A SASH participant receives a blood pressure check.

Partnership Improves Health, Saves Public Funds

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Thursday November 13, 2014

When Linda Ready started working at Cathedral Square five years ago, her title was “property manager” and she spent most of her time at Grand Way Commons on Farrell Street in South Burlington resolving typical tenant issues – faulty thermostats, cable outages, and the like. Now Ready is a SASH Coordinator and finds herself among a cadre of housing agency staff across the state pioneering one of Vermont’s most innovative and successful health care reform efforts.
SASH, short for Support and Services at Home, is a program developed by South Burlington-based Cathedral Square that has quickly spread statewide to 118 housing sites. The program connects older Vermonters with community-based support services and promotes greater coordination of health care using affordable housing facilities as the lynchpin. Regional affordable housing organizations partner with local service provider organizations, such as home health agencies and councils on aging, creating a SASH Team. Using evidence-based practices, core SASH staff provide services including a comprehensive health and wellness assessment, creation of an individualized care plan, on-site one-on-one nurse coaching, and health and wellness group programs.

“It seemed obvious to us that strategies to improve the health and wellbeing of Vermont elders should include the professionals with whom they spend the vast majority of their time,” said Nancy Eldridge, Cathedral Square’s executive director. “Staff at Cathedral Square and our SASH housing partners interact with residents every day and are best positioned to coordinate the services they need.”
Ready says this new model of coordinating care is paying off in terms of improved health status of the residents of Grand Way Commons, a facility with ninety-one age-restricted affordable apartments. 

“Recently we’ve been working very closely with a resident in her 80s, let’s call her Jane. In the last few months Jane’s been struggling with medication management for her Parkinson’s, inadequate nutrition and poor sleep, among a variety of other things. The SASH Team, which includes the Champlain Valley Agency on Aging and the Visiting Nurse Association, brought Jane and her daughter together at a Team meeting to discuss her challenges. Following this initial meeting, everyone had his or her ‘homework assignments.’ Now, Jane is following her medication plan properly, receiving assistance with food shopping, and getting her blood pressure under control.”

While SASH is improving the health outcomes of program participants, it is also proving to bring down health care spending, according to the draft findings of a recent third-party evaluation. The report found SASH participation results in an approximately $1,800 per year reduction in Medicare spending compared to a non-SASH enrolled Vermonter, and a staggering $2,200 per year savings compared to a non-SASH-enrolled New Yorker. More than 3,600 Vermonters are currently SASH enrollees.

According to Eldridge, the SASH evaluation is a dose of encouraging health care reform news.

Vermonters are grappling with state and federal attempts to reform our health delivery system,” she said. “This report highlights a great reform success story – making Vermont seniors healthier while bringing down costs. Everyone wins.”

Eldridge highlighted the critical partnership between the state’s Blueprint for Health and SASH, crediting the Blueprint’s director, Dr. Craig Jones, with recognizing the important link between affordable housing and health care.

For more information about SASH, visit www.sashvt.org.