Laying bare the lack of planning from Commonwealth Home Support to Support at Home – inspector-general of aged care, private sector, peak bodies speak at Senate hearing

The transition from Commonwealth Home Support Program into Support at Home (SaH) has received its most decisive questioning yet. At a recent Senate hearing, cross-sector experts called into question the planning, oversight and plan for not only the transition but the eventual SaH program itself. Aged Care’s inspector-general, Natalie Siegel-Brown weighed that the sector is “on the cusp of significant structural change” with no clear indication as to why. The language of questioning, from multiple viewpoints of government to private sector, has decidedly gone from confusion to scathing. With mounting pressure to front questions surrounding lack of planning and strategy to meet Australia’s ageing population, advocates and experts alike are doubling down on the government to acknowledge the fault-lines so as to then engage in the correct.

Senate hearing

Last week saw sector experts front a Senate hearing, where the transition into the new act, particularly its programs for home support came under significant scrutiny.

The Inspector-General for Aged Care, Natalie Siegel-Brown was last week direct and frank about her Office’s misgivings about the plan to move from the Commonwealth Home Support Program (CHSP) into the SaH before the Senate Community Affairs References Committee.

Siegel-Brown started by noting the predominant sentiment surrounding the program and the first inherent problem of moving away from it, “it is highly cherished.”

Addressing messaging from the government that the CHSP was not able to appropriately support the needs of senior Australians, Siegel-Brown highlighted that there was a glaring discrepancy between numbers served and funding. At 840,000 senior Australians on a CHSP package, over half the nation’s current aged care cohort, the program has only been receiving 8 per cent of Canberra’s budget for aged care.

Siegel-Brown noted that residential aged care receives 61 per cent of the budget, however with many calling for a realignment of aged care strategy, to keep seniors out of hospital and residential aged care, reform must look to truly supporting the effort to keep seniors at home.

As the cracks continue to emerge for the roll-out of Support at Home, Siegel-Brown tackled both the lack of funding to CHSP and the decision to transition away from it to a program heavily criticised.

She shared that with the move the sector was, “on the cusp of significant structural change” without substantive proof if the change would bring about large-scale benefits for the sector and seniors.

“The proposal is to merge [CHSP] into Support at Home, which from my perspective is a program that is predictably bearing out serious problems in practice. Why would we merge these two programs before we’ve ironed out the issues with Support at Home?”

Inbox flooded

Siegel-Brown shared with Senate members that her inbox was being “flooded” by emails detailing the impact of co-payments.

Powerfully, Siegel-Brown testified, “I don’t understand why we’re undertaking the transition at all.”

Continuing, “CHSP plays a really important role in keeping people out of hospitals. We risk longer wait times, accelerated deterioration, and we’re going to put further strain on the residential aged care sector, which we know already is unlikely to meet the demand of the next few years.”

Absence of data

A key lack of data and modeling has also surfaced from the Senate inquiry. When discussing the ability to navigate ahead, and the efficacy of the transition, Siegel-Brown confirmed what many have worried over, a lack of viable data underpinning the move.

Siegel-Brown shared on the record, that her Office has received no economic modeling from the Department of Health, Disability and Ageing. This has hampered her and her Office’s ability to consider the transition continuing.

In reviewing the publicly available video of the hearing, it is evident too, that when questioned, Department of Health, Disability and Ageing representatives did not directly respond to enquiries about the existence of completed evidenced data or substantive economic modeling. The representatives before the Senate were not able to confirm the existence of any clear roadmaps, plans for the transition progression, or a cost-benefit analysis between the CHSP continuing and SaH absorbing current and future entry-level aged care home support needs.

After pressing from Senate Chair Penny- Allman-Payne, department first assistant secretary Gerg Pugh said that modeling surrounding CHSP, SaH and approaches for the transition of one program into the next “exists” but it is not publicly available. When asked when the latest cost-benefit analysis had been conducted he did not have the answer, and took his answer on notice.

Fix current models

Provider leadership have shown increasing willingness to vocalise the confusion as to why the government has opted to transition to a new, more unstable model of support at home, before a comprehensive review was conducted of what had been in place.

This issue of reinventing a bumpier wheel, before conducting maintenance on the old came up in the Senate inquiry, with Meals on Wheels (MoW) senior leadership noting that CHSP funding and its model has not had a comprehensive modern review in over ten years. Leaders have shared that CHSP’s cracks have been left to widen in the face of rising costs, compliance expectations and demand.

Centering the continued importance of meal delivery, alongside social support services as key components of support at home in the aged care sector, the MoW leadership called on government to protect services that prevented deterioration. They highlighted that block funding has a place in smooth access to services that can keep seniors at home healthier, and out of hospitals and early RAC admissions.

OPAN

Craig Gear, the Older Persons Advocacy Network (OPAN) CEO was an additional expert who affirmed support for maintaining block funding for key services.

While he noted that OPAN, in principle, supports that progression of CHSP into SaH, within the new program model, he stressed that the royal commission’s recommendations surrounding “block funding”, “activity-based funding” and “individual funding components” must exist as central structures within it.

Gear used some of his time to support Siegel-Brown’s continued searing comments on the “maze-like” conditions of digital resource, My Aged Care, saying her recommendations must be acted upon.

He shared, “a really clear staged timeline is required and there must be co-design for those communities affected. Finally, fixing the issues in relation to the viability and affordability of any co-contribution model has to be addressed.”

Valuing block-funding

On top of Siegel-Brown’s advocacy for the agility of block-funding to “breath in and out” according to client needs, continued support for block funding came from Council on the Ageing Australia chief executive Patricia Sparrow. She noted that the advocacy group has and will continue to maintain belief in the mixed approach as well. Block funding being continued, was noted as critically necessary to rapidly and easily support services like meal delivery, social support and transport.

Tim Hick’s, Bolton Clarke’s executive general manager of policy and advocacy raised the concern that many providers have eyed, that of the consequences of adjusting away from block funding for critical services such as community nursing. Hicks raised the consequences of moving to siloed budgets across an extensively spread gamut of service types, all with small volumes.

He shared that the group is calling for the decision to delay substantial decisions surrounding CHSP and its lifespan, until the rollout of SaH has been completed. He pointed to the need to wait until the fault-lines of pricing and co-contributions have been settled.

He shares that as a provider they have heard from their clients, and as well acknowledge the findings from COTA Australia’s State of the Older Nation 2025 Report, that 91 per cent of Australians have expressed satisfaction with their CHSP overseen services.

“We don’t need wholesale change”, Hicks notes, “big, complex changes create distraction and burnout.”

“A simple path forward would be to extend the Support at Home co-contribution rates to CHSP after we make any course corrections, and indeed that extension to CHSP might also help offset some of the fiscal costs of reducing co-contributions in some of the areas that they’re currently problematically applied to.”