New Support at Home details reveal co-contribution cut-off date

The Department of Health and Aged Care has released a new Support at Home program handbook to help service providers prepare for their Support at Home transition ahead of its July 1 2025 implementation date.

While the handbook does not cover all operational details, it reveals that a new cut-off date of September 12 2024 means some Home Care Package recipients will have to pay co-contributions even if they access services before July 2025. 

The timeline

There has been no change to the Support at Home implementation timeline, with the staged approach as follows:

• From July 1 2025, Support at Home will replace the Home Care Packages (HCP) Program and the Short-Term Restorative Care (STRC) Programme 
• Home care recipients transitioning to the new program from July 2025 will be allocated Support at Home funding equivalent to their existing HCP level and aligned to the new legislated program rules
• The Commonwealth Home Support Programme (CHSP) will transition to Support at Home no earlier than July 1 2027
• CHSP providers will be covered by the new Aged Care Act from July 1 2025, with additional information to come

Streamlined assessments and budgets

Another well-known feature of modern aged care is the single assessment system. From July 1 2025, older people will be assessed for Support at Home through the new single assessment system and an integrated assessment tool.

All information captured during an assessment will inform what services an individual needs with an assessor working with the individual to develop a tailored support plan. Anyone approved for Support at Home will receive a notice of decision with their individual support plan to share with their Support at Home provider, which includes a summary of needs and goals, an ongoing quarterly budget and approval for short-term supports. 

Quarterly budgets range from a predicted $2,750 for classification 1 ($11,000 annually) and $19,500 for classification 8 ($78,000 annually). Up to $1,000 or 10% of a quarterly budget can be carried forward if it remains unspent. 

Case management fees will be deducted from quarterly packages and made available to providers as a total pool, with the entire financial year allocated to spending these funds. In a positive move, the new system still prioritises services from a single provider, although negotiations can be made to outsource services. 

Importantly, HCP care recipients, including those on the National Priority System awaiting an HCP at their assessed level, and STRC clients will automatically transition into Support at Home from July 1 2025. 

Those on the National Priority System will have Support at Home funding equivalent to the HCP level they have been approved for once Support at Home funding becomes available. They will not require a reassessment unless their needs have changed.

Existing STRC clients will complete their current program, but any who do require new programs after July 1 2025 will need to be re-assessed.

A new prioritisation system

While the Department hopes to reduce home care support wait times to three months by 2027, it acknowledges that existing HCP wait times will carry over into Support at Home. Additional funding will ease the burden in the future, but short-term change is relatively unlikely. It expects up to 300,000 Support at Home participants by 2034/35. 

A new prioritisation system will replace the National Priority System, rating participants as either high, medium or standard needs. If wait times for services exceed expectations an interim budget will be allocated.

Capped prices

A defined service list will provide clarity to Support at Home providers and older people about what is available under the program.

Additionally, providers will invoice the Australian Government for services delivered against each participant’s budget. Price caps will be informed by the Independent Health and Aged Care Pricing Authority (IHACPA) with a maximum capped price per hour or unit. Price caps will include administration fees, meaning providers cannot charge separate administration fees. 

Any services delivered that do not appear on the defined service list will not be Government-subsidised and will therefore require private funding.

This could impact services such as cleaning, which is capped at 52 hours per year (equivalent to 1 hour per week) or gardening, which is capped at 18 hours per year (equivalent to 1.5 hours per month). The annual caps ensure funding is available to focus on clinical needs and maintaining independence. 

Co-contributions for new and existing participants

Much has been spoken about regarding the new means-tested co-contribution system and the no worse off principle designed to prevent existing aged care participants from suddenly paying more for their care. Providers will be responsible for collecting participant contributions.

Under Support at Home, participants will only pay contributions on the services they have received. The contributions will be calculated at a rate per hour (or unit of service) at a set percentage of the price for each service type, where applicable. The Government will fund all direct care costs, meaning about 11% of services are paid for by older people.

Full pensioners will pay the least – 5% of service fees classified under ‘Independence’ and 17.5% for ‘Everyday Living’ – while self-funded retirees will pay 50% and 80%, respectively.

However, it appears that new information shared by the Department has created a new cut-off date for the no worse off principle:

“A no worse off principle will apply to the contributions arrangements for people who, on 12 September 2024, were either receiving a package, on the National Priority System, or assessed as eligible for a package. 

“Existing HCP recipients that do not pay an income-tested care fee will continue to make no contributions for the remainder of their time in Support at Home. Existing HCP care recipients that do pay income-tested care fees will transition into Support at Home with special discounted contribution arrangements. 

“When these participants move to residential care, they will stay on the existing contribution arrangements for residential care unless they opt to move to the new program contribution arrangements. Changes to accommodation payments in residential care would still apply to these participants, since accommodation payments are an agreement negotiated between the resident and their provider.”

This means anyone who is a new HCP entrant after September 12, including those already assessed but not approved – will pay co-contributions if eligible. Existing HCP income-tested care fee payers, including those on the NPS, will pay up to a quarter of their ‘Independence’ and ‘Everyday Living’ fees.

Exceptions will be made for those who have reached a lifetime cap of $130,000. 

For more information, including additional insights into provider payment arrangements, regulatory requirements and details on several trials, click here.