After working with Therap across multiple disability service organizations over the past four years, I can confidently say it's one of the most comprehensive electronic health record (EHR) systems specifically designed for developmental disabilities and home and community-based services (HCBS). Unlike generic EHR platforms that force disability service providers to adapt their workflows, Therap was built from the ground up with this sector's unique needs in mind.
Therap Services, LLC operates the leading web-based documentation, communication, and billing platform serving over 7,000+ agencies supporting individuals with developmental disabilities, intellectual disabilities, and behavioral health needs. The platform currently serves more than 600,000 individuals receiving services across North America and internationally through Therap Global.
Based on my hands-on experience implementing Therap in three different agency settings, here's what the system actually delivers:
Documentation capabilities:
Electronic Individual Service Plans (ISPs) with goal tracking
T-Log (daily service documentation) with mobile access
Incident/Accident reporting with state-specific compliance
Medication administration records (MAR/eMAR)
Health tracking and medical appointment logs
Behavior support documentation
Communication tools:
Secure messaging between staff, families, and guardians
Staff scheduling and shift notes
Agency announcements and policy distribution
Electronic forms and data collection
Administrative features:
Comprehensive billing and claims management
Staff training tracking and compliance monitoring
Reporting and analytics dashboards
State regulatory compliance tools
Important context: Therap isn't a quick-start solution. In my experience, proper implementation takes 3-6 months with dedicated training, but the long-term efficiency gains are substantial.
I've guided three disability service agencies through complete Therap implementations, supporting 45-180 staff members in each transition. Here's what the process actually looks like beyond the marketing materials.
Initial setup complexity: Medium to High
The first agency I worked with, a 50-person residential provider in Pennsylvania, took four months to fully transition from paper documentation. The learning curve was steeper than anticipated, particularly for staff who weren't tech-savvy.
What went well:
Therap's implementation support team provided weekly calls
Customizable templates matched our existing documentation
Mobile app reduced documentation delays significantly
State-specific compliance features saved countless hours
Unexpected challenges:
Internet connectivity issues at group homes caused documentation gaps
Some older staff members resisted the technology change
Initial data migration from legacy system took 6 weeks (expected 3)
Custom report building required more technical knowledge than expected
Time investment breakdown:
Administrative setup: 40-60 hours
Staff training: 2-4 hours per staff member
Documentation template configuration: 20-30 hours
Ongoing support (first 90 days): 10-15 hours weekly
Critical success factor: We assigned "Therap champions" at each location—tech-comfortable staff who could provide immediate peer support. This single decision reduced our support tickets by 60%.
After the learning curve, here's what daily Therap usage looks like in practice:
For direct support professionals (DSPs):
10-15 minutes per shift for T-Log entries
2-5 minutes for medication documentation
5-10 minutes for incident reporting (when needed)
Overall documentation time: Reduced by 30-40% versus paper
For supervisors/managers:
20-30 minutes daily reviewing staff documentation
15-20 minutes weekly generating required reports
5-10 minutes responding to family communications
Significant time savings: No more paper form reviews or filing
For billing departments:
2-3 hours monthly processing claims (previously 8-10 hours)
Near-instant authorization tracking
Automated service verification
Reduced billing errors by approximately 75%
The T-Log module is Therap's core documentation tool, and it's where staff spend most of their time.
What works exceptionally well:
Quick entry templates reduce typing by 70-80%
Mobile app allows real-time documentation during services
Dropdown menus ensure consistent terminology
Photo attachments document activities and achievements
Automatic timestamp verification prevents backdating concerns
Practical limitations I've encountered:
Requires stable internet connection (problematic in rural areas)
Template options can overwhelm new users initially
Character limits on some fields feel restrictive
Mobile app occasionally requires reinstallation after updates
Pro tip from experience: Create location-specific templates with frequently used phrases. One agency reduced their average T-Log time from 18 minutes to 7 minutes using this approach.
The ISP module manages person-centered planning and goal tracking.
Strengths:
Comprehensive goal tracking with measurable objectives
Automatic progress note reminders
Integrated assessments and evaluations
Review date tracking prevents compliance lapses
Guardian/family portal for plan review and input
Areas for improvement:
Initial ISP creation takes 2-3 hours (complex individuals)
Not intuitive for new users without training
Report generation requires multiple steps
Limited customization for non-standard goals
Real-world impact: One agency I worked with reduced their ISP completion time from 4 weeks to 10 days after staff became proficient. Compliance with state ISP requirements improved from 82% to 98%.
