Foundations Aim to Reduce Health Care Costs and Avoidable Use of Emergency Medical Services

Frequent Users of Health Services Initiative awards $4.5 million in five grants


The California Endowment and the California HealthCare Foundation, two private, statewide health foundations, today announced grant awards for five implementation projects across the state through the Frequent Users of Health Services Initiative. The Initiative is a five-year, $10 million program to create cost-effective and coordinated models of care that are responsive to the needs of the target population, while reducing avoidable hospitalizations and overuse of the state’s strained emergency room system.

Many “frequent users” of emergency rooms and inpatient services are people with serious health conditions who also suffer from mental health disorders, substance abuse and alcohol problems, and homelessness. Many of their medical crises could be prevented with appropriate proactive care of their conditions, thereby reducing their reliance upon emergency rooms and hospitals. The Initiative looks for new models of health care to decrease costly and inefficient use of ERs and hospitals and improve the quality, delivery, and outcomes of health care for individual frequent users in ways that suit their unique medical and psychosocial needs.

According to Dr. Melissa Welch, project director for the initiative, “We’ve witnessed significant progress from the initiative’s first round of funding in 2003. The seven projects funded in 2003 created more effective ways to link frequent-user patients to the multiple community-based services they need to manage their medical crises; this in turn reduces the need for hospital care.”

“Preliminary results from the Santa Clara County pilot project show a 41% reduction in emergency room visits and 43% drop in hospital admissions (among frequent-user patients who had eight or more emergency room visits in the prior year). In Santa Cruz County, early findings from our 2003 implementation grant show similar results, as well as a 46 percent reduction in clients’ need for and use of ambulance services,” added Welch.

For the Initiative’s second and final round of funding, which begins October 1, 2004, the foundations have awarded five, three-year implementation grants totaling $4.5 million. Grants were made to coalitions whose members include public and private hospitals and clinics, county agencies, and community-based organizations that are the major providers of health and health-related services for high-risk residents in their county or region. In order to receive a grant, each collaborative had to generate $1.8 million on their own in services, staff, operations and administrative costs, and new or re-directed funding. Projects were selected through a competitive Request for Proposals (RFP) process.

The Initiative’s final round of grants include:

  • Alameda Health Consortium*
    Northern Alameda County
  • The Hospital Council of Northern and Central California*
    Santa Clara County
  • Kaweah Delta Hospital Foundation*
    Tulare County
  • Tarzana Treatment Centers
    San Fernando and Santa Clarita areas of Los Angeles County
  • UC Davis Health System*
    Sacramento County

* Grantee was awarded a planning grant in the first round of funding in 2003.

The program office for the Initiative is located at the Corporation for Supportive Housing, a national nonprofit organization that works to expand permanent housing opportunities linked to comprehensive services for people who are homeless or at risk of homelessness and often have health, mental health, and substance abuse-related disabilities. For more information about CSH, visit www.csh.org. For more information about the Initiative and the grant awards, visit www.frequenthealthusers.org through the link below.


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About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.