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Everyone knows the feeling of exhaustion that follows a few nights of poor sleep. For children and adults with sensory processing disorders, lack of sleep is a frequently occurring phenomenon which negatively affects the person themselves, as well as the whole human ecosystem that surrounds them.
Through gaining an understanding of his own sensory quirks, as well as his close friendship with a boy with Down Syndrome, Caleb Polley was inspired to found Cubby Beds, a company that makes medical beds of a very special kind.
In this episode, you’ll hear about the numerous features which differentiate Cubby Beds from other beds in their category, including safety sheets and circadian rhythm lights. Caleb also explains how the company goes the extra mile for their clients in terms of helping them access insurance, and shares his exciting plans for the future which will further enhance sleep, safety and sensory regulation for a demographic group often sidelined by society.
“I am actually pretty sensory sensitive myself. We've had to turn off specific lights in our office, and I have a very specific bedroom environment for myself. Part of what we’re building comes from some of my own experience as well.” —@CalebPolley [03:00]
“The big focus for us is making it accessible to everyone, making it really friendly, making it be a product that you want to have in your home, not a sterile medical product, like many others.” —@CalebPolley [05:57]
“Hopefully one day, you don't have any camera and our bed is a normal bed. And that's really, I think, the end goal for every family and for us as well.” —@CalebPolley [29:14]
“If you get the bed, it's 100% worth it, we think it will be life changing for not just your kid but your whole family. But in the case that you don't, you're still learning a lot that'll help you advocate and help you learn how the process works for future things they might need.” —@CalebPolley [41:03]
Cubby Beds Contact Number - (855) 964-2664
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[00:00:02] RH: Hey, there. I’m Rachel.
[00:00:04] JH: And I’m Jessica and this is All Things Sensory by Harkla. Together, we’re on a mission to help children, families, therapists, and educators to live happy and healthy lives.
[00:00:11] RH: We dive into all things sensory, special needs, occupational therapy, parenting, self-care and so much more. In each episode, we share raw, honest, fun ideas and strategies for everyone to implement into daily life.
[00:00:24] JH: Thank you so much for joining us.
[00:00:31] RH:Hey, everyone. Welcome back to All Things Sensory by Harkla. You're listening to your good friends, Rachel and Jessica, and this is Episode 164.
[00:00:41] JH:We are chatting with Caleb, who is the creator of Cubby Beds. If you haven't heard of those before, you're about to get all the details. They sound amazing and just thinking about all the people who can benefit from it.
[00:00:58] RH:Yeah, not even just kiddos. So, if you're a parent, if you're a therapist, listen on in and see if this is something that could make your life and your child's life a little bit easier and more calm.
[00:01:13] JH:All right. Let's do it.
[00:01:14] RH:Let’s meet Caleb.
[EPISODE]
[00:01:15] RH:Well, hello, Caleb. How are you today?
[00:01:18] CP:I'm doing well. I'm looking forward to the podcast and chatting with you both.
[00:01:22] JH:Yeah, it'll be a good time. Before we let everybody know who you are, we're going to ask you five secret questions.
[00:01:31] CP:All right.
[00:01:32] JH:So, the first one is, what is your favorite podcast to listen to? Besides ours, of course.
[00:01:40] CP:So, since I'm an entrepreneur, one of my favorites is one called Business Wars, which is basically rivalries in business. So, like Coke versus Pepsi, or Nike versus Adidas, and kind of telling the story of that. But what I really like about it is that it's dramatized. So, if they're like riding a horse in the scene, you'll hear the horse neighing and like the road clapping or whatever. So, it kind of feels like you're in a movie, while also learning really cool things about some really amazing entrepreneurs and people in history. So, that's one of my favorites, for sure.
[00:02:11] RH:That’s cool. I haven't listened to that one. So, I should check it out. For sure.
[00:02:15] CP:It's a good one.
[00:02:16] RH:Okay, next question. Would you rather hike or go for a run? And I'm going to like caveat this one a little bit, because you are laid up with an injury. So, when you're all healed, which one would you like to do?
[00:02:29] CP:So, I am more of a mountain biker myself. So out of those two, mountain biking is my third option. If I were to choose, I also really like photography. So, hiking lends itself really well to photography. I don't love hiking on its own. But if I have a purpose and kind of exploring a really cool place, that's definitely my preferred method over running.
[00:02:51] RH:I'm kind of gathering the sense that you're a bit of a sensory seeker.
[00:02:54] CP:I am very much a sensory seeker. Very true. I am actually pretty sensory sensitive myself. We've had to turn off specific lights in our office, and I have a very specific bedroom environment for myself. Yeah. So yeah, part of what we’re building comes from some of my own experience as well.
[00:03:13] RH:We're right along with you as well. It's so interesting to talk to someone who has kind of an idea on those sensory needs and building your environment to your needs.
[00:03:25] JH:Okay. Who is someone that inspires you daily?
[00:03:29] CP:My mom's a big inspiration. She's a clinical researcher at University of Michigan. She has done a lot of really amazing research, mainly women's health, and is now setting up a lot of clinics across Africa to study violence against women, which is really tough in some of those countries. But she's also like the most bubbly and joyous person. So, I think people underestimate her when you first meet her and maybe don't think she's as smart as she is. And then she'll really show that over time. But she's been a big inspiration. She's not an entrepreneur, but the way she approaches projects has always been very entrepreneurial, and her focus and passion for it, I think has rubbed off on me.
[00:04:06] RH:That's amazing. I love it. Going from that very inspirational question to what food could you eat for the rest of your life, Caleb?
[00:04:19] CP:Oh, the rest of my life. That’s a tough one. Probably pho. That is my number one Vietnamese – pho, which is like a noodle soup. I don't know if I could eat it every day for the rest of my life, but that's probably my most ate single entree on a, definitely weekly basis. Most of the time. It's a little harder when it's 95 degrees out.
