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Priority Delays

If you are not confused by the approach to reforms to the Support at Home (SaH) Program you have not been paying attention.

SaH was listed as a Priority Area number one in the reforms. Great start! Well, not so fast, the outcome of being top of the priorities has been delay after delay. It feels like Friday afternoon at the airport and you don’t know if you will ever get home.

As we recently heard, CHSP will now transition to Support at Home ‘no earlier’ than July 2027. That’s a push back from 2025 which was delayed from 2024 which was pushed back from 2023 which was delayed from 2018 which in turn was pushed back from 2017 (it would be funny, except that it’s not).

After the debacle of the NDIS roll out, why did no-one get that the transition of a huge diversity of block funded services (used by over 800,000 people) to individual packages was going to be a monumental task that requires years of good planning?

It’s great that the Minister has listened to provider concerns, it is not so great that these concerns were not apparent to her predecessors on this journey. We know this Minister has a personal commitment to getting the reforms right, let’s hope the latest delay leads to much better planning this time around with some genuine co-design with providers and participants.

The basics: what is meant to be changing?

The Australian Government tell us they are busy introducing a range of practical measures to respond to the Royal Commission’s recommendations. Here’s a quick recap of the headline changes for SaH:

Creation of the new ‘Support at Home’ Program, replacing Home Care Packages, Short-Term Restorative Care and… (wait for it) CHSP
More funding for the sector (quantity TBA)
Revised Aged Care Quality Standards
Expansion of Quality Indicators
Better responses to diversity, dementia and Aboriginal and Torres Strait Islanders
Development of a single assessment system
Introduction of ‘care finders’
Development of new consumer contributions or increased taxation, to get more money into the system (our guess is it’s not going to be a new tax)

And the biggie is a whole new Aged Care Act (first in 27 years) that will reform rights and consumer choice and the provider registration process. It will introduce new quality standards and compliance measures.

Is there a cause for concern for a sector already weighed down by heavy handed compliance and government controls, you ask? Well, given you phrased the question that way you already know the answer.

Other than the CHSP delay, how’s the reform going?

Well, Minister Anika Wells wants to know too, so in June she requested a progress report on the Royal Commission recommendations from the Acting Inspector General of Aged Care, Ian Yates AM (Ian Everywhere to those of us who have been around a while).

The progress report was asked to answer how is reform implementation progressing and how is it being governed by the Department (or is anything happening, we mean, really?)

And, as we’d expect from a sector nearly mummified by red tape, the short answer was it’s slow going. There has been some progress though if you look hard enough.

Ian noted some big-ticket improvements, including significant increases in funding for home care and increased wages for aged care workers. But he also noted we need the Act before we get the real action.

We are currently in what feels like a holding pattern (and the pilot just told us we will not be landing any time soon) while a whole bunch of the recommendations from the Royal Commission are waiting on the commencement of the new Aged Care Act.

The Act will provide the legal basis for around 50 recommendations (either in full or in part). So, the Act is vital to the aged care reform puzzle.

None of these recommendations can be finalised until the new Act commences. This is planned for 1 July 2024, but the legislative process does not always run to schedule, and this process includes public consultations. History tells us the Act is very likely to get caught up in yet to be announced political wrangling. Other than that, what could go wrong?

And there’s so much that still needs doing, including:

Getting the Government’s position on key recommendations
Finalising key policy positions
Explaining how we will manage the transition to the new system
And of course, ensuring that delivery isn’t delayed even more

Waiting for an update

There’s a whole lot of providers feeling like they’re in limbo at the moment, with many of the Royal Commission’s recommendations facing slippage or waiting on the beginning of the new Act.

If it seems like the landing is moving further and further away – that might be because that might be. We will hear the latest update next week with the DoHAC Act and SaH webinar.

Yes, big reforms like this take time. But are we the only ones thinking that this plane might be diverted to a different destination before it runs out of fuel?

We are busy trying to build an audience for these Essential Briefings, so if you like this article it would be fabulous if you share it with other people you think might like it too.

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Roland Naufal

Roland has built (and at times threatened) his career by being outspoken about things that matter. He has over three decades of experience – from aged care CEO and Age Friendly Cities expert to the founder of DSC, Australia’s best known NDIS educators. This led him to ask the question: if radical honesty worked for Australia’s disability sector, then why not aged care, too? And here we are, folks.

Paul Sadler

Few people have as much experience in the aged care sector as Paul. 35 years, to be exact. He’s been a national and state CEO of aged care industry associations, CEO of a major aged care provider, and influencer of ageing policy, disability and community care programs for both national and state governments. He actually enjoys staying on top of the detail and is always ready to share his wisdom and insights (which comes in kind of handy).

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