Aboriginal and Torres Strait Islander Health
Indigenous Integrated Team Care Program (ITC)
Support for Aboriginal and Torres Strait Islander people with complex chronic illness
The Sydney North Health Network (SNHN) have now commissioned the Integrated Team Care (ITC) program to Grand Pacific Health. This program is an Australian Government initiative which forms part of the Indigenous Chronic Disease Package (ICDP). This aims to improve health outcomes for Aboriginal and Torres Strait Islander people with chronic health conditions, through better access to coordinated and multi-disciplinary care. ITC is currently available to all practices in the SNHN region.
The ITC program has three main components:
1. Care Coordination
Care Coordination is provided by the Grand Pacific Health ITC Care Coordinators who work collaboratively with people and their general practices, Aboriginal health services, medical specialists, allied health professionals and community services to assist in the provision of culturally sensitive health care and services.
For Aboriginal and Torres Strait Islanders enrolled on the ITC program Care Coordinator can:
- Help people to understand their conditions, medications and treatments;
- Assist people and their carers to manage one or more of their SEVERE chronic diseases (see below for details);
- Arrange and remind people and their carers of appointments;
- Assist people to access specialist and allied health services;
- Direct people to community programs; and
- Organise and assist with travel to and from medical appointments.
2. Supplementary Services
Supplementary Services funding may be used to directly pay for services by specialist and allied health providers, or to meet the difference between MBS rebates and fees charged. The funds may also be used to assist with the cost of local transport to and from medical appointments.
3. Development of culturally sensitive health services
The ITC is responsible for improving the cultural sensitivity of mainstream health services to ensure that Aboriginal and Torres Strait islander people are catered for locally.
Support for Aboriginal and Torres Strait Islander people with complex chronic illness
The ITC program is open to Aboriginal and Torres Strait Islander people who are at HIGH RISK, such as those that have a SEVERE form of one or more of these chronic diseases: Cancer; Cardiovascular Disease; Diabetes; Renal Disease; Respiratory Disease; or Mental Illness.
- GP needs to have evidence of frequent hospital admissions and/or emergency presentations over a 12 month period;
- Person is having trouble accessing and using the right services needed for their care; and
- Person requires coordination to manage multiple services.
How can an Aboriginal person be enrolled?
- Person must have a current GP Management Plan in place;
- Person must have a written referral from their GP (Please see referral form at top of page).
Further Information
If you would like further information regarding the ITC program please contact Grand Pacific Health.
Contact Numbers for GPH ITC Care Coordinators:
Intake Line:
1800 879 096
ITC Care Coordinator:
0439 208 370
Aboriginal Outreach Worker: 0483 048 163