[00:04:37] JH:That's true. Good one. All right, last question. What is your sensory quirk?
[00:04:44] CP:I have a couple I have already mentioned. I think flickering lights, like that other people don't see, definitely bother me quite a bit. But I would say besides that, it’s just kind of a smaller thing, sound and music is really important to me. So, I often have like noise cancelling headphones on. If I go somewhere, I've always got music. I just find it – I’ve definitely got a bit of ADHD as well. So, I find it helps me kind of focus and not be as focused on the rest of the environment. So, sound is a big one for me for sure. And if something, there's a bad sound, it seems to affect me or annoy me a lot worse than my other neurotypical friends.
[00:05:22] RH:I think it's so important to be aware of that. Oh, love it. Okay. First of all, before we jump into all the good stuff that you're doing, tell us who you are, what you do, why you do it, how you do it, all those good things.
[00:05:35] CP:Yeah, so I am the founder and CEO of Cubby Beds. We are a medical device company, which sounds like a big deal and kind of complicated and is in many ways, but on the surface, what we're making are smart beds for people with special needs. Although it's a medical device, and deals with insurance, and a lot of stuff with the FDA and things like that. The big focus for us is making it accessible to everyone, making it really friendly, making it be a product that you want to have in your home, not a sterile medical product, like many others. I can go a little bit more into the details of that product or how I created it, or what would it be helpful?
[00:06:13] JH: Yeah, like, why did you create it?
[00:06:15] CP:Yes, it's been a bit of a journey. So, there are two sides of it. One is, on the personal side, I had a good friend growing up named Ben who had Down syndrome. And my teachers in middle school, sophomore, saw that I was really drawn to Ben and just loved helping him and working with him. So, I ended up being his pure helper through middle school and part of high school until our kind of education paths split. But that was just a really fun experience coming friends with Ben, helping Ben, getting to know his family.
I remember being one of the – I think maybe the only kid at his like seventh grade birthday party in the McDonald's playpen, which I remember just being a really great time. And my brother did something similar with a young boy named Colin who had cerebral palsy, and was often at our house, power wheelchair, very different situation, but both kind of developed that empathy. And some of that, once again, I think probably came from my mom of kind of being the clinical medical side of things. So, that's personal side.
And the business actually started in a very different area quite a few years ago when I was back in college. It was to create pod beds for any type of shared accommodation. So, this would be, started off with travel hostels, and then student dorms, homeless shelters, disaster relief, really anywhere where people share a room and sleep together. The challenge with that in the business side really, and I still think it's a good problem to solve, but business side is if you sleep in a room with a bunch of other people, you're probably inherently there because you don't have or don't want to spend money. Therefore, you don't want to buy products.
So, that business frankly, kind of failed. It was really difficult to sell stuff. We did sell some beds, universities were a little bit easier. But that ended up kind of failing. But while doing that, I was researching other pod beds and came across different enclosed safety beds that have been on the market, in many cases for decades. Our oldest competitor, Posey Beds, would have been – it’s been around since I believe 1930. So very, very long time and hasn't seen much change in terms of new technology. I knew the sensory side was a really big aspect that was not addressed by these other products. I knew we could do a lot more with remote monitoring.
And then the other side, which I find really interesting, and is a lot of my background as far as a direct to consumer approach and an online first approach of building great marketing, a beautiful website, of guiding people through every aspect of this process instead of relying on doctors or their distributors to do so. We really want to have that direct connection with these families and that's part of the differentiation. The product is more innovative, has the latest technologies and a friendly design. And then our big goal is to really have a modern approach to how we work with families and with the medical system at large as well. So, I'll pause there, that's a lot of information. I can go deeper on the product as well, if you'd like?
[00:09:12] JH:Yeah, totally.
[00:09:13] RH:We definitely have a lot of questions about the design features of the Cubby Bed. And a lot of the people listening to us, we have a lot of parents, we have a lot of therapists, as well as others and, share with them why a Cubby Bed is beneficial, who it can benefit, and kind of those sensory design features that you included?
[00:09:39] CP:Yeah, so I'll start with some of the problems or issues that the Cubby Bed addresses and really, in many cases why insurance will pay for it, which is a really big part of the bed. And insurance has been, I guess to pause before we get into the issues, insurance has been really important for us because these beds are expensive. They're expensive to manufacture, they're very expensive to design and to go through the FDA process. And we don't want these beds to only be available to rich families that can afford it. Many of the families that need this are the ones that can't afford it and that's been really great. And over 80% of our beds that we sold this last year have gone through insurance, and that means that we can work with any family, not just rich ones. Many of the families who we work with are below the poverty line or are on Medicaid, and this might be the most expensive piece of equipment they have and that's been really cool to be able to do.
But that leads into kind of the problem side, which is important for accessing insurance of what problems that that addresses and if they're applicable. So, there's kind of three main categories of issues the bed addresses. The first one, that insurance cares the most about, is safety. So, these are – think about it simply as, what could cost money to insurance? And it's the patient or the user of the bed getting injured in some way. That comes down to seizures, elopement or wandering away or running away from a safe environment. Self-injury, so, a lot of the kids we work with will self-stimulate by banging their heads or hitting themselves or other manners. Entrapment is another big one that a lot of other beds don't address well of getting caught in between the mattress and the wall or the bed rails, burrowing under the mattress, getting access or leaving the bed through that.
