As a part of our interview series called “Women Of The C-Suite,” we had the pleasure of interviewing Holly Carmichael.
Holly Carmichael is the Chief Executive Officer of GT Independence, a family-owned, national financial management services company that helps people with long-term care needs or disabilities self-direct their care. Under her leadership, GT Independence allocates more than $340 million in Medicaid funds for more than 21,000 individuals across 14 states. Holly is committed to supporting self-determination and person-centered services to give all people, regardless of age or ability, the freedom to live life on their own terms and be surrounded by the caregivers they know and trust. As a mother of two children living with disabilities, she is a tireless and vocal advocate for inclusion, accessibility and equal treatment for all.
Thank you so much for joining us in this interview series! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?
Most kids don’t say, “I want to be the CEO of a financial management services company when I grow up,” and I didn’t, either. I loved teaching and going to school, and I was the child who was educating her stuffed animals at home. Originally, I planned to be an elementary school teacher, and I was headed along that path in college. Then, something shifted.
During college, I took a job as a direct service provider at a group home. That position gave me insight and perspective into an entire segment of the population that was isolated and cast aside. I changed my degree to focus on social work, with the intention of being a case manager. I wanted to come up with ways to help people with disabilities in the community.
At the time, my husband’s family had a business called GT Independence. It was small and just getting off the ground. I began helping out and just never went away. I had the opportunity to work in almost every position at GT, and those experiences would become extremely valuable in informing my leadership role and style today.
I grew with the company, and I felt like I was a true disability rights advocate and really understood the issues and the importance of self-determination. I believe that all people have an inalienable right to make choices about their lives and their care; it made complete sense.
And then I went on to have children, and my eyes were really, truly opened. My daughter, Maggie, was born with a rare disease that causes development disability and mobility impairments. When you live it and face the barriers to people with disabilities daily, it really brings the story home. I hadn’t recognized that some of the gaps existed in my own community — such as not being able to get my daughter into a school building — until it was a problem for my child.
The impact of self-determination hit home, and I started drawing those experiences with Maggie into my work. With the type of service GT provides, it has been beneficial to be on both sides of the equation. As someone who actually uses the systems we work within, I am more informed about how we can approach designing for and supporting people who rely on self-direction to live the lives of their choosing.
Can you share the most interesting story that happened to you since you began leading your company?
I was appointed CEO of GT only recently. The most interesting thing for me has been the number of people who have reached out or posted about how proud, excited or inspired they are about having a female leader. I didn’t anticipate the effect my appointment as CEO might have on other women at GT. More than 80 percent of our workforce is made up of women, and a number of them are mothers, too. The impact on these women has been huge, and their reaction has been both surprising and humbling.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
GT is based in Sturgis, Michigan, but we work with people and programs all across the U.S. Like many other organizations during the pandemic, we’re doing a lot of our work and event participation remotely. By now, you would think that I would be really good at time zone conversions, but I did show up to an event several hours early when I first started. Fortunately, we are in the Eastern time zone, so being early is usually my biggest mistake. I am getting better at verifying my time zones!
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I would be completely remiss if I didn’t recognize my husband, Dan. I couldn’t be where I am today without him. He helps me stay balanced and get through anything, and he supports all the different things I do. We lost our first child, and most couples don’t stay together after that type of hellish nightmare, but it forged our bond even closer. He has also become a really important role model for our son.
After losing our first daughter, we went on to have a healthy son, Dexter, our “rainbow baby” (as is called a child born after the death of another). He’s always been great and super smart, checking all those boxes on quizzes about growth and motor skills. When he was about two, we had Maggie, who needed a lot of supports. We had different therapists who would come and work with Maggie, and when Dexter was about three, some of them started suggesting that we should consider having him tested for autism. At first, we resisted. Once Dexter started preschool, though, he began struggling socially. Things would come up that ticked a whole other set of boxes.
We ended up getting Dexter tested, and he was diagnosed as being on the spectrum for autism disorder. We had him tested again at another provider, and at that time, Dan began realizing that he and Dexter were a lot alike. Dan decided to go through testing and learned that he is also on the spectrum. The experience has been really important for Dan. He feels better informed and better able to support Dexter, while also showing, through his own life, that the diagnosis isn’t a judgment and life is wide open. It’s not a label that is good or bad. It’s just part of who you are, and Dexter is just as amazing to us as ever.
