HIP Complex Care Services – Aged Care You are here:HomeHealth ProfessionalsGP LiaisonCommunity and Home ServicesHIP Complex Care Services – Aged Care Service overview The Complex Care Aged Care team is a multi-disciplinary team that works with clients with aged-related issues, who exhibit complex health care and psychosocial needs, and chronic illness or conditions. This service improves health outcomes for these clients taking into account the progressive nature of health needs, deterioration in functional status or social issues. The Complex Care Aged Care team provides a care coordination service and works collaboratively with health and welfare agencies in the local community. This can include a timely access to a Geriatrician or Aged Care Nurse Practitioner review for people living in the community. Care Coordination: The care coordinator provides one main point of contact that assists the client, carer and/or family to navigate the service system and facilitates the provision of proactive care. This ensures: Continuity of care Integrated care Communication between the client, carer and/or family and other health and social care providers is streamlined Duplication of services and processes are minimised. Team members Registered nurses, including Nurse Practitioner Physiotherapy Occupational therapy Dietitians Speech Therapy Social work Psychology Medical specialists (General medicine, Geriatrician Medical Specialists ) Pharmacy Service delivery 5 day a week service within business hours Number & frequency of sessions determined with client following a comprehensive assessment & goals setting Program duration 1 – 6 months Sessions available in the home & other community settings Eligibility criteria SVHM Primary Catchment: City of Yarra, City of Boroondara and southern part of City of Darebin. Clients linked to SVHM through Specialist or Outpatient service, Social Work Dept. or a History of emergency or inpatient admissions, and residing within: SVHM Secondary Catchment (parts of Darebin, Moreland, Stonington & Melbourne) Or as per case by case consultation with Manager Referral process Fax (03) 9231 2202 Referrals occur via email - HipCentralReferrals@svha.org.au Contact details Phone enquires via HIP Central 1300 131 470