Coordinated Community Care

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PWC Works projects reflect our commitment of striving for exceptional customer service, maximizing operational efficiencies, increasing modernization, providing excellent service delivery, and collaborating with the community for a coordinated response that achieves the best possible outcomes for our residents and the overall wellbeing of the county.


What is the Coordinated Community Care Initiative?

The Coordinated Community Care (CCC) initiative is Prince William County’s effort to help residents access the right services without relying on emergency responders for non‑urgent needs. Many residents call 9‑1‑1 for challenges such as mobility issues, chronic conditions, transportation barriers or difficulty navigating county systems. CCC will make it easier for residents to connect with the programs, agencies and community partners that can address these needs directly.

By building coordinated referral pathways, improving service navigation and bringing together Fire & Rescue, the Office of Community Safety, the Department of Social Services (DSS), Prince William Community Services (CS), the Prince William Health District, the Area Agency on Aging (AAA) and local organizations, CCC will create a more connected and responsive system of care.

Purpose of the CCC
The purpose of the CCC is to improve outcomes for residents who intersect with multiple systems by providing coordinated, compassionate and effective care.

Who the CCC Serves
The CCC serves individuals with complex medical, behaviroial health, housing or social needs who require a unified, corss-agency response.

CCC is in an active development phase. The Board of County Supervisors has funded a dedicated CCC position within Fire & Rescue and a partner position within the Office of Community Safety to lead program design, coordination, and implementation. Additional structures, staffing, and tools will be phased in as the model evolves and aligns with future budget decisions.

Infographic showing Coordinated Community Care, the multidisciplinary teams and service pathways as described in the Main Goals of the Coordinated Community Care Initiative section.

Main Goals of the Coordinated Community Care Initiative

CCC is being built as a countywide, team‑based model that improves how residents access services. The program is developing a coordinated approach that will grow over time as systems, staffing and workflows are established.

• Public Education and Navigation: CCC will provide clear, accessible information to help residents understand how to access county and community services reducing reliance on 9‑1‑1 for non‑emergency needs and improving awareness of available support.

• Integrated Intake and Call Routing: Working with the Public Safety Communications Center and other intake points, CCC is designing future pathways so that non‑urgent requests can be identified and directed to more appropriate services instead of triggering an emergency response.

• Field-Based Non-Emergency Response: As the model matures, CCC aims to support EMS and other field providers with alternative response options for residents who do not require emergency medical care but still need assistance, follow‑up or coordinated outreach. These service pathways include health and wellness, housing stability, transportation assistance, food and basic needs, behavioral health, social and community support and education and employment.

• Multidisciplinary Team Coordination: CCC is building a collaborative team that brings together Fire & Rescue, the Office of Community Safety, DSS, CS, the Prince William Health District, AAA and community partners to review cases, identify underlying needs, coordinate referrals and ensure residents receive the right support.

• Community and Institutional Partnerships: CCC is strengthening partnerships with hospitals, clinics, nonprofits, and faith‑based organizations to expand the range of services available and ensure residents receive coordinated, not fragmented, care.


Success Criteria for the Coordinated Community Care Initiative

• Improved access to health, safety, and wellness programs
• Reduced preventable emergency room visits

• Lower non‑emergency 9‑1‑1 call volume
• Residents with complex or chronic needs supported through coordinated care
• Strengthened collaboration across county agencies and community partners

PWC Works projects reflect our commitment of striving for exceptional customer service, maximizing operational efficiencies, increasing modernization, providing excellent service delivery, and collaborating with the community for a coordinated response that achieves the best possible outcomes for our residents and the overall wellbeing of the county.


What is the Coordinated Community Care Initiative?

The Coordinated Community Care (CCC) initiative is Prince William County’s effort to help residents access the right services without relying on emergency responders for non‑urgent needs. Many residents call 9‑1‑1 for challenges such as mobility issues, chronic conditions, transportation barriers or difficulty navigating county systems. CCC will make it easier for residents to connect with the programs, agencies and community partners that can address these needs directly.

By building coordinated referral pathways, improving service navigation and bringing together Fire & Rescue, the Office of Community Safety, the Department of Social Services (DSS), Prince William Community Services (CS), the Prince William Health District, the Area Agency on Aging (AAA) and local organizations, CCC will create a more connected and responsive system of care.

Purpose of the CCC
The purpose of the CCC is to improve outcomes for residents who intersect with multiple systems by providing coordinated, compassionate and effective care.

Who the CCC Serves
The CCC serves individuals with complex medical, behaviroial health, housing or social needs who require a unified, corss-agency response.

CCC is in an active development phase. The Board of County Supervisors has funded a dedicated CCC position within Fire & Rescue and a partner position within the Office of Community Safety to lead program design, coordination, and implementation. Additional structures, staffing, and tools will be phased in as the model evolves and aligns with future budget decisions.

Infographic showing Coordinated Community Care, the multidisciplinary teams and service pathways as described in the Main Goals of the Coordinated Community Care Initiative section.

Main Goals of the Coordinated Community Care Initiative

CCC is being built as a countywide, team‑based model that improves how residents access services. The program is developing a coordinated approach that will grow over time as systems, staffing and workflows are established.

• Public Education and Navigation: CCC will provide clear, accessible information to help residents understand how to access county and community services reducing reliance on 9‑1‑1 for non‑emergency needs and improving awareness of available support.

• Integrated Intake and Call Routing: Working with the Public Safety Communications Center and other intake points, CCC is designing future pathways so that non‑urgent requests can be identified and directed to more appropriate services instead of triggering an emergency response.

• Field-Based Non-Emergency Response: As the model matures, CCC aims to support EMS and other field providers with alternative response options for residents who do not require emergency medical care but still need assistance, follow‑up or coordinated outreach. These service pathways include health and wellness, housing stability, transportation assistance, food and basic needs, behavioral health, social and community support and education and employment.

• Multidisciplinary Team Coordination: CCC is building a collaborative team that brings together Fire & Rescue, the Office of Community Safety, DSS, CS, the Prince William Health District, AAA and community partners to review cases, identify underlying needs, coordinate referrals and ensure residents receive the right support.

• Community and Institutional Partnerships: CCC is strengthening partnerships with hospitals, clinics, nonprofits, and faith‑based organizations to expand the range of services available and ensure residents receive coordinated, not fragmented, care.


Success Criteria for the Coordinated Community Care Initiative

• Improved access to health, safety, and wellness programs
• Reduced preventable emergency room visits

• Lower non‑emergency 9‑1‑1 call volume
• Residents with complex or chronic needs supported through coordinated care
• Strengthened collaboration across county agencies and community partners