Home Up

Michigan Pathways to Better Health - Ingham County



Program Design:  Participants are assigned a Community Health Worker (CHW) as their care coordinator.  At the first home visit, using a checklist, the CHW assesses the individual's health status (including social and behavioral health status), housing and employment situation, and other dynamic areas of the individual's life, with the purpose of identifying any problem areas to be addressed, along with desirable outcomes that could be attained through Pathways.  Key steps in the Pathways include providing standardized education to the client and/or family members; identifying and eliminating barriers to receiving services, such as transportation, health insurance coverage, fear of the physician's office, and language and cultural barriers; and confirming that appointments were kept and evidence-based interventions received, and assisting with follow up services and compliance with treatment plans.  Although the defined outcome is usually related to health, it can also relate to an improvement in employment, education, housing, or other social conditions that affect health status.


Referral Process:  Contact Lori Noyer, Project Coordinator at 517-272-4179

To contact Angie Fuentes (Community Health Worker) call 517-303-5660 or use the form below and click submit.

Information Request

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