A damning report, co-authored by Infrastructure Victoria and the Victorian Aboriginal Community Controlled Health Organisation, exposes poor conditions within Aboriginal health and wellbeing facilities.
It reveals an audit of 200 buildings, used by dozens of Aboriginal community-controlled groups across the state, found 82 per cent need to be partially or fully replaced in the next 15 years.
The buildings are about 40 years old on average, with 17 of these more than 100 years old and the oldest built 174 years ago.
Most commercial buildings have a life span of 50 to 60 years.
Of the buildings assessed, 52 per cent were deemed to be at the end of their economic life.
Infrastructure Victoria chief executive Jonathan Spear said some sites posed a risk to staff and clients.
"There are also clinicians who have to work in a storeroom and staff who need to wear coats and hats inside because their buildings are unsuitable," he said.
The Dandenong and District Aborigines Co-operative, described by local federal MP Julian Hill as the "worst" facility in Victoria, was identified as the most serious case.
It services a growing Aboriginal community in Melbourne's southeast but was shuttered in August due to structural failure and the threat of asbestos exposure.
Staff have been working from home, reducing service capacity by 20 to 70 per cent.
In the small East Gippsland town of Orbost, the Moogji Aboriginal Council is operating out of a 1930s boarding house with "terrible mould", uneven floorboards and heating and cooling issues.
On cold days, staff light a fire in its makeshift boardroom and work off laptops.
The council's chief executive Louise Carey said it was "better than having blue toes and shivering all day".
The Aboriginal health organisation's chief executive Jill Gallagher said infrastructure funding for the community groups' buildings was often a "tennis game" between federal and state governments.
Latest national Closing the Gap data shows only five of the 19 targets are on track to be met and four are going backwards.
Evidence shows the "one-stop shop" model for community-controlled groups is effective in helping to close the gap in Aboriginal health and wellbeing outcomes, Dr Gallagher said.
The report calls for the Victorian government to fund and start building up to $150 million worth of related projects over the next five years and establish an interim fund to pay out $30 million a year for minor works and repairs.