Chronic and Complex Care program

The Program is staffed by multidisciplinary teams who provide relevant and supportive care to Adults with Chronic Health Conditions. Difficult to engage clients can access services through the outreach arm of the program.

About

These programs provide self-management education, support and care coordination for people diagnosed with one or more of the following chronic conditions:

  • Complex diabetes
  • Cardiovascular diseases
  • Respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD)
  • Musculoskeletal conditions (non-malignant) including arthritis, fibromyalgia, osteoporosis, trauma

The Programs have developed specific interventions and strategies including:

  • Assertive outreach to engage with people living in insecure housing, e.g. Supported residential services (pension-level)
  • Access to: Diabetes Healthy Option groups, Podiatry and Diabetes nurse education and Dietitians
  • Exercise physiology, massage therapy, Stress management and Respiratory Education sessions are available
  • Specific self management focused care with a key worker

The program works with interpreters for CALD clients and provides some services in languages other than English. Different services are available on multiple sites including Cranbourne, Pakenham, Cockatoo, Berwick, Doveton, Dandenong and Springvale

Cost

Community Health Care services are charged in accordance with the Victorian Department of Health Fee policy.

$8.30 for Health Care Card Holders and low income
$12.70 medium income
$83.70 high income
No charge for Aboriginal & Torres Strait Islander background; temporary protection visa/asylum seeker/refugee coming to Australia in the last five years; no income.

Eligibility criteria

Clients who live/work/study or consult a GP in the City of Greater Dandenong, City of Casey or Shire of Cardinia.

External referral process

1300 3 iCARE – ACCESS UNIT

T: 1300 3 iCARE – 1300 342 273
F: 959 iCARE – 9594 2273

NB: GP’s are requested to refer onto this service using the Victorian Statewide Referral Form housed in most clinical software. VSRF form

GP investigations to be performed

All or any relevant investigations may be required.

Internal referral process

T: Extension 49888
F: 959 iCARE – 9594 2273

Referrals will be received from

  • clients, family friends, carers
  • GP
  • Specialists and hospitals
  • Other agencies (eg Council)

Staff

  • key workers
  • massage therapists
  • diabetes nurse educators
  • podiatrists
  • diabetes dieticians
  • exercise physiologists
  • community development workers

When

Site opening times, approximately 9.00 am – 5.30 pm

Where

  • Community Health Service sites of Cranbourne
  • Pakenham
  • Cockatoo
  • Berwick
  • Doveton
  • Dandenong
  • Springvale
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