Joanna Tebbs Young
CIRCLES OF COMMUNITY
Just this past week, the United Health Foundation released its 2017 health ranking report. Holding fast to first position for many years, Vermont has always placed in the top five healthiest states, and coming in third after Massachusetts and Hawaii, this year has proved no exception.
There are many factors which determine such rankings, but one may well be the development of state-wide initiatives the likes of SASH (Support and Services at Home), a program which has caught the attention of leaders at the federal level.
Developed by the nonprofit housing provider Cathedral Square of South Burlington in 2011 and administered locally by the Rutland Housing Authority, SASH provides care and support to older Vermonters in their homes. Partnering with Rutland Regional Medical Center, Southwestern Vermont Council on Aging, VNA & Hospice of the Southwest Region, Rutland Mental Health, Housing Trust of Rutland County and National Church Residences, and Castleton University School of Nursing, the Rutland Housing Authority connects its residents with health and wellness services necessary to their well-being.
The results of this program, based on findings for 2011 to 2015 by a federally funded, third-party research group on behalf of the U.S. Department of Health and Human Services (HHS), are impressive. Participants, researchers found, had less difficulty managing their medications, higher overall functional status, and greater awareness of the relationship between nutrition and health. It was also reported that members of SASH groups established before April 2012, which primarily served residents living in affordable-housing communities, had fewer hospital admissions and saved an estimated $1,227 per person per year in Medicare expenditures. These statistically significant results were documented for 40 percent of SASH participants.
“SASH has helped me in so many ways,” says 87-year-old Theresa Stasny of Rutland, a six-year SASH participant. “When I fell a couple years ago, the SASH coordinator stayed with me until the ambulance came. When I was discharged from the hospital, they came and checked in on me.” SASH has also assisted Stasny with updating her advance directives, provided nutrition counseling for her diabetes, monitored her blood sugars and referred her to a new primary-care doctor. “They also helped me get new hearing aids.”
SASH Director Molly Dugan is grateful to see the findings of HHS’s study. “It shows that our initial program design — embedding SASH in affordable-housing communities and providing and connecting services to residents living there — continues to show positive results. Extending these same results to those SASH groups with a higher number of community-based participants is extremely important to us.”
A recently completed qualitative analysis by the Vermont Department of Health has also found the program to be of great value, based on interviews with a sample of primary-care physicians, SASH participants and staff. All three groups have an overwhelmingly positive opinion of the program and its impact in improving the health of the approximately 5,000 statewide participants.
“I see an impact on our population every day,” says Carol Keefe, Rutland’s SASH supervisor, who oversees the work of six SASH coordinators and five SASH wellness nurses serving thirteen housing sites in the Rutland region, along with the community-based panels who visit individual homes. “We’re supporting the SASH participant as well as their family.”
Kevin Loso, Rutland Housing Authority executive director, agrees. “We help guide caregivers, but we are also helping those who don’t have extra support so they can remain healthy and happy in their home.”
“It’s the interdisciplinary approach [of the SASH program],” says Loso, which has created positive results for Rutland’s approximately 480 participants, many with complex needs. As Loso points out, most people would prefer to remain in the place they call home for as long as possible. SASH has made this a reality for many of its participants. “I count this as a measure of success,” says Loso.
Successes such as these are what have now made this Vermont-born program a prototype for similar programs around the country. A three-year, $15 million demonstration funded by the U.S. Department of Housing & Urban Development is underway at 40 affordable-housing communities nationwide. SASH staff from Cathedral Square spent Nov. 16-17 in Washington, D.C., providing training in the SASH model to representatives from all 40 sites. In addition, Cathedral Square is working with the National Well Home Network in Rhode Island, Minnesota and several other states to replicate SASH statewide.
And at this time of year, the services provided by SASH are more essential than ever. “People can be home for the holidays,” says Loso. “That’s important.”
“I believe SASH is making a difference to me,” says Theresa Stasny. “SASH is there when I need them.”