And then the other two are sleep and sensory regulation, which often is tied to anxiety. So, for sleep, for autism, about 80% of kids with autism from some very large studies have shown daily sleep issues. And this might mean taking a long time to go to sleep, only sleeping a couple hours a night, sleeping way longer than they should. If you don't sleep well, that affects your mood, your energy, your learning, even your physical growth. Everything is affected by sleep. And then anxiety as well is often tied to sensory regulation or sensory processing and both sleep and safety are also tied to sensory regulation as well.
So, many times in times of stress, whether it's too little sensory input, or too much sensory input, that leads to safety concerns of bolting or self-injury or trying to do something they shouldn't be doing. It also leads to the sleep issues of not being able to fall asleep because you're hypersensitive to stimuli and you hear everything in the house or you're not able to do the self-stimulation of rocking back and forth, which usually helps calm you down. When you're falling asleep, you can't do that. Finally, it leads to anxiety.
So, a lot of the kids we work with are hyper, which means they need more input, or sorry, they would need less input if they're hypersensitive. Hypo would mean they need more input to feel better. We see that on both sides for sound, for light, for pressure, for vestibular sense, which is where your body is in space, and the rocking action, or smell. All of those sensory inputs are not always well controlled and that leads to safety, sleep and anxiety concerns. That's kind of broadly, a lot of the problems we address for the patient.
The last thing I would say is that all of these issues, especially the safety and sleep side, lead to not only the patient or the user of the bed having all of these problems, but it affects their entire family. If the kids aren't sleeping, or the parents are constantly worried about the kid getting hurt, that affects the parents, their siblings. It affects how they interact with their therapist, it affects them going to school. So, it ends up being a really kind of ecosystem-based problem if you don't address these issues more holistically at the source.
[00:13:37] RH:So, if someone hasn't seen a Cubby Bed before, can you kind of give us an overview of what it looks like? And tell us about some of those features that you've added in there that help with all of the sensory regulation, and kind of help promote that safe environment.
[00:13:54] JH:And better sleep.
[00:13:57] CP: Yeah, so the way I would describe it as it's kind of like a sensory cocoon. It enables full control of the environment, and that's the physical environment, the sensory environment, sensory as visual, sound, tactile, textures. It's basically enabling that user and their caregivers to control and then customize the environment. So, the way it looks is there's a canopy that goes over the top of the bed that provides 360 degrees of padding, so it's tensioned across the frame. Every wall is at least six inches away from any hard point within that frame, and if you push on the walls, it will feel kind of like a trampoline. So, that provides padding without using any foam. Foam is known to disintegrate over time. It might work for a little while but then it ends up causing safety issues later.
That canopy also helps control the environment. So, it helps with light. It helps with sound by baffling sound. It helps with visual stimuli within the room and that it controls the visual aspect of the room. If there's a mess over in the corner that can be very distracting for many of the kids we work with. And from there, you're really able to better control the environment. After the environment is controlled and kind of neutral, you're able to add sensory inputs. So, we have a circadian rhythm light that acts like a sunrise in the morning. So, slowly fading in, providing a much gentler wake up, and it is known to help you wake up in a better stage in your REM cycle. And then at night, it fades out like a sunset. So, it provides a psychological cue that it's time to go to bed and can be a really great end to a calming sensory routine as a part of your sensory diet before bed.
One of my favorite features built into it is it has a meditative breathing program built in as well. So, the light will actually pulse and get brighter as you inhale, and then as you exhale, the light dimmed. That can be really great if someone's kind of having a meltdown or a lot of anxiety. If they are able to do that, it can be a great thing to add.
There is a speaker that provides white sound, nature sounds, music, FM radio, and you can plug in a phone into an auxiliary port on the back and play whatever their favorite sounds are. There is also an optional vibration pad that can provide tactile input and then we, with every bed, ship an aromatherapy spray that's like a sleep spray before bed, which is lavender chamomile, vanilla, and basically provides an olfactory or smell based sensory input that can be tied to, “It’s bedtime,” and that can be a really great psychological trigger.
Those are the features. I know there's a lot here. So, feel free to ask questions on them. But we also have a safety sheet that prevents entrapment. So, the safety sheet zips to the sidewall of the bed above the mattress and prevents someone from burrowing underneath or getting entrapped. Quite a few other hospital beds or safety beds on the market have not addressed that issue. In some cases, we've heard of kids getting hurt. So, that's a really important thing for both the safety of the child, as well as when talking to insurance, it does set our bed apart in that it addresses a really critical safety aspect.
Last piece is on remote monitoring. So, this is something that we have built in with a camera to a microphone and sensor system. So, the camera can provide live view, night vision, 1080p color live view. You can also set it up to record either 24/7, or based on events. These events are things like motion detected or sound detected. So, this can help if something happened in the middle of the night when you weren't watching it at all times, and maybe if that's something worrisome, you could bring it to your doctor and show them the video. You can also set up this motion and sound notifications to alert you to your phone or you can integrate with Google Home or Alexa. So, you can set it up on a TV or an iPad and it'll send you notifications if it detects movement or sound. And that way you can check in remotely and even turn on some of those sensory features if you know they're agitated and want to do that remotely.
Very last thing is environmental sensors. So, we have four different sensors that check temperature, humidity, sound levels, and light levels, which are also really important, especially temperature. Many of the kids we work with are nonverbal, so they might not be able to tell you that they're feeling too hot, or there's a loud noise outside. So, you can check that all from the app and make sure that you can optimize it for the needs of the child.
[00:18:27] JH:Wow. I kind of want that setting with my bed. How big is it?
[00:18:32] CP:It's built around a full-size bed right now, which we started with – specifically because it can work with toddlers all the way up to adults, our beds work. And that's something I guess I didn't address in the last question of who we help. So, it's a really wide range of special needs as well as ages. We've had three-year-olds all the way up to we have dementia patients using our beds. The most common age is probably age three or four when they literally outgrow a crib and have nowhere else safe to be. And the parents are absolutely worried and I see pictures of the kids, like their hands and their feet are sticking out the end of the crib, but parents don't know what else to do.
