Do you have a diagnosed chronic health condition such as; cancer, diabetes, chronic respiratory or cardiovascular disease, or mental health diagnosis? Ask your GP for a referral to Daniel at ITC/CSS.

The Integrated Team Care (ITC) and Community Care & Supplementary Services (CCSS) programs aim to improve health outcomes for Aboriginal and Torres Strait Islander people who are living with a chronic disease through better access to coordinated multidisciplinary care. This is a free service available to all eligible Aboriginal and Torres Strait Islander people living with either cancer, diabetes, chronic respiratory, mental health, or cardiovascular disease.

Our IT/CCSS Care Coordinator’s provide culturally appropriate care and support client goal attainment.

Benefits of integrated team care

Because our team have extensive knowledge and understanding of local health systems, they work collaboratively with health professionals and can assist with the following:
  • Help to remove barriers faced by Aboriginal and Torres Strait Islander people with chronic conditions;
  • Coordinate appointments with specialists and allied health professionals;
  • Transport to and from appointments (excluding Toowoomba. Please refer to Patient Travel Subsidy Scheme Bus);
  • Fuel cards can be picked up from CRAICCHS (pending availability), you just need to bring along your specialist appointment letter
  • Offer home visits and clinical outreach service, including monitoring general observations;
  • Connecting and referring to support groups
  • Accommodation; when accessing specialist services away from home, including assisting with PTSS;
  • Increase uptake and ensure health assessments are current and up to date;
  • Provide follow-up care, including pre/post-operative care and support; and
  • Accessing funding to pay for medical aids, including: assisted breathing equipment, monitoring equipment, dose administration aids, medical footwear, mobility aids, and spectacles, in conjunction with the Medical Aids Subsidy Scheme (MASS).

Eligible persons wishing to enter the ITC/CCSS Program must be medically referred to the program by your nominated GP.