A Steady Hand When Life Feels Overwhelming
When a family is navigating several providers, schools, agencies, services, or important decisions at once, keeping track of communication, referrals, responsibilities, and next steps can become overwhelming.
Care Coordination for Families and Individuals in Crisis helps families bring those moving pieces into a clearer picture. During the current phased pilot, a limited number of families may receive human-reviewed care coordination focused on identifying priorities, organizing referrals, clarifying responsibilities, and maintaining follow-through.
CCFIC care coordination is distinct from psychotherapy, emergency response, legal representation, medical treatment, and case management provided by a government agency. An initial inquiry does not guarantee enrollment or placement in another service.
What Is Care Coordination?
Care coordination is a practical, collaborative service that helps individuals and families organize complex situations involving multiple needs, people, providers, schools, agencies, or community resources.
During the current pilot, a named coordinator may help your family:
- Bring clarity to a situation that feels chaotic or overwhelming
- Identify a small number of immediate priorities
- Break complicated problems into manageable next steps
- Organize referrals, appointments, responsibilities, and follow-up
- Prepare for conversations with providers, schools, agencies, or other supports
- Support communication among authorized participants when appropriate permission has been provided
- Identify barriers, unanswered questions, and decisions that require attention
- Review what is working, what is stuck, and what should happen next
You remain involved in every important decision. CCFIC helps organize the coordination process but does not replace your judgment, consent, or voice.
You don’t have to navigate complexity alone.
Who This Service Helps
CCFIC may be helpful when an individual or family:
- Is navigating several providers, schools, agencies, programs, or community resources
- Has difficulty keeping track of referrals, appointments, decisions, responsibilities, or next steps
- Continues to encounter gaps between services
- Is managing behavioral, emotional, school-related, medical, or family needs that involve several systems
- Needs help identifying priorities and preparing for conversations with providers or agencies
- Has received recommendations or referrals but is struggling to turn them into a workable plan
- Needs consistent review and follow-through so important actions do not disappear into the shuffle
CCFIC is designed for situations in which coordination itself is part of the problem. It does not replace emergency intervention, psychotherapy, medical care, legal services, or government-agency case management.
Fit is reviewed individually based on the family’s needs, CCFIC’s role and current capacity, applicable eligibility requirements, safety considerations, and available resources.
What Participation May Include
If your family is accepted into the pilot, the scope of coordination will be discussed with you. Depending on your family’s needs, permissions, and available capacity, participation may include:
1. A Named Point of Contact
A coordinator serves as your primary CCFIC contact and helps maintain a clearer picture of current priorities, open questions, and agreed next steps.
2. An Initial Coordination Plan
Together, we identify a small number of immediate priorities and document what should happen next, who is responsible, what information or permission is needed, and when the item should be reviewed again.
3. Resource and Referral Support
We may help identify potential therapists, medical providers, legal resources, school supports, community programs, or other services that appear relevant to the family’s stated needs.
A recommendation or referral does not guarantee availability, eligibility, acceptance, affordability, or a particular result.
4. Authorized Communication Support
When appropriate permission has been provided, CCFIC may help prepare for or support communication among participating providers, schools, agencies, family members, or community organizations.
Participation in coordination does not automatically authorize every person or organization to receive every piece of information.
5. Review and Follow Through
We review agreed actions, referrals, barriers, and commitments to identify what has changed, what remains unresolved, and what should happen next.
The frequency and duration of coordination depend on the agreed scope, the family’s participation, current capacity, and whether CCFIC remains an appropriate fit.
Limited Openings During the Phased Pilot
CCFIC is currently operating as a limited, phased pilot. Initial inquiries are being accepted, but capacity is intentionally limited while we refine our operating protocols, protected coordination workflows, and service model.
Submitting an inquiry does not guarantee enrollment. Each situation is reviewed individually based on the family’s needs, CCFIC’s role and current capacity, applicable eligibility requirements, safety considerations, and whether we can offer a useful next step.
If CCFIC is not the right fit or an opening is unavailable, we may help identify another appropriate contact or resource when possible. We cannot guarantee acceptance, availability, eligibility, or placement with another provider or program.
A first conversation can help clarify whether CCFIC—or another resource—may be an appropriate next step.
You are not alone. Help is available.
How to Get Started
1. Complete our brief Request a Call Back form. The form asks only for basic contact information and a general topic. Please do not include medical details, diagnoses, treatment information, Social Security numbers, or other sensitive personal information.
2. Have an Initial Conversation
We will contact you to learn generally what kind of help you are seeking and explain what CCFIC currently offers.
3. Review Fit and Availability
We will consider whether your needs fit CCFIC’s role, current pilot capacity, applicable eligibility requirements, and available resources. An inquiry or callback conversation does not guarantee enrollment.
4. Establish the First Steps
If CCFIC appears to be an appropriate fit and space is available, we will discuss the scope of coordination, initial priorities, necessary permissions, communication expectations, and the next review point.
If CCFIC is not the right fit, we may identify another potential resource or direction when possible.
A Message of Hope
A difficult season does not define your family. When responsibilities, referrals, decisions, and unanswered questions begin to pile up, having someone help organize the path forward can make the situation feel more manageable.
You deserve to be heard. You deserve clarity. You deserve compassionate, practical support.
CCFIC cannot promise that every problem will be resolved, but we can help eligible participating families identify priorities, understand their options, and take the next step with greater confidence.
CCFIC is a developing care-coordination initiative led by Samantha Lubin, LPC, of Post Oak Family Wellness, with systems, administrative, research, and program-development support from Laban Johnson of LJ Learn and The Concordia Initiative.
Community partners and volunteers may participate as specific roles, operating protocols, training requirements, permissions, and capacity are established. Their inclusion on this page does not imply that they currently provide services to every participating family.
If You Need Immediate Help
CCFIC is not an emergency-response or crisis-intervention service. This website and callback form are not monitored continuously and should not be used for urgent help.
If you or someone else is in immediate danger or needs immediate medical assistance, call 911.
For mental health, emotional distress, or suicidal crisis support, call or text 988 or visit 988lifeline.org.
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