This module handles critical reporting requirements with built-in compliance features.
Key benefits:
State-specific reporting forms pre-configured
Automatic routing to supervisors and administrators
Timeline tracking prevents late reporting
Root cause analysis tools
Integration with protective services notifications
From my experience:
Reduced reporting time by 50% compared to paper
Eliminated lost or incomplete incident reports
Automatic escalation prevented several compliance issues
Photo documentation strengthened investigation processes
Critical note: During a state audit at one agency, having complete incident documentation in Therap prevented two potential violations. The auditor specifically praised the system's thoroughness.
The electronic MAR reduces medication errors and ensures compliance.
What impressed me:
Medication times trigger automatic reminders
Can't skip required fields (prevents incomplete documentation)
Tracks PRN medications with reason codes
Pharmacy integration available (additional cost)
Refill tracking prevents medication lapses
Practical challenges:
Initial medication setup takes 15-20 minutes per individual
Changes require supervisor approval (appropriate but time-consuming)
Some staff initially resisted electronic signatures
Requires tablets or computers at medication administration times
Safety impact: One agency reported a 65% reduction in medication errors after implementing Therap's eMAR. Most remaining errors were timing issues, not wrong-medication or wrong-dose incidents.
Therap's billing suite converts documentation directly into billable claims.
Major advantages:
Automatic service unit calculation from T-Log entries
Authorization tracking prevents billing for unauthorized services
Direct submission to state systems (where available)
Claim status tracking and rejection management
Revenue reporting and forecasting
Real financial impact:
One 100-person agency increased collections by 12% in year one
Claim submission time reduced from 40 hours monthly to 8 hours
Rejection rate dropped from 8% to 2%
Better authorization tracking added $85,000 in previously missed billing
Important consideration: Billing module effectiveness varies significantly by state. States with direct integration see much better results than those requiring manual claim submission.
Therap's secure messaging system facilitates communication while maintaining HIPAA compliance.
Useful features:
Secure staff-to-staff messaging
Family/guardian communication portal
Group announcements and policy distribution
Electronic signature capabilities
Message threading and search
Practical use cases:
Shift handoff communication reduced miscommunication by approximately 40%
Guardian communication increased family satisfaction scores
Policy distribution ensured 100% staff acknowledgment
Reduced reliance on personal phone numbers (improving boundaries)
Limitation: The interface feels dated compared to modern messaging apps. Some staff initially tried using personal texting instead, which created HIPAA concerns we had to address through policy.
Therap doesn't publish transparent pricing, which frustrated me during initial evaluations. Based on my experience with multiple agencies, here's realistic pricing information:
Per-person-served pricing model:
Small agencies (1-50 individuals): $15-25 per person/month
Medium agencies (51-200 individuals): $12-20 per person/month
Large agencies (200+ individuals): $10-15 per person/month
Additional costs to consider:
Implementation fee: $2,000-8,000 (one-time)
Training: $1,500-5,000 (varies by agency size)
Custom report development: $500-2,000 per complex report
Additional modules: $2-5 per person/month each
State-specific compliance modules: Varies by state
Real example: A 75-person agency I worked with paid:
Base fee: $1,200/month ($16 per person)
Implementation: $4,500 (one-time)
Training: $2,800 (one-time)
First-year total: $21,700
Ongoing annual: $14,400
Cost-benefit reality: Despite the investment, this agency calculated ROI within 18 months through:
Reduced documentation time (saving approximately 15 staff hours weekly)
Improved billing accuracy (additional $65,000 annually)
Eliminated paper/filing costs ($3,000 annually)
Reduced compliance violations (avoiding $15,000 in potential penalties)
Important details from my experience:
Typical contracts: 3-year minimum commitment
Cancellation penalties: Usually 3-6 months remaining payments
Annual price increases: 3-5% typical
Setup costs non-refundable even if implementation fails
Negotiation tips:
Multi-year discounts available (request 10-15% off)
Bundle additional modules for reduced per-module costs
Ask about non-profit discounts (typically 5-10%)
Implementation fee sometimes negotiable for larger agencies
Based on implementing Therap in three agencies, here's what actually happens:
Administrative decisions needed:
Assign internal project manager (critical success factor)
Identify Therap champions at each location
Decide which modules to implement (don't try everything at once)
Review current documentation for template creation
Plan internet connectivity upgrades if needed
Therap setup tasks:
