Care Coordination &
Helping you anticipate needs and navigate challenges
We partner with you to:
Determine your personal goals for the future (e.g. "living at home for as long as possible", "not being a burden to my children", etc.), and create a road map to assist you in achieving these goals.
Assess each individual holistically to better understand unique circumstances and any immediate concerns. Our assessment covers physical safety, nutrition, cognition, social wellness, medical history, legal issues and financial wellbeing.
Work with family and other professionals involved in your care to identify and plan for changing needs as they happen. You decide who to involve in these conversations and we can help bring everyone together.
Develop a “care plan” --a step-by-step plan to prioritize action items and achieve your goals. Your customized plan of care will include recommendations and referrals for needed services, important timelines and the identification of specialty resources.
Implement your care plan by helping you navigate specific decisions, making closed-loop referrals to other JFS departments and partners in the community, checking in with you regularly, monitoring your progress and identifying new risks and challenges as they arise.
What is Evidence Based Care- Management?
Using proven best practices and strategies, we can:
Assist in navigating your experience by coordinating support services to optimize quality of life.
Develop a comprehensive plan of care based on assessment and client/support system input.
Monitor and adjust the plan as needed.
Arrange for community services such as transportation, support groups, cultural activities, housekeeping, purchase of supplies, nutrition, simple home repairs and more.
Provide unbiased, informed advice and an independent, professional assessment of the care situation.
Serve as a trusted, local representative for out-of-town family members.
Offer meaningful support in times of need.
Identify a wide range of service providers including chore and cleaning services, home care, legal representation and more.
This service is offered as part of the WISE Choice.
WISE is powered by
Through dedicated staff and volunteers, and in cooperation with a wide range of community partners, JFS strives to be a catalyst to meet the human service needs of all people of Washtenaw County.
We are committed to providing affordable, accessible, holistically-oriented and culturally sensitive care to our clients, whatever their identification, affiliation, lifestyle, background, race, religious creed, or national origin.
The most trusted names invest in us, because they trust us to invest in you.