by Aneesha Dhargalkar, MD
Published February 9, 2024; © 2024 Aneesha Dhargalkar, MD
Brian and Donna Sturgis thought of the idea of a free medical clinic for the poor back in 2002. They had both been helping people for a long time. The couple first met while serving as missionaries in Africa, and they were quite surprised to learn that they came from the same area, about 20 miles away from each other in Pennsylvania! Brian and Donna’s friendship quickly developed into romance, and they soon married and joined the Hershey Free Church.
As church members, the Sturgis couple discovered that many local low-income residents did not have medical care. This led to the birth of Hope Within Community Health Center. The church members provided staffing and financial support to get the clinic up and running.
Hope Within Community Health Center is now a primary medicine clinic in Elizabethtown, PA, opening in 2006. Since then, the center has grown from 1-2 volunteer medical providers offering services one day a week to more than 40 volunteer licensed providers available five days a week.
The vision of Hope Within is to serve the local community by meeting its residents’ physical, spiritual, and emotional needs. Real hope is prevalent in this center, love for one another abounds, and healthy, wholesome lifestyles are the norm. Values of compassion, collaboration, trust, excellence, and respect echo through the walls of this sacred space.
Hope Within aims to provide primary medical care to uninsured low-income residents in Lancaster, Dauphin, and Lebanon Counties. There are approximately 90,000+ people without health insurance in these three regions. Hope Within provides care to around 2500 patients each year in its medical, dental, and counseling areas. To be eligible, a patient must live in the counties listed and have a household income of 250% of the federal poverty level or less.
The clinic sees men, women, and children. Last year, the clinic had an influx of Ukrainian refugees. This resulted from a local church supporting them with housing and food resources. The church then referred these refugees to Hope Within for medical care. Many school-aged children attend the clinic, as Hope Within is a vaccine provider. This is essential because children cannot enter school until they receive all their required vaccines.
A Lifelong Journey
Mrs. Anne Marie McAlester currently serves as the executive director of Hope Within Community Health. A registered nurse by training, Anne worked in a New York hospital operating room before moving to Pennsylvania with her husband on the birth of her son. After this move, she switched careers and started working at a local Christian ministry as part of the church staff and theater, staying there for 10-11 years until 2012. Through her church connections, Anne met Brian and Donna Sturgis.
The Sturgis family was seeking an office manager for Hope Within and recruited Anne. She served in this role until 2018 when she left for personal reasons. But that was not the end for Anne and Hope Within Community Health. Anne received a call in early 2019 from the clinic board, asking her to serve as interim executive director after the departure of the director. She accepted the role and has been the permanent executive director of the clinic since June 2019.
Hope Within Community Health provides medical, counseling, and dental services.
On the medical side, there are approximately 30 volunteer medical providers, including physicians and advanced practice providers. There are 4 to 5 volunteer nurses as well. The clinic’s medical director oversees these volunteers. He follows up on all bloodwork and other testing ordered by the providers, who often return the following month. He then determines medication changes, procedures needed, and other next steps based on the test results. The nursing staff at the clinic executes the medical staff orders.
Many prescription medications are free of charge through the on-site dispensary. These include drugs to treat diabetes and medications for asthma care, including inhalers.
The counseling center is a vital part of Hope Within Community Health. It started in 2014 after the staff noticed a patient’s need for counseling services. Soon after, Hope Within began calling local colleges and inquiring about their counseling services. Now, graduate students in the counseling department of Lancaster Bible College perform their practicums and internships at the clinic. A site coordinator licensed by Lancaster Bible College supervises the sessions. The rapid expansion of this service led to the creation of a new counseling wing in 2020.
Launching in July 2020, the dental clinic of Hope Within was originally a “pipe dream,” according to Anne. But, through her guidance, the center was able to make this dream a reality. The old counseling wing serves as the space currently used to provide dental services. Hope Within offers primary dental care, including oral health screenings, cleanings, fillings, sealants, fluoride treatments, and dental education, all free for the patients.
The dental clinic staff includes two part-time dentists and three volunteer registered dental hygienists. Dental hygiene students from Harrisburg Area Community College also work at the clinic, providing evaluations and cleanings under the supervision of their director. An oral surgeon volunteers his time once a month to do dental extractions.
Given that Hope Within Community Health originated from Hershey Free Church, it is no surprise that this clinic maintains strong ties to the local religious community. Around 25-30 local churches provide regular funding to the clinic, donating anywhere from $50-$750 a month. Private individuals and businesses donate to the clinic as well. Anne and the rest of the clinic staff also run fundraisers and write grants for additional financial resources.
Hope Within also benefits from its relationships with local hospitals, which provide a large amount of in-kind help. Patients get basic laboratory testing, x-ray and ultrasound imaging, and other diagnostic testing through this in-kind arrangement. Lancaster General Hospital takes care of people living in Lancaster County. Both Hershey Medical Center and the University of Pittsburgh Medical Center provide services to patients from Dauphin County. This arrangement benefits both the clinic and the hospitals since this outpatient care can decrease emergency department visits and inpatient hospital admissions.
Despite the hard work of the Hope Within Community Health staff, challenges do exist. Supplies and equipment, specifically those resources used in the dental clinic, are costly: almost everything used by the dental staff is disposable or consumable. A second challenge involves accessing language translation services for those whose primary language is not English.
Finally, obtaining medical specialty care services beyond traditional primary care has proven difficult. When possible, the clinic will work with the patient’s financial aid to get a needed test or procedure. This can be challenging. Anne recounts the story of a young woman who was an undocumented immigrant. She required a specific gynecologic test that the clinic did not perform. Anne and her team jumped through many hoops to help their patient. She eventually received the required test, but not without much difficulty.
Compassion in Action
In the end, Anne remembers to focus on the clinic’s core values – compassion, collaboration, trust, excellence, and respect. She demonstrates these values in all her patient interactions. A recent example of this involves a 55-year-old woman named Linda.
Linda is a patient at the clinic who suffers from early-onset dementia. She worked as a nursery school teacher, transitioning from a full-time to a part-time position due to her illness. As her dementia progressed, Linda became more forgetful. For example, staff at the nursery school would give her scissors and ask her to sit on the floor and cut items from sheets of paper. But, when she got to the floor, Linda often needed a reminder of her assigned task.
With the reduced hours, Linda would leave work early. As a result, she would then go to bed at night earlier than usual. This would result in her getting up at 2 or 3 am and heading to the school, thinking that was the start of her work day.
One day, Linda didn’t attend her scheduled medical visit at Hope Within. Out of concern, Anne drove to her house and found an unkempt residence with no lights on and an empty refrigerator. Linda had thought there was an issue with the electricity, but all the light bulbs in her home had burned out.
Anne sprang into action. She ordered Linda an ample amount of groceries for her home, including a supply of new light bulbs. A local store made the delivery later that day. The next day, Anne returned to Linda’s home, changed the light bulbs, and helped clean and organize her house. Eventually, Hope Within was able to locate Linda’s sister and arrange for Linda to live in a senior living facility.
Anne described the role of the clinic this way: “The point of what we’re doing is trying to build relationships with people too so that they trust us. We are not just in and out – we spend a lot of time with our patients, and we listen to them holistically.”
Hope Within Community Health Clinic exemplifies this every day, and with Anne at the helm, they will continue to achieve their goals for a long time into the future.
About the Author
Dr. Aneesha Dhargalkar is an emergency medicine physician in Chester County, PA. She has a passion for healthcare worker well-being and is an aspiring medical writer. Dr. Dhargalkar can be reached at aneeshamd@gmail or through her LinkedIn page.