From Necessity to Nine Districts: Daniel Cummings on Building a Teletherapy Company in Rural New Mexico
When one of your school sites is a 70-mile drive from the district office, sending an SLP out for four kids starts to look less like a staffing plan and more like a math problem that doesn't work. Daniel Cummings knew that math. He'd been working in the schools in New Mexico since 2000, and the shortage of speech therapists in rural districts wasn't a surprise to anyone.
What turned into Unlimited Teletherapy started in 2011, when co-owner Keely Aragon-Horton needed to relocate but wanted to keep serving the same districts. The solution was straightforward: if the schools agreed, they'd deliver therapy through a screen. It wasn't a grand vision. It was a workaround that happened to solve a real problem.
More than a decade later, Unlimited Teletherapy has 16 SLPs on staff, contracts with nine districts across New Mexico, and a reputation built on doing the work well before ever promising to do it at all.
Find the Therapist First, Then Find the Contract
Most large teletherapy companies work the pipeline in reverse. They land the contract, then scramble to fill it. Danny and his partners, Keely and Nancy, took the opposite approach from the start.
"We make sure we have a therapist first," Danny says. "Before we tell a school we can help them, we try to find the therapist."
It's slower. It means saying no to opportunities sometimes. But it protects their reputation, and at their size, reputation is everything. Word of mouth from special education directors has driven much of their growth. One director mentions them at a conference, a colleague in another district follows up, and the relationship builds from there.
They also do their own outreach, searching school websites for districts that might need help and reaching out when they have availability. It's grassroots, but it works because they never overcommit.
Salaried Positions in a Gig Economy Field
One of the things that sets Unlimited apart is their compensation model. In a field where many teletherapy companies pay hourly or, worse, only for direct therapy time, Danny made salary positions a priority.
"Being speech therapists, we understand," he says. "We see both sides now. The business side and the employee side and the speech therapist side."
All three owners are practicing SLPs. They know what it looks like when progress reports pile up. They know the evenings spent finishing IEPs don't show up on a task log. So they built a company that accounts for that reality instead of pretending it doesn't exist.
"How many hours did they really work this week to get that IEP done or that eval or progress reports?" Danny asks. "A lot of things go unnoticed or take a lot of hours that the teachers and other staff may not realize we're responsible for."
That kind of awareness doesn't come from a business textbook. It comes from having done the job yourself.
2020 Proved the Model (and Tested It)
By the time COVID pushed every therapist onto a screen, Unlimited Teletherapy had been doing it for nearly a decade. They'd already worked through the tech issues, figured out troubleshooting for families, and built scheduling systems that worked at a distance.
"We definitely felt ahead of the game," Danny says. "But even with that said, it's been trying."
The silver lining? Staff and administrators who had been skeptical of telehealth finally saw that it worked. Teachers who used to dismiss the "teletherapist through the computer" were suddenly on the same footing, all remote, all trying to build a team from home. The playing field leveled, and communication actually improved.
Still, the year brought real challenges. E-helpers, the support staff who assist during teletherapy sessions, lost work when kids went fully remote. And the company briefly attempted expanding into occupational therapy but pulled back after turnover made it unsustainable. Danny was honest about it: "That might not be our cup of tea."
That willingness to step back from something that isn't working is just as important as the willingness to try it in the first place.
Contracts, Websites, and the Business You Didn't Go to School For
Danny is candid about the parts of business ownership that don't come naturally to SLPs. Contracts are a living document, changing with almost every new district. Some districts draft their own; others ask Unlimited to provide one. Over the years, the paperwork has grown "quite lengthy," shaped by experience more than by lawyers. In fact, they've needed surprisingly little legal representation, partly because the schools did their own legal vetting early on.
The website? Keely built it and maintains it. Marketing? Danny admits it's an area where they "lack some skills." But what they lack in polish, they make up for in clinical software expertise and genuine relationships with the districts they serve.
