How Do Family Caregivers Build the Business That They Need? Anne Patton on Founding A Better Life and Our Back Office Colorado

Episode SummaryWhen the school and disability-services systems couldn't give her son Chris — now 42 and living with autism — the life he deserved, Anne Patton built the infrastructure herself. In 2013 she founded A Better Life, a state-approved Program Approved Service Agency (PASA) that lets her bill Medicaid directly for Chris's residential, community, and employment supports, cutting out the 30–50% overhead that traditional agencies charge. Years later, realizing she wasn't the only aging mother running one of these agencies solo, she co-founded Our Back Office Colorado, a shared-infrastructure organization giving families of adults with disabilities peer support, succession planning, and collective bargaining power. This episode is a practical roadmap for any caregiver who has quietly been running a "business" — budgets, staff, compliance, hiring and firing — without ever calling it entrepreneurship.Key TakeawaysA Program Approved Service Agency (PASA) lets family caregivers become direct Medicaid providers — after background checks and state approval through Colorado's Department of Public Health and Environment, families can bill Medicaid directly for a disabled family member's care, avoiding the 30–50% cut that large agencies take.Caregivers of adults with disabilities are, in practice, running small businesses — payroll, hiring and firing staff, compliance, billing, and navigating shifting regulations (including COVID-era changes) — even when no one, including themselves, ever labels it "entrepreneurship."Shared infrastructure solves the aging-caregiver crisis — Our Back Office Colorado gives families of adults with disabilities pooled resources (succession planning, peer coaching, potential shared payroll/billing services) so aging parents aren't solely responsible for what happens to their adult children when they're no longer able to provide care.Succession planning is the missing piece for most caregiving families — most families never document a plan for their child's care because they're too consumed by day-to-day caregiving; existing resources tell families what to plan but rarely coach them through making it actionable.Lived experience is an "unfair advantage," not a liability — the most successful founders in this space, including Anne, solved a problem they personally experienced rather than one they observed from the outside, echoing broader research on what drives entrepreneurial success.About This EpisodeAnne Patton didn't set out to start a business — she set out to build a good life for her son. In this episode of Build Your Own Boat, Anne shares how advocating for Chris through Denver Public Schools, working in disability advocacy at Family Voices Colorado, and a frightening safety incident with a hired caregiver led her to found A Better Life, a Medicaid-funded service agency giving her — and Chris — direct control over his care team. She and host Janine Vanderburg trace the evolution from that first agency to Our Back Office Colorado, the shared-support organization Anne co-founded with other aging caregivers who were facing the same operational and succession-planning burnout. The conversation is a candid look at what it really takes to build a "business" out of necessity, love, and years of navigating bureaucracy — and why that makes Anne, and every caregiver like her, an entrepreneur in every sense of the word.About Anne PattonAnne Patton is the founder of A Better Life, a Colorado Program Approved Service Agency (PASA) providing residential, community, and employment services for her son Chris, who is 42 and lives with autism. A former banker turned disability advocate, Anne previously worked in finance and care coordination for Family Voices Colorado and the Chanda Plan Foundation, and has been active with the Arc of Denver and Advocacy Denver. Drawing on more than 40 years of lived experience navigating special education, Medicaid waivers, and home- and community-based services, Anne co-founded Our Back Office Colorado to give aging family caregivers of adults with disabilities shared infrastructure, peer support, succession planning, and a collective voice for policy change. Frequently Asked QuestionsWhat is a Program Approved Service Agency (PASA) in Colorado?A PASA is a Medicaid-approved provider designation that allows an individual or organization — including a family member — to bill Medicaid directly for a disabled person's residential, community, or employment support services, after passing background checks and compliance approval from the Colorado Department of Public Health and Environment.How can a family caregiver get Medicaid funding to support an adult child with a disability?Families can access Medicaid Home and Community-Based Services (HCBS) waivers once their family member turns 18, based on qualifying disability and support needs. Becoming an approved provider, such as through a PASA, allows the family to control hiring, scheduling, and care decisions directly rather than working through a third-party agency.What is Our Back Office Colorado?Our Back Office Colorado is an organization co-founded by Anne Patton and other family caregivers that provides shared infrastructure, peer support, and resources — including monthly coffee talks and future plans for shared payroll and billing support — for aging families supporting adult children with disabilities.How do I start a service agency to support a family member with a disability?Start by learning your state's Medicaid rules and provider requirements, connect with existing advocacy and parent networks (such as Family Voices or JFK Partners in Colorado), and be prepared for background checks, compliance training, and ongoing regulatory changes. Anne Patton recommends staying curious, talking to as many people as possible, and recognizing your lived experience as an advantage most professionals don't have.Why do aging caregivers need succession planning for their adult children with disabilities?Many aging caregivers have no formal plan in place for what happens to their child's care and housing when they're no longer able to provide it themselves, largely because day-to-day caregiving leaves little time for planning. Organizations like Our Back Office Colorado aim to coach families through building an actionable succession plan, not just outlining what one should contain.Resource StackOur Back Office Colorado — shared infrastructure and peer support for aging family caregiversFamily Voices Colorado — health navigation and advocacy for kids with special health care needsChanda Center for Health — integrative therapies for people with physical and other disabilitiesJFK Partners (University of Colorado) — early intervention and developmental disability training/servicesColorado Department of Public Health and Environment — state agency overseeing Medicaid provider approval and complianceColorado Medicaid Home and Community-Based Services (HCBS) Waivers — federal/s...