Keeping seniors out of the hospital

By Matt Sutkoski
Observer correspondent

Whitney Hill Homestead, along with about 120 senior housing sites in Vermont, has redoubled efforts to keep people out of hospitals, away from critical care facilities and out of medical debt.
A state health program called Support and Services At Home, or SASH, is saving a ton of money on Medicare expenses and keeping seniors out of hospitals, according to state health officials.
SASH, started three years ago, is voluntary for anybody in senior or assisted housing who wants to use it.
SASH coordinators and senior facilities staff help clients and residents through education and coaching to manage chronic health conditions like arthritis and diabetes.
Skill at managing such issues can keep people out of hospitals, which improves quality of life and saves on health care costs, particularly Medicare.
The SASH program serves more than 4,000 people statewide, in about 120 housing sites, including Whitney Hill Homestead in Williston, according to statistics provided by state health officials.
“This means less people going into the hospital and nursing home, which means less money spent by Vermonters and their families on hospital and nursing home co-pays,” said Molly Dugan, the SASH program director for Vermont.
Federal housing and health officials recently completed a study of how and whether SASH lowers costs. They tracked Medicare costs associated with SASH patients in Vermont with a control group in northern New York, which did not have a similar program available to them.
The study concluded Medicare expenditures each month for each patient were about $183 lower for SASH participants than for the New York control group. The Medicare cost was $146 lower for SASH participants in Vermont compared to Vermonters not participating in the program.
At Whitney Hill, residents can choose from an array of programs to help keep their health stable, said Beth Albert, a SASH coordinator for Cathedral Square, which operates Whitney Hill and other senior living sites in northwestern Vermont.
Benefits include Meals On Wheels, a garden on site, rides to medical appointments and seminars on managing health problems, such as living with chronic pain, Albert said. There’s even a Tai Chi class that will start soon, she said.
Residents at Whitney Hill and any other site where SASH is available can choose to what extent they want to participate, and when to take advantage of services, Albert said.
One resident of Whitney Hill, Jeff Carlson, said he finds SASH helpful.
Health problems mean he’s not as mobile as he once was, and can’t usually prepare meals for himself. So SASH arranges Meals on Wheels delivery for him, he said.
It’s also helpful that a nurse stops by to give him and others checkups. It’s convenient, he said, because it’s sometimes difficult to get out for visits to doctors offices.
People with the SASH program have also been helping him with prescriptions. “I have cardiac failure and they’ve been very good about getting me the proper medication,” he said.
Even if a medical condition forces a hospitalization, chances are the problem wouldn’t be as bad as if the patient had not been helped with managing the illness, Dugan said.
“The less acute health incidents leading to hospitalizations very likely means less dollars spend on medications and durable equipment. Additionally, the less acute health incidents, the less days away from work for those family members supporting their older relatives,” Dugan said.
If a SASH participant is hospitalized or needs to go to a nursing home, the client is helped with the transition when he or she goes back home.
SASH is going to undergo further refinement, Dugan said.
“We are already in discussions with many hospitals, nursing homes and physician practices around the state to improve our communications process. We know that the sooner our SASH staff and teams can be aware of changes in health status and hospital admissions, the sooner we can be working to get a transitions support plan in place,” Dugan said.
“We also want to increase the number of SASH staff trained to lead evidence-based health promotion programs such as falls prevention and managing chronic conditions in the community. This will greatly increase the access that Vermonters have to these proven programs,” Dugan said.
For more information, visit