There's a lesson in that for any private practice owner: you don't have to be great at everything on day one. You just have to be great at the thing your clients are paying you for, and honest about what still needs work.
Just Keep Plugging Away
Danny's advice for anyone thinking about starting a practice or teletherapy company is practical, not polished. Find good partners. Find great employees. Expect a lot of work, plenty of failures, and some real successes along the way.
"Just know that it's going to be a lot of work," he says. "But if that's what you want to do, you just keep plugging away. Do your research."
He and his partners went to conferences constantly in the early years, not just speech therapy conferences but telehealth conferences in general, trying to learn from anyone ahead of them. And above all, they listened to the districts. Every school has different needs, different constraints, different expectations.
Ten years in, with 16 therapists and nine districts, Unlimited Teletherapy is proof that starting from necessity doesn't mean thinking small. It just means you start with the problem right in front of you and build from there.
Running a teletherapy company or growing a private practice means juggling contracts, documentation, scheduling, and billing all at once. ClinicNote is a HIPAA-compliant EMR built for private practices and university clinics, keeping everything in one place so you can focus on your students and clients. See how ClinicNote works.
Transcript
Kadie: You are listening to Clinic Chats. Clinic Chats is a multidisciplinary therapy podcast that was created for students, professionals, clinic directors, and supervisors. Clinic Chats is bridging the gap between graduate programs and professionals, sharing personal journeys of the smallest of private practice startups, large and expanding practices, as well as university clinic triumphs and tribulations. We hope you'll find our podcast informative and helpful in your career endeavors. Clinic Chats is sponsored by ClinicNote, an electronic medical record company for private practice and university clinics. ClinicNote was designed to make scheduling, documentation, report writing, and billing effective, efficient, and HIPAA compliant.
Kadie: Okay, today on the podcast, I have Daniel Cummings, and he is the owner of Unlimited Teletherapy. Danny is actually now my boss, and so I'm honored to get to have him join me on the podcast today. Hi, Danny. How are you?
Danny: I'm good. How are you? It's great to join you today.
Kadie: If you would like to go ahead and give me a little bit of background about your own experiences in SLP, when did you graduate and get started?
Danny: Oh, gosh. I don't even know if I want to say that, but I graduated in 2000. I started working in the schools right out of grad school, had been in the schools ever since.
Kadie: And when did your mind start thinking, maybe I want to give teletherapy a thought, or where did the idea begin?
Danny: Well, that actually began in 2011, that one of the co-owners, Keely Aragon-Horton, she was actually having to move, and we were both here in the same, actually worked for an REC, so we were in a few different districts here in New Mexico working. But then she wanted to keep working in the schools, so we actually thought, well, if the schools agree, let's do teletherapy, and we'll just start our own company. It was more of a necessity. I mean, there's a lot of need here in rural New Mexico for speech therapists.
Kadie: Okay, so being there all along, you kind of had that background knowledge that the need was definitely there.
Danny: Yeah, we definitely knew the need was here, and thought that might be a way to reach some of these rural schools. I mean, one of our districts, like when we go to set up computers, to leave the exceptional programs office from there, from the main district building, one way to one of the schools is a 70-mile drive, so it's 140 miles round trip. To go out there to see four kids, you can see how that's not, it's pretty difficult and financially, just to send someone out there is a nightmare, right? So it's easier for the schools to contract someone who can do teletherapy, and so they're not paying for mileage and that time.
Kadie: Absolutely. It was first Keely and yourself, and to give the listeners a background, now there are three owners, Danny, Keely, and then one other, Nancy. So did you and Keely begin to grow the company first?
Danny: We kind of laid out a plan, and Keely said, you know, I have a good friend that I used to work with in another part of New Mexico, and I think she'd be a great asset. And so we actually all met in Colorado Springs one day and got together and spent a day drafting a business plan and having a model and an idea, and from there, we just kind of moved forward and grew. And when we initially started, it was really just myself, Nancy, and Keely, and we were working in school districts, and then we hired Colleen Cleveland. I think she's our longest tenured employee, and we've just been growing ever since.