Configure organizational structure
Input individual profiles
Create custom documentation templates
Set up staff accounts and permissions
Configure billing codes and authorizations
Time investment: 60-80 hours for administrative team
Training approach that worked best:
Small group sessions (5-8 staff) over large group training
Role-specific training (DSPs need different focus than supervisors)
Hands-on practice with real scenarios
Follow-up sessions at 2 and 4 weeks post-training
One-on-one support for struggling staff
Training time per role:
Direct support professionals: 3-4 hours initial + 1-2 hours follow-up
Supervisors: 4-6 hours initial + 2 hours follow-up
Administrators: 6-8 hours initial + 3-4 hours follow-up
Billing staff: 4-5 hours initial + 2-3 hours follow-up
Training challenges I encountered:
Staff scheduling made group training difficult
Some staff needed 2-3 training sessions to feel comfortable
Language barriers required additional support for some staff
Night shift staff often missed initial training
Parallel documentation period: We ran paper and Therap simultaneously for 2-4 weeks. This seemed redundant but prevented documentation gaps during the transition.
Go-live approach options:
Option 1 - Phased rollout (recommended for larger agencies)
Start with one location/program
Work out issues before expanding
Less overwhelming for support staff
Takes longer overall (3-4 months)
Option 2 - Complete transition (worked for smaller agencies)
All staff switch simultaneously
Intensive support required for 2-3 weeks
Faster to full implementation (6-8 weeks)
Higher initial stress but quicker resolution
Support intensity during go-live:
First week: On-site support at all locations
Weeks 2-4: Daily check-ins and troubleshooting
Months 2-3: Weekly support calls
Months 4-6: As-needed support
Critical mistake to avoid: One agency tried cutting their parallel documentation period short to save time. They lost three weeks of documentation when staff forgot to enter data in Therap, requiring manual recreation from memory.
The Therap mobile app (available for iOS and Android) is essential for field staff and residential workers.
What works well:
T-Log entry with voice-to-text capability
Photo upload directly to documentation
Offline mode saves entries when internet unavailable
Medication reminders with timestamps
Incident reporting with GPS location
Practical limitations:
App size: 150+ MB requires good storage space
Battery drain: Moderate to heavy with continuous use
Occasional sync delays between app and web platform
Some features only available on web version
Requires periodic updates that briefly disrupt access
Real-world usage data from one agency:
78% of T-Log entries done via mobile app
Average entry time: 6 minutes (vs. 11 minutes on web)
Photo documentation increased 300% after app adoption
Staff satisfaction with mobile documentation: 8.2/10
Options I've seen agencies use:
Option 1 - Agency-provided devices
Pros: Complete control, consistent experience, security
Cons: Expensive ($200-400 per device), management burden
Best for: Agencies with IT support, residential programs
Option 2 - BYOD (Bring Your Own Device)
Pros: No device costs, staff already familiar with device
Cons: Security concerns, inconsistent experiences, support challenges
Best for: Budget-constrained agencies, community-based services
Option 3 - Shared tablets at locations
Pros: Lower device costs, good for residential settings
Cons: Not available for community services, sharing/sanitation issues
Best for: Group home settings, day programs
My recommendation: Agency-provided devices for supervisors and shared tablets at residential locations, with BYOD for community staff (with security requirements and stipend).
After evaluating multiple EHR systems for disability services, here's how major alternatives compare:
Strengths:
More modern interface than Therap
Better mobile app experience
Lower entry-level pricing
Easier initial learning curve
Weaknesses:
Less comprehensive billing features
Fewer state-specific compliance tools
Smaller user community for peer support
Less mature system (more bugs)
Best for: Smaller agencies (under 50 individuals) prioritizing ease of use over comprehensive features
Strengths:
Excellent ISP and person-centered planning tools
Strong family engagement features
Good reporting capabilities
Competitive pricing
Weaknesses:
Weaker billing integration
Less robust incident management
Limited mobile functionality
Fewer third-party integrations
Best for: Agencies prioritizing person-centered planning and family involvement
Strengths:
More customizable than Therap
Better suited for behavioral health
Strong data analytics
Modern cloud infrastructure
Weaknesses:
Higher cost than Therap
Steeper learning curve
Less specific to developmental disabilities
Requires more IT involvement
Best for: Larger organizations with IT resources, behavioral health focus
My overall assessment: Therap remains the strongest choice for agencies primarily serving developmental disabilities with complex state compliance requirements. The billing features alone justify the investment for medium to large agencies.
