so we just start building it up systematically.
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Okay, so how often do you have kids come in?
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Can it be weekly?
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Can it be, you know, a couple times a?
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week.
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You know what should parents expect when they come to your centers?
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So I have demanded, when we have our families, come in with insurances, because you have to contract with insurance.
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So I had to fight, fight, fight, fight, fight for this right contract with insurance.
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So I had to fight, fight, fight, fight, fight for this right.
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And I stick to it because I've learned over my 25 years that if you do only come in once a week, that then if that child is sick and we're talking about little children forming a new habit, and I know as an adult if I only do something once a week and maybe skip a week, it makes it really difficult, yeah absolutely.
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So if we're asking these little kiddos to do it too, it just makes it such a struggle.
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So that thing that I fought for was a minimum of two times a week, Because in the event that they make once, you still can come in and get that you know therapy session at least for once a week, instead of the twice.
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So how long have you been doing this in these particular centers?
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How many years did you say?
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I've been having private practices since for 13 years.
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Okay, so do you have any great success stories?
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I do.
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I have children who I meet who are on the spectrum I think are my most profound, that stick in my mind because me not speaking and not eating, and so then kind of just take it all in from the parent's wishlist again, right, and you want to just try to advocate and push as hard as you can and go as fast as you can, but that's not going to help the child, right.
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So it's tough.
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You got to sit back and let things process and play out.
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But to get to go see a child who is nonverbal on a communication device and then get to see that then now they're a verbal speaker, oh wow, oh yeah, that's a big moment for a parent, right.
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And then taking them and knowing that they're on the verge of with a doctor's order saying that they only have 30 days.
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I have 30 days my team and I to get a child to start gaining one pound, and it doesn't sound like it would be hard to do.
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But when you have a child that's a picky eater, has a pediatric feeding disorder and diagnosed correctly for a long time, that's a pretty big challenge.
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And diagnosed correctly for a long time, that's a pretty big challenge.
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And especially if you have a communication delay or disorder with it, you can't do your best to explain and know if they're understanding.
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So I would say that those are probably my best stories ever is when I get to go meet that 30-day deadline and be like we didn't gain one pound, we gained two, we're on the way to recovery, we won't need your feeding too.
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But thanks, doc.
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So that makes me excited, because that's a parental right is to make your child feel healthy and safe right.
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And if you feel that now you can't do that because you have a medical professional telling you in a roundabout way that you failed here, you know you couldn't feed your kid, and why is that?
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Well, I don't get into the parent shaming, I just want to come and fix the problem and I get a lot of passion and joy out of doing just that.
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So those are probably my top.
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When you get to get a kid off of a communication device that otherwise wasn't having a voice and now their parent can hear them.
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So I hear the passion with you.
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I mean this really means a lot to you.
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You can tell Well, can?
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I just ask, how did you get into this?
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I mean, why did you go in this direction?
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I have a younger brother, my brothers I have an older brother and a younger brother, so I'm a middle child and my younger brother was a delayed talker and so with that four years between us, I was just like, oh my gosh, and I was watching my parents like really be upset by it.
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So I would just try every moment I had to even pitch in to be like, okay, say it like this, or let's try to do this.
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So I got to say my career, probably unofficially, but started at the age of six trying to get my brother to talk and I, yeah, and I just kept going with it and then, and then what was that?
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After he would start talking and that got better, I would see that my parents were just struggling because he had a learning disability and they were trying to go to the schools and go through the motions of the IEPs.
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But you got to think this was many, many years ago, right?
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So to see those struggles, then I was just like you know what this just seems like a good fit for me.
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I love it and I can really be impactful and make a difference, and so I got to experience it from the school level.
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I've worked in the school environment.
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Then I just knew that I love medical.
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But I couldn't do enough medical and I felt like I wasn't doing enough of what I got taught to do.
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So I love the schools and that's how I formed the private practice.
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That is so amazing that you started that young and you took your passion trying to help your brother when you were so little and you took it into a passion.
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I mean, I have so many things in my life.
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It's a stepping stone.
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Everything is getting us to where we are in life.
