Care Coordination

Care Coordination

Our Certified Community Health Workers (CHWs) provides community-based care coordination by helping individuals overcome social and medical barriers to health care and related services. 


At the heart of our work are CHWs, who build genuine, trusted relationships with the individuals and families we serve. Through these connections, CHWs identify unique needs and tailor support to help each person thrive.


CHWs serve as a vital link between clinical care and community-based services, making sure no one falls through the cracks. Many program participants face challenges such as unstable housing, lack of transportation, or difficulty understanding medical information. Our CHWs are here to break down those barriers and guide people toward better health and well-being.


CHWs begin by conducting a comprehensive social and medical assessment. Based on this, they work with each individual to develop and carry out a personalized plan aimed at achieving chronic disease self-management goals.


In addition to chronic disease support, our CHWs also specialize in working with pregnant women and their families. They offer culturally responsive education and support on key topics including:


• Newborn care

• Breastfeeding

• Safe sleep practices

• Smoking cessation

• Postpartum care and recovery


Through ongoing support during pregnancy and postpartum, our CHWs ensure families have the knowledge and resources they need to stay healthy and thrive.


Our Mission

We offer a holistic approach to help our communities heal by focusing on the whole person to reduce and eliminate health disparities in order to achieve good healthy outcomes.

Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth.
(3 John 1:2, KJV)

Outcomes

After you experience our services, you will feel…

Stronger: With new strength to endure. 

Transformed: You will have a new attitude, a new way of thinking, and a new outlook on life.

Assured: Confident in God as your help and peace.

Yielded: Submitting to God's will by accepting his invitation to rest.


Faith Driven: Motivated and energized to trust what God has planned for you. 

Restored: To bring you back to a place of peace and wholeness.

Encouraged: You will feel hopeful optimistic about your life and your future.

Equipped: Prepared with coping skills and strategies to deal with stressful situations

Disclaimer

We are Christian Pastoral Counselors, we are not licensed by the state of Ohio or any other state as a mental health counselor. We are credentialed members of Stay Free Today, Inc and Stay Free Ministries, LLC as licensed and ordained ministers and pastoral counselors.


We are in compliance with the Ohio Revised Code Chapter 4757.41.1 regarding exemption from state sponsored licensure:


Rabbis, priests, Christian science practitioners, clergy, or members of religious orders and other individuals participating with them in pastoral counseling when the counseling activities are within the scope of the performance of their regular or specialized ministerial duties and are performed under the auspices or sponsorship of an established and legally recognizable church, denomination, or sect or an integrated auxiliary of a church as defined in federal tax regulations, paragraph (g)(5) of 26 C.F.R. 1.6033-2 (1995), and when the individual rendering the service remains accountable to the established authority of that church, denomination, sect, or integrated auxiliary.