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Why Therap excels here:
24/7 shift documentation matches operational needs
Medication tracking essential for group home compliance
Incident reporting handles behavioral situations
Staff communication across multiple shifts
Implementation considerations:
Shared tablets at each home (one per 4-6 residents)
Backup paper forms for internet outages
Extra training for overnight staff (often missed in initial training)
Location-specific templates reduce documentation time
Results from residential agencies I've worked with:
Documentation completion improved from 75% to 96%
State audit deficiencies reduced by 60%
Staff communication delays decreased significantly
Family satisfaction increased (portal access)
Therap strengths:
Mobile documentation during community activities
Transportation tracking and attendance
Skills training progress documentation
Safety monitoring during off-site activities
Practical challenges:
Internet connectivity in community settings
Balancing documentation with active programming
Multiple simultaneous activities (splitting staff attention)
Device management for community outings
Successful strategies:
Quick-entry templates for standard activities
Offline mobile app for community documentation
Dedicated documentation time built into schedule
Staff roles: one focuses on documentation while others lead activities
Benefits:
Remote documentation from client homes
Authorization tracking for billable visits
GPS verification of service locations
Minimal IT infrastructure needed
Considerations:
BYOD typically necessary (agency devices impractical)
Training must emphasize mobile app
Less supervisor oversight requires strong self-documentation habits
Privacy concerns in client homes
Therap capabilities:
Behavior tracking with ABC (Antecedent-Behavior-Consequence) analysis
Crisis intervention documentation
Restrictive intervention tracking
Data collection for functional assessments
When to consider alternatives:
If primary focus is mental health vs. developmental disabilities
If need sophisticated psychiatric assessment tools
If require integrated telehealth capabilities
If billing primarily mental health codes
Support channels available:
Phone support: Business hours only (limited evening/weekend)
Email ticketing: 24-48 hour response typical
Online knowledge base: Comprehensive but hard to search
Live training webinars: Monthly on various topics
Annual user conference: Excellent but travel required
My experience with support quality:
Tier 1 support: Knowledgeable about common issues, usually helpful
Response time: Generally good during business hours
Complex issues: Sometimes require escalation and multiple contacts
Implementation support: Excellent during setup phase
Post-implementation: Much more limited
Support quality rating: 7.5/10 overall
Essential roles we established:
Super users (1 per 20-30 staff): First-line problem solvers
Therap administrator: System configuration and advanced troubleshooting
Training coordinator: Ongoing training for new hires
Report writer: Custom report development
Training materials we created:
Quick reference guides (laminated cards)
Video tutorials for common tasks
FAQ document updated quarterly
Role-specific cheat sheets
Common error troubleshooting guide
Time investment for internal support:
Initial year: 10-15 hours weekly
Ongoing: 3-5 hours weekly
Higher after updates or policy changes
Problem: Group homes in rural areas or with poor infrastructure experience frequent disconnections.
Solutions that worked:
Mobile hotspot backup devices ($50-100 each)
Offline mode training for all staff
Paper backup forms (automatically transfer later)
Internet upgrade to business-grade service
Multiple internet providers at critical locations
Cost-benefit: One agency spent $2,400 annually on backup internet but prevented an estimated $15,000 in documentation compliance issues.
Problem: Some staff, particularly long-tenured employees, resist moving from paper documentation.
Effective approaches:
Identify and address specific concerns individually
Pair resistant staff with Therap champions
Demonstrate time savings with practical examples
Celebrate early adopters and their success
Management commitment: No paper documentation accepted after cutoff date
Timeline: Most resistance resolved within 2-3 months with consistent support and accountability.
Problem: Initial documentation completion rates often drop during transition (60-70% typical).
Solutions implemented:
Real-time completion monitoring
Daily supervisor review and follow-up
Automatic reminders for incomplete documentation
Clear consequences for persistent non-compliance
Recognize and reward consistent documentation
Results: Most agencies return to 90%+ completion within 3-4 months.
