FUSE Research

MeckFUSE Pilot Project: Process and Outcome Evaluation Findings
Mecklenburg County, North Carolina
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In 2012, Mecklenburg County (North Carolina) Community Support Services (CSS) leadership was researching effective jail diversion models that would reduce recidivism and save public dollars, and discovered CSH’s Frequent User Systems Engagement, or FUSE. Based on what they learned from CSH, Mecklenburg County created a local FUSE initiative known as MeckFUSE – an interagency effort providing supportive housing to individuals that cycle between the criminal justice and homeless shelter systems in the County, home of the City of Charlotte. The Department of Criminal Justice & Criminology at the University of North Carolina at Charlotte has now thoroughly evaluated MeckFUSE and today released the results of its study. The three-year process and outcomes evaluation demonstrated improved housing stability, reduced rates of jail and shelter utilization, and reduced hospital charges. Overall, MeckFUSE is deemed successful in reducing system utilization costs among participants.

Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients
Economic Roundtable, 10th Decile Project , Los Angeles, California
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This study evaluates outcomes from April 2011 to May 2013 for 163 hospital patients screened by the 10th Decile Project in Los Angeles, which works with hospitals to identify the 10 percent of homeless patients with the highest public and hospital costs – the 10th decile – and provide immediate services for placing these individuals into permanent supportive housing. This is affordable housing that provides access to health and social services, such as mental health and addiction therapy, medical care, and case management. The triage tools that are used for screening employ accurate, simple to use statistical models that analyze information about individuals that is available in hospitals, jails and homeless service agencies affiliated with medical clinics to identify the one-tenth of homeless persons with the highest public costs and the acute ongoing crises that create those high costs. Because there are multiple paths into this highest-cost group, ranging from young persons with psychoses who are publicly disruptive to older persons are simply very sick, each tool uses a cluster of statistical models specifically designed to assess risk factors for different age and gender groups. An analysis of cost outcomes shows that housing 10th decile patients resulted in avoidance of significant public and hospital costs.

For the 10th decile patients studied in this evaluation who obtained housing, total annual average public and hospital costs per person are estimated to have decreased from $63,808 when homeless to $16,913 when housed – excluding housing subsidy costs.

Total health care costs, including jail medical and mental health care, are estimated to have declined an average of 72 percent, from $58,962 to $16,474 per person.

Taking costs for housing subsidies and supportive services into account, every $1 dollar in local funds spent to house and support 10th decile patients is estimated to reduce public and hospital costs for the evaluation population that was housed by $2 in the first year and $6 in subsequent years.

Harris County Mental Health Jail Diversion Program
Harris County, Texas
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The County Judge’s Office analyzed the criminal justice outcomes for homeless participants in this program, which was completed in August 2017. Analyses found statistically significant reductions in jail bookings by 1.6 and jail days by 83 days compared to pre-program utilization. Reductions were also seen in average number of misdemeanors and felonies. When comparing the group who received supportive housing with similar group that did not, researchers found the top five offenses (trespassing, theft, drug possession, assault, and prostitution) were reduced for those housed but actually increased for those that did not receive housing assistance.

Evaluation of the Forensic Assertive Community Treatment Program
King County, Washington
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The King County Forensic Assertive Community Treatment program (FACT) is an enhancement of an evidence-based practice to serve adults with serious mental illness, who also have a history of homelessness or who are at high risk of becoming homeless, and have extensive criminal histories. FACT provides housing and intensive community-based recovery oriented services with the goal of reducing use of the criminal justice system, reducing use of inpatient psychiatric services, improving housing stability and promoting community tenure. During the period documented in this report, 2008 through 2011, FACT was funded by the Washington State Department of Commerce’s Homeless Grant Assistance Program (HGAP) and the Veterans and Human Services Levy, administered by King County Mental Health, Chemical Abuse and Dependency Services Division (MHCADSD), and implemented by Sound Mental Health (SMH). A total of 56 individuals have been served by FACT; the first 51 individuals to be enrolled are the subjects of this evaluation.

Minneapolis / Hennepin County Office to End Homelessness
Research, Planning and Development Department
Frequent User Service Enhancement (FUSE) Program
Read more about their results.

In 2007, Hennepin County conducted a study which found that 266 individuls used approximately 70,000 nights of stay in shelter, jail, and detox over five years, costing $4.2 million. As a result, local nonprofit agency St. Stephen’s Human Services created the Frequent User Service Enhancement program, which began in April 2008 and has housed 41 people to date. FUSE targets people who are high users of both the single adult shelter system and the criminal justice system. It uses a “housing first” model that places individuals in affordable housing with case management first, in order to provide stability before addressing their other barriers. The program focuses on reducing the involvement of the criminal justice and other government systems that provide emergency services to people experiencing homelessness.

Reducing Homelessness, Incarceration and Costs Through Supportive Housing FUSE New York City

The Frequent User Services Enhancement (FUSE) initiative is a supportive housing program developed by CSH with support from various government agencies that provided housing and support services to individuals who were frequently cycling in and out of jails, homeless shelters, and hospital emergency rooms in 2008 in New York City. A two-year follow up evaluation by Columbia University Mailman School of Public Policy found that FUSE participants spent significantly fewer days in jails and shelters and engaged in less cycling between public systems. These service use reductions resulted in significant cost savings to the government and tax payers.

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