Kadie: Yeah. It's amazing. And how many therapists do you have total now?
Danny: We have 15 right now, and we actually just hired another one yesterday, so we'll have 16 starting Monday. Plus the three of us, the three owners are all speech therapists.
Kadie: Right, right. That is so neat. I think, you know, I just started in August, and there might have been 12 or 13, so I think just in that short time frame, obviously you're still acquiring other schools or districts.
Danny: Yeah, we are, and that's the idea, and we'd, you know, right now we're completely based in New Mexico, which, like I said, there's definite need, but we would like to branch out and see what we can do in other states. We just, sometimes it's a matter of just time to look.
Kadie: Right, yeah, and you all do your own therapy as well as the business side.
Danny: Yes, we do. It's not near as large of a caseload as it used to be. We've cut down just because we have so many responsibilities on the business end. As you know, the more employees you have in districts, it's the more time the business end consumes. So, yeah, we all have a small caseload right now, but in the past, we've had a full caseload and tried to do this.
Kadie: Yeah, and who would have thought that teletherapy would be really taking off this year, of course, not for the best of reasons, but I'm sure you all feel a little bit ahead of the game this year.
Danny: Oh, we definitely feel ahead of the game. Being able to implement this and have already gone through some of the tech issues and knowing what students and parents might have trouble with at home and how to troubleshoot and how to schedule and all that stuff. Yeah, we definitely felt ahead of the game, but even with that said, it's been trying.
Kadie: Right, yeah. We all signed up for that. You know, we signed up for teletherapy where a lot of individuals didn't, so that has to be more difficult.
Danny: Oh, absolutely. One thing I do think is coming out of this is some of the teachers or staff or members of the school or community that were maybe a little iffy on the teletherapy or telehealth side of things, and not even speech therapy, but they're getting to see that it does work and can be beneficial and it can be a good tool to use.
Kadie: Right, and I think it's really been a growing point as far as our own involvement in communication with the teachers, because maybe before they were all in person and thought, oh, that teletherapist through the computer, she doesn't matter, but now it feels like everyone is trying to create a team from their own home, so we're all in it together.
Danny: I think that's a great point. It's really forced, like you said, the staff that's on site to communicate more so than they probably ever have had to do, and that's definitely a good thing.
Kadie: I want to backtrack a little bit to when you're first getting your ducks in a row to start a business, whether it's teletherapy or a private practice that's brick and mortar, which are the majority of our guests, there's obviously legalities. Whenever you sign a contract with the school, I'm sure you over the years have tweaked your paperwork on how we create this official document. How has that developed over the years?
Danny: It's developed quite lengthy, actually. It depends on the district. Some districts, they draft the contract, and we review it and then have to make changes or recommend changes or disagree or agree. Some districts like for us to provide the contract, so it's gone through quite a few editing and changes over time. Even today, it's like a living document. It changes almost every time we do a contract, it seems like.
Kadie: And in that contract, do you guys typically involve a lawyer? I'm sure at this point, you've got to have some sort of representation.
Danny: You know, we haven't had to have too much representation at this point. We've had to, the schools on their end that contact, when we initially started, they contacted their attorneys and made sure everything was on the up and up, so we had a pretty good draft to go from. We have had to reach out a couple of times, but honestly, not as much as a person would think.
Kadie: Oh, well, that's a good thing. I first heard of the company through a close friend of mine, and so obviously, when she first told me about you all, I, of course, went to the website. And all of that is something that a lot of people as SLPs don't think of. How do you develop a website? So at what point did you guys get your website up and running, and who did you hire out, or if one of you made it?
Danny: Actually, we got it up and running somewhat early in the business. I'd have to say 2012. And Keely actually is responsible for building the majority of our website and upkeep, but I actually think that's where marketing and probably a little web design and things like that, that's probably where we lack some skills that we need to build on. But no, Keely did a great job with that, and that's kind of her baby.