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You know, I mean that's what I always say and there's a reason for everything, and we just really don't even know where we're going to end up.
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But I mean that is just so amazing that you took those skills and then you fed that passion and you ended up getting a master's degree in this and now you actually are this founder of this, these facilities.
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But you have an issue right now.
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You could lose it Right.
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Yeah, so I did cater to the military at all three of my practices.
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So I am a widow after my husband passed away.
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Oh my gosh, I'm so sorry.
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Thank you.
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So it was when our daughter was two years old.
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So I really devoted myself to just make it happen so that, as a single mom raising our daughter, that I can make sure I never missed a beat with her schooling, field trips, and I wanted to be at that classroom mom.
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So I knew too I couldn't work for anybody and go attend all that stuff.
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It'd just be impossible, right, or I'd be unemployed.
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So, with starting my own practices, it was really really important to me.
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But also the other part, that why I catered to where I was and where I landed, which is in Camarillo, california, there's military bases and I'm a military, such a nice upbringing from a military career that he had of 30 years, and so I just felt very comfortable and it was my weird way, if you will, of serving our country because I wasn't in the military, but I got to give back because I got to serve all these families and they have a lot of challenges because a lot of times they're like a single mom or single parent too, because they're deployed right.
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So I really kind of relate in a weird way Like I get it, you're on your own too, I am, I get you and let's get through this together.
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But the other challenge is is that the military families are usually at only one place for about three years, but by the time they find their therapist and get settled, sometimes they have less than two years, or around two years, to go get something fixed.
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And that's a challenge, because some of these things take time, and so I set up my practices all by these military bases because I just love serving them.
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But that problem that you're addressing or talking about is that it's a real big one is that our military has transitioned over to another healthcare management company to guide and run them as of January 1st 2025.
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And as a result I know it takes a lot to go get everything operating.
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I couldn't even imagine what they have on their plate to go do, but it's resulted in us medical providers not getting paid since January 1st 2025.
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Oh my gosh.
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And with three locations and staff like therapists are not minimum wage workers, you know.
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On the average they're like 60 to $75 an hour.
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So, and then the problem with healthcare insurance that a lot of people don't know or understand is that they could say well, sean, why don't you just close your doors or lay some people off?
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Well, you can't, you're not allowed by your contract to go not see and treat patients, because then it falls under patient abandonment, okay, and treat patients, because then it falls under patient abandonment, okay.
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And we're still expected to see and treat everyone as we have been, but we're not getting paid.
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So how?
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yeah, I mean, you can't operate like this, obviously you can't.
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You can't keep the doors open, you can't even keep the lights on.
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I mean, yeah, I mean, so I really don't even know.
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For one thing, let me go back to the insurance aspect, because I really don't know that much about insurances.
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My kids fortunately if, unless things change I'm not really sure, but you know with adoption and their disabilities and everything that came with them also came Medicaid.
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So I do know that with insurances, if something changes because all of a sudden our dentist no longer took straight Medicaid or you know there was a Buckeye change or whatever, and they're like, sorry, now you have to pay cash or whatever, because now we no longer accept that.
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So sometimes I mean, fortunately for me, I can just change.
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When it's open enrollment, I can change to another Medicaid provider.
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I don't know what happens in your case.
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I mean, what happens if the entire insurance just doesn't accept it anymore?
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I mean, can you end up trying to become a provider for that insurance that they do accept now?
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learning in life, life's lessons.
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I was so happy and content serving them, never thinking in a million years something like this could happen.
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I've been ranked on TRICARE's website as being an exceptional provider for many years, but it happened to all of us, right?
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So it's this transition process that they had to go through, and what I had to do is quickly buckle down and go get what's called a credentialing specialist to go start getting us on other insurances, so that then I'm not dependent per se.
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But that does.
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It's part of my passion, and mission has always been to help these families, because I feel like if they're overseas and they're fighting for us and they're helping our country, the last thing they need to do is to hear from their spouse or loved one that they got another fight to come back to, that their child isn't getting the health care that they need, and it might be a stretch.