In my work, I often talk about how to release and relieve stress. As a busy leader, what do you do to prepare your mind and body before a stressful or high stakes meeting, talk, or decision? Can you share a story or some examples?
The way I approach a high stakes event is by adopting the mindset of an musician in an orchestra. I find it helpful to reflect on what I need to do and how I need to conduct myself. I’ll ask: What is the role I need to play? What do I need to accomplish? And then I “turn it on” as if I’m on stage, commanding a presence. I put 100% of myself into the opportunity in front of me.
There’s a saying, “Wherever you are, be all there.” It’s about being mindful to be present in the moment. When I’m in my work mode, I’m all there. And when it’s time to relax and be with my husband and kids, I’m all there, too. It can be a challenge to switch over and find that balance, and sometimes it isn’t perfect; I’m always feeling things out and readjusting.
As you know, the United States is currently facing a very important self-reckoning about race, diversity, equality and inclusion. This may be obvious to you, but it will be helpful to spell this out. Can you articulate to our readers a few reasons why it is so important for a business or organization to have a diverse executive team?
If everyone looks and thinks the same, you’ll have one answer to a problem. In that case, you don’t really need a team; you just need one person. A more diverse team will offer a variety of perspectives and lived experiences, which can provide new and unexplored angles from which to approach an issue as well as potentially more viable solutions to consider.
At GT, we see diversity as a distinct benefit. It’s a way to understand more about the daily challenges of the people we serve, and we have many viewpoints we can draw on to devise the right solutions. We’re proud to employ people across 22 states, representing various races, backgrounds and belief systems. We speak 23 languages among us, and about 10% of our employees self-identify as having a disability. This diversity is a strength, and it truly helps us achieve more as an organization.
As a business leader, can you please share a few steps we must take to truly create an inclusive, representative, and equitable society? Kindly share a story or example for each.
This is about making a commitment to take action, not just saying the right words. We can start within our own businesses and instill a strong, inclusive culture. At GT, we made a commitment to promoting diversity, equity and inclusion across our workplaces. To do that, we split our human resources department in two, ensuring we have one group that is focused on this initiative. Part of our HR group has a more traditional role, dealing with the expected tasks associated with compensation, benefits, compliance, recruiting and hiring.
The other part of our HR group is focused on culture, belonging and employee engagement. We have a defined team that takes on this responsibility, and we have an understanding as an organization that it’s not about being culturally competent, but achieving cultural humility. We are on a lifelong journey of learning, reflection and adjustment. Part of this journey involves courageous conversations and employee resource groups. And for every job, regardless of level, there are expectations that we are all cognizant of cultural humility as well as biases that could creep in.
With our leadership team, we are always listening and finding ways to be more approachable. Our executive team takes time to meet every new hire at GT so we can begin forging strong internal relationships. We have quarterly “Ask Our CEO” sessions, where any employee can ask me anything. And we work to support all of these efforts at GT because it’s not enough to talk about it. You have to walk the walk.
Ok, thank you for that. Let’s now jump to the primary focus of our interview. Most of our readers — in fact, most people — think they have a pretty good idea of what a CEO or executive does. But in just a few words can you explain what an executive does that is different from the responsibilities of the other leaders?
The CEO is committed to setting the overall direction of an organization and has to look at it globally. Developing a good team and trust in that team is on the CEO’s shoulders; it is their responsibility to have the right people in the right place and doing the right things the right way. Also, and maybe it sounds cliché, but I really think it is important for a CEO to live their company’s values. As the company’s leader, a CEO shouldn’t have a pass on that.
What are the “myths” that you would like to dispel about being a CEO or executive. Can you explain what you mean?
One myth is that the CEO is the smartest person in the room or knows everything. If that’s the case, you’re not doing it right. No one can possibly know everything. A CEO needs to surround themselves with other perspectives, value input, and be approachable so others feel empowered to share their experiences.