Kadie: How do you end up finding contracts today? Maybe by word of mouth, or have you all done much as far as getting the name out there in New Mexico?
Danny: You know, a few have been word of mouth. We've definitely had some referrals from special ed directors in certain districts that really like what we do. And so, you know, they go to a big meeting or a conference and they run into a colleague and they're saying, well, we're looking for a speech therapist, do you have any ideas? And, you know, they're throwing our name out there. So that's actually helped a lot. And of course, we do our homework. We search the school websites and we try and find schools that might need some help. And if we have the availability, we reach out to them and see if it's a good fit.
Kadie: Nice. And so do you, and I don't know if there's a right or wrong answer here, but do you typically find an opening in a school first and then hire for it? Or do you normally have contacts made with SLPs who potentially are interested?
Danny: Yeah, I think this is how we're different from some of the bigger companies. We make sure we have a therapist first. So before we tell a school, yeah, we can help you, or no, we can't. We try and find the therapist first, to be honest.
Kadie: I think it's smart because what would you say then? And then your reputation's on the line if you never come through.
Danny: That's exactly right. I think we're still small enough that our reputation has a lot to do with us getting more contracts or, you know, a positive word out there. We've been very fortunate to have great staff like yourself and the other SLPs on our staff. We've just been honestly blessed to have such amazing SLPs.
Kadie: Aw, well, that is nice. Do you think that one day you have interest in expanding to other therapy disciplines? Or for the time being, would you focus on SLP but in other states?
Danny: You know, last year, we had some districts that were really interested in trying to get telehealth for occupational therapy. And we tried that. Unfortunately, we had some turnover with our occupational therapists. I think we went through, well, we went through two and we're trying to hire a third. And we just finally told the district that that might not be our cup of tea. So we're going to focus on the speech therapy. We would like to get some other disciplines, maybe social work. You know, we're honest, we're open to any of them. We just, I think we have to find the right fit of someone that maybe has some experience with teletherapy in their discipline.
Kadie: So it's been about 10 years now that you all have been in business. Would you say that 2020 could have been the hardest? Or do you think back in 2011 or whenever you said?
Danny: Yeah, I think the startup was probably a little more difficult. But this year's a close second. That's how I'm going to word that.
Kadie: So you were in person in your first years as an SLP. And then right away, once Keely joined, then you kind of made that transition pretty seamlessly to going to teletherapy.
Danny: Yeah, at first it was more of a hybrid model. I was actually going to the districts still, and Keely and Nancy were doing a lot of the teletherapy. Just because of where I was located, I could go to some of our districts. But as time went on, I, myself and Jenna Love, we lived in one of the towns that we were contracted with. So we did go on site. But right, as of last year, basically everyone is telehealth, except for me. I'll go in and I'll see a few of our more difficult students on site here where I live.
Kadie: And that is a benefit of you being a little more local.
Danny: Yeah. And, you know, I don't know if it's a benefit or not. I'm just here. So I go ahead and go.
Kadie: I'd like to explain the difference in your model as far as, you know, a lot of the big box companies might be hourly. And it is an opportunity to have a salary job while being a teletherapist, if you're okay with me sharing that.
Danny: Absolutely. And that's one of the reasons why, I think for a lot of us, why we are even able to take the job. Because for most families, I don't think an hourly school year contract is necessarily going to work.
Kadie: Right. And I even think some of them go even into, they pay for only your direct therapy time.
Danny: Honestly, being speech therapists, we understand. We see both sides now, for sure. The business side and the employee side and the speech therapist side. So we made it a priority to not only take care of our students and our districts, but also a priority to take care of our employees.
Kadie: Yeah. It's been amazing. And just like you said, you're all three speech therapists yourself. So it's like, you know, that when that progress report time comes or when you're bogged with IEPs, it's like, you know that there are evenings that you put in. It's just, it's appreciated.