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And I also say in my own personal opinion, after doing this for almost 10 years with military insurance, that I feel like it could be considered a national security concern or threat, and what I mean by that is and you can speak to it too, as a parent that if you were to lose your services that you're providing to your child and we know that they love structure and routine, and I close my doors.
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And now there's three different cities that don't have services that I was providing to these families.
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That's all.
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Those families are going to just be kind of unraveling a little bit.
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The behaviors are going to come back, the trips to the ER because they do have some behaviors that then get pretty rough and tough, you know, hanging on a wall or a floor, or you know they get themselves into harm's way because they're not regulated, they're not doing as well as they normally could or usually do.
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So then that military member has that on their plate, wondering how is their spouse or how are their kids doing without therapy in play?
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now and they're getting great stories right, or even if they're not deployed yet, they're at home and they're having sleepless nights now because their child can't sleep.
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It's wreaking havoc in their whole household because their child is struggling.
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And this is all because there's no continuity in care, because if people like me have to close our doors and it is happening all over you can read about it on social media all over the place there's threads after threads of you know TRICARE isn't paying and it's not.
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I'm not blaming anyone, it's just the process that's happened and occurred and it's super unfortunate that it's taking such a long time.
00:23:05.864 --> 00:23:31.096
But I just got to say to my parents and to everybody out there and to other providers that I hope everybody can hang in there along with myself to keep everything going, Because the saddest shame is, if you can't make it in that window of time, that they we don't know when we're going to get paid still If you can't stay open, then all these families suffer, but not just the families themselves.
00:23:31.096 --> 00:23:36.876
Like I said, it becomes then, in my opinion, a national security threat or concern, Did you?
00:23:36.896 --> 00:23:38.038
guys have any heads up.
00:23:38.038 --> 00:23:39.259
Did you have any?
00:23:39.881 --> 00:23:40.521
No, not at all.
00:23:40.521 --> 00:23:44.268
That would have been nice, but we knew that there was.
00:23:44.268 --> 00:23:46.411
Because the country is divided in two.
00:23:46.411 --> 00:23:51.647
It's called Tricare East for the East Coast and Tricare West for the West Coast.
00:23:51.647 --> 00:24:02.003
However, I got to say Tricare West is far bigger and covers more area of our country than Tri-East and they have different management companies that run them.
00:24:02.404 --> 00:24:15.556
For the East Coast they have a company called Humana and then on Tri-West, we have on Tricare West we have Tri-West now, and so we knew that the big date was going to happen on January 1st, that they officially take over.
00:24:15.556 --> 00:24:20.361
But we were also told, don't worry, in 2024, this is their blended year.
00:24:20.361 --> 00:24:25.547
So we thought like, okay, they're working on it behind the scenes Like they're a big company.
00:24:25.547 --> 00:24:29.810
This was a $65.1 billion contract.
00:24:29.810 --> 00:24:50.343
I'm sure they've got fabulous teams ready to go, but technology is technology and databases and people Like there's a lot of unpredictability and when they took it over, what we're getting back from them is just that there's glitches in the computer system and there's this problem and there's that problem, and so we just got to ride it out.
00:24:50.343 --> 00:24:53.306
But we didn't know that this was going to happen.
00:24:53.405 --> 00:25:05.181
No one could have been prepared for it for this, like they don't see them being able to transition, transition and be able to pay you at any point or have back pay or anything there's.
00:25:05.181 --> 00:25:07.005
No, they don't see that happening.
00:25:07.746 --> 00:25:10.019
They don't know when and when we call.
00:25:10.019 --> 00:25:18.319
It's just really frustrated staff on their end because some of us are getting a little heated, because this is a situation.
00:25:18.319 --> 00:25:18.861
It's critical.
00:25:18.861 --> 00:25:27.405
I've been in business, this is my livelihood, this is what I've done for my career, and it's under threat.
00:25:27.405 --> 00:25:35.959
So sometimes you know the other providers probably can be heated too, and you know you don't want to take it out on the person that's trying to help you at the insurance.
00:25:35.959 --> 00:25:39.728
They don't know themselves the person answering the phone.
00:25:39.728 --> 00:25:44.787
So they've even confessed like you know, we're quitting, like we can't take it.
