Driven to Serve – An Interview with ARRM CEO Sue Schettle

In this insightful interview, Sue Schettle, the CEO of ARRM (Association of Residential Resources in Minnesota), shares her journey, challenges, and opportunities within the Intellectual and Developmental Disabilities (IDD) sector. With over two decades of experience leading nonprofits, Sue brings a unique perspective to her role at ARRM, driven by a personal connection to the cause. In this Q&A session, Sue discusses her transition into the IDD space, the complexities providers face, and ARRM’s initiatives to improve support for individuals with disabilities.


TMP: What led you to ARRM?

Sue Schettle: What led me to ARRM was my niece. I have about 20 years of experience leading nonprofits, but I was burnt out and wanted to move to a more meaningful career. When I saw the CEO opportunity at ARRM, it immediately caught my interest because of my adult niece, for whom I am a godmother. 

I am very involved in her life, and she is supported in a family foster care setting. I thought I could wake up every day excited to work for my niece Heidi, her friends, and the people who support her. It filled a void and warmed my heart. So, I came to this role knowing how to run a nonprofit but also being very mission-focused on what we do at our association. It’ll be seven years this fall, and the time has flown by.

TMP: This was your first jump into the IDD space. Have you stayed engaged in these last seven years? What motivates you to work within this community?

Sue Schettle: The biggest shock to me was the complexity and regulation within the IDD human services space. Coming from the healthcare sector, where I ran a medical society for doctors, I thought the transition would be easy. However, I quickly realized how burdensome the regulations are for our providers to function daily. The amount of regulation providers have to be mindful of daily was enlightening. This keeps ARRM at the forefront for our members; we help them navigate the policies and practices of our Department of Human Services and serve as their voice to guide policy decisions.

TMP: What are the top challenges providers in Minnesota are currently facing?

Sue Schettle: The big ones are staffing, workforce management, and funding. Many professionals in the space are burning out, having worked in the sector for 20-30 years and nearing the end of their careers. We are actively trying to cultivate new leaders to bring innovative thinking to workforce challenges. Funding is also a significant issue. We have high expectations for individuals we support, wanting them to live in their homes and have the same opportunities as those without disabilities. However, there is a disconnect between funding and the actual impact on the community. Legislators sometimes focus too much on the bottom line without seeing the necessity of investing in the infrastructure to support these individuals.

TMP: Many professionals in this space have a personal connection to someone with IDD, driving their mission. Is that something you’ve seen as well?

Sue Schettle: Yes, many individuals in this field have a personal connection, whether it was their first job out of college, a family member, or another significant experience. This connection drives their passion for the work. However, those without this experience often have preconceived ideas about the sector, and we constantly educate legislators and others about the unique roles and challenges faced by direct support professionals.

TMP: Can you share some of the current initiatives ARRM is looking to advance?

Sue Schettle: One of our strategies to address workforce challenges is to explore new ways to support people. We’ve invested in developing a curriculum to teach providers, managers, and individuals about using remote support and assistive technology. Simple technologies, like monitors for refrigerators or stoves, can significantly support individuals without needing a person present. Additionally, we are focused on legislative priorities such as workforce funding and exploring alternative payment models and value-based purchasing. Minnesota hasn’t yet fully engaged with managed care plans, but we are preparing our providers for this transition by collecting meaningful data to support future decisions.

TMP: What role does data play in the future of service provision?

Sue Schettle: Data is becoming an increasingly important tool for us. We are helping our providers collect meaningful data to impact how they support individuals. This preparation is crucial for when Minnesota decides to adopt value-based purchasing or alternative payment models. We are partnering with consultants to produce data that will lead to actionable insights and better support individuals’ outcomes.

TMP: What legislative differences are you dealing with that might not be seen in other states?

Sue Schettle: Minnesota is not as advanced in data collection as some other states, but there is still an opportunity for exploration. We have made progress in securing reimbursement increases for direct support professionals within the waivered systems, ensuring inflationary adjustments every two years. This provides some stability for our providers, though it is never enough. We are also focusing on innovative solutions like technology to better utilize our workforce and support individuals according to their preferences.

