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New Bipartisan Report Says Nation Ill-prepared for Expanding Senior Population, Highlights Vermont Housing/Health Model

Posted May 25, 2016

Support And Services at Home (SASH) Model Called a “Success Story”

A report released Monday, May 23rd by the Bipartisan Policy Center (BPC) says the U.S. is on the verge of a “major expansion of its senior population.” The report holds that most older adults want to age independently in their homes and communities, yet most homes and communities can’t safely and affordably accommodate this desire. Recommendations include increasing the availability of service-enriched housing (like Vermont’s Support and Services at Home model) to improve health outcomes in seniors while cutting the growth in Medicare expenditures.

Bipartisan Policy Center, a Washington, DC-based think tank seeking policy solutions from both parties, formed a Senior Health and Housing Task Force to evaluate the linkage between health care and housing. The resulting report, Healthy Aging Begins at Home, points to integration of healthcare and housing systems as a proven route to better management of chronic diseases, improved health outcomes, and a reduced financial burden on our health care system.

Healthy Aging Begins at Home recognizes Support and Services at Home (SASH), a Vermont model launched by Cathedral Square, as a successful way to coordinate community resources (healthcare providers, Area Agencies on Aging, mental health providers, and nonprofit housing organizations) in support of seniors who choose to age in their home. “Initial data demonstrate positive impacts on resident health, health care utilization, and a slowing of the growth of Medicare expenditures relative to two control groups.”

“This BPC report holds broad implications for the nation as seniors become a greater percentage of our overall population, “said Kim Fitzgerald, Cathedral Square CEO. “SASH is an important solution to challenges faced by our healthcare and housing systems.”

The full report is available at

For a link to the full press release, including contact information, click here.

For more news on the SASH program, click here to view a recent piece by VPR – “Vermont’s Innovative Elder Care Program, SASH, Cited As A National Model”


Study: Vermont Housing and Health Care Model Shown to Improve Senior Health and Cut Growth in Medicare Spending

Posted April 29, 2016

South Burlington, VT—RTI International and LeadingAge Center for Applied Research recently released the results of their Second Annual SASH (Support And Services at Home) Evaluation. The SASH model; created in South Burlington, VT, by Cathedral Square, residents of Heineberg Senior Housing and partner community agencies; connects low-income Vermont seniors and adults with disabilities with community-based services and promotes coordination of health care. The evaluations of SASH gauge the model’s efficacy in facilitating healthy and economically viable “aging in place”. The federally commissioned study lays the groundwork for national expansion of the model.

The report concludes SASH participants demonstrated statistically significant lower growth in expenditure across categories including total Medicare expenditures, emergency room visits, hospital outpatient department visits, and primary care/specialist physician visits. Against a comparison group, SASH participants in the most experienced panels show growth in Medicare expenses was lower by an estimated $1,536 per beneficiary per year.

Senator Bernie Sanders, a long-time SASH supporter, released the following statement: “I believe that all seniors deserve to age with respect, dignity and have access to the social and medical supports to stay healthy and at home. SASH is a leading model to help seniors achieve that goal.”

“We’re pleased by the Evaluation results. It’s rewarding to see our beliefs confirmed by hard data,” said Kim Fitzgerald, Cathedral Square CEO. “But the real measure of what we do is feedback (SASH participants) give us. They make it clear we’re making a difference in their lives through better health and the freedom of independent living.”

Amy Kandilov, lead investigator for RTI International added, “The aging baby boom generation presents social, economic, and health challenges. We’re encouraged by these findings that SASH offers a cost-effective way to address the impact of an aging population.”

RTI International and its subcontractor, LeadingAge, were engaged by the Office of the Assistant Secretary for Planning and Evaluation, the U.S. Department of Housing and Urban Development, and the Administration for Community Living to evaluate the SASH model through a mix of qualitative and quantitative methods. In this second year of evaluation RTI conducted site visits in four geographic area of Vermont, interviewing staff from core partner organizations including: area agencies on aging, visiting nurse associations, mental health agencies, and the Blueprint for Health’s Community Health Teams. The evaluation team also conducted quarterly calls with SASH staff to collect ongoing feedback on implementation of the program.

View the report here:


Job Opportunity: SASH Coordinator at VSHA

Posted January 12, 2016

Make a difference by assisting elderly residents & residents with disabilities obtain needed supportive services from the community to prevent premature & unnecessary institutionalization; assess individual service needs; determine eligibility for public services; & make resource allocation decisions to enable residents to remain safely in their homes. SASH responsibilities fall into three broad categories of intervention: transitional care, coordinated care & self-management education.

Bachelor’s Degree & experience in a related social service field; knowledge of community services, strong interpersonal skills & the ability to coordinate & deal effectively one-on-one & in group settings. Grant funded position is based in Montpelier & covers residents at properties in Northfield, Barre, Bethel & White River Jct. For position details, requirements & qualifications, visit Cover letter & resume to: HR, VSHA, 1 Prospect St., Montpelier, VT 05602-3556. VSHA is an Equal Opportunity Employer.


