Cathedral Square describes new affordable housing, outlines SASH services and funding gap

Representatives from Cathedral Square told a legislative committee that the nonprofit manages 29 affordable-housing properties across northern and northwestern Vermont and operates the SASH (Support and Services at Home) program that serves older adults and people with disabilities.

Cathedral Square Director of Policy and Strategic Initiatives Molly Dugan said the organization has produced both urban and rural housing, highlighted recent openings and projects in the pipeline, and emphasized the role of Vermont Housing and Conservation Board (VHCB) funding in preserving permanently affordable units. "For the record, my name is Molly Dugan, and I'm director of policy and strategic initiatives at Cathedral Square," she said.

The testimony focused on two linked themes: housing production owned and operated by Cathedral Square, and the SASH services model that delivers on-site wellness coordination and nursing support. Molly Dugan and Liz (statewide SASH administrator, Cathedral Square) described the program's staffing, reported participant counts and cited evaluations that attributed reduced emergency and inpatient use to SASH participation.

Cathedral Square said it now manages 29 properties across the region and noted recent developments and planned openings: Bayview Crossing (20 homes, opened 2022 in South Hero); an expansion at Kelleys Field adding 24 units that will accept residents in February; a 33-unit project in downtown St. Albans expected this summer; a 30-unit project planned for Highgate Village; and a 65-unit redevelopment at Whitcomb Woods in Essex. The organization also operates two licensed assisted-living communities (about 30 assisted-living apartments in its flagship downtown property and a 14-unit memory-care community in Williston) and several special-purpose developments in partnership with local behavioral-health providers.

On rents and financing, Dugan said projects use layered funding including low-income housing tax credits, VHCB funds, project-based Section 8 in some units and short-term construction lending from the Vermont Housing Finance Agency. "For those units, no one is paying more than 30% of their income for their rent," Dugan said when describing project-based Section 8 units, and she noted examples where residents paid only a small monthly rent because it represented 30% of their income.

The SASH program is embedded across Cathedral Square properties and with partner housing organizations statewide. Liz, who identified her role as "statewide administrator of SASH," said SASH operates through regional partnerships and a consistent staffing model: a full-time SASH coordinator (considered a community health worker) plus a part-time wellness nurse (typically 10–15 hours per week) for each panel of residents. She described panels as groups of roughly 70–100 participants served by one coordinator and the part-time nurse. "Currently, our funding is capped and we're funded through healthcare dollars primarily for SASH," Liz said, explaining why SASH cannot automatically be added to every newly developed housing site without additional funding.

Program size and outcomes described during the briefing included: 140 apartment communities with SASH activity statewide (staff said the presentation map showed housing sites), about 5,000 current SASH participants and roughly 12,000 participants served since the program began. Presenters cited a multi-year federal evaluation that found slower growth in Medicare and Medicaid spending for SASH participants, attributed to fewer ER visits, fewer inpatient hospitalizations and delayed transitions into higher-cost long-term care.

Services provided through SASH teams include health assessments, blood-pressure clinics, chronic-disease self-management classes, group wellness programming (tai chi, bone-strengthening classes), and embedded mental-health clinicians in some sites. Presenters said the embedded mental-health clinicians — funded in part through congressional directed spending and other sources — were able to connect most referred participants with clinicians within three days in pilot sites and that men engaged at higher-than-national-average rates in those mental-health services.

Presenters and lawmakers discussed accessibility and wait lists. Dugan said Cathedral Square has two fully accessible units in some properties and that most units are built “adaptable” so they can be made fully accessible for incoming residents. She also said there are about 1,300 people on Cathedral Square's wait list for the system's 29 properties; waiting times vary by property and can range from about one year to five years. When asked whether applicants needing accessible units were disadvantaged, Dugan said placement is first-come, first-served on lists and that staff work with applicants to match needs to available units.

Lawmakers asked about the SASH-for-All pilot, which extends SASH-style services to families and other nontraditional populations. Presenters said that pilot began with congressional directed funding and additional AHS support, is operating in Brattleboro partner sites, and that roughly 87% of participants in those pilot communities qualify for Medicaid.

No formal votes or legislative actions were taken during the briefing. Presenters asked lawmakers to consider additional VHCB funding to support pipeline projects; Dugan cited a gap between the roughly $13 million she said is currently available at VHCB and approximately $50 million in project requests in the pipeline.

The presentation closed with Cathedral Square representatives noting the combined housing-plus-services model both reduces healthcare utilization and helps prevent homelessness and eviction by stabilizing residents in supportive, affordable homes.