TMP: Tell me about the ARRM annual conference.

Sue Schettle: The ARRM annual conference is our biggest event of the year. This year, we are expecting around 800 attendees, the highest number we’ve had. The conference attracts a range of participants, from C-suite executives to middle managers and direct support professionals. We aim to provide content that appeals to all these levels, and the event is a highlight for our staff and attendees. It’s a great opportunity for learning, networking, and celebrating the work we do.


Sue Schettle’s dedication to the IDD community shines through in her leadership at ARRM. Her connection to the cause, combined with her extensive experience in nonprofit management, drives her passion for improving the lives of individuals with disabilities. Through innovative initiatives, legislative advocacy, and a focus on data-driven approaches, Sue and ARRM are making significant strides in addressing the challenges faced by providers and enhancing the support available to those in need. The ARRM annual conference exemplifies the organization’s commitment to fostering collaboration and sharing best practices within the community.

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TMHP Billing Solution! Watch the Webinar

Simplify Billing, ISS, and More with TMP

Are you feeling the pinch of inflation tightening its grip on your IDD provider agency’s finances? Are you tired of facing constant headaches caused by TMHP billing or the new ISS regulations? Join us for this informative webinar where we unveil how TMP has solved the Texas billing roadblock, made ISS service simpler, and more!

TMP has always called Texas home, and our Founder, Larry Hill, continues to operate his own provider businesses within the state. His deep commitment to the IDD community not only enhances the care of those he directly serves but also supports the dedicated service providers in our great community.

In this session, we’ll dive deep into the world of ISS, TMHP billing, pharmacy connections, and IDD-specific digital software tools crafted by seasoned, Texas-based providers who understand the unique challenges faced by agencies like yours. Discover how leveraging these innovative solutions can empower your operation to accomplish more with fewer resources, ultimately boosting service outcomes, enhancing staff performance, and driving down operational expenses.

During this complimentary webinar, you’ll gain invaluable insights into:

  • Harnessing the power of our TMHP billing integration to eliminate headaches and optimize financial management.
  • Understanding the detrimental impact of inflation on your business and actionable steps to counteract it effectively.
  • Finishing IDD and ISS documentation in MINUTES…not hours.
  • Unveiling the secrets to transition from mere survival to growth and success.
  • Learn how to leverage TMP’s pharmacy integration.
  • Overcoming the challenges of change management and embracing transformative technologies with confidence.
  • Exploring the myriad benefits of adopting IDD-specific software designed by industry experts and advocates within the disability community, versus opting for a generic platform.

Presenters
Larry Hill – Founder of TMP, Owner of Hill Resources Inc, IDD Advocate

Gary West – CEO of TMP

Tim Strombel – Director of Marketing at TMP

Want to learn more about what TMP’s IDD-specific software can do for your provider agency? Reach out today to set up your free demo and learn why so many providers trust TMP.

A Journey of Love and Service: An Interview with PAR CEO Mark Davis

Mark Davis, CEO of Pennsylvania Advocacy and Resources (PAR), has dedicated his life to advocating for individuals with disabilities. Starting his journey as a teenager, Mark’s early experiences shaped his lifelong commitment to this field. In this interview, Mark shares insights into his background, his motivation for continuing his work, and the pivotal role of PAR. The conversation delves into the challenges faced by Pennsylvania providers, the organization’s key initiatives like the Sustainability Project, and the importance of data-driven approaches in transitioning to value-based care. Additionally, Mark discusses his collaboration with the American Network of Community Options and Resources (ANCOR) to impact services on a national level.

TMP: Tell me about your background. I know you’ve been in and around the space for a long time. What led you to where you are now?

I go way back. When I was 14 years old in 1974, my mother, who was the volunteer head leader of the Lake River Girl Scout Council, asked me to help her with the Easter Seals Camp. My job was to assist kids with disabilities in learning how to swim as a water safety instructor. I had no formal training, but I took on the challenge.

