For Your Health
For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

On the road again

UND Department of Occupational Therapy graduate LaDonna Bannach takes her Fargo-based team of occupational and physical therapists on the road

Time is money.

And because time is money to the parents of children who need pediatric occupational or physical therapy services, says occupational therapist LaDonna Bannach, many rural clients were missing needed services due to the long travel distances that required parents to leave work to see Bannach or one of her therapists.

“That would mean the parent taking time off work and pulling the child from school for half a day,” says the graduate of the UND School of Medicine & Health Sciences occupational therapy program and CEO of Beyond Boundaries, a Fargo-based pediatric therapy provider. “It’s literally a four- or five-hour process, so parents would have to choose to not have the care their child needs or lose work or school hours.”

It was an unsustainable scenario for many families, Bannach says – but not one without a solution. So with a little creative thinking, and with the help of some friends and supporters, she retrofitted a solution.

“Might as well buy a bus”

Laughing today at her own bravado, Bannach said that after working through some logistics during COVID and talking the issue through with her team of therapists — many of whom are also SMHS graduates — she decided, “I might as well buy a bus.”

In 2021, then, Bannach and crew took a handful of grants and other donations and converted them into the Beyond Boundaries Mobile Therapy Unit (MTU) in an effort to take her team’s services on the road.

Occupying what was once a school bus, the MTU is a mobile sensorimotor space and mini gymnasium that now travels out to Beyond Boundaries Therapy clients in places like Valley City, Lisbon, and Milnor, N.D.

And as far as Bannach can determine, it’s the only mobile therapy unit in the upper-Midwest.

Equipped with a suspension swing, rope ladder, balance blocks, and other play therapy modules, the MTU and its traveling therapists offer most of the services clients would find in a brick-and-mortar facility. These include therapies specific to children looking for assistance with attention/behavior, strength/endurance, feeding, social skills, gross and fine motor coordination, sensory integration, and pediatric incontinence — all wheelchair accessible.

Bannach says that Beyond Boundaries was the first provider in the area to utilize an integrated occupational therapy (OT)-physical therapy (PT) approach to treating pediatric incontinence.

“Every day we provide the foundational aspects of therapy, but then we also have a lot of very specialized pieces of what we do,” she says with a smile, adding that most of her therapists specially trained in pediatric incontinence are UND grads. “The pediatric incontinence program is one of those specialties. And now we have research that has been published on our approach – it’s a really great program.”

Acknowledging that the North Dakota weather plays a role in determining how far the bus can travel, and when, Bannach says that she tries to keep the MTU on the road through November.

“Then we’ll start up again in March or April. There is a heater system on the bus, but it’s not insulated, so when it’s really cold we have to close it down. It has been super fun, though. The therapists have it all decorated right now for Halloween, with cobwebs all over and pumpkins. The kids love it.”

No child left behind

Such outside-the-box thinking on care provision is in her blood, Bannach says.

As far back as 2008, she was noticing that parents were facing “catastrophic deductibles” that likewise limited their ability to access therapy — geography notwithstanding.

In response, Bannach and her UND alumnus-husband founded a community nonprofit organization dedicated to providing comprehensive support services to individuals of all ages and abilities and their families in the Fargo-Moorhead area.

“It has always been part of who I am — making sure that no child is left without care,” she says, her eyes dampening just a bit.

Called the House of Everyday Learning, the nonprofit organization’s goal is to help remove barriers that prevent children and families from receiving needed services, in the hope that clients can move closer to functional and independent living.

Within six months of its rollout, the MTU has provided a mobile facility for therapists to screen, evaluate, and/or treat over 120 children in rural North Dakota.

“We started the nonprofit to help take away that burden for families,” Bannach explains. “Whether the issue is clients are uninsured or underinsured, there’s an avenue for us to provide them with therapy. We know our clients and we know the families we serve — over 450 clients a week — and it is absolutely amazing, the difference we’re making.”

Roll on

For its outreach work, the Beyond Boundaries and House of Everyday Learning teams were jointly given the Outstanding Rural Health Program award in 2022 at the Dakota Conference on Rural and Public Health.

Presented to a program that “delivers services in innovative ways through collaborative partnerships to improve the access and quality of care to rural North Dakota residents,” the award was a first for Bannach and crew.

And they hope it’s not the last.

“The award was extremely humbling because we’re just doing our thing,” she says. “To know that our program was really looked at highly and that we’re really meeting a need in these communities is rewarding.”

Moving forward, Bannach says she’ll continue to apply for grant funding to ensure that Beyond Boundaries outreach services remain free to the client.

“We need to continue to provide free screenings and services in those communities to individuals who are interested,” she says. “If it is deemed necessary that a child needs a medically-based evaluation, then insurance typically helps and more services are covered.”

And, says Bannach, she loves taking on UND PT and OT students needing clinical training, who in her mind are as prepared as ever for therapy careers.

“When I look back at things, I see what a great, well-rounded OT program UND had, even at that time, and how it really prepared me for practice,” she muses. “I felt like I stepped out after I graduated and was ready to rock and roll and was very well-prepared. And that’s very consistent with what I see now — the students coming out of UND are amazingly prepared, well-organized, eager to serve, and ready to take on the challenges of the world.”

By Brian James Schill