FUSE: Homeless Outreach in Action


On any given weekday, you might find ShelterCare Housing and Services Navigators Lindsay Weiss and Austin Wilson working in a surprising variety of locations. On some days you might find these members of the Housing Intervention Program (HIP) at Washington-Jefferson Park, along the Willamette River or near the Union Pacific Railroad tracks running through Eugene and Springfield. On other days it’s not unusual to see them at places like the Eugene Mission or The Dining Room. Or, you might run into them entering or leaving the Lane County Jail. Why are they traveling all over the community and working in such an unusual mix of locations? Because that’s where they find the individuals who are the targets of their special brand of homeless outreach.

Lindsay and Austin represent the cutting edge of ShelterCare efforts, championed and funded by Lane County Health and Human Services, to move some of the most-difficult-to-house homeless adults off the streets and into apartments. These people are the so-called “super utilizers.” They have been identified by the county as the homeless individuals who make the greatest use of public services through arrest, incarceration, emergency room visits, hospital stays or unsuccessful social service interventions. All have been homeless for an extended period of time. Most have criminal records, behavioral health challenges or serious, untreated medical problems—or some combination of those issues.

The theory behind the outreach effort is called FUSE, which stands for “Frequent Users Systems Engagement.” It is a model that has been tested in more than 20 communities across the country. The overarching goal of FUSE is to reduce public costs by identifying homeless people who account for the greatest share of those costs and targeting them for housing and wraparound supports.

The Lane County/ShelterCare FUSE project has three intertwined components that make it both unique and effective:

Data Driven: Homeless individuals are tracked as they use community services and Lane County analyzes this data to identify super utilizers. This information is used to compile a list of people, given to the HIP outreach team, who are targeted for housing and services.

Partnership Focused: The FUSE initiative is directed by a workgroup consisting of: law enforcement; hospitals; jails; fire and emergency services; insurance companies; court systems; housing agencies; and behavioral health providers. This cooperative system carries over to the outreach team, which is building a diverse network of providers, including other nonprofits, who are committed to delivering necessary services to FUSE clients.

Outreach Based: The HIP team takes FUSE to potential clients—not vice versa. That’s why Lindsey and Austin spend their times in the parks, jails and places where homeless individuals frequent. Armed with a laptop and a wireless data plan, they can start filling out online paperwork while sitting at a picnic table if necessary. If a client needs to replace their ID or visit a medical provider, they can drive them to their destination and make sure the process gets started.

Yet technology and transportation are not the keys to outreach success—relationship building is. Many FUSE clients have little trust in systems or offices or programs and have given up hope that they can ever get off the streets. To build relationships, Lindsay and Austin invest a lot of time in listening to people, in the process earning their trust and learning about the barriers that stand in the way of change. Once trust is earned and barriers are identified, the navigators can get to work preparing clients for a move off the streets, lining up support services and locating housing that suits their needs.

The payoff comes when clients are handed the keys to his or her own apartment. On November 23, Rick Downing moved into an apartment in downtown Eugene after several years of living on the streets. In the process, he became Lane County’s first FUSE success story. Meanwhile, Lindsay and Austin are already hard at work reaching out to more super utilizers and looking for ways to change even more lives.

Read more about Rick Downing and the ShelterCare HIP outreach team in this wonderful story that appeared on the front page of the Eugene Register-Guard on Thanksgiving Day, 2016.

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