Danny: Absolutely. We've actually talked about that every year. Like, okay, this is what it says on the task log, but how many hours did they really work this week to get that IEP done or that eval or progress reports? Like you said, it's definitely a lot of things go unnoticed or take a lot of hours that the teachers and other staff may not realize that we're responsible for.
Kadie: What would you say is like the biggest struggle of being an owner of a teletherapy company?
Danny: Time. Lack of time. And this year may change all of this, but before, I think we had a lot of teachers or administration principals that were definitely not on board with teletherapy. And to convince them, I'm not a very good salesman, but it took a lot of, some of our admin, it's taken a lot of work to get them to buy in or even give it a chance. That's probably been the biggest struggle.
Kadie: For sure. And that kind of sparked something else in my head. I'm thinking, obviously right now, most of us are remote. Our kids are remote, so we're dealing with families, but typically we're working much closer with our e-helpers, the people who are paid, I think, by the school, or are they paid by Unlimited?
Danny: We have actually a number of e-helpers that is paid through Unlimited. And we also have some of our schools, if they have an e-helper, it just depends on how, back to the contract, how they want to structure that and how they want to do it. But yeah, unfortunately, being completely remote has been really hard on our e-helpers and trying to make sure they get some work and things like that.
Kadie: Yeah. What a bummer for them. I'm sure it has not been a good year at all, so definitely have to keep that in mind. So that's been a struggle, like you said. What about the biggest success over the last decade in business? Is there a moment that sticks out in time where you think, you just remember feeling like, wow, I've put this together. We've done it.
Danny: It was probably about the fourth or fifth year. Nancy, Keely and myself, we went, we actually went out to Vegas, had our annual business meeting there. And we really felt like we made it, like, you know, if we want to keep this going, it's going to keep going. We just kind of looked at each other like, is this year five already? So that was probably it.
Kadie: Yeah, you know, and like I said, we've been very fortunate to have the staff we have to continue to grow and to put out a good name for Unlimited Teletherapy. And do you have a number in mind of how many districts and how many schools you all are serving right now?
Danny: Oh, gosh, I used to know this off the top of my head. I can't tell you the number of actual school buildings because it's a lot. Right now, we're in nine different districts.
Kadie: Oh, wow. That's awesome.
Danny: Yeah. So as far as school sites, it's way up there as far as buildings.
Kadie: Yes. Well, I've looked up just the scenery of those areas and it looks so beautiful. So one day maybe I'll come out and meet some of my favorite students or something.
Danny: Oh, you should. I think you'd love it. When most people hear New Mexico, they think, well, one, is it a state? And two, desert and cactus, which it is high desert. But like where I'm located, lots of mountains, rolling hills. The town I live in, our elevation is 6,600 feet. We're way above sea level. So it's an interesting place.
Kadie: Well, is there anything else you'd like to add about being a business owner or encouragement for those who might want to take a step in the direction of private practice in any capacity?
Danny: You know, sometimes you just have to take that plunge, find good partners and find great employees. And just know that it's going to be a lot of work. There's going to be some successes. There are going to be a lot of failures. And just, if that's what you want to do, you just keep plugging away, do your research. I can't tell you how many conferences we went to at the beginning of this regarding teletherapy and not even just directed at the speech therapy side of things, just so we could try and get a leg up on what we should be doing and how to do it. And also listen, listen to your districts because their needs vary greatly. I think that's important. The communication thing with your schools, with the staff, with administration. Some principals have been a tough sell on the teletherapy side of things. So maybe 2020 will help that, though, since they've been forced to do it.
Kadie: Right. Yes. And let's hope that the kids can get back in school in person. Who knows when? I hope soon. I hope by the fall, hopefully we'll be on the right track.
Danny: Yes.
Kadie: Thank you so much for taking the time to join me.
Danny: Oh, thank you.
Kadie: Thank you for joining me and listening to Clinic Chats, the speech therapist's private practice podcast. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey through private practice, please email me, kadie at clinicnote.com.