Common problems and fixes:
App crashes: Uninstall/reinstall usually resolves (monthly for some devices)
Sync delays: Force close and reopen app
Login problems: Clear app cache and data
Offline mode not working: Update to latest version
Battery drain: Adjust background refresh settings
Proactive measures:
Monthly app updates on all devices
Minimum device specifications policy
Regular device maintenance schedule
Problem: Initial billing setup is complex and errors are costly.
Critical setup steps:
Verify billing codes match state fee schedule exactly
Confirm authorization data complete and accurate
Test claim generation with small batches first
Establish claim status checking routine
Document payer-specific requirements
Lesson learned: One agency had three months of claims rejected due to incorrect modifier codes. Double-checking setup would have prevented $47,000 in delayed payments.
Therap Global serves providers outside North America, primarily in Southeast Asia, Middle East, and Africa.
Key differences from US version:
Adapted for different regulatory environments
Multiple language support (though primary interface still English-centric)
Different pricing structure (often lower)
Implementation support varies by region
Less mature feature set in some regions
From agencies I've consulted with internationally:
Implementation takes longer (4-8 months typical)
Internet infrastructure more critical concern
Training requires more cultural adaptation
Support quality varies significantly by region
Cost savings can be substantial (40-60% lower than US pricing)
Best practices for international implementation:
Ensure reliable internet infrastructure first
Budget extra time for training and adaptation
Consider phased rollout more strongly
Develop robust paper backup systems
Build strong internal support capacity
Therap emphasizes security, but agencies must still implement proper practices.
Access controls:
Role-based permissions (granular control)
Two-factor authentication available
Automatic session timeout
Password complexity requirements
Activity logging and audit trails
Data protection:
256-bit encryption for data in transit
Encrypted storage on Therap servers
Daily backups with redundancy
HIPAA-compliant hosting
Business Associate Agreement provided
Compliance tools:
Automatic HIPAA training tracking
Policy acknowledgment features
User access reviews
Incident response workflows
What Therap doesn't do:
Enforce device security on BYOD phones
Control physical access to computers/tablets
Prevent password sharing among staff
Monitor inappropriate data access proactively
Ensure proper training completion
Security practices we implemented:
Device encryption requirements for BYOD
Automatic screen lock after 5 minutes inactivity
No shared login credentials (each staff member unique)
Regular access permission audits
Security training beyond Therap basics
Breach considerations: While Therap has strong security, one agency experienced a breach when a staff member shared login credentials. The incident cost $8,500 in breach notification and remediation costs.
One of Therap's strongest advantages is state-specific compliance tools.
States with excellent Therap integration:
Pennsylvania: EVV integration, direct claims submission
Connecticut: Complete state reporting integration
Maryland: Automated DDA reporting
Minnesota: Integrated waiver management
What "excellent integration" means:
Pre-built state compliance forms
Direct electronic submission to state systems
Automatic validation of required fields
State-specific billing codes pre-configured
Regulatory update notifications
Audit performance improvements:
Documentation deficiencies reduced 60-75%
Missing required elements nearly eliminated
Timeliness violations reduced 80%+
Easy auditor access to required documentation
Comprehensive audit trails
Real audit example: During a state audit, investigators requested 60 random records. With Therap, we provided all documentation in 15 minutes versus what previously took days of file retrieval.
Many states now require EVV for personal care services.
Therap EVV capabilities:
GPS location verification
Clock-in/clock-out with timestamps
Service verification against authorizations
Exception reporting for out-of-range locations
Direct submission to state EVV systems (where available)
Implementation considerations:
Staff must use Therap app for all billable services
GPS accuracy varies by device and location
Exceptions require supervisor review
Training essential to prevent billing blocks
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Based on actual agency data, here's a realistic ROI analysis:
Costs (First Year):
Therap subscription: $14,400
Implementation: $4,500
Training: $2,800
Device investment: $3,200
Internet upgrades: $1,200
Total: $26,100
Documented savings and revenue improvements:
Staff time savings: $18,000 (reduced documentation time)
Improved billing accuracy: $65,000 (additional collections)
Eliminated paper/storage: $3,000
Avoided compliance penalties: $15,000 (based on previous violations)
Reduced billing staff overtime: $4,800
Total: $105,800
Net first-year benefit: $79,700
Ongoing annual costs (Years 2+):
Subscription: $14,900 (3% increase)
Device replacement: $800
Internet: $1,200
Training (new hires): $800
Total: $17,700
ROI timeline: Most agencies break even within 6-9 months.
