In-home aged care proposed reforms

19 January 2023

The Australian Government is committed to delivering a reformed program for in-home aged care by 1 July 2024 and this starts by listening to the people that access and deliver these services.

From 18 October to 25 November 2022, a new program for in-home aged care discussion paper was open for feedback..

Over 520 submissions were received, including responses from:

• older people, their families, and carers

• personal care workers, nurses and allied health professionals

• service providers

• peak bodies and advocacy groups.

At the same time, the department conducted extensive consultation with stakeholders across the sector, including online Q&A information sessions, attended by over 900 stakeholders.

What we heard

Thank you to everyone who submitted a response to the discussion paper.

Key feedback received from older people, their families, and carers included:

• Many want to have the ability for reimbursement when they are self-managing
• Care partners must support people and not make decisions for them
• Support for having a budget, and for prices and fees set by Government
• Support for access to additional services when needed, and timely access to a goods, equipment and home modifications scheme
• Interest in more detail on how in-home care in a group setting – for example home sharing, would work.

Key feedback received from service providers included:

• Support for supplementary grants for different service types and thin markets
• Support for flexible funding to meet changing needs
• Concerns that if older people are self-managing, over-booking may leave no budget to pay invoices
• Where the client has multiple providers, there are concerns about accountability
• Need for clarity on what functions are included in care management
• Concerns about workforce constraints and competition for staff
• Concern about the proposed system being too transactional, which could limit innovation for community organisations
• Providers are looking for a greater focus on client outcomes and quality.

Respondents also wanted details on:

• The assessment and classification arrangements
• Access to respite under the model
• Implementation and transition arrangements

What we’re doing

The department is considering your discussion paper feedback as we continue to engage with stakeholders to inform our final advice to Government about the new program for in-home aged care.

On 7 December 2022, the Department held the third ‘Reforming in-home aged care update’ webinar, attended by 2,036 people with over 260 questions submitted.

The webinar outlined the proposed design of the new program, feedback received from the online submission process and next steps.

The webinar also provided updates on the:

• Home Care Package (HCP) price caps on administration and management charges that came into effect on 1 January 2023.
• Commonwealth Home Support Programme (CHSP) extension of funding agreements until 30 June 2024.
• New Aged Care Act in development to focus on personal centred, rights based and risk proportionate care with registered aged care providers.

During the webinar, we explained why the discussion paper referred to the in-home aged care program, rather than Support at Home. As the government makes its final decision about what it wants to do with the program, the name will be finalised.

We also addressed how the activity-based funding model will work in rural and remote areas. The Independent Health and Aged Care Pricing Authority (IHACPA) will set prices that incorporate the total cost of service delivery. IHACPA will consider the option of loadings by different MMM regions to cover higher costs. The program will also have thin market grants for providers with higher travels costs.

Questions from the webinar also highlighted significant interest in consultation with Aboriginal and Torres Strait Islander communities, and the need for more clarification around the role of care partners and what qualifications they will require.

You can watch a recording of this webinar, which includes the slides, captions and Auslan interpreters.

Informing the sector

As the new program develops, we will regularly update the Reforming in-home aged care webpage, which includes:

• Upcoming events through the consultation calendar, such as targeted group discussions and webinars.
• Key resources such as quarterly fact sheets for older people and industry stakeholders, discussion paper materials and data migration information.
• A list of past consultations that include materials that were presented and reports with outcomes, where available.

Targeted consultations will continue in early 2023, including engaging with CALD and First Nations providers.

For more information on the in-home care reforms, please contact sah.implementation@health.gov.au.