WCAX Features the SASH Program

Posted January 28, 2015

WCAX recently featured the SASH program as part of its coverage. Below is an excerpt from the article:

Nancy Baker and Rebecca Sleeman live at Cathedral Square in South Burlington. Sleeman has lung problems, but she’s able to breathe a sigh of relief thanks to a program called SASH.

“Feeling of security, maybe we can stay in our homes longer and still be watched and have a place to live,” Sleeman said.

SASH stands for Support and Services at Home. It’s a program aimed to reduce costs Medicare spends on seniors. Participants say SASH helps coordinate doctor visits to their homes and they have health services available to them at all times.

“We have two nurses, two wellness nurses, who are great. They’ll come to see you at your home or they’re downstairs in the office,” Baker said.

The SASH program is one of a kind and it’s only in Vermont. It started in 2009 to provide seniors and disabled people at Cathedral Square with reliable care at home and prevent expensive trips to the hospital. But it has expanded. And the program began getting federal funding in 2011.

“We’ve gone from one SASH program in 2009 to 52 different SASH panels across the state. So, we now have roughly 4,200 people in the state of Vermont participating in SASH,” said Molly Dugan, the director of SASH.

In addition to increasing access to health care, the SASH program aims to decrease health care costs across the state. SASH is part of the Blueprint for Health Reform, Vermont’s plan for sustainable health care reform.

To read the entire article click here. You can also view the video coverage using there or in the embedded video below.


SASH Program Featured in LeadingAge

Posted December 18, 2014

LeadingAge recently featured Vermont’s SASH program in an article titled Affordable Senior Housing Plus Services Program Slows Growth in Medicare Costs. The article highlights early findings from a 3-year study conducted by the LeadingAge Center for Applied Research and RTI International, which can be found here. Below is an excerpt from the article citing findings from a first-year evaluation:

The SASH evaluation is funded by the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services.

The first-year evaluation compared SASH participants living in U.S. Department of Housing and Urban Development (HUD)-assisted properties to 2 demographically similar groups:

  • Medicare beneficiaries in Vermont who live in HUD-assisted properties and are included in a MAPCP medical home, but are not SASH participants (non-SASH/MAPCP).
  • Medicare beneficiaries in upstate New York living in HUD-assisted properties who are not participating in a MAPCP demonstration program or the SASH program (non-SASH/non-MAPCP).

First-year results show that, between the baseline and intervention periods, total Medicare expenditures increased for all groups. However, the growth in these expenditures was lower for SASH participants, relative to either comparison group.

The evaluation also examined SASH participants who joined the program earlier and those who joined later.

The purpose was to gauge the impact of SASH on participants who had a longer exposure to more mature program operations. Those who joined the program earlier experienced a statistically significant lower rate of growth in:

  • Total Medicare expenditures and post-acute care payments, compared to the non-SASH/MAPCP group.
  • Total Medicare expenditures and acute care, post-acute care and hospital outpatient payments, compared to the non-SASH/non-MAPCP group.

This may indicate that the SASH program will see a continued, and, perhaps, stronger effect as it operates longer.

To read the entire article, which includes an overview on how SASH works, click here.


Federal Government Extends Support for SASH Program

Posted October 29, 2014

A recently published article from VTDigger discusses the government’s decision to extend the funding of the SASH (Supportive And Services at Home) program. SASH helps Vermont’s most vulnerable citizens, seniors and individuals with special needs, access the care and support they need to stay healthy while living comfortably and safely at home. SASH is available in many communities throughout Vermont and serves primarily persons 65 and older and persons with disabilities. Participation is voluntary and free of charge. To learn more visit the SASH website here.

From the article:

The federal government recently extended funding for a pilot program that supports Vermont’s Blueprint for Health, a primary care management initiative.

That is welcome news for seniors at Town Meadow Senior Housing in Essex, who benefit from Blueprint’s Support and Services at Home, or SASH, program.

SASH is essentially an extension of Blueprint’s multidisciplinary community health teams, which bring social workers, nurses and therapists into a place like Town Meadow to help seniors live healthier and stay independent.

Town Meadow serves its own residents, but also acts as a hub for seniors living in their own homes who need similar support.

“What’s really great about this program is that it gives us a lot of flexibility,” said Nancy Eldridge, CEO of the nonprofit affordable senior housing company. SASH allows rehab and physical therapy programs to be tailored to seniors needs, with options like tai chi and counseling, she said.

SASH is supported by $700 per person per year payments from Blueprint, which is in turn funded through per member per month payments from commercial insurers, Medicaid and Medicare.

The federal extension of what is known as Multi-Payer Advanced Primary Care Practice ensures that Medicare will continue to make payments to Blueprint.

To read the entire article from VTDigger click here.


Harrington Village and Wright House Grand Opening Celebration

Posted September 11, 2014

On Wednesday a large crowd gathered to celebrate the opening of Harrington Village and the Wright House in Shelburne, Vermont. Three local nonprofit housing development groups – Champlain Housing Trust, Housing Vermont, and Cathedral Square, came together to build this mixed-income, mixed-generation neighborhood consisting of 78 new homes. In addition, Champlain Housing Trust and Green Mountain Habitat for Humanity are working together to build four affordable homes on the property. As of now there are 42 family apartments in Harrington Village and 36 senior apartments in Wright House. The Wright House also offers SASH (Supportive Services at Home) at no additional cost to residents.


