Chronic Disease Management

In an effort to reduce the burden of chronic disease in Lucas County, the Health Department is collaborating with a variety of community partners, through Healthy Lucas County, and providing the public assistance with Community Health Workers. This process is replicating the Pathways Model and assisting adults with risk factors for chronic disease or a diagnosed chronic disease to help better manage their health.

The responsibilities of a Chronic Disease Management Community Health Worker is to find at risk or non-compliant community members with chronic diseases or chronic disease risk factors and connect them to needed prevention and medical services (i.e. health care, foot exams and treatment, diabetes education, dietician, exercise programs, etc.), while removing barriers to care, (i.e., transportation, housing, insurance, etc.) in order to improve the clients’ overall health status.