OK, so I followed the guidelines and changed mod_perl, Apache2::*, constants, etc. I had to uncomment a reference to Apache2::Connection so references to $r->connection->remote_ip() would work.
At that point, I can restart the server and load SessionManager, but the minute I try to connect to localhost, I get a 404 error and the logs show only "File does not exist: (null)". This is merely from loading the module, not actually using it for anything. So at this point it seems like the module is really unusable, at least for mere mortals like myself.