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Across California, many hospital emergency departments are treating individuals who visit hospitals multiple times a year, often because of complex physical, mental, and social needs. Known as "frequent users," these individuals often experience chronic illness, mental health, and substance abuse disorders, and homelessness.
Launched in 2002, the Frequent Users of Health Services Initiative (the Initiative) was a six-year joint project of The California Endowment and the California HealthCare Foundation, with program direction and technical assistance provided by the Corporation for Supportive Housing. The Initiative included six pilot programs designed to test new models of care for "frequent users" of hospital emergency departments. Through grant making and intensive programming, the Initiative focused on building a more responsive system of care to decrease frequent users' avoidable emergency department visits and hospital stays.
Meeting the Needs of Frequent Users: Building Blocks for Success
This toolkit offers ideas, strategies, tools, and tips to help service providers, hospital administrators, program managers, and local decision makers meet the needs of frequent users.
Frequent Users of Emergency Departments: Addressing the Needs of a Vulnerable Population in a Medicaid Waiver: California is now engaged in a debate about how a new Medicaid 1115 waiver should be structured. The Administration and the Legislature seek a waiver that would atttract greater federal resources, preserve the health care safety net, improve health outcomes, and expand coverage. A waiver provides a unique opportunity to the State to transform care for frequent users of emergency rooms and other populations with similar vulnerabilities. Through this white paper, CSH promotes the successes of the Frequent Users of Health Services Initiative, as well as advocates for a waiver that allows for reimbursement for non-medical services, such as case management, transportation, vocational services, and linkage to permanent housing, through community-based providers that are integrated and flexible, that offer services in a range of settings, and that coordinate care for patients who experience difficulties accessing appropriate treatment. For more information about the white paper or the recommendations included in the paper, contact sharon.rapport@csh.org. Read a summary version of the white paper by clicking here.
Additional Information:
About the Initiative
Facts and Findings
Policy Information
Resources
Frequent Users of Health Services Initiative: Final Evaluation Report
The Lewin Group, a health policy research and management consulting firm, conducted the external process and outcome evaluation. Evaluation findings show a 61% decrease in emergency department visits and a 62% decrease in inpatient days for clients enrolled in the programs for two years.
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