Aged care sector says Support at Home not working

The Older Persons Advocacy Network (OPAN) has blasted the Albanese government, demanding urgent action to address the ongoing challenges threatening to destabilise the transition to the Support at Home (SaH) program.

The current Commonwealth Home Support Program (CSHP) is due to wind up in July 2027, however, OPAN has listed increasing wait times, unaffordable essential services, a lack of cottage respite and a host of implementation woes, as urgent issues with SaH that need to be addressed by the federal government.

“Greater funding is needed to alleviate the assessment and reassessment wait times, which show no sign of abating,” OPAN chief Craig Gear said.

“We also call on the government to provide assessors with the ability to override the algorithmic decision based on clinical judgement where it is clear the algorithm has underassessed their care needs.”

Despite the recent introduction of the new Aged Care Act, the Productivity Commission's most recent Report on Government Services (RoGS) revealed an increase in aged care assessment and service commencement times.

The median time for older Australians to receive an aged care assessment rose by 22.7 per cent in 2024-25, from 22 to 27 days. Even more significantly, the median time between assessment approval and signing a service agreement nearly doubled, jumping from 118 days in 2023-24 to 245 days in 2024-25.

“The uncertainty and confusion being experienced by older people is unfair and detrimental to their wellbeing,” Mr Gear said.

There have been over 100 submissions published by the Transition of the Commonwealth Home Support Program to the Support at Home Program Senate Inquiry by the Community Affairs References Committee, which is due to report on April 15.

In its submission, not-for-profit aged care provider Whiddon echoed OPAN's sentiment, saying delays are causing real harm for older Australians including unmet care needs, family burnout and extended hospital stays.

“We continue to experience firsthand, some of the challenges our clients face, waiting for packages and package uplift. This challenge remains a characteristic of the system in these early stages,” Whiddon’s submission said.

“Compounding this, CHSP was originally designed to provide entry level support; however, prolonged waitlists for higher levels of care have seen it increasingly relied upon to meet more complex and escalating needs.

“While this has enabled older people to have their basic needs met and maintain a level of stability within their communities, it is not sustainable under current funding arrangements as needs continue to increase.”

Co-payment crisis

OPAN also took aim at the increasing costs associated with essential aged care services, reporting that older people have repeatedly shared that the financial hardship application process is overly complex.

“Our network member advocates have told us that older people are reducing their services due to the price increases,” Mr Gear said.

“Nobody should need to jeopardise the care they need, which is why better transparency around prices is required. This includes access to transport, especially in rural areas. We are pleased the department and Commission are taking regulatory action where providers have not fully displayed their prices.”

The Senate Inquiry heard during a public hearing on February 6 that meals, showers and continence pads have become out of reach for some aged care recipients due to increasing co-payment requirements.

Home care specialists Silverchain told the Committee that it has observed reluctance among clients to take up the new Support at Home program.

“Many CHSP clients currently receive fee reduction and waivers that were at the discretion of their provider but under Support at Home, this is no longer possible, so they are needing to pay significantly more in co-payments,” the submission said.

“Since October 2025, nearly one third of our CHSP clients who have received a Support at Home classification have decided to stay on CHSP. This speaks to the perception by consumers that CHSP is a ‘better’ program than Support at Home.”

Respite care

Providers and peak bodies have argued that cottage respite is fundamentally unviable under the Support at Home fee-for-service model (individualised funding).

Further submissions to the Inquiry detail concerns that removing block funding destroys the financial stability required to keep staff and beds available for emergency or unplanned respite.

“The most effective way to secure the future of cottage respite is to maintain block funding,” a submission by Hammondcare said.

“It gives providers predictable revenue streams, allowing them to spread fixed costs like infrastructure maintenance and staffing and ensure respite can be accessed flexibly and quickly when needed. Alternative methods are likely to increase costs for both providers and clients.”

On top of the economic considerations, Mr Gear said the unavailability of cottage respite under the new scheme could lead to an increase in unnecessary hospitalisations and premature entries into residential aged care facilities.

“Older people deserve to be treated with dignity and respect. Although Support at Home enshrines these principles through the Statement of Rights, it is abundantly clear that the program is failing to meet community expectations,” he said.

“This is consistent with the feedback received from older people and OPAN’s advocates, who have seen a significant rise in enquiries and increased demand for support since the changes took effect.”

“Reform fatigue”

Inquiry submissions also warn that the transition is exacerbating “reform fatigue” and burnout among the workforce. There are specific concerns that the new model undervalues non-clinical roles (such as bicultural workers and coordinators) and that the administrative burden of unit pricing will drive workforce attrition, particularly in Aboriginal and Torres Strait Islander services.

The National Aboriginal and Torres Strait Islander Ageing and Aged Care Council (NATSIAACC) reported that ongoing shortages of Aboriginal and Torres Strait Islander workers, high staff turnover rates and reform fatigue all threaten the continuity of care for clients, which has been identified as critical to Elder and Older Person safety, trust, and wellbeing.

“National Aboriginal and Torres Strait Islander workforce strategies consistently emphasise the importance of growing, valuing, and retaining an Aboriginal and Torres Strait Islander workforce that is community-based, culturally grounded, and supported through secure employment, training pathways, and appropriate remuneration,” the NATSIAACC submission said.

“Feedback from NATSIAACC members indicates that current reform settings risk moving in the opposite direction.”

This is leading to disrupted care relationships and reduced quality and safety of services for Elders and Older People.

“The transition to SaH assumes a workforce that is stable, digitally capable, and able to absorb increased administrative and compliance demands. However, ACCOs [Aboriginal Community Controlled Organisations] reported high levels of reform fatigue, with successive changes placing sustained pressure on organisations already operating in thin markets,” it said.

“Members consistently emphasised that reform will only succeed if it is grounded in the principle of “Mob caring for Mob,” supported by deliberate investment in Aboriginal and Torres Strait Islander workforce growth and retention.”

---

The next public hearing for the Senate Inquiry into the Transition of the Commonwealth Home Support Program to the Support at Home Program will be held in Brisbane on February 16.