Integrated Team Care model

Aboriginal and Torres Strait Islander peoples with chronic disease can receive help to manage ongoing chronic conditions through the Integrated Team Care (ITC) program (previously known as Care Coordination and Supplementary Services).

The ITC program provides eligible Aboriginal and Torres Strait Islander clients with a dedicated Care Coordinator to work closely with them, their GP, practice nurse, allied health practitioners, and specialists as part of ongoing care. They can help with:

  • providing support to follow a care plan and support to work towards self-management
  • arranging and attending appointments
  • organising transport to attend appointments
  • acquiring medication aids related to the chronic condition(s)
  • helping clients understand their condition and how to manage it
  • understanding medication.
Eligibility and providers of the ITC program

To be eligible for care coordination under the ITC program, Aboriginal and Torres Strait Islander clients must be enrolled for chronic disease management through a general practice or an Aboriginal Medical Service, have a GP management plan and be referred by their GP.

Integrated Team Care (ITC) aims to improve care coordination and access to services for Aboriginal and Torres Strait Islander peoples across the region through our following partners:

For more information, see our ITC flyer.