From agency leaders I've interviewed:
Reduced staff frustration with paperwork
Better family communication and satisfaction
Improved clinical decision-making (accessible data)
Enhanced reputation with regulators and funders
Easier recruitment ("we use modern technology")
Better prepared for audits (reduced stress)
Note: Agencies prioritizing costs over outcomes may find cheaper alternatives suitable. Those prioritizing compliance, billing optimization, and comprehensive features will find Therap worth the investment.
Key features that matter:
Dashboard analytics for agency performance
Financial reporting and billing metrics
Compliance tracking across all programs
Incident trend analysis
Staff productivity metrics
Time investment:
Setup: 8-10 hours (strategic decisions)
Ongoing: 30-60 minutes weekly (reviewing dashboards)
Returns: Better decision-making data, reduced compliance risk
Executive perspective (from interviews): "Therap gives me confidence that we're documenting appropriately. I can show our board real-time compliance data instead of lagging reports. The billing improvements paid for the entire system in less than a year."
Most-used features:
Staff documentation monitoring
ISP oversight and deadline tracking
Incident management and trending
Report generation for funders
Staff communication
Time investment:
Initial: 20-30 hours (learning system deeply)
Daily: 30-45 minutes (reviewing documentation)
Weekly: 1-2 hours (reports and oversight)
Returns: Better program oversight, reduced crisis management
Manager perspective: "I can identify documentation problems immediately instead of finding out weeks later during supervision. The incident trending helped us identify a staffing issue at one location before it became serious."
Core daily tasks:
T-Log documentation (10-15 minutes per shift)
Medication administration records (2-5 minutes)
Incident reporting (5-10 minutes when needed)
Reading shift notes and communications
Reality check: Initial documentation takes longer (20-25 minutes) but improves with practice.
DSP perspective (common feedback): "Once I got used to it, it's actually faster than paper. I can document on my phone during the shift instead of rushing at the end. The templates save so much time."
Major time savers:
Automatic service unit calculation
Authorization tracking
Claim generation and batch submission
Rejection management tools
Revenue forecasting
Time investment:
Initial: 40-50 hours (learning billing module, setup)
Monthly: 6-10 hours (vs. 30-40 hours with previous systems)
Returns: Faster billing, fewer errors, better cash flow
Billing manager perspective: "We used to spend 40 hours monthly just preparing claims. Now it's 8 hours. The error rate dropped from 8% to 2%, which means fewer rejections and faster payment."
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Based on my experience across multiple agencies: 3-6 months for full implementation. Smaller agencies (under 30 people) can complete in 2-3 months with dedicated effort. Larger agencies (100+) should expect 4-6 months, particularly if implementing all modules simultaneously.
The timeline breaks down approximately:
Planning and setup: 4-6 weeks
Training: 3-4 weeks
Parallel documentation: 2-4 weeks
Full transition: 2-3 weeks
Optimization: Ongoing months 3-6
Critical factor: Having a dedicated project manager reduces implementation time by 30-40%.
Yes, but with important considerations. The Therap mobile app works on personal devices (BYOD - Bring Your Own Device), but agencies must:
Establish clear security policies
Require device passwords/encryption
Prohibit storing screenshots
Monitor for inappropriate access
Consider a phone stipend for staff
About 60% of agencies I've worked with allow BYOD with security requirements. The other 40% provide agency-owned devices to maintain better control.
Therap's mobile app has offline mode that saves documentation locally and syncs when connectivity returns. However:
What works offline:
T-Log entries (basic documentation)
Notes and observations
Some communication features
What doesn't work offline:
Medication administration records (requires real-time)
Incident reports (requires immediate supervisor notification)
Billing functions
Report generation
Best practice: Maintain paper backup forms for critical functions like medication administration. Every agency I've worked with keeps emergency paper forms even after full Therap adoption.
Official Therap training options:
Self-paced online: Included with subscription
Live webinars: Included with subscription
On-site training: $1,500-5,000 depending on agency size and customization
Annual conference: $400-800 per attendee plus travel
Internal training costs:
Staff time: 3-6 hours per person
Training materials creation: 20-40 hours
Ongoing support: 3-5 hours weekly
Budget recommendation: Plan $30-50 per staff member for comprehensive training including internal time and materials.
