This proposed study will examine whether health coaches can improve the management of COPD in a population of vulnerable patients cared for in 'safety-net' clinics. The study is designed as a randomized controlled trial for patients with moderate to severe COPD. Patients will be randomized into a health coaching group and a usual care group. Those in the health coaching group will receive 9 months of active health coaching. Outcome variables will be measured at baseline and after 9 months