One memorable experience involved helping a boy named Tony. Without any proper introduction or guidance, I found myself in a life-threatening situation where Tony almost drowned. This incident was a turning point for me. It was the moment I realized that working with people with disabilities was in my heart and blood. Despite my career weaving in and out of different fields over the last 20-30 years, I never forgot that experience.

My background includes an undergraduate and a master’s degree in education and counseling. I interned at Hiram College and General Motors, intending to become an industrial counselor, but my path led me to human services and behavioral health care. I started and ran companies, worked in managed care, and eventually focused on provider-influenced and provider-led services for people with disabilities.

TMP: What motivated you to continue working in this field?

It’s been a journey of love and service. My personal mission has been to ensure that people with disabilities have every opportunity in life that you and I have. It’s simple but challenging. Twenty-two years ago, I had several career options. After deep thought and consultation with trusted mentors and my wife, I chose to work for a trade association because it allowed me to leverage my gifts and talents to impact many lives. I saw it as a calling to touch the lives of 60,000 people with intellectual disabilities.

The opportunity to influence and improve the lives of people with disabilities has been equally rewarding and frustratingly slow. Through my work with various organizations, including PAR (Pennsylvania Advocacy and Resources for Autism and Intellectual Disability) and ANCOR (American Network of Community Options and Resources), I’ve been fortunate to be able to help those organizations work toward making a significant impact.

TMP: Tell me about PAR – the organization you serve. How long has it been around, and what is its goal?

PAR has been around since 1970. We are the largest organization in Pennsylvania focused on providing services for people with intellectual disabilities and autism. Our key services include advocacy, training, education, consultation, and networking opportunities.

We are known for our political advocacy, working with the governor’s administration and the legislature at the state and federal levels. We also provide state-of-the-art training and best practices through our training arm, PARedu. Additionally, we offer consultation services and networking opportunities through various committees and member services.

TMP: What specific issues are Pennsylvania providers facing right now?

The issues we face are similar to those nationwide. Workforce shortages are a significant challenge, and most providers struggle with waiting lists and are unable to serve everyone in need. We’re also grappling with how to effectively use technology and create sustainable systems.

One of our major initiatives is the Sustainability Project, which aims to transition from the current fee-for-service model to more value-based, risk-sharing arrangements. We’ve been working on this since around 2012 and continue to refine our approach based on feedback from various stakeholders.

TMP: Can you share some opportunities for PAR to continue impacting the future?

Our focus is on system reform. The current fee-for-service model is unsustainable, and we need to move towards value-based care and risk-sharing models. The Sustainability Project is central to this effort. We’ve developed a framework for several possible pilot programs and continue to gather feedback to ensure these changes are feasible and beneficial.

Additionally, the state is moving towards performance-based contracting, which will require careful implementation to ensure it truly bridges to a more sustainable future rather than just being another fee-for-service system.

TMP: What role do EHRs (Electronic Health Records) and software play in this transition?

EHRs and data-driven approaches are crucial for the future. Organizations that are more data-literate and able to use EHRs effectively will have a significant advantage. However, this transition will take time to happen. It’s a big shift, and some providers still rely on manual processes.

The goal is to move from process-focused to data-informed decision-making, ultimately leading to value-based, evidence-based practices that improve outcomes. Our efforts with the Center for Disability Information and other initiatives aim to push the use of data to inform policy and practice and thereby improve the lives of people with disabilities.

TMP: Moving from rigid processes to an outcome-based service model is the way of progress in this space. When do you see that coming to fruition?

It will take time. While we can gather data on service costs, we currently lack systems to monitor and define outcomes for people with intellectual disabilities or autism. The relatively small size of our population, coupled with the high degree of variability in need, makes standardizing outcomes challenging.

However, it’s essential to move towards more flexible, outcome-focused services. Plans should be dynamic, reflecting the changing needs and desires of individuals. The shift towards outcome-based models will involve significant changes in how we monitor, define, and achieve these outcomes.

TMP: Tell me about your work with ANCOR and how your mission in Pennsylvania translates to the national association level.