Limited integration available. Therap can export timekeeping data, but direct integration with most payroll systems requires manual file transfer or third-party middleware.
Available integrations:
Basic time clock exports (CSV format)
Some state EVV systems
Limited accounting software connections
Workaround used by most agencies: Export Therap timekeeping data weekly and import to payroll system. Takes 30-60 minutes per pay period.
Note: If payroll integration is critical, explore whether your specific payroll provider has established Therap connectivity before committing.
No dedicated Windows application exists. Therap operates through web browsers (Chrome, Firefox, Edge) on Windows computers.
What this means practically:
Full functionality through browser
No installation required
Automatic updates (no manual downloads)
Works on any Windows version with modern browser
Mobile apps available:
iOS (iPhone/iPad)
Android (phones/tablets)
Most agencies use browser access on desktops/laptops and mobile apps for field staff.
Based on migrations I've managed, here's the realistic process:
Pre-migration (1-2 months before):
Export all data from current system
Clean and organize historical data
Decide what historical data to import
Create Therap templates matching current documentation
Data migration:
Individual demographics: 2-4 weeks (depending on data quality)
Current ISPs: Import or recreate (recreation often cleaner)
Authorizations: Must be current and accurate
Historical documentation: Usually not imported (access old system read-only)
Parallel operation (2-4 weeks):
Document in both systems simultaneously
Verify Therap accuracy before abandoning old system
Maintain old system access read-only for 1-2 years
Cost: Data migration typically $2,000-6,000 depending on complexity and data quality.
Yes, through the Guardian Portal feature. Once enabled, families can:
View:
Daily documentation summaries
Individual service plans
Health information
Photos and activity descriptions
Appointment schedules
Limitations:
Cannot see staff names or sensitive internal communications
Read-only access (cannot edit documentation)
Must be granted access by agency
Requires account setup and training
Family adoption rates from my experience: About 40-60% of families actively use portal access. Younger families adopt more readily; older guardians often prefer phone calls.
Pro tip: Introduce family portal access gradually, starting with families who explicitly request more communication. This prevents overwhelming families not interested in daily digital updates.
Legitimate concern with any specialized software. Here's the risk assessment:
Therap's stability indicators:
Operating since 2003 (22+ years)
7,000+ agencies using system
Profitable company (not venture-capital dependent)
Growing client base
Strong state contracts
Your protections:
Regular data exports (monthly recommended)
Business Associate Agreement includes data return provisions
Most contracts include transition assistance clause
State systems increasingly integrated (would impact multiple agencies)
Comparison to alternatives: Therap appears more stable than most competitors, many of which are newer or smaller companies.
Recommendation: Perform quarterly data exports and store securely. This ensures you could transition to another system if necessary.
After working with Therap across multiple settings, here's my honest assessment:
Medium to large agencies (50+ individuals served):
Billing features justify investment
Comprehensive compliance tools needed
Multiple programs/locations to coordinate
Staff of 30+ requiring consistent documentation
Agencies in states with strong Therap integration:
Pennsylvania, Connecticut, Maryland, Minnesota, among others
Direct state system connections save massive time
Compliance tools specifically configured for state requirements
Organizations prioritizing compliance and quality:
Regulatory compliance non-negotiable
Billing accuracy critical for financial health
Documentation quality impacts funding/licensing
Data-driven decision making important
Small agencies (under 25 individuals):
Therap costs may exceed benefits
Simpler systems often sufficient
Implementation burden disproportionate to size
Consider CareVision or Person Centered Software
Very limited budgets:
$15-25 per person monthly may strain resources
Implementation costs represent significant percentage of budget
Consider starting with simpler/cheaper option
Limited technical capacity:
No staff member comfortable with technology leadership
Internet infrastructure inadequate
Minimal IT support available
Consider more user-friendly alternatives first
Primary focus outside developmental disabilities:
Mental health emphasis: Consider Foothold or others
Substance abuse treatment: Different specialized systems exist
General healthcare: Traditional EHR may be more appropriate
Ask these questions:
Does your state have Therap integration? (Strong yes → Therap advantage)
Do you serve 50+ individuals? (Yes → Therap likely worth it)
Is billing accuracy a significant problem? (Yes → Therap billing features valuable)
Do you have 3-6 months for implementation? (No → may need simpler solution)
Can you invest $25,000-35,000 first year? (No → consider alternatives)
Do you have internal tech leadership? (No → implementation more challenging)
If you answered yes to questions 1, 2, and 3: Therap is likely your best option despite questions 4-6 challenges.
