SASH is helping people, saving Medicare money
by Aging in Place: Claudette Hollenbeck
Mar 22, 2018 | 1153 views | 0 0 comments | 64 64 recommendations | email to a friend | print
In the fast-paced, over-stimulating world of 2018 most of us focus our energies on the problems and issues right in front of us and do not spare much time or effort on “What might happen.” So if you are a functioning, healthy-enough person, you don’t go looking for trouble. However, trouble has a way of finding you anyway. One slip on the ice on the way to get your mail from the mailbox is all it takes. Then the cascade of decisions, expenses, and worries begin. Luckily we have here in the Deerfield Valley a Medicare-funded program to help. Before you find yourself in crisis, you need to know about where to turn for help.

In 2011, Cathedral Square, a nonprofit housing provider in South Burlington, came up with a plan to link Vermont seniors in their housing with health care resources across a wide spectrum. SASH, the Support and Services at Home program, would use office space in the housing facility for their staff, a 40-hour-per-week coordinator and a 10-hour-per-week nurse. Medicare is willing to fund this because it saves them money, big time. Suppose that slip on the ice results in a broken leg and a rib fracture. If you live alone, how will you manage? Do you even know where to turn first for advice? Can you stay at home with a leg cast and sore rib? Will you have to go to a nursing home to recover? Hospital and nursing home care cost Medicare a big bundle. Hence SASH.

SASH is focused first of all on preventive care: exercise classes, medication management, nutrition counseling, etc. But when the crisis occurs they are the ones who can come to your aid and set up the services to make it possible for you to recover at home. Initially they were expected to sign up 100 people, which they call a panel. SASH here in the valley signed up 100 folks lickity-split and had to open another half panel of 50 more very quickly. The Cathedral Square model was an urban one, focused on a sort of “captive” population all housed near each other. When it became clear that this was saving Medicare an estimated $1,227 per person per year, the clamor began to expand it into more rural communities. Butterfield Common in West Dover is an affordable housing complex developed by Windham and Windsor Housing Trust in Brattleboro. It seemed to be an ideal cluster of folks for a SASH program and Shires Housing out of Bennington agreed to partner with WWHT and pay the salaries of the staff, probably largely because our Deerfield Valley Health Center is a Bennington medical affiliate.

However, as those of us who live in this valley know only too well, life in a rural area comes with complications. Shires Housing is currently running about a $30,000 a year deficit in the Deerfield Valley because community members of the SASH panel are not all clustered in one place. Transportation costs and travel time are running up that deficit. Also, people living in their own homes or apartments may have living conditions that contribute to more health care needs. Isolation alone can be a significant factor. All this makes serving a rural population quite a bit more difficult than was fully expected. Some local folks, encouraged by Becky Arbella, the first coordinator we had, tried to get enough signatures to justify an article on the Town Meeting warnings of the participating towns, but did not get started early enough to do it. The hope was to get the valley towns to each allocate some funds to offset that $30,000 deficit. Now that we actually have this resource locally, we do not want to lose it.

To contact SASH call (802) 464-0438.

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