I co-chair the ANCOR Alternative Payment Model Group with Kathy Carmody from Illinois. One of our goals is to focus on outcomes that matter to the individuals we serve, rather than just meeting state-imposed requirements. We aim to provide people with the dignity and autonomy to shape their futures according to their values while aiding in the viability of providers.

Through ANCOR, we collaborate with other states, sharing best practices and working towards common goals. The partnership with ANCOR allows us to leverage our efforts in Pennsylvania to share a broader national impact with our colleagues.


Mark Davis’s journey is a testament to the power of love and service in making a difference in the lives of people with disabilities. His dedication to advocacy, system reform, and data-driven approaches continue to shape the future of services for individuals with intellectual disabilities and autism.

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IDD Community Insights – Spreading Love and Building a Culture of Care

Navigating the landscape of Intellectual and Developmental Disabilities (IDD) services requires dedication and innovation. Andrew Hill, Individualized Skills and Socialization Program Director at Hill Resources, may only be in his 20’s, but he has been involved in the IDD community since he was a little kid. With a profound commitment to excellence and a passion for serving others, Andrew opens up to share what brought him into the IDD space and the impact he wants to have on a community that has always meant so much to him and his family.

Tell us how you are involved in the IDD community.

I am currently the Individualized Skills and Socialization Program Director at Hill Resources. In addition, I’ve served as a resource to many families and caregivers (in the IDD community) in my surrounding area helping them receive services. One of the parts of my job I love the most is seeing our individuals flourish and expand their abilities to include many new critical daily life skills.

How did you gravitate towards the IDD service field?

It’s a pretty sweet story. My whole life I saw my dad care for and love our clients as if they were his own family. As a result, I had an increased number of “brothers and sisters.” Many of the individuals that we served became some of my sweetest friends. While I was attending Hardin-Simmons University, working on my bachelor’s degree, I realized something. The world needs one thing the most. Love. Unconditional love. 

Anyone who has worked with the IDD population knows that if there’s one thing they do best, it’s love. I believe God has equipped me to be the hands and feet of Jesus in their lives, empowering those in our care to share with the rest of the world this same love. My dad modeled this beautifully by leading with kindness, truth, and love. I hope to continue this legacy. 

What was so appealing about working in the IDD space for you?

This list could be quite long, but I’ll narrow it down to three key aspects that appeal the most to me: the diverse population I serve in the IDD community, the dynamic nature of my role, and the nurturing work environment characterized by love and support. 

Embracing each day’s uniqueness and wearing multiple hats to cater to individual needs enriches my experience in the IDD community.

What are some of the daily challenges in trying to deliver excellent service for your clients?

The challenges seem to always be shifting and evolving, but the underlying challenge is always trying to deliver the best level of service and care possible. With that goal in mind, we are constantly looking to identify opportunities to improve staff training, communication, and service delivery. 

Inflation has been tough to navigate, but we have developed several unique strategies within our group that blend new technologies with the love and care our team brings to the community. TMP’s software certainly plays a role in helping us ‘do more with less’ as they say.

Inflation is a hot topic right now as the cost of goods keeps going up, but reimbursement rates are flatlining. How have you worked to address this imbalance?

There are several ways in which I’ve aimed to address this, both on a micro and macro level.

When the cost of living is so high and state reimbursement is so low, there is little to no room for error. Taskmaster Pro has improved our billing systems drastically. Take ISS for example. The time it took my staff to complete the paper forms averaged around 30 to 45 minutes a day. Now, our staff can document their assigned clients in under 30 seconds.

We’ve all heard time = money, but I would challenge that by saying, “time = money + better care.” The more time you can spend with the client, the better their quality of life is. There’s a ripple effect. More time with the client = better outcomes. Thanks to TMP our staff now have more TIME to spend serving our clients and not filling out stacks of paper or scrolling aimlessly through forms trying to remember their designated tasks. 

In addition, bringing awareness to Texas. Our industry needs emergency rate relief, period. There’s no dancing around that fact. Our hope is that soon, Texas legislators will recognize the discrepancy and fix the problem that is working against client care. 

Inflation is also combated by implementing technology. TMP ultimately lowers costs and increases returns. It maximizes billing while saving the provider time, and basic supplies such as ink and paper, and improves staff retention rates drastically, just to name a few ways.

