The field of applied behavior analysis (ABA) is growing exponentially, as are the organizations that are providing ABA services. Maintaining quality can be challenging during periods of rapid growth. Regardless of an organization’s size, scaling quality care is vital for the continued success of our field and for the patients we serve. When considering sustainable systems change, we are obligated by our ethical code to develop a system that benefits others, treats others with compassion, dignity, respect, integrity, and ensures competence. At Centria, we have developed a clinical framework that begins with understanding our client's values from the start of care. As Montrose Wolf outlined eloquently in 1978, as practitioners, we should continually ask ourselves if what we are doing matters to those with whom we are working (Wolf, 1978). It’s a simple question, but one that can often get lost in the middle of a therapeutic plan based upon standardized and criterion-referenced assessments. During this panel, we will be discussing the development of our patient-centered, values-aligned approach to therapeutic intervention. We'll discuss a multi-step process across a large-scale system, including; communication strategies, our mentorship model, training systems, and the development of tools to assess outcomes and monitor implementation.