Foundations Join Forces to Improve Health of Chronically Ill Uninsured

Initiative aims to reduce health care costs and use of emergency medical services


At a time when the number of uninsured Californians is rising significantly, The California Endowment and the California HealthCare Foundation, two private, statewide health foundations, today announced the launch of the Frequent Users of Health Services Initiative, a five-year, $10 million program aimed at creating a cost-effective, comprehensive, and coordinated health care delivery system to address the unique health and medical needs of chronically ill, uninsured Californians.

Many “frequent users” of the health care system are the homeless, substance abusers, the disabled, and the chronically and mentally ill who have serious health conditions and often use emergency rooms and hospitals for medical crises that could have been prevented with appropriate ongoing care. These visits result in inflated expenses, often absorbed by the public and private health systems, which drive up health care costs for everyone. 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.

As part of the Initiative, several demonstration projects that address new models of caring for frequent users will be funded throughout the state. One-year planning grants of up to $100,000 and three-year implementation grants of up to $900,000 will be awarded in April 2003 through the Initiative’s first round of funding.

“We can no longer turn a blind eye to the growing number of chronically ill, uninsured Californians who place a burden on our health care system,” said Robert K. Ross, M.D., president and CEO of The California Endowment. “With public health funding shrinking and health care costs rising, we must develop improved models of care for this high-risk population.”

“This is an opportunity to help patients that are among the most challenging to serve,” said Mark D. Smith, M.D., M.B.A., president and CEO of the California HealthCare Foundation. “It is difficult to manage their care and coordinate services because they receive care from a number of providers in a number of different settings.”

Eligible grant applicants are 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. Grants will be awarded through a Request for Proposal (RFP) process. The first RFP was released on October 10, 2002. Letters of Intent are due November 4, 2002, and full proposals are due January 7, 2003. Grants will be awarded in years 2003 and 2004.

Dr. Melissa Welch, Project Director for the Initiative, has had first-hand experience addressing the needs of “frequent user” patients as the former chief medical officer for the Community Health Network, San Francisco’s public health delivery system that serves the uninsured.

“We must not only challenge ourselves to respond to the needs of all health care consumers, but also challenge the systems and policies that pose barriers to care for those chronically ill, uninsured patients who are often in most need of care, ” states Dr. Welch. “The Frequent Users of Health Services Initiative meets this challenge by creating opportunities for changes in the financing and delivery of health care, while promoting cost-effective, high-quality models of care for uninsured patients.”

The 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.

More information about the Initiative and the RFP can be found online 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.