Can Support at Home deliver on its promises and reduce wait times?
Published on 19 March 2025 (Last updated on 1 April 2025)
The home care sector in Australia is facing an escalating crisis, with wait times for Home Care Packages (HCPs) not only reaching unprecedented levels, but staying there.
Once a system that promised timely support for older Australians wishing to age in place, it is now struggling under the weight of growing demand, workforce shortages, and systemic changes.
As the Australian Government introduces the Support at Home program, immediate intervention might not even be enough to stop the situation from deteriorating further.
The waiting game
HCP wait times have ballooned at all levels over the past year, with the time ranges below all displaying the expected wait time for people that are medium priority, starting from the date on the letter of approval:
- Level 1: Less than 1 month
- Level 2: 3-6 months
- Level 3: 9-12 months
- Level 4: 6-9 months
- Level 1: 6-9 months
- Level 2: 6-9 months
- Level 3: 9-12 months
- Level 4: 12-15 months
These figures represent a stark turnaround in form after wait times for all levels dropped to between 1-3 months in early 2023. This trend is concerning for most in the sector, including consultant and Founder & CEO of DR Care Solutions, Danielle Robertson.
“The whole aged care system has a backlog and it’s only going to get worse. I haven’t seen it like this before and I’ve been in the industry 38 years,” Ms Robertson told Hello Leaders.
Part of the problem can be attributed to increasing demand as more baby boomers begin accessing aged care services for the first time. Then there is the shift to a Single Assessment System which is raising some concerns over the quality of staff being hired and trained.
The recently introduced Single Assessment System replaced assessments conducted by contracted private Regional Assessment Services (RAS) and state and territory-run Aged Care Assessment Teams (ACAT). Now, a mixture of private organisations and state/territory governments are completing all assessments for people living at home. State and territory governments provide all in-hospital assessments.
“We have a massive shortage of workers in aged care. This has been coming for years; even before COVID-19 we had short staffing and a lack of skills in Australia. Now the quality of assessors is changing,” Ms Robertson said.
“I am often attending assessments with my clients as an advocate to make sure they’re going to get the right services. I’m seeing a lot of younger assessors who haven’t got the experience. They’re asking just a checklist of questions and they’re not getting to know the client or their particular requirements.
“It’s not a very personalised approach even though they say it is. So in reality, people are getting low-level packages which are hardly worth it, two or four hours a week, when someone needs 16 hours, 30 hours, possibly even 24/7 care.”
Building workforce capacity
Last year’s Federal Budget set aside $531.4 million to release an additional 24,100 HCPs in the hope of meeting some of the demand – it catered for roughly one-third of the 68,000-strong wait list at that time.
Since then, industry insiders put the total wait list at closer to 80,000 people.
Ageing Australia CEO Tom Symondson says access to home care is vital for older Australians so they can maintain independence, dignity and connections to their own communities, close to family and friends.
With the 2025 Federal Budget to be released next week – in the shadows of a looming election and impending reform deadlines – he’s urging the Australian Government to dig deep and provide more critical funding
“Lack of workforce is often cited as a factor for not increasing packages. Although not universal in every part of Australia, many of our members tell us there is workforce capacity to care for more older Australians. However, providers can’t employ workers to deliver packages that don’t exist,” Mr Symondson said.
“A July 2024 Ageing Australia survey showed that 73% of home care respondents could accept new clients if more home care packages were available.
“Ageing Australia advocated for MYEFO 2024-25 funding of $1.8 billion for 55,000 packages, at an average of $33,000 per package, to address existing wait lists and meet increasing demand before the commencement of Support at Home on 1 July 2025.
“It’s hoped the reforms under the New Aged Care Act will go some way to relieve the issue, with the introduction of the Support at Home Program and the associated increase in packages, but the challenge is immense for providers. The timelines are so tight they border on the impossible.”
Impossible is a word that hasn’t been used consistently while talking about aged care reform, yet Mr Symondson’s statement could be right on the money.
Providers are not yet in a position to bolster internal workforces to provide more workers for HCPs or packages under Support at Home. Even if the government was to provide funding for more packages, there is no surplus of qualified, experienced workers ready to fill the gaps.
“Innovation and technology can help but it’s still attracting the right number of people who have the right skills and are appropriate for that job which is the challenge,” Ms Robertson said.
“If the government gives everyone a package they’re still going to be in a similar position to those approved for the Commonwealth Home Support Programme (CHSP). You ring ten providers now for different services and everyone has waitlists.
“Speeding up the assessment and funding process is essential but if we don’t have the carers and support available everyone will be in the exact same position.”
A problem with no single solution
The government’s goal is to reduce waiting times for home care under Support at Home to just three months by 2027. It’s ambitious.
It also likely requires a wide range of interventions to ensure that the greatest amount of burden on the system simply isn’t shifted to another step in the process.
For Ageing Australia, time is one thing they would like more of so that aged care providers can be better prepared to operate under Support at Home from day one.
“With only months to prepare, providers need to overhaul entire systems, replacing complex ICT infrastructure. And yet all of the information to complete this process is still not available,” Mr Symondson said.
“Without more time, we’re likely to see confusion for both older people and providers. As a member of the Government’s Transition Taskforce, we at Ageing Australia are advocating for practical and achievable solutions.”
Elsewhere, Ms Robertson acknowledged a variety of sector needs that would improve the entire process for accessing home care.
This would include better international recruitment pathways for qualified care workers, particularly registered nurses, who have to study for Australian qualifications regardless of past experience.
Then there is the necessary focus on training and education for assessors and other aged care workers involved in the placement process. Technology and scale are two tools that will help improve some elements, yet she warned that there is an ongoing risk that personalisation is lost when organisations are juggling large numbers of aged care recipients.
Ms Robertson even spoke about the attitude shift required toward who pays for aged care. She believes that the government cannot be relied upon 100% to fund the costs for everyone, and more people – and their families – must acknowledge that they will be spending money on aged care and that could be in the private sector.
“I’m looking at the Support at Home program and I wonder if it is going to keep people out of residential care or is it going to influence more people to spend their kids’ inheritance?” she queried.
“Some people are very willing to pay for their aged care services and others will not put their hand in their pocket at all if the government can pay for it. I even know of people who give away all their money so they can collect a pension, and then they have limited options when they have to access aged care.”
With no easy answers for one of the sector’s most challenging problems, only time will tell how Support at Home will actually impact access to aged care.