Another myth is that the CEO has no boss, and that couldn’t be further from the reality. As CEO of GT, I am held accountable to many stakeholders. First, it’s my responsibility to make certain we provide a good service to the people we serve. Also, I need to answer to our employees and ensure we’re creating a great workplace where people are proud to work. Of course, I’m also accountable to GT’s owners.
Lastly, I believe I have a duty to show leadership to the stakeholders in our industry and the healthcare system as a whole. GT is delivering a model of long-term services and supports that we think is the best model out there; it is the most cost effective, produces the best outcomes, and helps people live a life of their choosing. It’s important that we share best practices and encourage others to follow suit.
In your opinion, what are the biggest challenges faced by women executives that aren’t typically faced by their male counterparts?
One of the biggest challenges for female executives is having the benefit of the doubt. Women often have to prove that they are worthy of a role, while it is often assumed that a man knows what he’s doing. Women also seem to need to be more cognizant of their communication style. We may get labeled or perceived negatively if we take strong positions in negotiations or in holding people accountable, but the same tone or demeanor is considered acceptable when used by a man.
What is the most striking difference between your actual job and how you thought the job would be?
The most striking difference for me is the amount of work you don’t get to do. I really like to roll up my sleeves and get involved, but as CEO, there are many responsibilities and demands on my time. I have to trust my team to carry out our vision, which is why it is so important to have good people in the right places.
Also, it has always been easy to think that the CEO could do it all. The reality is we have limited resources to go around, so sometimes I have to say no to really great ideas. It’s difficult, but it’s about prioritizing and choosing the best concepts that will get us to the finish line.
Do you think everyone is cut out to be an executive? In your opinion, which specific traits increase the likelihood that a person will be a successful executive and what type of person should avoid aspiring to be an executive? Can you explain what you mean?
At GT, and in every organization, you need contributors at every level. I feel very lucky to work alongside all of my colleagues at GT because everyone has a critical role in helping the people we serve — it really does take a village. Not everyone aspires to becoming an executive, and that is completely fine.
For those who want to be in a leadership role, I think one of the best traits is to have a solid planning or building mindset. Whether it’s about solving a problem or mapping where you want your company to go, it’s important to visualize how to get from point A to point B and then put solid steps in place. Good judgment and analysis is also important. Leaders receive a lot of information, and it’s important to take time to filter it, process it and weigh all the options to make the best decisions. And finally, you need a commitment to do whatever it takes, even if that means taking a call that wouldn’t normally come to you.
What advice would you give to other women leaders to help their team to thrive?
Build connections and relationships, especially with your team. That can be huge. You want to be able to trust the people working with you so you can have healthy conflict and dialogue spurred by all the diverse perspectives in the room. Don’t be afraid to ask for other angles on a problem you’re considering, or ask if there are other issues you might not be aware of. And work on cultivating a set of shared values as well as shared goals so that you can commit to reaching them together and celebrate hitting them together.
How have you used your success to make the world a better place?
A quote attributed to Theodore Roosevelt sums things up nicely: “Far and away the best prize that life offers is the chance to work hard at work worth doing.” I really hope that through my work I’m making the world a better place. I feel fortunate that, through GT, we can help tens of thousands of people access self-determination and have choice in their long-term services and supports. We are helping people live more fulfilling lives thanks to having caregivers at home who can assist them; people aren’t constrained to spending their days in nursing homes or in bed. My hope is that self-determination can be available and accessible to everyone.
My professional development and success has also enabled me to become a strong advocate, for everything from self-direction to inclusive playgrounds to something truly close to my heart: novel therapies for Maggie. Maggie was born with PMM2-CDG, a rare disease discovered in the 1980s that causes intellectual developmental disability and mobility impairment. There were no developed treatments when she was born, and she shares the disease with only about 1,000 people in the world.
We were lucky enough to stumble upon a researcher, Ethan Pearlstein, in the rare disease network who was able to find an existing drug that helps treat her condition. Through our partnership, we have been on an incredible journey. We formed Maggie’s PMM2-CDG Cure LLC and joined Perlara PBC to study a single-patient investigational drug. We received the Food and Drug Administration’s compassionate use authorization, and Maggie became the first person in the world to trial a potential cure for her disease. Out of the partnership with Perlara, we formed a joint entity called Maggie’s Pearl.
