Housing advocates urge full VHCB funding and expanded supports including SASH mental health clinicians

MONTPELIER, Vt. — Nonprofit housing developers and service partners urged the House Human Services Committee on Feb. 14 to fund the Vermont Housing and Conservation Board at its full statutory level and to expand supports that are embedded in affordable housing.

Molly Dugan, co-chair of the Vermont Housing and Conservation Coalition and a representative of Cathedral Square, told the committee the coalition "is asking you all to support the full statutory funding for the Vermont Housing and Conservation Board, which is currently in the governor's budget." Dugan said that statutory amount is $36,900,000 and added that members are also seeking "at least $40,000,000 above the full statutory share on the housing side" to match the project pipeline she described.

The request came during a multi-witness presentation that combined housing production priorities with details about supportive services delivered from housing, most notably the SASH (Support and Services at Home) model. "We have to have the housing first, and then we can layer in the services," Kim Fitzgerald, CEO of Cathedral Square, told the committee as she described SASH's origins, current scale and some program results.

Fitzgerald described SASH as a two-person core team for a panel of roughly 70 to 100 participants: a full-time SASH coordinator and a part-time wellness nurse. She told the committee that SASH began in 2009 at a Cathedral Square site and later received demonstration funding through the Medicare Advantage Primary Care Practice (MAPCP) program; the work now receives payments under Vermont's all-payer ACO arrangement with OneCare. Fitzgerald said SASH operates at nonprofit housing sites and in surrounding community-based locations and that the program is now at about 57 panels across the state, with a goal of 57.5 by year end.

Witnesses cited independent evaluation results as evidence of impact. Fitzgerald said a multi-year evaluation found SASH lowered Medicare expenditures and that later analyses identified Medicaid savings as well. She summarized the findings as roughly $1,400 per participant per year in Medicare savings and about $400 per participant per year in Medicaid savings tied to participants remaining longer in independent housing.

Jana (last name not provided), a clinical social worker and one of the newer SASH emotional-wellness clinicians embedded by Washington County Mental Health, described the newly expanded mental-health component of SASH. "We provide supportive therapy individually and groups. We can triage what's going on and kind of support referrals that are needed for care coordination," she said, adding that services are free to participants and offered flexibly by telehealth, phone or in person. The expansion, funded through a mix of Congressional Direct Spending awards and CES funds, places clinicians or emotional-wellness coaches on about 20 panels; Jana reported that in the first year about 145 participants (approximately 30% of the expanded panels) engaged with clinicians and clinicians logged roughly 1,400 visits.

Cathedral Square and other providers also described targeted initiatives built on the SASH platform: a blood-pressure screening and management program that identified almost 900 participants with previously undiagnosed or uncontrolled hypertension and produced measurable reductions in systolic and diastolic rates over three years; a fall-risk assessment and prevention effort; and on-site dental clinics that performed more than 100 cleanings in a recent outreach effort covering 12 communities.

Elise Schanbacher, executive director of Addison Housing Works, described how resident services and a separate family-support program operate alongside SASH at some sites. Addison Housing Works reported a portfolio that includes more than 750 permanently affordable homes (including rental apartments, two senior housing sites with SASH, nine manufactured housing communities with approximately 340 homes, and 76 shared-equity homeownership units). Schanbacher said the housing provider has seen a rise in residents exiting homelessness and in acuity of mental-health and substance-use needs. From 2016 to recent years, she said the share of units dedicated to people exiting homelessness rose from 15% to 22%; roughly 80 families now live in units set aside for those exits, out of about 350 apartments mentioned for one portfolio segment.

Schanbacher also summarized results from a family-support pilot: participating households grew from 104 households (68 children) in 2023 to 144 households (94 children) after the program added a second coordinator in 2024, and 96% of participating households remained stably housed at the end of the reported year. She said the program has helped manufactured-housing residents apply for repair and weatherization funds and has leveraged roughly $454,000 in MHIR and weatherization dollars since mid-2023.

Committee members asked witnesses about local partnerships, SNAP outreach for older Vermonters, coordinated entry for people exiting homelessness, and how resident services interact with other community providers. Witnesses described monthly partner convenings, confidentiality releases that allow coordinated care planning, and local examples where property-based resident services helped prevent voucher loss or other crises by acting quickly on information property staff observed.

Witnesses repeatedly framed the argument as twofold: state VHCB funding is essential to produce the housing that enables services, and consistent operating or program support is needed so providers can keep people stably housed and reduce higher-cost health care and long-term-care transitions.

No formal votes or committee actions were taken during the testimony; members indicated the subject will remain part of upcoming budget deliberations and bill hearings.