00:25:44.787 --> 00:25:50.460
So then we know that they're losing staff, they're losing providers.
00:25:50.460 --> 00:26:03.236
What's going to happen here's the result Already, and you might be able to speak to it too is that there's already a shortage of all of us that can do this level of help for this population of children with special needs.
00:26:03.876 --> 00:26:11.355
Um, and there's, uh, there's, you know, a broad, a broad region of, like what that encompasses.
00:26:11.355 --> 00:26:20.041
There's, you know, um, down syndrome, there's autism, there's just neurotypical kids who you know have a stuttering or fluency disorder.
00:26:20.041 --> 00:26:21.545
There's just a wide spectrum of it.
00:26:21.545 --> 00:26:38.145
All right, but what's going to happen is when more people close their doors, then the waiting list that already exists, that nobody's supposed to have, is just going to keep growing and growing, and then there's regression.
00:26:38.145 --> 00:26:39.613
That's the other shame of it.
00:26:39.673 --> 00:26:39.974
It doesn't work.
00:26:39.974 --> 00:26:42.805
Oh my gosh, regression happens so quickly.
00:26:42.805 --> 00:26:44.037
I mean it can.
00:26:44.037 --> 00:26:46.142
Like you said earlier, it can happen in a week.
00:26:46.142 --> 00:26:47.105
I mean.
00:26:47.105 --> 00:26:49.058
So that's why you want to go two times a week.
00:26:49.058 --> 00:26:51.626
I mean it really does happen that fast.
00:26:51.626 --> 00:26:53.071
I know with my three.
00:26:53.653 --> 00:27:10.147
Yeah, when I worked in public schools as a speech therapist and that's how I started my career I got to do regression statements and we did them literally over a holiday break to just go see if the child's not present for just the holiday break how much retention there is.
00:27:10.147 --> 00:27:12.664
And let me tell you we found that there was a lot.
00:27:12.664 --> 00:27:20.463
So that's why those regression statements had to be done, because they knew that it was a thing and I just can't.
00:27:20.463 --> 00:27:26.019
It's disheartening, it's really upsetting to know how much I've given.
00:27:26.019 --> 00:27:29.708
In my team I employ over 35 people.
00:27:29.708 --> 00:27:34.076
They're fabulous, they're just amazingly talented people.
00:27:34.076 --> 00:27:41.827
We all have our own camaraderie together and to dismantle that or put it on pause is just a crying shame.
00:27:41.827 --> 00:27:59.078
You know, I'm hopeful that I can even find funding so that then I can keep my doors open to keep serving the military families and, while doing that, diversifying to get on those other insurance panels as much as we can, as quickly as we can, to help them.
00:28:00.000 --> 00:28:02.986
And until that happens, what do you?
00:28:03.066 --> 00:28:03.326
need.
00:28:03.326 --> 00:28:27.748
We need coverage for operation expenses, whether it's a capital investor that can help us to support us for the possible three, maybe six months at tops, so that we can remain open, because what I do know is with the credentialing specialist expert who I have and I'm very blessed and grateful to have found her, and you said everything happens for a reason.
00:28:27.815 --> 00:28:29.459
How I found mine was sensational.
00:28:29.459 --> 00:28:39.005
She's super good at what she does, so if I can go get those other insurance panels going, then that will help supplement that.
00:28:39.005 --> 00:28:45.422
We wouldn't need nearly as much to keep the operation expenses going because we'll no longer be TRICARE solely dependent.
00:28:45.422 --> 00:28:50.885
And then the other thing I do is I have master classes and I used to not do them.
00:28:50.885 --> 00:29:08.805
I used to not do them as nearly as frequently, but now I'm bringing them back because it is something that I enjoy doing, because I'm very grateful for being on your show, but I'm also I don't know look up to the fact that you have this following, because it's learning how many followers it takes.
00:29:08.805 --> 00:29:15.654
You know, to have a backing and then seeing how long it takes to get that many followers is a big job, right.
00:29:15.654 --> 00:29:25.096
So I have like only a thousand followers on my website and then to see how many people listen in on your talk show, it's pretty amazing.
