When adults with neurological conditions can access occupational therapy (OT) services, they have better outcomes. Unfortunately, many people who are living in the community with these conditions do not participate in OT services. This can compound deficits, lead to re-hospitalization, and negatively impact independence and quality of life. The issues with access for this population, specifically adults aged 18-65, can largely be attributed to lack of awareness of the role and scope of OT, lack of availability of specialized services, and issues with affordability. Evolve Occupational Therapy (Evolve OT) is a program designed specifically for this group, adults with neurological conditions aged 18-65 who have difficulty accessing OT services. This innovative approach to service delivery provides an alternative access pathway, treatment, and payment models that are intentionally designed to increase participation in and utilization of OT services. With this program, it is expected that patients will report increased satisfaction with participation, increased quality of life, and outcomes will hopefully effect change amongst policymakers.