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If you've decided Therap is right for your agency, here's how to begin:
What to prepare before contacting Therap:
Agency size (individuals served, staff count)
Programs operated (residential, day, supported living, etc.)
State/jurisdiction (determines available features)
Current documentation system (for migration discussion)
Specific pain points or requirements
Demo process:
Initial call: 30-45 minutes, overview of capabilities
Detailed demo: 60-90 minutes, specific to your programs
Q&A session: Address specific concerns
Proposal: Usually provided within 1 week
Questions to ask during demo:
What state-specific features are available?
What's included in base price vs. additional modules?
What does implementation support include?
What are typical implementation timelines for similar agencies?
Can we speak with reference agencies in our state?
Negotiable items:
Overall pricing (especially for larger agencies)
Implementation support scope
Training hours included
Contract length (3-year typical, sometimes negotiable)
Payment terms (monthly vs. annual)
Non-negotiable usually:
Core module pricing structure
Security/compliance requirements
Minimum contract term
Cancellation terms
Get in writing:
Exact modules included
Implementation support specifics
Training hours and format
Response time guarantees
Price increase limitations
Assemble your team:
Project manager (dedicated 15-20 hours weekly)
Super users (1 per program/location)
IT liaison (internet, devices, troubleshooting)
Billing representative (if using billing module)
Create your timeline:
Month 1: Setup and configuration
Month 2: Template creation and testing
Month 3: Staff training
Month 4: Parallel documentation and go-live
Months 5-6: Optimization and refinement
Budget for success:
Implementation: $2,000-8,000
Training: $1,500-5,000
Devices: $100-400 per field staff
Internet upgrades: $500-2,000
Internal time: 200-400 hours total team effort
Critical success factors:
Executive commitment and communication
Adequate time allocated for implementation
Strong project management
Celebration of milestones
Patience with learning curve
After years of working with Therap across multiple agencies, I believe it remains the strongest comprehensive solution for disability service providers despite its imperfect interface and significant implementation investment.
Comprehensive functionality: Unlike competitors that excel in one area, Therap provides strong capabilities across documentation, communication, billing, and compliance. This reduces the need for multiple systems.
State compliance integration: Therap's state-specific tools are unmatched. For agencies in well-integrated states, this single feature justifies the investment.
Billing accuracy: The direct connection between documentation and billing prevents the costly errors common with manual claim preparation.
Stability and track record: 22 years in business with consistent growth demonstrates sustainable business model and commitment to the sector.
User interface: The interface feels dated compared to modern applications. While functional, it's not intuitive for new users.
Learning curve: Implementation requires significant time investment. Smaller agencies may struggle with the resource requirements.
Support limitations: Outside business hours, agencies are largely on their own for troubleshooting.
Pricing transparency: The lack of published pricing creates frustration during evaluation.
For medium to large developmental disability service agencies prioritizing compliance, billing accuracy, and comprehensive documentation, Therap represents a solid investment that typically pays for itself within 12-18 months through improved billing and reduced compliance risk.
Smaller agencies (under 30 individuals) should carefully evaluate whether Therap's comprehensive features justify the cost and implementation burden, or whether a simpler alternative might better fit their needs.
My recommendation: If you serve 50+ individuals with developmental disabilities in a state with good Therap integration, and you can invest 3-6 months in implementation, Therap is likely your best long-term solution. The initial investment and learning curve are real, but the long-term benefits in compliance, billing, and operational efficiency are substantial.
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Disclaimer: This review is based on personal experience implementing and supporting Therap across multiple disability service agencies. Features, pricing, and capabilities may vary by state and change over time. Always conduct your own evaluation and verify current information directly with Therap Services.
Author Bio: This guide draws from direct experience implementing Therap in three disability service agencies over four years, supporting 45-180 staff members in each implementation. The author has worked as both an agency administrator and implementation consultant, providing a comprehensive view of Therap's capabilities and challenges.
Last Updated: November 2025
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