The Source for

Housing Solutions

The FUSE Model:

Frequent Users Systems Engagement

Background/Tonight’s Discussion

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VCEH entered into agreement with the Corporation for Supportive

Housing to develop a template for implementing the FUSE model in

Virginia.

VCEH was asked to attend the Commission’s Issues of Homelessness

and Affordable Housing Leadership Team’s October meeting to advise

on homelessness in Fredericksburg. VCEH discussed directing the

team’s efforts on homelessness toward those with the highest needs.

Team recommended that the Commission consider implementing a

FUSE pilot in partnership with the Continuum of Care and under

VCEH’s leadership.

Tonight’s Discussion:

Overview of FUSE

Why should we implement in PD-16?

Next Steps

FUSE is Supportive Housing

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Permanent, affordable, independent, tenant

centered, flexible, voluntary

The Institutional Circuit of Homelessness and

Crisis Service Systems

The Institutional Circuit

“Million-Dollar Murray”

Indicates complex, co-occurring social, health and behavioral health problems

Reflects failure of mainstream systems of care to adequately address needs

Demands more comprehensive intervention with coordinated system response

Individuals with disabilities such as serious mental illness and chronic health and substance abuse issues who will need longer-term services

Low Need

Individuals with limited employment history and educational achievement, and who may have substance abuse, health or mental health challenges

Individuals who are able-bodied and employable, who face an income/affordability gap; also may need short-term assistance with community reintegration

A Spectrum of Needs

Moderate Need

High Need

FUSE is Evidence-Based and

Reduces Recidivism

40% fewer jail days

91% fewer shelter days

50% fewer psychiatric

inpatient hospitalizations (not

shown)

86% in housing after 2 years

Cost benefit analysis showed

$15,000 in savings per client

Results from Columbia

University’s evaluation of the

New York City FUSE program,

released in

November 2013

Typical FUSE Client

FUSE clients cycle between systems, with little opportunity for

engagement in each. Outcomes for this client are poor, and

typically they have many issues stemming from mental illness,

substance use, and chronic health conditions

Supportive housing can break cycle of homelessness and

incarceration among individuals who are known “frequent flyers”

of jail and shelter

Frequent User Case Study

DHS DOC DHS DOC DHS DOC DHS DOC DHS DOC DOC DHS DOC DHS DOC DHS DOC DHS 1-J

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DHS

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Neither System

Re-entry FUSE – Operating

Re-entry FUSE – Significant planning

Health FUSE – Operating

Health FUSE – Significant planning

King Co FACT

KCC/SIF

SIF+FUSE/Ert

Just in Reach 2.0

Project 25

Maricopa Co

FUSE

Hennepin Co

FUSE

Washtenaw

FUSE/SIF

Detroit FUSE

Chicago FUSE

Columbus BJA

FUSE

Wash. DC FUSE

NYC FUSE

CT SIF CT FUSE

Rhode Island FUSE

Richmond FUSE

MeckFUSE

Denver FUSE

Travis Co

BJA

Louisville ACT

CSH is the National Expert on

Frequent User Initiatives

NEW - Miami FUSE

NEW –

Hudson Co

FUSE

NEW – Iowa City

FUSE

NEW – Clark Co

FUSE

Houston 1185

Program

Tarrant Co. FUSE

Orlando Hospital FUSE

Fredericksburg FUSE

Why PD-16?

One of the five central goals of the FRCoC’s 10-Year Plan to End

Homelessness reads,

“Create a system that eliminates correctional, emergency healthcare and

other public service agency burden for servicing homeless clients by

directing resources at data-driven discharge planning, targeted housing,

and case-management solutions.”

The FUSE Initiative is the only evidenced-based practice that focuses

directly on this goal to answer the question, “Can permanent supportive

housing reduce the cost and frequency with which public institutions have to

serve the most vulnerable homeless in the community?”

A way for the Commission to determine how much it costs to jail and/or

provide emergency healthcare services to the area’s high need homeless

population, and determine if there are savings associated with housing and

wrapping intensive supportive services around these individuals.

Key Components of the FUSE Model

Cross-systems, data-driven identification of target population

Assertive targeting, outreach and recruitment

Supportive housing

Enhanced service coordination and care management

Measure reductions in use and cost effectiveness

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CSH’s FUSE Blueprint

Data-Driven

Problem-Solving

Cross-system data match to identify

frequent users

Track implementation progress

Measure outcomes/impact and

cost-effectiveness

Policy and Systems Reform

Convene interagency and multi-sector working group

Troubleshoot barriers to housing placement

and retention

Enlist policymakers to bring FUSE to scale

Targeted Housing and Services

Create supportive housing and develop assertive recruitment

process

Recruit and place clients into housing, and stabilize with

services

Expand model and house additional

clients

Next Steps

With the Commission’s support, VCEH will provide the following:

Invite stakeholder group (hospital and RRJ reps, CoC members,

UMW data support, etc.) to a December kick-off with CSH’s

Senior Program Manager and leading expert on FUSE

implementation.

Begin working with stakeholders to complete data-match and

determine target population.

Assist Micah in lining up supportive housing units and case

management.

Approach FUSE clients with housing and supportive services.

House study group, track the impact against control group and

report out to GWRC.

Questions?

Hunter Snellings,

Virginia Coalition to End Homelessness

(Virginia Housing Alliance – 1/1/16)

hunter@vceh.org

804-332-0560