And then condition wise, the most common for us is likely autism. But we've had beds delivered to kids with autism, cerebral palsy, epilepsy, Down syndrome, Angelman syndrome, Fragile X, fetal alcohol syndrome. And then we'll probably, in a couple years, we're pretty focused on the pediatrics child area now, but there's also a really big addressable area in dementia, stroke and traumatic brain injury, that they had fairly similar issues with sensory processing, with sleep, and with safety concerns that we also think we can help with.
[00:19:47] RH:I just have to say I'm impressed with all of the sensory design components that you included. Like the vibrating pad –
[00:19:58] JH:I like that one.
[00:19:59] RH:Does the mattress come as well? It comes with the mattress?
[00:20:04] CP:Yeah, so the mattress is, it depends on how you get it. So, if you go through insurance, we include a mattress with every bed, typically an eight-inch gel memory foam mattress. So really comfortable. A lot of the hospital bed mattresses, I felt, don't really feel like a real mattress. They're all vinyly and plasticky and all that. So, we include that with every bed. We also include a waterproof mattress cover with every bed if they have incontinent issues.
But if you're buying it directly from us, or we do offer upgrade options through insurance, we have three different mattress offerings that go from kind of simpler memory foam options up to a hybrid cooling 10-inch option which has both coil and memory foam, which provides better support, but it's still really comfortable and that's often better for bigger kids or people that are heavier. But all that's to say is, you can also use your own mattress at home. A lot of families have already bought a really expensive mattress, or they have a very special type they want. And in that case, our beds will work with any full-size mattress, as long as it's 10 inches thick or less to work with our safety sheets.
[00:21:09] RH:Does it sit on the ground? So, do you put the mattress on the ground, the bed on the ground, does it go on? Like explain that to me.
[00:21:18] CP:So, it can. Generally, we have feet on the bed right now. And so, the mattress sits 18 inches off of the ground on average, depends a little bit on the mattress thickness. But that 18 inches is a pretty optimal transfer height for many wheelchair users, which is why we chose it. We can customize it. So, we can both remove those feet and make it sit all the way on the ground. If it's a really small child or you're really worried about falls, we can also raise it as well, so that the caregiver is not bending over quite as much. But 18 inches for now is the standard.
[00:21:54] RH:Okay, that was my thought, because I was trying to visualize if someone had a like a, what's the word, like a frame for their mattress or a frame for their bed. If they had something already, they wouldn't need it because it comes with everything that it needs already.
[00:22:07] CP:Yeah, so we do get that question from time to time. Ours is a complete system. So, it's the frame, it's everything you need for a bed. There's no way to attach it to an existing frame, but you could use your existing mattress.
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[00:22:20] RH: We just want to take a minute and talk to you about our company, Harkla. Our mission at Harkla is to help those with special needs live happy healthy lives. Not only do we accomplish this through the podcast, but we also have therapy products, easy to follow digital courses and the Harkla Sensory Club to try to bring holistic care to you and your family.
[00:22:38] JH: Listeners of the All Things Sensory podcast get 10% off their first purchase at Harkla with a discount code, “Sensory.” We’d recommend checking out some of our best-sellers, like the compression sensory swing, weighted blankets or our course on sensory diets.
[00:22:55] RH: Here’s the best part, 1% of each sale gets donated to the University of Washington Autism Center to support autism research and fund scholarships to families in need to receive in-clinic therapy for their child.
[00:23:05] JH: Learn more about Harkla and all we have to offer at harkla.co. Don’t forget to use the discount code “sensory” to get 10% off your first purchase. That’s S-E-N-S-O-R-Y for 10% off.
[00:23:27] RH: The best part is, all Harkla orders come with a lifetime guarantee and free shipping.
[00:23:34] JH: You really can’t beat that.
[00:23:35] RH: No.
[00:23:36] JH: No, you can’t. Okay. Let’s go back to the show.
[INTERVIEW CONTINUES]
[00:23:40] JH:So, what is the setup look like? Like when the bed arrives? Is it complicated to put together?
[00:23:52] CP:That's a good question and something we put a lot of thought into on the design side, both in how you put it up and also how it's shipped. So, I'll start on the shipping side. It's kind of the journey, I guess. So, a lot of other hospital beds and safety beds, you get shipped on a pallet and it's a really huge process and you have to do it via freight with a forklift and stuff like that, which can be really difficult for a family if they're buying it directly, and for the distributors who work with insurance to actually set it up in like an apartment, or think of a downtown New York place. That's going to be very difficult.
So, we've actually broken the bed down into three different boxes, four if you include the mattress, and they all ship via UPS insured, typically ground shipping, which is two to three days across the entire US. Those separate boxes make it easier, like it's like the poles, the slats, the main box, and the mattress. That just makes it easier to move it through apartment hallways and carry it up the stairs and kind of get it into your home, which we found to be a bit of a pain point.
Once you have it in your home, there's a couple of setup options. So, the first is, I guess we'll start if you buy it directly. So, we've spent a lot of time on setup, it generally takes people, their first time, roughly an hour to an hour and a half to set up. My personal record is 32 minutes, so pretty quickly. But I've done it many, many times. Setup is pretty straightforward. It's basically clicking together connectors and poles, it only requires one tool, which is an Allen key, which is included. And then you're basically setting up the frame, zipping on the canopy around it, zipping in the electronics hub, which contains all of our electronics in one case, and then setting up the software on the apps to control the electronics.
