Kalwun’s Integrated Team Care (ITC) program contributes to improving health outcomes for Aboriginal and Torres Strait Islander people with chronic health conditions through better access to coordinated and multidisciplinary care.

The ITC team works to close the gap in life expectancy by improving access to culturally appropriate mainstream primary care services (including, but not limited, to general practice, allied health and specialists) for Aboriginal Torres Strait Islander people.

Our objectives are to:

  • contribute to better treatment and management of chronic conditions for Aboriginal and Torres Strait Islander people enrolled in the program
  • improve access to appropriate healthcare through care coordination and provision of supplementary services for eligible Aboriginal and Torres Strait Islander people with chronic disease
  • foster collaboration and support between the mainstream primary care and Aboriginal and Torres Strait Islander health sectors
  • improve the capacity of mainstream primary care services to deliver culturally appropriate services to Aboriginal and Torres Strait Islander people
  • increase the uptake of Aboriginal and Torres Strait Islander specific Medicare Benefits Schedule (MBS) items, including Health Assessments for Aboriginal and Torres Strait Islander people and follow up items.

Eligibility

To be eligible for this program you must:

  • be of Aboriginal and/or Torres Strait Islander descent
  • have—or be at risk of—chronic illnesses
  • be a registered patient in a Mainstream General Practice.

Accessing the service

Access to this program can be by self-referral, GP referral or family/friend referral among other referral pathways.

Complete the Integrated Team Care Referral Form and email to This email address is being protected from spambots. You need JavaScript enabled to view it.

For more information on the Integrated Team Care program, call the team on 5526 1112.

The ITC team

The Integrated Team Care team consists of an Indigenous Health Project Officer and Outreach Worker, each with specific responsibilities to help clients manage their health concerns.

Indigenous Health Project Officer

This role works to:

  • collaborate with local Indigenous health services and mainstream health services in a partnership approach for the delivery of primary care services
  • improve the capacity of mainstream primary care services to deliver culturally appropriate services to Aboriginal and Torres Strait Islander people
  • improve the integration of care across the region, including cross-sector linkages and the development of a regional plan for Aboriginal and Torres Strait islander health for the Gold Coast region
  • increase the uptake of Aboriginal and Torres Strait Islander specific Medicare benefits schedule items, including Health Assessments for Aboriginal and Torres Strait islander people and follow up items
  • support mainstream primary care services to encourage Aboriginal and Torres Strait Islander people to self-identify.
Outreach Worker

This role:

  • provides transport/support for Aboriginal and Torres Strait Islander mainstream clients who have a chronic illness so they can attend Health Assessment, GP follow up appointments, specialist, allied health appointments, being admitted or (released from hospital depending on availability), community pharmacies and delivery of Webster packs
  • Makes sure clients are registered for Close the Gap (CTG) within their medical practice for cheaper or free medications
  • Increases access to primary health care services for Indigenous Australians
  • Provides practical assistance for Aboriginal and Torres Strait Islander people residing in the Gold Coast area to access appropriate care
  • Encourages and supports community members to self-identify with primary health services and to obtain a current Medicare card
  • Fosters collaboration and support between mainstream primary care services and the Indigenous health sector to achieve the best outcomes for Aboriginal and Torres Strait Islander patients
  • Identifies existing barriers experienced by the local Aboriginal and Torres Strait Islander community in terms of accessing primary health care
  • Assists clients that need to access the Care Coordination and Supplementary Services Program.