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They work with each family to develop a plan that provides them with individualized services that are based on their unique needs. This includes helping the family to negotiate the ongoing, dynamic, process that brings all of the systems together to develop the family's comprehensive and coordinated plan. Care Coordinators work with the family on many levels, including engagement, assessment, crisis intervention, implementation of the family's plan, monitoring of services, transition, and finally discharge, follow-up, and evaluation of how well the plan worked.