Photo credit: Jon Shenton/Champlain Housing Trust

Governor Peter Shumlin, who was present to speak to the crowd and celebrate the efforts of everyone involved, made this statement in yesterday’s press release:

“After many years of planning and persistence, this new neighborhood in the heart of Shelburne is now a reality. Harrington Village, including Wright House, brings together homes for all ages and a variety of income levels. Surrounded by open land but in the center of the village, it is providing both affordable housing and a good quality of life for residents.”

While there is great need for more safe and affordable housing across the state of Vermont, it is in particularly high demand for Chittenden County where vacancy rates are currently less than one percent. In their coverage of the event, this New England Cable News article mentions some of these issues facing Chittenden County and the fact that while many are already benefiting from this new housing, there is also a long waiting list of people looking to live in both Harrington Village and Wright House.

For further coverage of the event, click here and here. You can also view the video coverage from WCAX in the embedded video below:


SASH Program’s New Website is Now Online

Posted April 21, 2014

The SASH (Support and Services at Home) Program has a brand new website online now, thanks to Cathedral Square.

The SASH Program is designed to provide personalized coordinated care to help adult participants stay safely at home regardless of their age or residential setting.

The new site connects the community to SASH resources, success stories, news, and contact information.

Visit the new website, and learn more about Vermont’s SASH program from the video below:


SASH Program Benefiting Boomers

Posted December 2, 2013

Support And Services at Home (SASH) is a care partnership which connects the health and long-term care systems to nonprofit affordable housing providers statewide.  The SASH program brings care management and preventive assistance directly to seniors and others with service needs.

SASH was piloted at Cathedral Square (CSC) properties, and is now at 93 housing communities throughout the state.  Nancy Eldridge of CSC recently wrote in the Burlington Free Press on the impact SASH is having on boomers and on the importance of the program’s expansion:

As the CEO of Vermont’s premier affordable senior housing organization, I found “Vermont’s ‘age wave’ brings jobs” (Sept. 2) about the “age wave” in Vermont to ring true. At Cathedral Square we’re on the front lines observing the explosion of boomers seeking to live independently while receiving needed support. Finding appropriate solutions to the challenges of an increasing senior population both in regards to housing and to health care is the heart and soul of what Cathedral Square (CSC) is about…

CSC recently completed the 36-apartment second phase to Thayer House in Burlington’s New North End. Applicants lined up outside our doors for hours before we opened for business on the day we began accepting applications. Every apartment was leased up within 29 minutes. Meanwhile, we still have a waiting list that exceeds 950 unique households.

As the article notes, the rise in the senior population is accompanied by their need for coordinated care…CSC knew how critical it was to have a service delivery program so seniors could remain in their homes safely as they aged. In 2009 CSC developed and launched Support And Services at Home — “SASH.”

SASH embeds care management and coordination programming in the home, and puts residents in the driver’s seat of their care plans. The SASH program is part of Vermont’s overall health care reform and it addresses the underlying causes of avoidable Medicare and Medicaid expenses. SASH focuses on wellness, prevention and care management.

Each CSC property serving the elderly has a SASH coordinator and part-time wellness nurse who are supported by the expertise of their local home health agency, area agency on aging and mental health agency. The wellness nurse provides coaching on proper medication management, monitors vital signs, provides self-care counseling and education post-discharge from hospitals or nursing homes. The SASH coordinator has daily contact with residents enabling targeted interventions.

Together, the SASH staff serves as extenders to Blueprint for Health primary care providers and the aging services network — all to keep seniors and others with service needs safe at home.

Initial data from two years of operating the SASH program indicates that not only does it improve the quality of life for SASH participants, but it saves money. As SASH staff incorporates ways to prevent falls, bolster nutrition, foster community, alleviate isolation and depression, we are seeing fewer falls, fewer trips to the hospital and fewer re-admissions…

It only makes good sense that the housing provider be part of the health care solution in our aging state, and fortunately state and federal officials see this logic. The road ahead has many challenges — recruiting a skilled health care workforce, providing an adequate supply of affordable housing, building a reformed health care system with enough capacity to serve an aging population — but Vermont is making the system changes needed to succeed. CSC is committed to seeing that we do succeed.

Read the full article online here or as a PDF.  View this video to learn more about SASH:


Cathedral Square 2012 Annual Report

Posted May 28, 2013

Please see message below from Nancy Eldridge at Cathedral Square announcing  Cathedral Square’s 2012 Annual Report.

“This past year has been full of growth. Thank you. We could not have done it without you – our partners, donors and other supporters.  We hope you enjoy reading about our statewide Support And Services at Home (SASH) initiative, our newest community Thayer House in Burlington, the 80th Anniversary of the Ruggles House Foundation and much more in our 2012 Annual Report – Cathedral Square’s 2012 Annual Report. Vermont is on the forefront of change and we are happy to be a part of it with you.”

View PDF of Cathedral Square’s 2012 Annual Report


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