TANGENTYERE COUNCIL
POSITION DESCRIPTION
Position Title
ABORIGINAL HEALTH PRACTITIONER - CHRONIC DISEASE CARE COORDINATION
Division
Social Services
Classification
5.1
Job Holder
Vacant
Prepared By
Jo Duncum / Richard Farrell
Staff reporting to position
0
Date
29/7/2013
1. Position Summary
This is an Aboriginal identified position.
The Chronic Disease Care Coordination program is funded as part of the Commonwealth Government’s policy imperative
to Close the Gap and specifically as a strategy to tackle Chronic Disease through improving the access of Aboriginal
Australians to specialist, general practitioner and allied health services.
The primary objectives of this position are to deliver the following outcomes:
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To provide advocacy to patients requiring Chronic Disease Care Coordination
To ensure all patients have an identified Chronic Disease care plan;
To accept referrals for Chronic Disease Care Coordination;
To support patients to access required specialist, GP and allied health services in a timely manner;
To provide appropriate information to patients to improve their understanding of their illness;
To develop knowledge of strategies to assist in the improvement of health outcomes;
To support patients to engage in healthy lifestyle activities;
Provide a supportive environment to patients to improve self efficacy
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Responsibilities
1.
To work within the DoHA Indigenous Chronic Disease Package: Care Coordination and Supplementary Service
Guidelines1 to provide Care Coordination to identified patients;
To identify patients with Chronic Diseases to ensure that they have timely reviews, health assessments and GP
Management Plans;
To collaborate with the Chronic Disease Care Coordinator, local General Practitioners, specialists, Alice Springs
Hospital, Community Health Centres and Central Australian Aboriginal Congress to ensure best practice in
tackling Chronic Diseases;
To update the CCSS online reporting tool (MMEX) to update de-identified patient data reports as part of the
National Data Collection;
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To assist patients to develop self management skills and to utilise community support skills;
1.
Major Accountabilities
ACCOUNTABILITIES
1. To work within the DoHA Indigenous Chronic
Disease Package: Care Coordination and
Supplementary Service Guidelines to provide
Care Coordination to identified patients;
2.
To identify patients with Chronic Diseases to
ensure that they have timely reviews, health
assessments and GP Management Plans;
3.
To collaborate with local General Practitioners,
specialists, Alice Springs Hospital, Community
Health Centres and Central Australian
Aboriginal Congress to ensure best practice in
tackling Chronic Diseases;
4.
To update the CCSS online reporting tool
(MMEX) to update de-identified patient data
reports as part of the National Data Collection;
5.
To assist patients to develop self management
skills and to utilise community support skills;
PERFORMANCE INDICATORS
 Coordination of a Care Plan for each Chronic
Disease Patient referred;
 Number of referrals received;
 Number of clients supported to access
specialist and allied health services;
 Number of occasions where clients have been
supported to receive Care Coordination or
Supplementary Services;
 Completion of reports providing both
qualitative and quantitative assessment of all
work carried out as directed by Medicare Local
and Tangentyere Management.
 Coordination of a Care Plan for each Chronic
Disease Patient referred by a local GP;
 Maintenance of detailed case notes;
 Completion of reports providing both
qualitative and quantitative assessment of all
work carried out as directed by Medicare Local
and Tangentyere Management.
 Development of collaborative interagency case
management plans in conjunction with
stakeholders;
 Development and implementation of a self
evaluation program and stakeholder survey
tools;
 Completion of reports providing both
qualitative and quantitative assessment of all
work carried out as directed by Medicare Local
and Tangentyere Management.
 Maintenance of transaction receipts;
 Maintenance of service data extracts from the
CCSS online reporting tool (MMEX);
 Completion of data reports as directed by
Medicare Local and Tangentyere Management
 Development of resources2 in conjunction with
primary health providers, Allied Health
professionals and health promotion workers
supporting self management, nutrition and
appropriate recreational activities;
 Development of collaborative interagency case
management plans in conjunction with
stakeholders;
 Development and use of an appropriate data
collection and evaluation tool;
 Maintenance of detailed case notes;
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4.
Relationships
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Internal
Division
 Office of the Chief Executive
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Early Childhood, Youth & Family Services
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Community Centres
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Social Services
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External
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Medicare Local
Alice Springs Hospital
Medical Specialists
Community Health Providers
Healthy Living NT
Cardiologists
Surgeons
Endocrinologists
Prosthetists
Osteopaths
Physiotherapists
Psychologists
Radiographers
Registered Nurses (Specialists)
Speech Pathologists
5.
Competencies
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Key Stakeholders
 Chief Executive
 Chief Operating Officer
 Policy Officer
 Divisional Manager
 Early Childhood Services Coordinator
 Family Services Coordinator
 Youth Services Coordinator
 Yarrenyty Arltere Learning Centre
 Hidden Valley Centre
 Karnte Centre
 Divisional Manager
 Tangentyere Aged and Community Services
 Indigenous Case Management Service
 Chronic Disease Care Coordinator
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Local General Practitioners
St John’s Ambulance Service
Allied Health Professionals
Baker IDI
Heart Foundation
Audiologists
Podiatrist
Chiropractors
Counsellors
Dental Hygienist
Diabetes Educators
Nutritionists
Exercise Therapists
Exercise Physiologists
Orthoptists
Commitment
Strong self determination
The position requires a mature attitude to prescribed duties that rely on motivation to deadlines and all
tasks given in a prescribed time frame
An understanding and commitment to punctuality, attendance and adherence to Tangentyere Council Staff
Code of Conduct is essential
Teamwork
Actively shares knowledge, information and expertise with other team members
Proactive in identifying solutions to common team challenges and goals
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Communication
Have a high level of interpersonal and communication skills, particularly in a cross cultural environment
Ability to communicate and listen to community members’ concerns and desires
Have a demonstrated ability to communicate confidently in a strategic manner with senior management
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OHS
Establish and maintain the framework for the occupational health and safety system in the area of program
responsibility
Maintain participative arrangements for the management of occupational health and safety
Adhere to the organisation’s procedures for identifying and controlling hazards and assessing risks
Adhere to the organisation’s procedures for providing occupational health and safety training and records
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6.
Cultural Awareness
Must have an awareness and understanding of Aboriginal culture and law
Must be able to in conjunction with senior management meet with external agencies to actively continue to
raise awareness of the current complex issues that face Indigenous Australians in today’s society
Qualifications and Selection Criteria
Essential:
1. Certificate IV in Aboriginal and Torres Strait Islander Healthcare and registration with the Aboriginal and Torres
Strait Islander Health Practice Board Australia – AHPRA;
2. Experience working with people with complex needs;
3. Ability to analyse complex issues, develop strategies, monitor performance and evaluate outcomes;
4. Well developed interpersonal and communication skills, particularly in a cross cultural environment, including the
ability to produce concise and accurate reports and the ability to resolve conflict;
5. An understanding of issues involving Central Australian Aboriginal people;
6. An understanding of Aboriginal culture;
7. A commitment to community led practice, human rights and self-determination;
8. Ability to work collaboratively in a multi-disciplinary environment;
9. Hold a current NT Driver’s licence; hold or be able to obtain a Ochre Card and First Aid Certificate;
7.
Verification
This section verifies that the position holder and the manager have read the attached position description and
are satisfied that it accurately describes the position.
Position Holder:
Name:
Date Effective:
Signature:
Manager:
Name:
Date Effective:
Signature:
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