SASH® (Support and Services at Home)
SASH® (Support and Services at Home) is a nationally acclaimed program that supports the health and well-being of Medicare recipients -- typically adults 65 and older and people with disabilities. It is a free, voluntary program, developed by Cathedral Square and funded in Vermont by OneCare Vermont and the Vermont Department of Disabilities, Aging & Independent Living. It is part of the state's initiative to reform health care by investing in wellness and addressing the social determinants of health, including housing.
SASH is available to all Cathedral Square residents in independent and assisted living. SASH is based in affordable-housing communities and surrounding neighborhoods throughout Vermont, providing care and programming right where people live. Anyone who qualifies for Medicare is eligible to join a SASH panel in their community free of charge, regardless of whether or not they live in affordable housing. To learn more about becoming a SASH participant, visit the SASH website.
SASH participants create their own "healthy living plans" and participate in SASH programs, events and activities as they choose. An on-site SASH coordinator and wellness nurse provide regular check-ins and create programming targeted to the needs and desires of residents. Programming ranges from exercise classes and educational sessions to cooking classes, guest lectures and performances, outings and social activities.
SASH staff make regular home visits to review participant's goals and progress, identify any risks, and alert community partners and primary care providers to issues such as prescriptions that need to be refilled. We typically provide the following services for each participant:
- Wellness check-ins and health coaching on chronic conditions
- Help in developing systems to manage medications
- Planning for successful transitions to and from hospitals or nursing homes
- Help in scheduling medical appointments and completing advance directives
- Initiatives to reduce isolation and support emotional wellness
- Regular blood pressure clinics along with one-on-one and group education about hypertension prevention and management
- Communicate with primary care providers to discuss participants' medications and other interventions
The SASH coordinator and wellness nurse work with a local team of health care providers, hospitals, primary care practices, member affiliates of Vermont Care Partners, and the VNAs of Vermont to coordinate necessary care and treatment. This relieves the participant of having to manage this care on their own and ensures that the care they receive is consistent, effective and cost-efficient. This helps SASH participants remain living independently in their own home as they age.
In addition to helping improving the health of participants, SASH has been independently documented to reduce Medicare and Medicaid expenditures for participants.
SASH is based in 200 affordable-housing communities in Vermont and serves over 5,500 participants statewide at any given time. Beyond Vermont, SASH is the inspiration for a seven-state demonstration by the U.S. Department of Housing & Urban Development, and it has been replicated by affordable-housing providers in Rhode Island and Minnesota. Providers in additional states are working with the National Well Home Network to bring SASH to their region.
Want to learn more? Read this article by U.S News & World Report and visit the SASH website.