Community. It's a well-worn word, but to Judy Bentley, MA, RNC, a 66-year-old nurse practitioner in St. Louis, community nursing is a life. Bentley's Community Health-in-Partnership Services (CHIPS) is 15 years old and still going strong, thanks in no small part to its founder's foresight, dedication, and ingenuity in providing free health care to the mostly uninsured, mostly African American JeffVanderLou neighborhood in northern St. Louis. "I understood that clients who generally need the services and know they can't afford it don't access it," says Bentley, a 2004 Robert Wood Johnson Community Health Leadership Program award recipient.
Whether supermarkets, banks, beauty salons, or hardware stores, wherever people go in JeffVanderLou is where you'll find Bentley and her CHIPS staff, connecting to the medically underserved public. With a kind word and a reassuring touch, the CHIPS nursing and medical staff encourage the demoralized, the skeptical, the untrusting, and the proud to participate in blood pressure screenings and weight assessments. More important, however, they begin a health care dialogue, establishing a foundation of trust that encourages those often too embarrassed to seek the help they need. "That's where I think the biggest challenge is. We give them options and education," says the soft-spoken Bentley, who spent 14 years as a public health nurse and a nurse practitioner before founding CHIPS in 1990.
Reared by the Oblate Sisters of Providence in Normandy, Missouri, from the age of five (in accordance with her mother's dying wish), Bentley credits the convent life with forging in her a strong will and a keen social awareness. After her three children began to leave the nest, in 1974, the stay-at-home mother began taking classes at Saint Louis University. Because she was studying "just for fun," Bentley was shocked when officials informed her she had enough credits to graduate. Although she admits to having had no initial interest in nursing, a friend convinced Bentley she possessed the temperament for it; she certainly had the perseverance. Diagnosed with uterine cancer while still a student at the age of 37, Bentley completed an 11-month accelerated nursing program, despite the college's initial recommendation that she not take her nursing boards until after she received treatment.
When an anonymous benefactor made a substantial donation to her Catholic church some years later, Bentley's pastor knew just whom to approach. Given the single instruction that the money go to "the children and their families," the pastor asked Bentley to create a much-needed community health care program.
The basement of St. Teresa of Avila Church served as the initial base of operations for CHIPS; Bentley kept her office in the rectory. A local pediatrician was the first to volunteer his services, and word-of-mouth publicity gradually brought in a steady stream of young patients. It was only when a podiatrist came onboard a short time later, bringing an influx of ailing older adults, that Bentley says she realized the full scope of the community's need. "How long are you going to stay open?" Bentley recalls many of her elderly patients asking her, to which she repeatedly replied, "Forever."
"In a community where they'd suffered continuous abandonment-where projects would come up and would go through their funding and close down," says Bentley, "I thought to myself, I better keep this going."
And that is just what Bentley has done. Even when the program's initial benefactor passed away and the parish relocated, Bentley convinced her managing staff to stay on voluntarily until she was able to find funding through government grants and other outlets. Today the CHIPS program has a fully equipped medical facility, funded through the assistance of private foundations, private donations, and other sources. Volunteer clinicians offer a wide spectrum of services in a variety of disciplines - pediatrics, orthopedics, internal medicine, cardiology, family medicine, dentistry, and ophthalmology. "The program is really driven by demand and our clients' needs," Bentley explains.
CHIPS complements its clinical services with acupuncture, herbal and nutritional counseling, and massage therapy. Social services are also a fundamental element of CHIPS, says Bentley, who has integrated mental health care into the program. Also, working alongside St. Louis ConnectCare, the hub for specialized care in St. Louis, CHIPS also serves as a "big brother" to patients who may require attention beyond their own resources, accompanying them down the intricately red-taped path of America's health care system.
It's a balance of services that has worked for thousands of patrons. Of the 90,000 patients CHIPS has treated since 1990, Bentley cites Arnetta Kelly as one of the most exemplary. Years ago, the uninsured Kelly couldn't afford to visit a physician, let alone pay for the medication she was prescribed after a hospitalization. Bentley convinced Kelly to make an appointment with a CHIPS physician, who diagnosed a heart murmur with complications. Now a manager of a residential center for older adults, she has her own health insurance but continues to receive her health care at CHIPS-and insists on paying for it, crediting the program with saving her life, Bentley says. Kelly has become a vital advocate of the program.
Always looking for new avenues to expand its outreach program, CHIPS has also cultivated a partnership with the area's only synagogue, in which they hold monthly health screenings.
Says the gung-ho grandmother to her nursing colleagues: "We can't stand on the sidelines and think that we're all going to be taken care of and we're all going to be okay. We're not going to be okay unless we make it okay."