Danger ahead for CHSP
3 minute read
We all know it’s beyond foolish to ignore the signs of danger when a situation gets tricky. Well things have got very complex with the future of the Commonwealth Home Support Program (CHSP) and the warning signs are clear.
CHSP is a vital part of a successful aged care system, providing entry level support while encouraging volunteering and the development of local community based services.
In a recent article, I highlighted that inadequate indexation of CHSP is squeezing providers and resulting in falling sustainability. CHSP was the only part of the aged care system that was going backwards - serving less people than five years ago. Well, in a positive development the trend was reversed in 2023-24 and client numbers grew.
Many of us are wondering – what does the future hold for CHSP? Are we moving backwards or forwards? Which way should we be looking?
The Federal Government first announced its commitment to merge CHSP with the Home Care Package program way back in 2015 - it will now be ‘at the earliest’ in 2027. The intent of the merger has always seemed to be to create a new layer of individualised funding for the 834,000 people in CHSP.
Is individualised funding really the best option for CHSP a decade after the idea was born?
The Aged Care Royal Commission agreed that a single aged care program should be established, covering CHSP, Home Care Packages, Short-Term Restorative Care and residential care.
But (and it’s a big one) they recommended that this single program should adopt a mix of funding models - not just individualised funding.
WIth so much money, time and resources invested in the Royal Commission, they concluded that social supports, respite, assistive technologies and home modifications should be funded in a mix of block funding and activity based funding.
To put this in current policy language ‘activity based funding’ is funding that varies according to the assessed needs of the individual. ‘Block funding’ is just another name for grants.
The Commissioners argued that “activity based funding should be supplemented with block funding … to ensure area coverage, continuity of service, and service viability. This approach combines the access, efficiency and transparency advantages of activity based funding, with the greater flexibility and confidence provided by block funding.”
So in short, the Royal Commission thought grant based funding would remain vital to a healthy aged care ecosystem.
Grant funding helps overcome some of the problems of individualised funding. It can be designed to ensure that services would be available to a widely dispersed population and help organisations to get services to places where it’s expensive to go.
A similar model is adopted in residential care via the Australian National Aged Care Classification. There’s a payment for the service infrastructure (called a ‘base care tariff’) and a subsidy based on individual needs.
Providers agree with the Royal Commission and are consistently telling us there are huge risks in relying on individualising funding. CHSP currently operates as a critical backstop for Home Care Packages when people are waiting for individualised assessment and services. And, the cost of administering individual budgets for over 830,000 people would be incredible - the risks of getting it wrong are huge.
Maybe this is why the Government has got its policy knickers in knots over CHSP; ‘no earlier than 2027’ - that smells of policy confusion.
Two years ago, the Support at Home Alliance proposed a model where CHSP is set up as a true choice for older people. In Holland, given the choice, about 85% of people elect for (not-for-profit) grant funded services over an individualised voucher.
The warnings are clear from the Royal Commission and are obvious from overseas experience. Let’s listen to CHSP providers all over Australia telling us individualised funding won’t work for lots of people in lots of places. The services provided via CHSP are far too important to be crashed by poorly informed policy zeal for the new Support at Home Program.
Let’s get smart and see the signs of danger. Let’s give older people the services they need and greater choice about how they get them. Let’s keep CHSP services alive via a mature mixed funding model.
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