So, that's if you buy directly yourself. Most of our beds actually go through our medical equipment distribution partners. So, we work with over 30 in the US, including the two largest in the complex rehab space, which would be New Motion and National Seating and Mobility, which many of your listeners may have worked with for wheelchairs, or adaptive bikes or bathroom equipment. If that's the case, they will actually – we ship it to them and they'll actually come and set it up in your home for you and show you how it all works, which is really great.
And last thing I'd say is we can also offer that service ourselves. If you guys or your listeners are wanting to get it directly and don't want to deal with the headache of setup, which we fully understand, we can do White Glove delivery setup across the US and so that's generally between $200 to $400 to have a team come out and set it up for you, depends a little bit where you live and how far of a drive it is for them. But that's a nice option if you're stressed or strapped for time, it just keeps it easy for you.
[00:26:41] RH:For sure. Wow, you guys have thought of everything.
[00:26:44] CP:We're trying.
[00:26:45] RH:I had another question thinking about the design. If a kiddo is wanting to elope, is there a way to zip it from the outside or keep the child safe inside so they aren't able to unzip and climb out on their own?
[00:27:01] CP:Yeah, so that's a really critical safety feature of the product, to prevent elopement, to prevent them from falling, to prevent confusion, and then dealing with other things in the room that maybe they shouldn't be without supervision. So yes, and there's a couple of kind of stages of that that I'd like to talk through, which I think is a unique approach.
First of all, the canopy can be fully enclosed with both fabric and mesh. So, some of our kids really love the full fabri, kind of tense, like feel, of not being able to see it out and that provides some comfort to them. Especially the kids with autism, they really seem to love that enclosed space feel. But if that's not the case, or they want to watch TV through it, or see mom and dad, you can roll up the fabric and have that stored out of the way and just have the tension mesh.
On all three doors, we have two long side doors and one end door, we have two aspects of safety mechanisms. The first is that you can – it's basically a zipper hide pocket that, from the inside, you zip it all the way up, and it hides the zipper from the inside, preventing someone from opening it. The second, so some of these kids are Houdini’s as I call them, they figure everything out and they've got little fingers. The second method is, we can also – on the zipper, as well as there's a little cord loop on the outside and then we have a little buckle clasp. So, you can clip that together and then that would be a secondary level of safety to prevent that elopement or leaving the bed.
But we hopefully don't want to have to use that mechanism forever for these kids. And our viewpoint is that it's not binary, keep them in there or let them roam free and get into trouble and maybe hurt themselves. So, the goal for many of our kids is to eventually, hopefully not use our bed, that's like the dream for many of our parents and get increasing levels of autonomy and freedom and responsibility over time. So, the intention of a remote monitoring system with the camera and motion detection, is you can start to rely on that more and more over time, and perhaps have a camera outside of the bed and outside in the hallway too. Our cameras are modular, you can add multiple. But then over time, you can stop relying on that, and they're leaving the bed when they should. But then hopefully one day, you don't have any camera and our bed is a normal bed. And that's really, I think, the end goal for every family and for us as well.
[00:29:21] JH:For sure.
[00:29:22] RH:Yeah, definitely as therapists, that is our goal, is to use these products as needed. And then once the child gets the hang of it, they can kind of transition away from them.
[00:29:33] CP:Yup. Some are able to. Some, unfortunately, will use the bed probably for the rest of their life. In that case, it's also a really valuable tool. But hopefully, you can keep working towards those goals and make progress.
[00:29:45] JH:Absolutely I love it. Now, you mentioned before we started recording that you have OTs that you work with as well. What's their role?
[00:29:56] CP:Yeah, they’re probably the most critical third-party player in, kind of, the insurance process. And so, before I kind of get into the OT role, I’ll just walk really quick how insurance works for our bed and then I think that will play into how the OT piece into that was a really big part.
So generally, you are going to get our bed typically for qualifying safety concerns. And I do want to say, it's not guaranteed that you get our bed through insurance. It's an expensive bed. Some insurance companies in some states, especially if you're on your Medicaid, are really good with it, some are not so good. We want to be transparent with the families. We don't want to get their hopes up too much to work for a long time and then they're completely heartbroken, they didn't get it. So, we try as hard as we can to give them the tools, the guidance, the review, and really as much hand holding as we can throughout the process to make it as easy and as fast as possible. But I never want to guarantee that you will get one 100%. We don't want to put families in that position.
But if a bed seems like a great fit for you, typically the qualifying safety concerns are what gets you the insurance coverage. So, these are documented medical history of things like seizures, elopement, self-injury, entrapment, really anything if you think about it that the insurance company would have to pay for, that's when they start to say, “Oh, maybe it's cheaper to get a bed than it is to pay for another injury.” That's unfortunately kind of how they look at it. So, if that's the case, and you have one of those qualifying medical safety concerns, generally the first step is to get a prescription from your doctor or physician for a Cubby or Cubby Plus safety bed. That kind of kicks off the process.
From there, that prescription would go to one of our medical equipment supply partners like New Motion or National Seating and Mobility and they're the ones that generally work with insurance to submit the documentation, to help you create the documentation, to file an appeal if you get a first denial, and then ultimately to set up the bed and provide support for you as well. They will then work with a therapist, ideally, your current therapist, typically an occupational therapist, or physical therapist, sometimes an ABA or BCBA. And from there, they create what's called a letter of medical necessity. This is basically tying all of your medical history in with the features and value of the bed. Saying that, “Yes, they have seizures and this is how the bed addresses that.”
