Community health worker program impacting lives of Ottawa County residents in need 

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FOR IMMEDIATE RELEASE  |  April 15, 2019

Community health worker program impacting lives of people in need 

In 2015, Ottawa County completed its first Community Health Improvement Plan (CHIP). The plan identified access to care, mental health and healthy behaviors as priority areas needing the most attention to improve the health and well-being of Ottawa County residents. As those involved in the planning process wrestled with what strategies could have an impact on these priority areas, we discovered an innovative model based on Community Health Workers (CHWs) called Pathways to Better Health. Thanks to the CHIP Steering Committee’s dedication; we secured funding* to design the Ottawa Pathways to Better Health (OPBH) program as a 3-year pilot. Plans for sustainability include identifying sources of revenue to maintain, or grow, this valuable program. Not only does this program address the greatest health needs in Ottawa County (identified again in the 2018 CHIP) but it also saves health care and social services money.
"The organizations that have made this program possible is truly one of the most collaborative funding projects I have seen," declared Executive Director Patrick Cisler, Community SPOKE. "We celebrate the good work taking place and look forward to many more years of success!"
The value of a CHW model is two-fold. First, it helps connect health care and social service providers in a community. Health care providers treat a patient’s medical issues but may not have a role in treating underlying root causes; often called social determinants of health. These can include food insecurity, lack of secure housing, transportation difficulties, unemployment, substance abuse and poor mental health. CHWs connect people with the appropriate, and much-needed, health and social service resources—taking a much more holistic approach to care. Second, the CHW model provides an advocate to the people with compounding health issues and helps them navigate the complicated health care system.
For someone struggling, having a CHW by their side goes a long way to getting the help they need. CHWs serve as a trusted advocate; whether it’s completing insurance applications, arranging transportation to an appointment, helping with language or cultural barriers, or encouraging them to follow a treatment plan.
"In just the two years of the Pathways to Better Health program, its received more than 800 referrals," stated Administrative Health Officer Lisa Stefanovsky, Ottawa County Department of Public Health. "People’s health is improving, they are finding it easier to navigate the health care system and they are getting connected to the appropriate care they need because of this program." 

Evidence of Need
Ottawa County Community Health Needs Assessments

Plan to Improve
Ottawa County Community Health Improvement Plans

kimberly

Shandra helps me not worry so much. She connects me with resources that are important.

-Kimberly

sara

Britney was so nice. She encouraged me to quit smoking and got me into LifeCircles. I haven't been in the hospital for almost a year.

-Sara

lillian

This was the worst year of my life. I lost my job, my home and ended up in the hospital. I was referred to the program where I met Dan. He’s been a lifesaver!

-Lillian

servicesreferral

Eligibility:

  • 18 years of age (or older) or pregnant;
  • Live in Ottawa County (including 49423 zip code);
  • Enrolled in or eligible for Medicare and/or Medicaid;
  • and have two or more chronic health conditions (such as diabetes, depression, anxiety, heart disease, arthritis, asthma, hypertension or long-term pain).


OPBH has nine community health workers who:

  • Meet clients at their convenience in their home or elsewhere.
  • Help clients set goals.
  • Guide clients through the health care system.
  • Link clients to medical care based on their specific needs (primary, dental, specialty, mental health, substance abuse treatment or other).
  • Help clients manage their health conditions and prescriptions.
  • Help clients reduce hospital and emergency room visits.
  • Link clients to community services and resources (food, clothing, housing, financial and utility assistance, transportation, education, employment and much more).
opbh data

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*Collaborative funding provided by:

funder-logos

Media Contact
Kristina Wieghmink, public information officer
616-494-5597 or kwieghmink@miottawa.org

Program Contact
Susan Keen, program supervisor
616-393-5601 or skeen@miottawa.org