What is diabetes?

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.

Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

Sometimes people call diabetes “a touch of sugar” or “borderline diabetes.” These terms suggest that someone doesn’t really have diabetes or has a less serious case, but every case of diabetes is serious.

Diabetes Management Program Goals:

1. Improve your quality of life with our help
2. Develop a treatment plan
3. Work with your Primary Care Physician on your treatment plan
4. Refer you to helpful community resources

A treatment plan is only successful when you understand it, follow it, and commit to making the right choices every day. If you have diabetes, you must make the right choices about your diet, exercise, medications, and monitoring every day. We are here to help you!

What is asthma?

Asthma is a chronic disease that inflames the airways. This means that people with asthma generally have inflammation that is long lasting and needs managing. An asthma episode, also called an asthma flare-up or asthma attack, can happen at any time. Mild symptoms may only last a few minutes while more severe asthma symptoms can last hours or days.

Common symptoms include:

• Coughing

• Wheezing (a whistling, squeaky sound when you breathe)

• Shortness of breath

• Rapid breathing

• Chest tightness

Asthma is common among children and teens. When you can’t breathe, it can be very scary. We understand, and we are here to support you.

Asthma Management Program Goals:

1. Learn about asthma and what causes attacks

2. Reduce your asthma-related symptoms

3. Develop a treatment plan

4. Prevent visits to the emergency room or hospital

5. Help you find support from others with asthma

What is heart failure?

Heart failure means that the heart isn’t pumping as well as it should be. Your body depends on the heart’s pumping action to deliver oxygen- and nutrient-rich blood to the body’s cells. When the cells are nourished properly, the body can function normally.

With heart failure, the weakened heart can’t supply the cells with enough blood.

Common symptoms include:

• Fatigue
• Shortness of breath
• Coughing

Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.

Heart Failure Program Management Goals

1. Help you manage and reduce the symptoms and complications of heart failure
2. Develop a treatment plan
3. Prevent visits to the emergency room or hospital
4. Improve your quality of life

What is a “high-risk” pregnancy?

A “high-risk” pregnancy means that you have one or more things that raise your — or your baby’s — chance for health problems or preterm (early) delivery.

Some of these things are:

• Being 17 years old or younger
• Being 35 years old or older
• Being underweight or overweight before becoming pregnant
• Being pregnant with twins, triplets, or other multiples
• Having high blood pressure, diabetes, depression or another health problem
• Having problems with a previous pregnancy, including premature labor

Not getting prenatal care, smoking, taking illegal drugs, and drinking alcohol also can cause health problems for a pregnant woman and her baby.

Our goal is to help reach your 37th week of pregnancy.  Your personal nurse care manager will work with you up until you deliver and for two months after you have your baby.

High-Risk Perinatal Program Goals

1. Help you manage and reduce the symptoms of your high-risk pregnancy
2. Develop a treatment plan
3. Work with your OB on your treatment plan
4. Help you find support from others with high-risk pregnancies

What is “behavioral health?”

Behavioral Health or mental health, is an important part of an individual’s overall health and well-being. It defines the mind-body connection which guides many aspects of our daily lives. How we think, feel, act, and respond to the world around us illustrates how healthy we are “mentally.” Many of us have life-experiences and circumstances that negatively affect our mental health.

As with physical health, untreated behavioral health issues can lead to chronic depression, anxiety, hallucinations, and mood disturbances. Community ensures that behavioral health services are available at the appropriate time and in the least restrictive setting possible, so Members can safely access care without adversely affecting their physical and/or behavioral health.

Mental health services provide help to children and adults with a range of diagnosis, including, but not limited to:

• Drug, Alcohol, and Opioid Abuse
• Anxiety
• Depression
• Attention Deficit Hyperactivity Disorder (ADHD/ADD)
• Schizophrenia

Community’s Behavioral Health Team is comprised of licensed mental health professionals who along with the member, identify goals for continued stability, provide referrals and resources to help resolve barriers to care, and monitor treatment and discharge planning needs.

Behavioral Health Program Goals:

1. Ensure access to behavioral health care services
2. Delivery of personalized case management services through ongoing assessment, consultation, and coordination of care
3. Encourage communication between behavioral Health, Nursing, and physical health providers to work jointly to meet Member’s overall health needs
4. Assess your needs and connect you to appropriate resources in the community
5. Support a healthy lifestyle by treating physical and behavioral needs together