I’ve been charting Maggie’s progress through my blog, Maggie’s Cure, starting with her first dose of the investigational medication in early 2020. She has made huge gains since. Her speech has just exploded, helping us to know her more and have conversations and understand the real Maggie. Her fine motor and gross motor skills have improved, and positive signs are showing up in her labs, as well. Another child in Canada is taking the same drug in a single-patient trial and is on a similar trajectory. He has taken his first independent steps. It has been phenomenal to see.
We’re so excited by what lies ahead. As COO of Maggie’s Pearl, I’m working with our CEO, Ethan, to get a 30-patient trial approved by the FDA to help more children and make the world a better place for them. We are working to remove barriers and to provide equitable access, such as by giving travel vouchers to families. It has been an unreal experience. We’ve needed persistence, pushing and luck, especially in meeting the right people at the right time to be able to pull everything together. For families who are touched by rare diseases, which often don’t have the push for funding as more common illnesses, I feel that our efforts can provide some hope for the future.
What are your “5 Things I Wish Someone Told Me Before I Started” and why? (Please share a story or example for each.)
1. Do something today that your future self will thank you for. It’s easy to get bogged down with so many things coming your way. Make sure you take time to prepare for your future. That could mean focusing on recruiting staff to get people in place to help you achieve your goals.
2. You can do anything, but you can’t do everything. There is a finite amount of time and resources, so it’s important to pause and prioritize. You can be a mile wide and an inch deep, so you need to put resources where they are needed most. As you build a larger team and build trust, you can do more and entrust others to carry out your vision.
3. Do your best and leave the rest. After having the experience of losing our firstborn, nothing can compare when it comes to having a bad day. We are all human and can only do so much. Sometimes we make mistakes or get delayed, but it will be okay; we have tomorrow. The world goes on.
4. Trust your gut. Decisions need to be made all the time, and a lot of analysis can go into them, which is necessary. But you also need to be confident in your gut instinct. Oftentimes, when I reflect on having a feeling that I didn’t heed, I realize that I could have made a better decision had I trusted myself.
5. It’s okay to rest. Leaders need persistence, but they also need energy. When you get tired, know that it’s okay to step back and rest to revitalize yourself. It’s not quitting; it’s learning that you need to restore you energy levels so you can come back stronger than ever to pick up wherever you leave off.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.
It’s difficult to choose one, so I’ll narrow it down to my top two passions. One is self-direction. It is the best-kept secret in the healthcare system and is really underutilized. Our goal at GT is to make it available to everyone. It gives people a choice in who provides long-term services and supports for themselves or a loved one. Making it widely available can help solve some significant problems our country faces, from long-term care options and caregiver shortages to the national debt and Medicaid’s budget. Programs have been shown to make efficient use of Medicaid funds, and the impact on people who have control over their lives is immeasurable. And it’s not just for people living with disabilities; it’s also for people who need assistance while aging, and that is something everyone will likely face one day.
The second movement would focus on the idea of inclusion in education. Gaps still exist, especially for children with disabilities. We see a lot of segregation, barriers and lack of supports. All children can benefit from inclusion, and a high volume of research has demonstrated that. Unfortunately, the inclusion model has not been fully embraced everywhere, and parents continue to struggle to get basic opportunities for their children. That is not okay.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I love the quote, “The best time to plant a tree was 20 years ago. The second best time is now.” The ADA may have passed more than 30 years ago now, but that tree is not fully grown. For instance, I had to get a ramp added so my child could go to her school. But, this quote is a reminder that there are other seeds to plant so that families coming after mine don’t face the same challenges. It’s not too late to do something today that will make an impact tomorrow.
We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.
I would want to meet someone with potential to ignite real change, so I would choose Dr. Jill Biden. She is in a position to influence and empower, and given her background in education, I would love to share the perspective that children with disabilities continue facing significant issues with inclusion in schools. In 2021, how are we still sending these children to separate buildings, sometimes literally in the middle of a cornfield, instead of into schools with their peers? We need to plant some seeds and start growing some trees. We need to make sure that we don’t have any segregated settings in education. I would welcome a conversation with Dr. Biden, and hopefully that conversation would spark action.