This Nurse Practitioner Is Taking Healthcare Directly to the Unhoused
Rachel Melson, DNP, FNP-C, a nurse practitioner and Director of the Outreach Clinic at Swope Health Services in Kansas City, Missouri, was recognized in late 2025 with the inaugural Ewing Marion Kauffman Foundation Uncommon Leader award for her work expanding access to healthcare for unhoused individuals. The award includes a $150,000 prize and honors leadership addressing systemic inequities through innovative community-based solutions.
Melson has led Swope Health’s Outreach Clinic for nearly a decade. Established in 1987, the program provides free healthcare services to unhoused patients, including primary care, vaccinations, medications, and follow-up care. Under her leadership, the clinic has expanded beyond traditional healthcare settings to reach patients where they are.
Expanding Access Through Mobile Care
A cornerstone of the program is Swope Health’s Mobile Medical Unit, a fully equipped clinic on wheels that delivers care directly to shelters, transitional housing sites, and community locations across Kansas City. The unit allows patients facing transportation, financial, or social barriers to receive care without visiting a fixed clinic.
According to Swope Health Services, more than 2,600 patients were seen through the mobile clinic in 2025 alone, representing a significant increase compared to prior years.
Patients seeking care through the mobile unit often present with unmanaged chronic conditions such as hypertension, chest pain, and gastrointestinal issues. For many, the outreach clinic represents their most consistent point of access to medical care.
People experiencing homelessness face significantly higher rates of chronic and infectious disease. Data from the National Health Care for the Homeless Council show elevated rates of hypertension, hepatitis C, and HIV within this population, along with increased vulnerability to respiratory and infectious illnesses.
Delayed care is common, often driven by stigma, lack of access, and competing survival priorities. Melson’s approach emphasizes patient dignity, trust-building, and continuity of care, which she says improves engagement and follow-up.
By fostering relationships and meeting patients in familiar environments, the outreach team has seen increased willingness among patients to return for care, adhere to treatment plans, and address long-standing health concerns.
Nursing Leadership and Equity-Focused Care
The Kauffman Foundation’s Uncommon Leader award recognizes individuals whose work promotes equity and systemic change. In announcing the award, foundation leadership highlighted the importance of innovative solutions that address complex social challenges beyond traditional systems.
Melson’s work reflects the expanding role of nurses and nurse practitioners as leaders in population health and community-based care. By integrating clinical expertise with an understanding of social determinants of health, the program offers a model for expanding access to care outside traditional healthcare settings.
Her work illustrates how nurse-led initiatives can expand access, build trust, and improve care for underserved populations.
🤔Nurses, share your thoughts about this below.
