Chronic conditions program

Description of the services

The service undertakes assessment, care planning & coordination, self-management support/interventions, and monitoring, review and discharge of adults with a chronic condition. Difficult to engage clients can access services through the outreach arm of the program. A range of interventions are available from individual appointments with clinicians for consultation and treatment, and group programs focusing on self-management support and information. The main target chronic conditions are diabetes, CVD, respiratory conditions and musculoskeletal conditions.

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.
Eligibility criteria  Clients who live/work/study or consult a GP in the City of Greater Dandenong, City of Casey or Shire of Cardinia OR who cannot access services due to poor transport accessibility OR the service required is not available at the local community health service.
GP Investigations to be performed  All or any relevant investigations may be required.
Cost  $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.
Where
  • Community Health Service sites of Cranbourne
  • Pakenham
  • Cockatoo
  • Berwick
  • Doveton
  • Dandenong
  • Springvale
When  Site opening times, approximately 9.00 am – 5.30 pm.
Staff
  • key workers
  • massage therapists
  • diabetes nurse educators
  • podiatrists
  • diabetes dieticians
  • exercise physiologists
  • community development workers
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.  More information on VSRF – www.gpv.org.au then click on Resources or contact your local Divisions of General Practice.
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)
Last updated and approved July 2010