When Nurse Practitioner Hope Jensen walked away from a 24-year nursing career, she didn’t have a clear next step, only the certainty that the system she once loved had become unsustainable. “The first six years were amazing,” she said of her time in family medicine after transitioning from women’s health. “The last five were awful.” Constant leadership changes, team turnover, and escalating stress had taken a toll. So in 2018, she left.

What followed was a period of searching. A non-compete clause kept her from seeing patients, so she worked in sales, tried her hand at a hospital position, and even took a role with a major pharmaceutical company, none of which felt right.

Then, by chance, she crossed paths with Dr. Jon Van Der Veer, a physician launching a Direct Primary Care (DPC) practice in Des Moines. She took a chance in joining him and got a front-row seat to what DPC could be. Then, she used that experience to share DPC even further.

“Without a mentor, it seems impossible,” she said. That mentorship gave her the knowledge and confidence to launch her own practice.

By June 2022, she’d formed her own LLC, and by October, the non-compete was finally up. She opened her practice doors, With Hope DPC Clinic, with 40 core patients already committed to following her. But what came next wasn’t just about restoring the joy of patient care. It was about answering a unique call for help from an unexpected source—the local jail.

Through her work with public health and her existing relationship with the county’s public health director, Hope had become a volunteer vaccinator for the Vaccines for Children (VFC) program. That’s when she learned the local jail was looking for a healthcare provider. The current system required staff to transport inmates to a nearby clinic for even minor issues, a risky and expensive process. And since medical insurance is invalid while incarcerated, care was expensive for the county.  

Hope had seen jail-based care work before in Des Moines, so she started the conversation. They landed on a solution that made sense for a rural county: one four-hour onsite clinic each week, with care provided under a DPC-style membership agreement. The monthly fee would depend on the number of inmates.

She was clear with all involved from the start: she’s not the jail’s medical director. The jail decides who she sees and when. She’s also not a mental health provider, although she refers patients to the jail’s mental health team when needed, and many individuals have already received mental health services before she steps in. With approximately 90–95% of the population carrying a behavioral health history, she encourages other clinicians to think seriously about their scope of comfort before exploring this kind of model.

Each week, Hope comes prepared, packing up a mobile clinic setup with urgent care supplies and reviewing her patient list the day before. When she arrives, she treats individuals in a cell that’s been converted into a treatment room. “The jail staff really appreciates the consistency”.  

She’s typically on the road just one morning per week, and her practice understands that time is dedicated to jail visits. The model has provided her practice with steady supplemental income, especially meaningful during the early months. While not as predictable as traditional DPC membership fees, it’s consistent. She sees between 2 and 8 inmates per week and says that’s the right limit to avoid pulling too much time from her regular clinic.

For others considering similar work, Hope recommends investing in upfront legal support. She worked with an attorney who understood her practice model and helped navigate considerations like CLIA certifications and liability. “Put the time in up front,” she said. “Those conversations lead to the changes you want to see.” For Hope, the work is challenging, but deeply rewarding. 

"My work in the jail is a powerful example of what Direct Primary Care truly represents—quality, affordable, and coordinated care delivered where it makes the most sense for everyone involved.”

Her story is a reminder that when you say yes to the kind of care that drew you to medicine in the first place, new opportunities can emerge, sometimes in the most unexpected places.

To learn more about Hope Jensen and With Hope Clinic, visit www.withhopeclinic.com.