Founded in 1999, the mission of Health Care Without Walls is “to improve the lives of women who are homeless or marginally housed through quality health care, education and advocacy.” When organization founder, Dr. Roseanna Means, finished medical school and her residency, she took a job in “mainstream medicine” to pay the bills. Along the way, she felt a loss of idealism that had initially brought her into the profession of medicine. It was while she was working at Massachusetts General Hospital that she had her “ah-ha” moment. She found herself walking past homeless people on her way to work and became bothered that there were people outside a major medical institution that were not receiving the care they needed.

Dr. Means took action. She worked with Boston’s Health Care for the Homeless for seven years. During that time, she observed that homeless women using traditional healthcare access venues, even when staffed by doctors trained in caring for the homeless, can feel overwhelmed when impaired by exhaustion, mental illness and fear. She wanted to dedicate herself to women’s health issues as well as to address the dire consequences of the inefficiencies in the current healthcare system for vulnerable women and children.

Dr. Means began providing free care to these women by designing a model that involved going to them in the places they felt safe. She offered her help in one shelter in 1998 while she concurrently ran a private practice. Soon she recruited other physicians to help and what began as a volunteer effort grew to become an alternative and complementary medical model that emphasizes the importance of “gap” care—closing gaps in access and treatment by addressing the entire context of their lives.

HCWW’s unique, relational approach to medicine allows these women to visit our walk-in, shelter-based clinics, receive immediate medical care, build trust, gain skills to manage their health, and reconnect with the healthcare system through our emphasis on intensive care management. HCWW addresses several key determinants of health including housing, food, transportation, and personal safety, leading to improved health outcomes while also lowering the cost of unnecessary ER visits and hospitalizations for women with no place else to go.