For Andy Tran and Jeff Farmer, a chance encounter at Farmington’s Westfarms Mall led to a multi-state business that helps people with mental illness and acquired brain injuries who are on Medicaid, live independently, while saving the state money and creating jobs for caretakers.
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For Andy Tran and Jeff Farmer, a chance encounter at Farmington's Westfarms Mall led to a multi-state business that helps people with mental illness and acquired brain injuries who are on Medicaid, live independently, while saving the state money and creating jobs for caretakers.
The Millennial co-founders of Farmington-based Center for Transitional Living LLC (CTL), both 30, see it as an across-the-board benefit.
“The most cost-effective, I would even say human-rights thing … is programs like we have right now,” Farmer said of businesses like CTL that offer an alternative to institutionalization. “It's just getting a lot easier to access agencies like ours and obviously, from our perspective, that's a good thing.”
CTL serves clients on what's called Medicaid waivers and who opt to receive care and services in a community setting, with assistance from home caregivers, rather than in a state hospital or institution. The services must be cheaper than in an institution.
About 75 percent of CTL's clients have a mental illness or acquired brain injury, or ABI, and more than half of its ABI patients require 24-hour care, Farmer said. Others need less help, such as assistance with daily chores, errands or medication reminders.
CTL also cares for the elderly on Medicaid who don't have a mental illness or ABI, but have physical limitations requiring assistance and want to live independent of a nursing facility.
Tran and Farmer say the cause drives them more than the money — seizing on a Medicaid waiver program designed to help people live in the community and to assist a population other businesses may shun for the low margins. Using cloud-based software and technology, Tran and Farmer say they've adopted efficiencies to profit under strict cost caps required by the state.
“I feel like it gives us an advantage to the old-fashioned style … of social work,” Tran said of dealing with everything from case notes to billing.
“A lot of the billing is now cloud-based and it's getting more efficient,” which saves the state money, too, he said.
High demand
Farmer and Tran serve a growing need.
Demand for institutional care is decreasing, while demand for community care is increasing statewide and nationally, said Dawn Lambert, who co-leads the community options unit and manages the strategy group within the Division of Health Services at Connecticut's Department of Social Services.
Just last week, for example, the state Department of Developmental Services announced plans to privatize dozens of group homes and other services for the intellectually disabled.
The state could use more businesses in the community sector, Lambert said, citing the state's growing aging population and more citizens choosing community-care options.
The percentage of Medicaid long-term care recipients receiving services and support in the home has risen from 52 percent in 2007 to 60 percent last year, according to state statistics.
That trend is expected to continue, Lambert said, adding that it's not just elderly fueling the rise.
“I think the state is looking to build the comprehensive package of services, like the mental health waiver services, and really looking to attract qualified providers and honor the preferences of people,” she said.
She cited a U.S. Supreme Court decision in 1999, Olmstead v. L.C., that required states to give people with disabilities a choice of where to receive long-term care services, not only in institutions.
“We're doing it because it costs a little bit less, we're doing it because it does improve quality of life, but at the end of the day, we're also doing it because it's the law,” Lambert said.
Early beginnings
Growing up with mothers who were social workers, Tran and Farmer were introduced early to helping people and, as Farmer said, “we kind of share the passion for doing something more.”
So when the former college buddies at Eastern Connecticut State University bumped into each other at the mall about mid-2012, both working in jobs they felt ready to change, they got to talking about the waiver program, with which Farmer was familiar, did research and decided to launch a business in that niche.
“We were just like, 'Let's just try it and see what happens,' ” said Tran, who majored in biology at ECSU and Farmer in business.
They incorporated CTL in early 2013 and each continued to work their day jobs while building CTL on personal time. They rented an office in downtown Hartford and got their first client there six months later. Their next client was in Greenwich.
“We're like, 'We better get in our car and make this happen,' ” said Farmer, who was living in Newington at the time, but now lives in Stamford, near Norwalk, where CTL also has an office. Tran lives in East Windsor.
Farmer kept his full-time job at DSS until CTL grew to about 50 clients and 50 employees.
“That was a really long, difficult journey,” Farmer said of balancing full-time jobs while starting a new company.
Tran found a new job after re-uniting with Farmer in 2012, working as a neurophysiologist for Safe Passage Neuromonitoring, a position he loves and continues to maintain as he works with Farmer to build CTL. His job is to monitor brain and spine surgeries and help doctors avoid nerves.
“It's like another set of eyes” for the doctor, Tran said.
CTL has grown to about 150 clients and has 118 employees, roughly split between full and part time. Clients are spread throughout the state, with the exception of the northwest corner.
The company has also begun serving clients in Colorado and Massachusetts and has visions of continued expansion, said Neil Connors, CTL's business manager and lawyer, also 30.
The company's on track for about $1.8 million in gross revenue this year, up from $1.2 million last year, $500,000 in 2014 and $50,000 in 2013, Farmer said.
About 99 percent of CTL's patients are on Medicaid. A few are on private insurance, a segment the company seeks to grow.
Aside from care assistance, CTL also is certified for prevocational services, such as resume preparation for waiver clients, that are Medicaid reimbursable, and for vocational services for on-site job training of people with disabilities. CTL would welcome an employer partner for the latter.
“That's one of the more progressive policies here in Connecticut,” Connors said.
“Rather than just pay for folks to get care, they'll also pay to have us train them to make a resume, train them to use Microsoft Office Suite,” Connors said. “That can be done anywhere, at their homes or in the library.”
CTL, as its name, Center for Transitional Living, suggests, also hopes to add physical centers to its business — places where clients can learn, socialize and connect to their communities, Tran said.
“Eventually, we want to start doing day programs so our individuals that we do take care of, they actually can go to a place … where they can either do some activities, prevocational work, or we can teach them how to do things, or apply for services, or even have a recreational area for them,” Tran said.
CTL would like to bring those services into centers across Connecticut and other states in which it operates, Connors said.
