What I do
Each engagement draws on the same underlying capability: the ability to find where operational process and data intersect, and build something better. That instinct runs through every service area below.
A new program launch is only as strong as the infrastructure underneath it. Most launch failures aren't vision failures — they're operational ones: the governance structure that seemed fine at incorporation becomes a problem at month eight, the EHR doesn't produce the reports DDS requires, the staffing model collapses under real volume. Updraft Advisory works with organizations from earliest planning through first-year operations — covering governance, regulatory compliance, payer relationships, data systems, and the reporting infrastructure that funders and boards expect to see. The work is hands-on and operational, not advisory from a distance.
Technology in this service area
EHR selection and implementation · RCM build-out (payer contracting, credentialing, clearinghouse, billing) · Reporting infrastructure · Board-level dashboards · Workflow automation · Power Automate · PolicyStat · Smartsheet
PACE de novo launch
At Element Care, built a site from scratch outside the core service area. Grew to 100+ participants, no-deficiency CMS review, GLFHC partnership including 340B pharmacy.
ABA/behavioral health startup
Co-founded RBTR Institute end to end: board governance, HR, finance, payer contracting, credentialing, clearinghouse, EHR integration, Excel transformation logic, QuickBooks revenue tracking, Power Automate workflows. Full cycle, fully documented.
DDS day services — College Navigation
Wrote the RFR, qualified with DDS, and launched as a new blended service line — from policy concept to operational delivery, with data tracking built in from the start.
Adult Foster Care expansion
Grew AFC program from 50 to 125 participants, restructuring operations, oversight, and reporting systems while maintaining compliance and quality.
The legal close is the easy part. What follows — integrating two leadership teams, two sets of contracts, two cultures, and two data systems while continuing to serve people — is where most mergers either find their footing or quietly begin to unravel. Updraft Advisory brings direct experience from both sides of a major merger, and from the COO seat that has to make the combined organization actually work.
Technology in this service area
Multi-platform EHR integration · Executive dashboard from EHR and finance systems · Real-time contract utilization tracking · Board-level quality and risk dashboards · Leadership restructuring supported by data architecture
CLASS + LifeLinks → Incompass
As CEO of CLASS, led the merger creating Incompass Human Services — $25M, 1,000+ individuals. Board relations, finance, external affairs, and operational and systems integration.
Post-merger COO leadership
Led Incompass through COVID, turned around a struggling Individual Supports program, implemented EHR with executive dashboard, completed CARF and state audits without findings. Built multi-platform reporting for real-time contract utilization visibility.
Leadership & overhead restructuring
Restructured CLASS leadership team, reducing overhead by $200K annually while improving operational capacity and board-level visibility into quality and risk.
PACE closure & participant transition
At PACE Vermont, implemented corrective action plan and managed full site closure — seamless continuity of care for all participants through transition.
Most advocacy efforts stop at the ask. The work that actually shifts reimbursement methodology, funding formulas, or regulatory structure requires something harder: an airtight analytical model that makes the outcome feel inevitable to the people who have to approve it. That's a different skill set than advocacy communications — and it's the one Updraft Advisory brings.
Colleagues say
Al is recognized among sector peers as an expert on rate methodologies and regulatory expectations for day program operations — bringing analytical rigor and deep state agency knowledge to the work.
— Based on direct feedback from senior nonprofit and healthcare leaders in Massachusetts
Technology in this service area
BLS wage data modeling · Rate methodology analysis · Coalition data synthesis · Structured analytical case-building · Presentation-ready findings for state agency engagement
The ADDP rate campaign is the proof point: built the analytical case that moved Massachusetts DDS reimbursement from the 50th to the 75th BLS wage percentile — significant statewide rate increases for IDD providers. This requires coalition relationships, deep familiarity with state agency methodology, and the ability to build the analysis, not just describe it.
Human services organizations operating under DDS, MassHealth, or CMS oversight face a category of operational challenge that general management consultants aren't equipped to navigate: program audits, corrective action plans, policy writing tied to regulatory requirements, staff development in compliance-heavy environments, and systems implementations that have to work within payer and state agency constraints. Updraft Advisory has operated at that intersection for thirty years — not as an observer, but as the person accountable for the outcome.
Technology in this service area
CMS audit documentation and response · End-to-end RCM (payer contracting, credentialing, clearinghouse, EHR, billing) · 340B pharmacy partnership management · Clinical EHR selection · Power Automate · QuickBooks integration
Full PACE operational range
De novo launch and no-deficiency CMS review at Element Care. Corrective action and managed closure at PACE Vermont. Community health partnerships including 340B pharmacy. Active interest in PACE expansion to younger adults meeting nursing-home-level-of-care criteria.
ABA & behavioral health operations
Built end-to-end RCM from scratch at RBTR Institute — payer contracting, credentialing, clearinghouse, EHR integration, Excel transformation logic, Power Automate workflows, QuickBooks revenue tracking. Full cycle, documented for handoff.
Regulatory policy writing
Authored program policy manuals and regulatory documentation at multiple organizations — including DDS-qualifying documentation for new service lines and CMS corrective action plans.
Staff development & culture
Built interdisciplinary team cultures at Element Care and Incompass — including supervision structures, training architectures, and the performance frameworks that hold quality accountable in regulated environments.