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

$10 million, five-year initiative awards seven grants

The California Endowment and the California HealthCare Foundation, two private, statewide health foundations, today announced grant awards for seven demonstration projects across the state through the Frequent Users of Health Services Initiative. The Initiative is a five-year, $10 million program aimed at creating a cost-effective, comprehensive, and coordinated health care delivery system to improve care and reduce inappropriate use of high-cost emergency and in-patient services. The projects will address new models of care that are responsive to the needs of the target population while reducing overuse of the state’s strained emergency room system.

Many “frequent users” of the health care system are people who are homeless; suffering from substance abuse and addiction; have disabilities; have a chronic illness; and/or are mentally ill who have serious health conditions. Many of their medical crises could be prevented with appropriate ongoing care, avoiding use of costly emergency rooms and hospital services. By creating better ways to provide care to this high-risk population, it may be possible to both improve their health status and lower medical costs.

According to Dr. Melissa Welch, project director for the Initiative, “Even with proposed state and local budget cuts, many resources already exist to help those who make up the frequent user group. Unfortunately, there are few systems in place to coordinate preventive medical and non-medical care services. A coordinated effort would keep a substantial number of frequent users out of hospitals and emergency rooms, ultimately breaking the cycle of repeated and unnecessary use of high-intensity services.”

Six one-year planning grants of up to $100,000 and one three-year implementation grant of $900,000 have been awarded through the Initiative’s first round of funding. A second round of funding for implementation projects will occur in 2004.

Grants were made to coalitions or collaboratives 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 a county or region. Projects were selected through a competitive Request for Proposal (RFP) process.

The Initiative’s first round of planning and implementation grants include:

Implementation Grant:

  • Santa Cruz County Health Services Agency, Santa Cruz County Planning Grants:
  • Alameda Health Consortium, Alameda County
  • County Medical Service Program (CMSP) Governing Board, Sonoma County
  • Hospital Council of Northern and Central California, Santa Clara County
  • Kaweah Delta Healthcare District Foundation, Tulare County
  • UC Davis Health System, Sacramento County
  • University of California, Irvine Medical Center, Orange CountyThe program office for the Initiative is supported by 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, or substance abuse-related disabilities. For more information about CSH, visit For more information about the Initiative and the grant awards, visit the Web site through the link below.

    The California Endowment, a private, statewide health foundation, was established in 1996 to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. For more information or to download a copy of the RFP, visit through the link below.

Contact Information:

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.