Healthy North Coast

Care Coordination and Supplementary Services

North Coast Primary Health Network (NCPHN) is funded to provide the Care Coordination and Supplementary Services (CCSS) program throughout the North Coast with Care Coordinators employed in all NCPHN regional offices.

The CCSS Program was established in 2009 and is funded by the Australian Government.

The aim of the CCSS program is to contribute to improving health outcomes for Aboriginal and Torres Strait Islander people with chronic health conditions through better access to coordinated and multi-disciplinary care.

Care Coordination: Is provided by qualified health workers, which include nurses and Aboriginal Health Workers, to support patients to access services consistent with their GP Care Plan. This may include arranging services as required, access to transport to attend appointments, support and advocacy at appointments and ensuring regular reviews are undertaken by patient’s primary care providers.

Supplementary Services: Provides support for patients to access urgent and/or essential allied health or specialist services, access to transport and some medical aids. These funds are subject to a set of guidelines, and only where services are not publicly available.

Eligibility: Clients/Patients referred to this program must:

  • Be of Aboriginal and Torres Strait Islander decent
  • Have been diagnosed with one of five chronic diseases: cancer; diabetes; respiratory; renal and heart disease
  • Have been referred to the program by a GP, who has completed a GP Management Plan

Referral: Referrals should be sent to one of the NCPHN regional offices, marked ‘Attention’ CCSS Coordinator. The relevant Care Coordinator will then contact the service and client to discuss moving forward.

Template referral forms are available for Medical Director and Best Practice software through the regional offices.

For further information contact your local Care Coordinator at:

Tweed Heads: (07) 5523 5501

Lismore: (02) 6627 3300

Coffs Harbour: (02) 6659 1800

Port Macquarie : (02) 6583 3600