Ask the expert: Improving access to health care for rural and remote Island families with Susan Fox

Tell us about the work of Outreach Therapy. What areas of the Island and the surrounding islands does the organization serve?

Outreach Therapy has worked with children and families for 40 years. We provide pediatric physiotherapy, occupational therapy, and early childhood mental health programs.

In our early days, our focus was solely on the Alberni Valley. Over the years, we have expanded to provide outreach services to Tofino, Ucluelet, Bamfield, and Ahousaht. Thanks to funding from Children’s Health Foundation of Vancouver Island, we have been able to innovate and provide an Occupational Therapy program to all Nuu Chah Nulth nations from the northwest to southwest of Vancouver Island over the last three years.

How did you become involved with Outreach Therapy and what led you to pursue a career in this field?

I have been involved with Outreach Therapy for 18 years. I have always felt called to serve the community and have worked for diverse non-profit organizations in administration and accounting positions prior to becoming Executive Director of Outreach Therapy.

This career path is personally meaningful, as I have a brother with cerebral palsy and a son who experiences learning disabilities and developmental coordination disorder. As a young girl, I remember accompanying my mom to take my little brother to his occupational therapy and physiotherapy sessions in our neighbourhood in the Okanagan. As such, I have tremendous gratitude for these child development heroes and so much passion for this work.

Children’s Health Foundation of Vancouver Island is a proud supporter of the Skills that Achieve Readiness for School (STARS©™) program. Can you share a story of a time that the impact of the STARS©™ program was most evident?

STARS©™ was born out of our desire to serve more children, particularly those with barriers to accessing traditional therapy.  The program integrates occupational therapy and kindergarten-readiness skills through play-based learning, which enables participants to learn pre-numeracy, literacy, and fine motor skills, as well as self-confidence that sets the stage for success in school.

A local mom was extremely worried about her son starting kindergarten. She saw social media posts from fellow moms with children the same age as her son who were working on pre-counting, the alphabet, colours, and shapes.

He also experienced issues with sensory processing; textures of clothing were difficult for him, and he was terrified of water. He was overwhelmed with anxiety at times and didn’t always know how express his emotions. She was scared that he wouldn’t be able to manage in kindergarten, because she knew his development was not equal to other kids his age.

When they were invited to join the STARS©™ group at Outreach Therapy in Port Alberni, she was thrilled. After only eight weeks, her son was able to write his name. She remembers, “when I saw my son print his name for the first time, I just sobbed. I was so happy. I just knew he was going to be okay in kindergarten.”

Her son is now five and is thriving in kindergarten. He reads by himself, understands math concepts, and can print sentences. According to the proud STARS©™ mom, without the program, “he would be nowhere close to where he is now. I have no worries about him entering grade one.”

Has Outreach Therapy had to adjust the way its services are delivered because of the COVID-19 pandemic? If so, how?

Absolutely. It is part of our team culture to think in an innovative and divergent way, so we began imagining at the beginning of last month how we could support families at a distance. In the middle of March, we started working remotely and providing phone consultations. Later in the month, we partnered with Nuu Chah Nulth Health and First Nations Health Authority to begin delivering telehealth services using Zoom.

We are thrilled to be able to provide ‘face-to-face’ telehealth services to families located in rural and remote areas. Typically, we can’t travel to those located in very remote communities due to cost and time restrictions, and a family might have to make the long journey into Tofino or Ucluelet and would receive less timely care. While virtual care has limitations, this new service delivery model will allow us to reach a greater number of families and enable remote families to have more equitable access to care going forward.  

I am grateful that Outreach Therapy has been able to continue to connect with families and be a resource for them throughout these challenging times. It’s needed now more than ever.

You’ve been an advocate for reaching rural and remote families on the Island and surrounding islands to ensure everyone has access to health services. Tell us about your vision for virtually connecting with isolated communities.

Outreach Therapy’s vision statement, ‘limitless possibilities for all kids,’ has been a guiding principle in our digital transformation. How can we reach that vision? Certainly not by carrying out services in the same way.

Virtually connecting families through telehealth is essential to reaching our vision of providing an impact for all families on Vancouver Island and the surrounding islands. Rural and remote communities have lived with barriers to timely and equitable access to care for too long. Canada is comprised of a 33% rural and remote population – that is huge!

In my mind, the question of sustainable practices emerges as well. It is not sustainable to keep asking for funding to carry out services in the ‘old ways.’  Outreach Therapy wants to be a leader in bringing solutions to the table and testing these solutions.

Fortunately, Children’s Health Foundation has been at the forefront of supporting solutions that look to goals of access to care. I am inspired to work with the Foundation, which I believe will be the driving force behind transforming care for Island Kids in the future. They are committed to an Island-wide approach and to bringing all care providers together as one cohesive Island community.

Telehealth is now more important than ever for rural, remote, and urban families alike amidst COVID-19. What do we need to consider in these changing times?

As with any model of delivery, there are pros and cons. In traditional face-to-face models, geography and transportation can be major barriers to accessing care. While telehealth eliminates these barriers, we see new ones emerge.

I have been concerned that digital poverty, or lack of access to Wi-Fi and devices, technology illiteracy, and distrust of adopting telehealth would create new barriers for our local families. While they haven’t yet been an issue, I believe that families need better access to connectivity and devices and worry about the digital divide. It is essential to address digital equity in our most vulnerable families.

Is there anything else you’d like to mention that I haven’t asked you?

Our families have been incredibly resilient in the face of such difficult circumstances. I draw daily inspiration from their dedication, devotion and tireless effort to supporting their kids. They, too, are superheroes.

Outreach Therapy is humbled to be there for Island families. I am so grateful for the support of Children’s Health Foundation of Vancouver Island, and am very excited to be a part of change movement hosted by the Foundation made possible thanks to the support of your change-making donors.  Your donors should feel incredibly excited about how their gifts are transforming the face of care for Island kids.

In gratitude – thank you! In Nuu Chah Nulth – Tlecko! Tlecko!