Support at Home online workshops

26 April 2024

From 12 to 21 February 2024, we held 8 online workshops with in-home aged care providers to help refine the new Support at Home program.

Each workshop focused on a different proposed design feature of Support at Home.

What we heard

Care management

Care management will be its own service type under Support at Home. It will play a vital role in ensuring aged care services contribute to the wellbeing of older people.

Areas of discussion included:

• Refining the proposed definition and scope of activities for care management services.
• Undertaking clinical oversight is important for safety and quality but can be complex and time consuming.
• Adequate care management funding is needed for positive age care results and to help providers meet regulatory obligations.
• Support for flexible funding arrangements given care management needs are highly variable and change over time.

Self-management

Older people who choose to self-manage their aged care can continue to do so under Support at Home. We expect they will be able to run their services and manage their budget with support and oversight from a registered provider.

Areas of discussion included:

• Care management is important for self-managed clients, but we need to clarify what this looks like and define provider obligations.
• Further detail on the proposed scope of activities a self-managed client can do would complement the defining of provider obligations.
• Compensating providers when self-managed clients use third party services is complex, but solutions are being explored.

Funding model

Support at Home participants will have quarterly budgets with the ability to save funds between quarters up to a defined limit.

Providers will be paid on a fee for service basis with supplementary thin market grants.

Options are being considered for people in group settings such as. retirement villages or rural communities. This could include to pooling funds for shared services like on-call personal care and minibus service.

Areas of discussion included:

• The ability to save some funding between quarters is important to meet temporary unplanned needs. The limits should be high enough to avoid participants having insufficient funding in emergency situations.
• Supplementary grants will help maintain the viability of providers in thin markets who face extra service delivery challenges, including higher operational costs.
• Pooled funding may be beneficial to some older people in group settings, but there are risks to implementing this kind of model. A trial is recommended.

End-of-Life Pathway

We are considering options for people with less than 3 months to live, who want to stay at home. This includes access to higher levels of home care support.

Areas of discussion included:

• Older people living with life-limiting conditions can benefit from a range of complementary health, aged care, community and specialist palliative care supports.
• Priority access into the End-of-Life Pathway is critical. This includes streamlined assessment and access to services, assistive technology and home modifications.
• Assessment tools may be helpful in identifying who would benefit from the pathway.
• Good communication between the team of service providers and the older person is important.
• Informal supports play a key role in keeping older people at home. We need to support carers through education and respite.

Restorative Care Pathway

The Restorative Care pathway will replace the current Short-term Restorative Care (STRC) programme on 1 July 2025. Restorative care will apply an intensive, clinical approach to improve an older person’s function and wellbeing, helping them be independent for longer.

Areas of discussion included:

• Importance of effective care management to ensure good gains during a restorative care episode.
• Setting expectations with the older person is important to achieving good restorative outcomes. This starts with thorough assessor training and clear clinical restorative guidelines.
• Motivation to improve function is important in determining suitability for restorative care.
• Providers wishing to deliver restorative care should provide evidence of connections to the allied health workforce. They should also have examples of results.

First Nations

This workshop explored how to support First Nations people to access culturally safe, trauma-informed and healing-aware care under Support at Home.

Areas of discussion included:

• The need for clear and culturally appropriate information for providers and older people, families and carers.
• The importance of culturally safe and timely assessments.
• The importance of minimising time between a person seeking support and receiving services.
• The importance of adequate funding for care management to allow time to build trust, enable service delivery, and explain options.
• The importance of flexible service delivery options for culturally safe care.
• The challenges of remote locations, including costs and access to workers or equipment.
• Concerns if required to ask for consumer contributions.
• New providers need support to enter the aged care market.

Assistive technology and home modifications

Support at Home will introduce a new Assistive Technology and Home Modifications Scheme (AT-HM). This scheme will be separately funded to give participants access to AT-HM funding upfront without needing to save up funds from their individual budgets.

Areas of discussion included:

• Timely and streamlined access to AT-HM, especially where there is an urgent need, such as after a serious fall.
• Training and guidance for assessors to allow appropriate AT-HM recommendations.
• Setting appropriate AT and HM funding tiers.
• Funding AT-HM coordination activities. This includes wraparound services like sourcing and fitting equipment, educating older people on how to use equipment and following up to ensure it meets their needs.
• Project management considerations for home modifications, including cost variability, follow-up requirements and organising alternative accommodation if required.
• Prescription considerations to avoid bottlenecks and shortages of prescribers/Allied Health professionals, especially in regional, rural and remote areas.
• Loan scheme considerations, including ensuring equitable access and custom AT when required.
• Including innovative AT-HM solutions in the AT-HM list.
• The higher costs of supporting and delivering AT-HM to older people in rural and remote areas.
• Clarity on regulatory requirements for both providers and subcontractors, particularly in relation to HM.
• Guidance on the scheme, including information on provider responsibilities, reasonable costs and client contributions.

What we’re doing

We are using this feedback to refine the final design of the Support at Home Program.

We will continue to engage with the community and providers in the lead up to implementation of Support at Home.

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