In Texas specifically, where would you like to see improvement in IDD policy?

Partnership makes good policy and good policy makes great practice. I would love for Texas policymakers to give providers a seat at the table. There’s an incredible need for a respectable relationship between the private sector and the state government. We want to partner with them as a team.

As providers, we are greatly invested in the progress of IDD policy. I think it would be great if IDD policymakers grew their investment in the space. I would love to see them spend time annually assessing the field, attending IDD programs both public and private, and studying the implications of their policy changes. I truly believe a tremendous amount of issues would be solved if policymakers analyzed while experiencing the field in person, the quantitative and qualitative data that appears as a result of regulations.

Being around the IDD space for the majority of your life, what advice would you give other providers who are learning and trying to deliver great care to this space?

I’ve heard countless staff who’ve worked for other providers say things like “The other company told me to never get attached.” or “People always said never become close with the individuals.” But truthfully, I fundamentally disagree with this belief. Treat them like family. Become attached.

When you form a relationship with them, you don’t just care with your hands, you care with your heart. If you want to deliver great services to this population, create a culture of intentionality, respect, and love.

If you manage people, look for ways to bless them. It could be as simple as encouragement or stopping by and bringing them coffee. This goes a long way and encourages a culture of trust and respect. Not only does it bless the staff, it blesses the clients. A micro-level action can have a macro-level impact. Action creates culture, culture creates change.

How has utilizing TMP for your IDD software impacted operations?

It’s impacted our operations in almost every way. I am a firm believer in technology and efficiency. TMP is just that. Billing, staff scheduling, behavior management, user analytics, micro and macro internal staff communication, record keeping, case management, and staff training, just to name a few. Because it’s an enterprise system, it’s a one-stop shop for everything you need to run your business.

One thing I want to highlight is that TMP bridges the gap between DSPs and management and/or healthcare professionals. Anyone who doesn’t utilize TMP probably knows that often there’s a major communication barrier between DSPs and other service providers. There’s so much valuable information that a provider can miss if the frontline resource (Otherwise known as the DSP) isn’t able to communicate what’s going on. 

A tool that TMP has crafted is what they call an IBAM. This serves as an invaluable resource for collecting data reflecting the well-being of a client on the frontline. Behavior analysts, nurses, case managers, doctors, etc. all use this data to form the most educated decision relating to their healthcare practice.

In addition, I’ll speak to our ISS program specifically. As a manager, I’m able to schedule an off-site outing, assigning which staff and clients will be attending and where they will be going. The system automatically populates an event on the calendar and creates ISS logs while requiring staff to fill them out correctly. The system creates guardrails to eliminate recoupment on billing. For example, it will not allow you to submit a log where the ratio does not comply with state requirements. The system allows me as the manager to track logs too. I can see which ones are missing, pending, approved, etc. This allows me to maximize our ISS billing and ensure we maintain best practices.

Hill Resources has been a trusted TMP partner for a long time. New TMP modules are consistently tested in the Hill provider ecosystem to ensure they perform as providers require. What advantages do you see in being a partner like this?

If TMP wins, I win, and the IDD population around the nation wins. Our partnership proves to be invaluable. We’ve all heard the phrase “see a need, fill a need.” Our partnership is just that. We see a need in the field and they fill it! ISS is a perfect example. We quickly saw that there was a need for a more efficient method to document ISS logs. After much brainstorming, seeing the struggles our staff had with the paperwork, and receiving their opinions, we came up with an idea on how to solve the problem. Now, our staff are spending a fraction of the time documenting and more time caring for our individuals. That’s a tremendous win.

In the ever-evolving landscape of IDD services, Andrew’s commitment to excellence and innovation remains unwavering. Through Andrew’s role at Hill Resources and advocacy efforts, he continues to inspire and empower others, ensuring individuals with disabilities receive the support they deserve. Reflecting on his insights and experiences, we are reminded of the transformative power of love, technology, and collaborative partnerships in enhancing the lives of those in the IDD community.

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