Integrated Team Care
Integrated Team Care (ITC)
Supporting mob living with chronic conditions in Toowoomba & Warwick
Carbal’s Integrated Team Care (ITC) team walks alongside Aboriginal and Torres Strait Islander people living with complex chronic conditions, helping you understand your health, get to your appointments, and stay connected with the care you need.
What is a Chronic Condition?
A chronic condition is a long-term health issue that needs regular care and support. Here’s what that means:
Long-Lasting Condition
These illnesses stick around for months or years. They don’t clear up quickly and often need ongoing attention to keep you well.
Doesn’t Improve on Its Own
Unlike a cold or flu, chronic conditions don’t just pass with rest. They usually require treatment, monitoring and proper management.
Needs Ongoing Support
Managing a chronic conditions often involves working with your GP, specialists and other health workers plus the steps you take every day to stay strong.
Chronic conditions can affect your heart, lungs, kidneys, mind, blood, or other parts of the body, and often need regular check-ups, medicine, or lifestyle changes to help you stay well.
Some Common Chronic Conditions Include:
Diabetes
Heart Disease
Lung Disease
eg: Asthma or COPD
Kidney Disease
Cancer
Ongoing Mental Health Conditions
👉🏾 With the right support, mob can live strong and well while managing chronic conditions
How Can Carbal’s ITC Help?
The program provides practical, on-the-ground support for people living with complex chronic conditions.
Our team works with you, your doctor and other health services to:
Yarn to you and break down the medical talk
Work with you on your care plan
Organise appointments and services
Take the pressure off by helping with transport, costs and tricky paperwork.
What is Care Coordination?
Care Coordination is about making your health journey easier, clearer, and more supported.
Your Care Coordinator is there to walk alongside you and keep everything on track by:
Helping you understand your chronic condition and what it means for your everyday life
Making sure your GP Care Plan stays on track
Checking in and spotting early signs when your health might need more attention
Speaking up for you and helping you navigate the health system
Being someone who will listen, yarn and support you without shame
Eligibility
All participants must:
Have an ITC Referral (from GP)
Identify as Aboriginal &/or Torres Strait Islander
Have one or more chronic conditions
Have a Current GP Care Plan
Have a Current Mental Health Care Plan
for Mental Health referrals
Please Note: All participants must be up to date with their 715 Health Assessment (within 12 months)
🩺 Your GP will be kept in the loop every step of the way
Supplementary Services
Your Care Coordinator can approve certain supports under federal guidelines. This extra help is offered when it can improve your health or make it easier to manage your care.
This may include:
Services where no bulk billing is available
Allied health and specialist services not funded by Medicare
Medical aids needed for managing your condition
ITC Statistics
Our team are proud and committed to delivering strong outcomes for our mob, with more people getting to appointments, more care plans completed, and more support reaching community when it’s needed most.
In 2025, we have delivered:
Number of Clients
Number of Care Coordination Services
Number of Transports
Transport
Medical Transport Services
Outreach Workers are here to assist our mob to get to your medical appointments safely and on time. If you need a lift to the doctor, hospital, specialist or any other health appointment, our team is ready to help.
We’re all about making things easier, supporting mob, and keeping you connected to the care you need.
Phone to make a booking:
Please Note:
- Transport depends on availability
- 24 hours notice is required
Meet the Team
Toni Crossley
ITC Manager
Tania Young
Care Coordinator
Shayla Collins
Care Coordinator
Matt Gilroy
Outreach Worker
Karen Young
Administration
Deadly Outcomes for our Community Members
One of our clients was connected to the ITC Program for help managing Diabetes, Heart Disease and Chronic Kidney Disease.
When we first met with him, we found out he had been going without some of his basic needs just so he could afford a community meal service.
Working together with Elder Care Support, our ITC team had a proper look at his Commonwealth Home Support Package (CHSP). We were able to get the right referral codes sorted for meals and domestic help, which meant he no longer had to pay out of pocket.
This change made a big difference to his life, he could finally keep up with living costs, pay for his medications, and still enjoy getting out and about in community.
We then teamed up with Queensland Health to coordinate his specialist appointments and organise transport. Because of this support, he has attended every single appointment for the last three months, with zero missed visits, a huge win for his health and wellbeing.
While he was waiting for an upgrade to a higher-level home care package, ITC also helped him with medical aids at home to keep him safe and supported.
After a few yarns about his longer-term needs, we connected him with the Aboriginal Disability Liaison Officer (ADLO) to guide him through starting an NDIS application. This means he’ll have the right supports around him now and into the future.
Tania Young
One of our clients was referred to the ITC program for Mental Health support after going through an extremely tough time. Earlier this year, she was involved in a serious farm accident, leaving her with multiple fractures and internal injuries. She spent many months in hospital and then in a rehabilitation facility working hard to recover.
When she was finally discharged, Carbal supported her with safe accommodation. Our ITC team stepped in straight away to make sure she had what she needed, including medical aids and fresh, home-cooked meals from our kitchen to help her heal and stay strong.
Since then, ITC has been working closely with Queensland Health to help her get to her regular rehabilitation and therapy appointments each week. Her dedication to her recovery has been deadly to see.
More recently, ITC helped her access a specialist neurologist for a nerve conduction study, an important step before she undergoes a major surgery next month. Without ITC support, she wouldn’t have been able to afford this appointment, which could have delayed her treatment.
We’ll continue to stand beside her, including arranging transport to Brisbane for her upcoming surgery appointment, making sure she gets the care she needs with as little stress as possible.
Shayla Collins
Contact Carbal’s ITC Team
All enquiries related to ITC can be directed to Carbal’s dedicated team based at Charnley Street.
If you have a non-urgent general enquiry, you can now get in touch by sending us an online message:
Carbal ITC
– Integrated Team Care
Address:
18-24 Charnley Street
Kearneys Spring QLD 4350
Opening Hours:
Mon-Fri: 8:30AM – 4:30PM
Phone:
Online Enquiries
Do you have an enquiry related to Carbal’s Integrated Team Care services?
We’d love to hear from you!
Please submit your details and a member of our ITC team will be in touch to discuss further with you.
