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Saint Elizabeth Community’s SASH (Support and Services at Home) was recently highlighted by Grantmakers in Health
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A decade ago, primary care practices and housing nonprofits in Vermont partnered to reduce chronic conditions among older adults and younger adults with a disability in collaboration with the state’s Blueprint for Health. Today, as an extender of the Blueprint, Support and Services at Home (SASH), which supports healthy aging in place, is helping to advance health equity in the state.
The SASH model theory of change is that by empowering the lowest-income Vermonters to define and achieve their life goals, they can become a primary determinant of their own health. SASH differs from traditional housing-based care models because it integrates three critical components into a single program: individualized health plans and activation, clinical care coordination during care transitions, and a set of hyper-local structured relationships between the housing organizations and specific health care and community-based aging organizations. SASH currently offers services to residents in 140 publicly assisted housing sites and their surrounding neighborhoods. The results have been impressive, as studies have shown that SASH has helped to:
- reduce health disparities,
- improve diabetes and hypertension management and prevention,
- reduce Medicare and Medicaid spending, and
- increase access to mental health services.
SASH in Rhode Island
In 2017, Saint Elizabeth Community (SEC), a nonprofit housing organization, piloted the SASH model at a 149-unit HUD property in Providence. SEC is now expanding SASH to three additional housing nonprofits, including Pawtucket Public Housing Authority. Eighty-two percent of the Pawtucket residents have incomes below 30 percent of area median income. Most residents, whose top needs are access to mental health services and reducing isolation driven by COVID-19, are Hispanic, Portuguese, and Cape Verdean.
The SASH expansion in Rhode Island has been made possible with federal Money Follows the Person funding provided by the state. The state and federal government are testing SASH as a diversion strategy to prevent nursing facility admissions.
Housing to Health
The Rhode Island SASH and SASH-based initiative demonstrate:
- the value proposition of housing to health,
- many nonprofit housing champions have fully committed to a population health model,
- the need for health and housing partners to leverage public funds to scale and expand, and
- the importance of prioritizing the empowerment of people facing health inequities.
This expansion of SASH models represents a national opportunity to advance CMS’ goals of equity and affordability in health care. Supporting primary care practices and the mission of affordable housing, partnering organizations can improve the quality of life for vulnerable populations through this scalable and replicable population health system.
Original online publication web address: https://www.gih.org/views-from…
