June 11, 2018

“Hey my numbers are great. And I feel great. I went to the doctor and they reduced my blood pressure medication!” said one client to Heather, a Community Health Worker for Mendonoma Health Alliance. Heather explained, “I gave him a big hug and a high five and told him to keep up the good work!”

In December 2017, this client was admitted into Emergency Room for congestive heart failure (CHF) and
high blood pressure. A week later, when discharged, this 55yr old man agreed to use MHA’s Care
Tansitions services. The client had been in and out of the hospital, every 3-4 months, due to
hypertension crises complicated by CHF and diabetes. Heather suggested he consider asking his primary
care provider for a referral to a hypertension specialist. Fortunately, he was referred to the
hypertension specialist who was also working with MHA as a consultant for our Chronic Care
Management program (CCM). In turn, the specialist referred the client to the CCM Support Network
where clients are taught how to self-manage their condition in a support group atmosphere and
encouraged to make positive changes that help facilitate a healthier life.

MHA has continued to check in with this client on a monthly basis. He has progressively improved his
health with regular exercise, lowering his salt intake, losing weight, and implementing mindful breathing
skills – all topics which were explored during support group sessions.


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