Jean Shelton began work as executive director and CEO of On With Life in November 2017, succeeding Julie Fidler Dixon on her retirement. Shelton was most recently CEO of Iowa Digestive Disease Center, and previously was regional vice president of Physicians and Clinics for UnityPoint Health. The comprehensive brain-injury rehabilitation center opened its doors in Ankeny in 1991. The nonprofit was founded in 1987 by eight Central Iowa families who each had a loved one who had sustained brain injuries. On With Life serves as a regional referral resource for hospitals statewide and regionally, and is one of just a handful of accredited brain injury rehabilitation centers in the world that operates apart from a major medical center. The organization’s Ankeny campus completed a major expansion project in 2015. Among newer areas of rehabilitation that On With Life is expanding into are therapies for Parkinson’s disease, stroke recovery and concussion injuries. 

Did you start your career in the health care administration field? 
I’ve been in health care administration since the early ’90s. I’ve had prior experience with UnityPoint Health; I was in several leadership roles there and then moved on to the Iowa Digestive Disease Center as their CEO. As I continued to near the end of my career cycle; I really wanted to get into a field that was more mission-focused, something that I could look back on and say, this was something I was a part of. This was just the perfect opportunity at the perfect time for me. 

Were you familiar with On With Life from your work with UnityPoint Health?
On With Life has this amazing reputation, and so of course I was aware of it. We did get an award as a Best Kept Secret recently, so I think there is an opportunity for more people — even in health care — to understand more about it. I had some preconceived notions about what On With Life was about, and so when I came and interviewed, I found that it was [what I thought] but also so much more. … Seeing it in real life, it’s a whole new world. 

What sort of difference has the facility expansion made in the past couple of years? 
That expansion has allowed us to serve 400 more individuals over the course of a year. We actually have a demand for more space, and we aren’t quite sure what the limit is. But we were able to expand into this wonderful Parkinson’s treatment program called Big and Loud, which has some evidence-based features that target broader, louder movements and vocal activity to slow the progression of Parkinson’s. So that was a really nice opportunity for us with the new space. … It’s been very well-received and many people are asking for more follow-up services. They feel it’s really made a huge impact for them. 

Other growth areas? 
In addition to Parkinson’s, stroke is becoming one of the conditions we’re treating and serving here. Recovery and return to home or work are the best possible outcome. And we’re going to begin a complex concussion clinic so that we can provide outpatient services that target concussion specifically. We’ll bring in specialized equipment to do so. Ultimately, what I would love to see is that there is enough protection out there with helmets so that we aren’t needed. We’re finding out more that even the smaller bumps have an impact, and we have to be ready to respond to that. … Now there’s a blood test for concussion, and we’re excited about that. I think we’re going to see a lot more research and information come out in the future. 

What other technology advances do you think will spur better treatment? 
I wish there were more innovations; there’s no cure, obviously, for brain injury, either acquired or traumatic. However, people are going through our system a lot faster, but with brain injury it’s a slower recovery [than that timeframe]. We’ve seen upwards of a 45-day decrease in length of stay. So an individual may be up and walking and look like they’re doing OK, but they may forget where they’re going, or they may forget who they are. So mobility isn’t always the best measure of success. We’ve had to look at whether we need day programming or respite care for families to support them. … I think we’re looking more and more at the support services, to make sure gaps are filled and that needs are met. 

What are some examples of new therapies being used? 
We just got a brand-new piece of equipment that will help us with concussion. It’s kind of like a giant TV screen that’s interactive. We have bicycles that have electrodes attached that help move the muscles for an individual. One of the things we’re looking at in the future is driving simulation. We do have a vehicle here that is more to help a person learn how to get in and out of a vehicle, but we would like to see driving simulation as a part of that. 

Probably our biggest addition is our healing gardens. We have several acres of garden that will target different sensory needs. For instance, it’s built so that from their wheelchair they can look up and enjoy the garden and not just see the sky. There is also a playground to help parents practice playing with their children. We have different obstacle courses built into the garden so that individuals can practice real-life challenges. 

What are the biggest challenges your organization faces as a nonprofit? 
We’ve followed the changes in Medicaid very closely. We have a facility in Glenwood that’s 100 percent Medicaid. We’re a good portion Medicaid here also. If Medicaid destabilizes, that’s always a worry I have. We’ve been blessed so far that the outsourcing of Medicaid has gone OK. We obviously aren’t making a ton of profit off of the Medicaid/Medicare population, but it’s the niche that we have. … It’s definitely one of our top concerns. We’re doing OK. We’ve been blessed with a strong foundation and we get a lot of community support, not necessarily in dollars but in volunteers and political support. 

What changes are on the horizon in the next year or two? 
I think we will see a very large expansion of our outpatient program; we have just completely outgrown where we’ve gone so far. That’s probably No. 1 on our horizon. For our kind of therapy, a lot of it is large gym space — we need room to move. We typically function in a trans-disciplinary team, so it’s not unusual to see two therapists with one individual as we target certain functions. We’ve come up with a two-year and five-year plan of about 1,000 to 2,000 square feet each. And you’ll see more intentional therapies for Parkinson’s and stroke. We’ll probably move our admin team and look at giving space to make nice contiguous gym space. 

What do you enjoy doing as hobbies?  
I do volunteer work in animal rescue; I have a strong passion for that. I have two Great Danes that keep me busy. I paint; I like acrylics and oils and I do mostly landscapes. That’s been my form of meditation — it just allows you to breathe a bit and sit back.