The other part that's critical is addressing less costly alternatives. So, “They have seizures, well just put a regular hospital bed there with bed rails so they don't fall out.” Well, they can still fall out, they could get entrapped, there's hard things there. And other ones often, “Put a mattress on the floor, instead of having them do that.” Well, there are still electrical outlets in there, they're still hitting their head, they're still a fall risk from a standing position. It's basically addressing all of the issues, all of the less costly alternatives you've tried or ruled out, and then how the bed, a Cubby Bed, uniquely addresses all of those challenges. That's really where the occupational therapist comes into play. They often have that data. They often know what those less costly alternatives are. And ideally, with some education from us, they can understand how our features are both unique and really address most of these really critical issues that these kids face on not only a nightly basis, but sometimes during the day as well.
So, last thing I would say on that is we're building, which I think is also somewhat innovative in the industry, is we're building a lot of tools to make this easier for both the family and the occupational therapist. So, brochures and tools that the family can bring into their doctor and OTs to help educate them on how our bed is unique and the value it provides, and then also tools to help these occupational therapists create these letters of medical necessity in a standardized and really quick manner so that they don't have to spend hours doing it, which ends up being a pretty big burden for a lot of therapists and then they often end up being not as good. So, that's a big goal of ours, is not only making this innovative product, but how do we remove friction and difficulty and confusion from every aspect of this insurance process, which is how most families get our beds.
[00:34:16] RH:Yeah. And I will say that so many families are already overwhelmed as it is, to dealing with the insurance, dealing with the providers, dealing with all of these things, they almost feel burnt out at that point. And they're like, “It's not even worth my time,” but to have a smooth process and a team that actually cares about them and helps them. It's a game changer.
[00:34:38] CP:That's exactly right. I mean, we see ourselves as advocates for the family. If you run into confusion or you're not sure what to do on a step or someone's not calling you back, we're going to call them and we're going to kind of fight for you on your behalf. If you get a denial from insurance, we would love to look at that. We'd love to understand what went wrong, how to improve it, and that helps not just you, but it also helps future families that are going to be going through a similar process. That iteration and kind of evolution over time will just make it easier for everyone else in the future.
[00:35:08] JH:Oh, for sure.
[00:35:09] RH:It's amazing.
[00:35:11] JH:It is.
[00:35:12] RH:So, one of my questions is like, what's a big challenge that you have to deal with on a regular basis? Just being in this entrepreneurial world, being in the special needs world, this disability world, what's the challenge that you go through?
[00:35:28] JH:Yeah, I would say there's two. The first would be on the reimbursement front, and just that it's super complicated working with insurance, but also incredibly important. And then the second is building a physical product, especially in a year of COVID when everything got shut down all the time, and especially a lot of the countries where you get materials from, like most steel is made in China. Our bed frames are steel. I just got a call from our supplier about 20 minutes ago that our steel costs went up 40%, which is because they shut down all their factories a year ago and then that kind of whiplash – it takes a while for the end users and end buyers to feel that. But that's been difficult.
We had factories shut down several times by government order because of COVID. Luckily, we were able to work through it. And we did have some longer delays this summer with shipping, which we felt absolutely horrible about as these families often needed the bed yesterday. But these families are also incredibly patient and really forgiving. We've really appreciated that support over what's definitely been a challenging year.
So, it’s kind of the manufacturing side which has been a big challenge. But we're working through, we are moving to a much larger factory. All US based still. That's a big goal of ours is manufacturing here in the US, both for the story but also for quality and making sure that we can be in the factory. It's even a woman owned factory, which is very cool and kind of rare. But we like that as most customers we talk to are on the mom front a lot of the time, so it's nice to be able to tell that story.
The reimbursement side is also a really big challenge. Although I kind of like to look at it as a puzzle. The biggest challenge is that every insurance company is different. And then also every state is different. So, some states are amazing, like Minnesota, Ohio, Indiana, a lot of states are amazing. But then we have really difficult states, like Texas has been horrible for us to work with, specifically with Medicaid, which is a lot of the population we work with. They barely pay as much as it costs to manufacture the bed. So, it's almost impossible for us to actually sell it. And especially when we work with distributors, they have to take their fee, that's really difficult.
[00:37:42] JH:How’s Idaho?
[00:37:45] CP:I would have to look. It's a smaller state, so it doesn't pop up top of mind. But what I would say is the best way we've learned about this is talking to our distributors or talking to the hospitals or clinicians that often work with other types of safety beds. And if a safety bed from another company is pretty well covered in your state, or you've heard of other families getting it in your state, if that's the case, then it's likely that we're going to be covered as well. We bring a lot of unique features, we bring a lot of additional value in my opinion. But from the insurance perspective, they kind of look at it as, “You’re a safety bed, you kind of are all the same,” and that's good for us because it allows us to kind of ride on their coattails and the work that they've done, and being available for 50 years in some cases.
[00:38:30] RH:Interesting. So, that's frustrating, that insurance only pays what they'll pay, regardless of what the price is of the bed.
[00:38:41] CP:Yeah, yeah. It's complicated to get into. But it changes state by state, changes insurance company by insurance company. There are some insurance companies that just have policies, they won't pay for this type of bed, which is really unfortunate. The other thing, though, that is important here is that although insurance might not pay for it, and we'd rather you get that answer sooner rather than later as we're going through the process. If insurance says no, we'll go through an appeal and provide more information. Some families do get denied twice, and then it's kind of like, “Alright, we might need to wait a year or until you switch insurance or something like that.”
But the road is not done there. There's a lot of other options. A ton of our beds have been paid for through Medicaid waivers, which often provide more flexible funding options and we fit into several categories there of assistive technology. Medical equipment could maybe even be argued as a home modification. And then we've had a lot of charities and foundations buy our beds for families. So, Make A Wish Foundation has bought quite a few. There's a lot of large foundations and we have a good list on our website.
