CHSP - the Poor Cousin’s Getting Poorer
3 minute read
I increasingly hear CHSP described as the ‘poor cousin of aged care’. Inadequate funding, delays and a lack of forward planning now characterise the program.
Well, the poor cousin just keeps getting poorer and it seems very few people in the family want to talk about it.
The Aged Care Royal Commission found that indexation arrangements in aged care have systematically robbed providers of billions of dollars. Government underfunding amounted to $9.8 billion every year over the decade to 2019, equivalent to 58% of total aged care expenditure in that year!
Of that massive total, inadequate indexation has reduced government expenditure by 22.4% and rationed supply (not enough Home Care Packages) has reduced funding by 25.7%.
Inadequate indexation has had a huge impact on CHSP. As costs have continued to exceed funding, providers have found it difficult to provide the same levels of service. Some CHSP providers have renegotiated their funding agreement to reduce the number of contracted outputs but at a higher unit price. Others have tried to provide services above their contracted hours, threatening their organisational viability.
CHSP services are starting to fold.
The outcome for clients is that an increasing number of older people are being denied support because CHSP services are simply unavailable or providers have closed their books to new clients. Other older people are having their services rationed.
Precious few people outside of CHSP are raising this as the huge issue it has become.
Government is making advocacy more difficult by not letting us know the numbers in the growing waiting lists for CHSP services, they are hiding the problem. We do not have visibility of who is missing out in CHSP - unlike the Home Care Package waiting list (which we know is not even close to an accurate picture of wait times anyway).
Government already knows what needs to be done. Their own Aged Care Royal Commission recommended that they should adopt a fairer indexation formula for home care and CHSP. Royal Commission recommendation 111 was that the government should review funding for home care and CHSP to address the inadequacy of current indexation. This recommendation detailed a fairer formula for the much needed change to indexation arrangements.
This is one of the recommendations that the Government chose not to implement. And now the Independent Health & Aged Care Pricing Authority (IHACPA) has taken charge of subsidy advice, but the government hasn’t asked it to advise on CHSP costs. So don’t hold your breath waiting for that process to deliver the desperately needed increases in funding.
Based on history, we simply cannot trust the government to come up with adequate pricing arrangements any time soon for CHSP (or SaH).
The constant erosion of the value of CHSP funding has been accentuated in recent years by a failure to provide growth funding for the program. CHSP is the only aged care cousin where the numbers of older people it supports has gone backwards in the last five years. From 2018 to 2023 the number of CHSP clients reduced from over 841,000 to around 816,000 people. This has been at the same time that demand has continued to skyrocket.
Sorry to rain on anyone’s parade while people are celebrating the aged care reform package just announced, but this is an urgent issue that needs to be immediately addressed as part of the reforms.
CHSP provides essential low-level services, which if deployed early prevent or delay people needing to access to higher levels of home care or residential care. As we focus on all the other aspects of aged care reform, we need to protect this vital service for over 800,000 older Australians in need.
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