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Maricopa FUSE

Maricopa FUSE responds directly to one of the most pressing policy problems currently facing Maricopa County, Arizona, and the nation as a whole – rising public spending on health care (Medicaid) with poor health outcomes. In Arizona, a major contributor to growing public spending on Medicaid is a small subset of individuals who are caught in a “revolving door” of emergency room visits, inpatient hospitalizations, detox stays, and involvement in other costly crisis health services. Often referred to as the ‘5:50 population’ (the 5% of beneficiaries that represent 50% of costs), they have complex and co-occurring physical and behavioral health challenges, limited support networks, and more often than not, experience homelessness or unstable housing situations.

Maricopa FUSE will systematically address the needs of individuals who have chronic histories of homelessness, mental illness, and inappropriate, frequent use of emergency rooms and other costly crisis care. Over 24 months, FUSE partners will design the program model, move 15 frequent users into supportive housing in the community, and link individuals to comprehensive, coordinated health, mental health, addiction, and wrap-around services in the community in order to reduce their use of crisis care. By leveraging the resources of multiple service and housing agencies, our goal is to create a continuum of care for highly-vulnerable individuals and to demonstrate strong health and housing outcomes for this group, and system level (cost reduction) outcomes, laying the groundwork for broader, countywide replication.

CSH's Role

CSH has a wealth of experience in the health arena, which provides the foundation for the FUSE pilot. CSH implemented a six-year frequent user pilot in California. Through third-party evaluation, the pilot demonstrated that homeless clients who were connected to permanent housing experienced deeper reductions in ER and inpatient hospital stays than those not in supportive housing. CSH also has deep experience in using inter-agency data to identify high utilizers of services from multiple public systems. In Maricopa FUSE, CSH is providing program development, pilot evaluation and on-going technical assistance to project partners.

Impact and Outcomes

Supportive housing has emerged as a comprehensive intervention to meet the complex needs of frequent users, while reducing public costs for crisis care.  Research shows that high cost frequent users placed in supportive housing  exhibit improved accessed to care, decrease in risky behaviors,  and improved health outcomes.

Partners

  • St. Joseph’s Hospital and Medical Center
  • Circle the City
  • Native American Community Health Center
  • Maricopa Health Care for the Homeless
  • Valley of the Sun United Way
  • Native American Connections
  • Arizona Housing Inc.
  • Arizona Behavioral Health Corporation

 

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