And then the last is we do have a pretty reasonable 36-month – between 6 to 36-month financing. So, that can bring it down to a couple $100 or $200 a month, depending on your options to be able to get the bed. And that can be a great way to kind of segue into it, or some families will even do that beforehand, and then file for insurance later if they need the bed immediately and don't want to wait several weeks to potentially several months for insurance to go through the process.
[00:40:19] JH:Gotcha. Wow.
[00:40:22] CP:A lot of different ways to find these types of things, we’re learning. I mean, even in Texas, we just are now working with the Texas government, Texas will not fund our beds for like 90% of kids. But if you are blind, they will fund them all day long. We've had three or four go out in the last two weeks for blind kids in Texas. I'm not sure why. It's probably a wealthy governor, or someone who many years ago had a blind child and was like, “Hey, here's a bunch of money for this program.” But as we develop and learn, we're making kind of internal databases and hoping to be able to route families to more of these types of unique and kind of hidden sources of funding.
[00:41:03] RH:Well, I just think it's so helpful for families who are struggling so much in this area of sleep, and that they just need a tool, they need a resource, they need a company that they can trust and look up to. I'm so happy that we connected and we were able to meet you and share your story with everyone.
[00:41:20] CP:Yeah, me too. That's really the approach we like to take with this. So hey, there's a chance you might not get our bed, if you try to go through insurance. And your child is three years old, you're just starting to figure this out, you're so overwhelmed with doing everything. And even if you don't get the Cubby Bed through insurance, this process is the same for many different types of medical equipment you're going to need to potentially get whether it's a wheelchair, an adaptive bike, a stroller.
So, learning through this, and we will be a guide for you, no matter if you end up with a Cubby Bed or not, it’s going to give you the education to be able to do that for the rest of that kid's life. And that's really how we tend to look at it and try to frame it to families because it is a good amount of work to go through this process. And if you get the bed, it's 100% worth it, we think it will be life changing for not just your kid but your whole family. But in the case that you don't, you're still learning a lot that'll help you advocate and help you learn how the process works for future things they might need.
[00:42:17] JH:That’s so true. Do you guys have anything new on the horizon that you're working on?
[00:42:24] CP:Yeah, we've got a bunch of new things. The biggest thing is we've hired a couple new team members this week. So, their names are Erica and Austin. Erica will be heading up our customer care division. So really working with this hand holding guidance process through insurance and all the customer questions. And then Austin is going to be working really hard to basically get our name out there with referral sources. So, the doctor’s offices, seating clinics, children's hospitals, the distributors, and get them talking about it and suggesting it to families. So, that's been a big part of my work the last few weeks, which has been really exciting.
Product wise, we plan, shorter term we plan to launch a smaller size of the bed. So, a single or twin size that's more fitted for apartments or really small children, which we’ve gotten that request pretty often. And then we'll also do some different color options, probably some purples and pinks and things like that, that'll be a little different. And then long term, what I'm really excited about is building a lot more data and analytic capabilities into the bed. This is diving a little bit into the weeds. But I think as an OT, and your audience will find it interesting.
So, these are likely some of the, if not the most highest cost patients in society. They need incredible amounts of medical care. They often have these conditions their whole life, their lifespans are often not that much shorter. And people always think of dementia as being incredibly high cost. Autism is expected to be on par by the late 2020s, which is pretty wild for most people to understand.
The other challenge is these kids can't tell you often how they're feeling or how new medication is making them feel or that you fed them a new food and now it's making their stomach hurt every night. So, our longer-term vision is not to just create a safety bed, but it's really to create a kind of monitoring platform for these kids, that you have sensors on the bed that can detect things like seizure activity, sleep quality, heart rate variability, which is often tied to anxiety, movements. And then we can correlate those outputs with inputs, such as changes in medication, changes in their diet, changes in the sensory environment. By correlating those two data sets, you could actually start to understand from one person, that they just got a new ADHD medication in the day and now they're having three times as many seizures, or they're sleeping two hours less, but their heart rate variability is 30% higher, which probably means they're not feeling good. And that would really help give a voice to these kids that can't tell you how they feel or how this change is making them feel.
And then longer term, if we have thousands of beds out there, you can start to see trends that this type of food or this soundtrack, or this type of medication, generally does really well or doesn't do well with these kids. And that's really valuable data for not just the families and their caregivers, but also clinicians and doctors and OT’s like you guys, and then ultimately insurance as well and then we can prove the bed is working, and we can show how other things that insurance is paying for are also helping that child or that patient. So, that's like the 10-year vision. That's a long way out. But I think that that ends up unlocking some really cool research, some really cool data, and just making a lot of kids lives better.
[00:45:38] RH:Yeah, I really like that idea, especially the heart rate variability, because that's so telling.
[00:45:44] CP:I mean, that's already done with like Fitbit and Apple Watch and stuff like that in some manner. But most of these kids can't wear that because of sensory issues. So, having a non-contact solution that number one, is non-contact, number two, they're inherently going to use it every day because they sleep in the bed. So, you're going to get consistent data. That ends up being really, really helpful, I think.
[00:46:07] RH:Totally. Wow, fantastic. That's amazing. I'm so excited. And 10 years that isn't even far away.
[00:46:13] JH:No, it’s not.
[00:46:16] CP:Hopefully less. Hopefully like five years. But things always tend to take a little longer than you think.
[00:46:20] RH:Well, we are in your corner. We're rooting for you. If you need any help. Like we said, before we started recording, don't hesitate to reach out to us, because we're happy to provide data and input in any way we can.
[00:46:31] JH:For sure.
[00:46:31] CP:Yeah, we'd so appreciate that. And we don't have all the answers. Like I said, this is kind of a puzzle for us too. We’re just trying to figure it out and every situation is different. Every state is different. Every family is different. So yeah, we appreciate the help and love any suggestions that you or your audience has on, if stuff is confusing, or things don't seem right, or ways to improve. We're always open to that feedback and iteration.
