what we do

Care Coordination

The Care Coordination Program assists older adults, those who are 60 years and older, who were recently hospitalized or suffered a health crisis and reside in CAPCOG’s 10-county region. The program provides short-term services to help clients to remain independent and make future plans. Care coordinators will complete an assessment to identify client needs and develop an individual care plan. Arrangement for appropriate services and their follow up is managed by an assigned care coordinator. The program provides assistance within 30 days for those older adults who are without the financial resources to pay the total cost of needed care. A care coordinator assesses a person’s needs, then links clients to in-home services on a temporary, short-term basis.

Care Coordination Services may include:

  • Homemaker services
  • Limited personal assistance
  • Durable medical equipment not accessed through Medicare
  • Emergency Response System
  • Other services can address needs identified by assessment and care planning

Important note: All services are short-term, temporary and are provided at no charge. Contributions toward the cost of the service are encouraged and welcome.

To submit a care coordination referral, call 512-916-6062 or email a Care Coordination Referral Form to Sonia Flores, AAACAP intake specialist.

Referral forms also can be submitted by fax to 512-916-6042.