This article was first published in the Fall 2023 print newsletter. View the pdf version with full formatting here
Housing is often cited as one of the most important social determinants of health, and lack of affordable housing can cause instability in the form of eviction, foreclosure, homelessness, and an entire range of insecurities — all of which can further strain health and mental well-being. For over a decade, the innovative and impactful SASH program has been improving health outcomes for seniors by connecting them to community-based supportive health and social services. Now, a new pilot program is bringing these services and resources to a broader population of WWHT residents.
SASH stands for Support and Services at Home, and is a free, voluntary health and wellness program designed to help Vermont’s most vulnerable citizens access the care and support they need while living at home. The traditional SASH program provides services and care coordination to older adults – typically 65 and older – and adults with disabilities, and is based in affordable housing communities with client panels that include the broader community members throughout Vermont. SASH For All is a new pilot program being tested in a select group of Brattleboro and Putney housing communities, offering this same model of care to residents from 18 to 64.
Operating since 2012, the traditional SASH program has been shown to improve population health, reduce costs, and enable people to age in place safely and healthily. Molly Bennett is the SASH Coordinator based in WWHT’s Windsor Village. She describes how the benefits of SASH extend far beyond conventional health care.
“We have a SASH participant who lives in a remote part of the Windsor area. He is disabled and very isolated. When meeting for his annual reassessment we learned that he was struggling to pay for his Boost, which is a significant part of his nutrition. We were able to connect with his primary care provider, who wrote an order for this nutritional supplement to be paid for by his health insurance. We then worked with a social worker at Mt. Ascutney Hospital to find a pharmacy to fill the order.”
Molly was also able to help this same participant obtain a new mattress, and a portable washing machine, both necessities relating to his disability. Her contacts at Mt. Ascutney Hospital helped find the funds to cover costs. “It is the relationship between SASH and Mt. Ascutney Hospital that makes these interventions possible,” says Molly. “They have been an integral partner with WWHT since the beginning of the program.”
Like traditional SASH, SASH for All is an entirely free and voluntary program. The goal is to provide a broad and flexible spectrum of support and resources within the home to empower participants to achieve goals they have set for themselves.
Funding for SASH for All was secured by Sen. Bernie Sanders as part of the FY 2022 federal budget. If successful, SASH For All will be a prototype for statewide implementation, potentially serving more than 10,000 Vermonters.
“The thing that is special about SASH,” said Senator Sanders, “is that in a dysfunctional health care system, SASH cuts through the bureaucracy and confusion to bring care to the people, where they are at. What SASH does is create living environments for people where they can get and stay healthy, avoiding costly and stressful trips to the emergency room. I am proud to have helped expand this good work through the creation of the SASH for All pilot project. I look forward to continuing to work with SASH so they can support more Vermonters to live healthy, independent lives for years to come.”
Barbara Carey is the SASH for All Wellness Nurse assigned to the pilot program in Brattleboro. She has been working for a full year with the program, and is based at WWHT’s Birge Street location. She says that although the two programs are structured the same, they have proven to be very different.
“Within the traditional SASH, older adults are dealing with chronic illnesses that they’ve had for a long time,” she explains. “Their health issues really stand out for them. They are already highly interactive with the medical community — they have an implicit trust in that population. Our folks are younger, have families, jobs – aren’t necessarily dealing with chronic health issues, but are dealing with a lot of mental health issues, substance use, and social insecurities.”
Barbara says one of the biggest challenges for the new SASH For All program is finding ways to engage and connect with more residents. “We have a lot of interaction with Birge Street, but less with people in other locations. But, when people do come to us in crisis, we’re able to help them with what they’re dealing with by making referrals, and giving them guidance. The SASH Coordinator has been very successful in stabilizing situations so people don’t lose their housing – I’d say that is a real benefit.”
Although she is a registered nurse, Barbara describes her role as more of a coach. She has helped residents with individualized health needs such as finding a primary care doctor, sorting through medications, and navigating the complexities of the medical system. She has coached a couple of residents through stressful situations, helping them maintain their health goals. She has also started building a foundation of community programming, offering classes in art, Yoga, nutrition, and mindfulness training. She says the needs are unique and widely variable.
“We are definitely trying to help people feel heard, trying to validate the struggles that they’re having, and trying to bring them into some social connection. One thing we are looking at is setting up a Community Circle here at Birge Street. This would be an opportunity for people to get to know each other, mitigate misunderstandings, and give people some tools for navigating the stresses of living in a communal environment.”
Jodie Riker is a SASH For All participant along with her partner Chris Reagan. They live in WWHT’s 109 Green Street property. Jodie and Chris are both blind, and Chris has a rare syndrome that affects his kidneys. He goes to dialysis 3 times a week and needs a kidney transplant. Jodie says things can get very stressful, but SASH has helped make life a little easier.
“For one, they helped us get a volunteer to help us read our mail,” says Jodie. “That is a huge help. And Barbara helps us with things like trying to get our State IDs, birth certificates, and if we need help getting medical care. At times, things can get stressful and frustrating, but I know I can always call Barbara, and she helps me manage. I wish all the housing companies had something like this.”
Barbara believes the new SASH for All program has great potential to meet a real need in the community. The program is currently working with a team of consultants to evaluate their work and measure impact.
“I love this work,” says Barbara. “It feels super meaningful to me. And I think it’s exciting to have all these smart people that we’re working with, looking at the SASH For All program as its own unique entity, trying to figure out how to make this program as successful and impactful as traditional SASH has been.”