[00:46:57] JH:So, where can our listeners find you?
[00:46:59] CP:Yeah, the best way to find us is definitely our website. So cubbybeds.com. C-U-B-B-Y-B-E-D-S. We don't do that much on social media yet. It's been a very hectic year and social media can end up being a really big time suck. But we do have a Facebook page, we have an Instagram page. So, those are good places that we'll be starting to push out a lot more content on. We'll also be creating a Facebook community in the next few months, that'll be a great place for families to understand how to access insurance, how to improve, how they use the product, how to share suggestions to each other. And then you can also email us athello@cubbybeds.com or you can text or call us at (855) 964-2664. We would love to talk with you. We do conversations all day. We're starting to set up kind of a virtual demo room where we'll have a bedroom scene in our office and a camera always set up. And that way we can walk people through the whole bed without having to be there in person, which tends to be a lot easier for people.
[00:48:04] JH:That's cool.
[00:48:06] RH:Oh, I love it. I love what you're doing. That's so cool.
[00:48:09] CP:Yeah, it should be fun. COVID, I think has been a really challenging year, but has also made a lot of those things easier in the doctors’ offices and stuff are now used to telemedicine and dealing with Zoom. All that, I think, really plays into this online first approach of being able to access anyone anywhere, not just if you're in a major city close to the hospital or clinic.
[00:48:30] JH:For sure. Do you guys only ship within the US?
[00:48:34] CP:So, right now, we only ship to the US and Canada. We get a lot of questions that are, it’s very difficult, because we're an FDA regulated medical device, there are import/export regulations that are not applicable to like if this was a regular bed. So, we're working with some consultants on trying to figure that out. But it's something we have to tread very carefully on as it's actually legal matters, not just regulations that you don't have to worry about. We hope to probably work on Australia and the UK first, as we think those are probably easier. But it's probably six months out before we're really able to start looking into other countries.
[00:49:13] RH:Gotcha. So cool.
[00:49:15] CP:I guess the last thing on other countries is there is possibility that someone locally, like a medical equipment supplier or your local children's hospital, if you live in Australia, for example, they might know how to do that in a legal manner that complies with the regulations, because they probably do it all the time for other US based medical equipment that they want to order. So, if that's the case, and you live in Australia, or you live in the UK, or heck if you live in China, and you can find someone there that knows the laws, we would love to work with them and talk with them. That's how we learn a lot of this stuff. So, just reach out to them, reach out to us and we're happy to try to navigate it together. It doesn't mean we won't work on it, just we got to tread carefully and make sure we're approaching it correctly.
[00:49:57] RH:Got to cross your T's and dot your I's, for sure.
[00:50:00] CP: Yep. That's important.
[00:50:01] RH:Yeah. Cool. All right. Well, thank you so much for taking time out of your day to hang out with us and share your story.
[00:50:08] CP: Yeah, it was a lot of fun.
[00:50:09] JH:Yeah, we appreciate it.
[00:50:12] CP:I appreciate you bringing me on and I'm sure we'll be connected more in the future, as there's a lot to do here and a lot that we still need to learn and smart people like you are the only way that we're going to able to do that over time. So, I appreciate you having us on.
[00:50:24] JH:Thank you.
[00:50:23] RH:Thanks, Caleb. We’ll talk to you later.
[00:50:24] CP:Thank you. Have a good rest of your day.
[00:50:26] RH:Thanks. Bye.
[END OF EPISODE]
[00:50:28] JH:All right, you guys, hopefully you go check out Cubby Beds, go to their website, they look really cool. They sound really cool. They've got a lot of cool features.
[00:50:38] RH:Yeah, check out the virtual option to be able to look at the features and see if it would work for your kiddo or your client, if you're a parent or therapist. I just feel like it's really helpful to have these tools in your back pocket to know they're available if needed.
[00:50:56] JH:I know. I'm just thinking of all the kids who have seizures when they're sleeping and we don't even know and this is just such a great opportunity to be able to monitor and see how their sleep is affecting their day.
[00:51:10] RH:Yeah, and all of the kids, I mean, I'm just thinking of so many kiddos who I've worked with who could totally benefit from something like this, just from a safety standpoint.
[00:51:19] JH:Yeah, for sure.
[00:51:20] RH:So, if this is what you needed today, glad it's helpful. If you know someone who could benefit then just send this podcast or send Cubby Beds their way, so they can check it out and we'll just spread the word.
[00:51:32] JH:Alright guys, thanks for listening and we'll talk to you next week.
[00:51:35] RH:Okay. Bye.
[00:51:37] RH: Thank you so much for listening to All Things Sensory by Harkla. If you want more information on anything we mentioned in the show, head over to harkla.co/podcast to get all of the show notes.
[00:51:49] JH:We always have the show notes and links, plus full transcripts to make following along as easy as possible for everyone. If you have followed up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at @harkla_family. If you just search Harkla, you’ll find us.
[00:52:08] RH:Like we mentioned before, our podcast listeners get 10% off their first order at Harkla, whether it’s for one of our digital courses, one of our sensory swings, the discount code SENSORY will save you 10%. That code is S-E-N-S-O-R-Y. Head over to harkla.co/sensory to use that code right now so you don’t forget.
[00:52:31] JH:We’re so excited to work together to help create confident kids all over the world and work towards a happier healthier life.
[00:52:37] RH:All right. We’ll talk to you guys next week.
[DISCLAIMER]
[00:52:40] RH:Just a friendly reminder, this is general information related to occupational therapy, pediatrics, and sensory integration. We do not know your or your child, therefore, we do not know any specific needs. Therefore, you should always refer back to your pediatrician and occupational therapist for more information.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
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