Take Charge of Your Health is a Care Transitions Intervention Program that helps high-risk patients manage their medical conditions and avoid unnecessary hospital readmissions. Health Coaches work individually with participants to provide health education, medication management, support to follow through with medical care, and connections to other community-based services. If needed, access to medical equipment and emergency medication is also provided. The program's goal is to empower individuals to "take charge" of their health by understanding and managing their conditions to the best of their abilities.