Support at Home is a complicated, opaque, inefficient scheme for all – part four: reform judged on impact not intent

Support at Home has brought in sweeping changes to how home care operates across the sector, for hundreds of providers and staff, impacting seniors and wider society. Examining these in a series is to highlight the very real impacts of legislation on the ground, and the equally real need for reform.

Adrian Morgan is General Manager at home care provider Flexi Care. What he shares is not abstracted macro commentary but lived moments from the offices, halls and homes of the organisation. These stories hold weight for they are a clarity bell on reform, not touting intent but exposing impact. Testament to seniors, families and providers, these micro moments are loud in the collective. Leaders, seniors and advocates remind, reform’s yardstick is impact embodied not intentions exclaimed.

Impacts on the ground

In assessing how the program has landed, the routine of providers, the impact of bureaucracy on staff, of meeting topics day-in and day-out, is optimised insight.

“The sector has had a mad scramble.”

“It’s been bad for the sector, it’s bad for seniors, it’s bad for providers, it has impacted”.

Morgan notes the stark shift October 31^st to November 1, “the biggest difference has been with the home care partners”.

“The end of October last year, working with home care package clients, most of the time was spent, fairly directly supporting older people, and if you needed to do something, for example, if the person needed a wheelchair, the process that to go through would be fairly straightforward. You’d hear from the person, you’d think about what you know about them, and then you’d arrange for an occupational therapist to see the person, and fairly quickly. As long as they had some funds in their package, you could get that organised pretty quickly for them.”

The game has changed, “but now the contrast is at the moment, huge amounts of time from senior’s care partners is being taken up by paperwork associated with the complexity of SaH, of the assistive technology and phone modification system, it’s a real nightmare.”

 “And, so things that used to be simple and might take, you don’t know, 15 minutes all up, that’s gone, all the bits and pieces might be taking hours now. And then you have to wait to hear whether it’s approved.”

Then the salt is poured, “and then you find out it’s not fully approved.”

“People needing some assistance, $5000 or $6000 here, and they can get only $2000 and then you’ve got to chase that up and find out, well, why was that? And they [government] can’t tell you, and then you’ve got to explain it to the client and the client doesn’t understand.”

This is the reality on the ground, this is providers doing care in 2026, “this means that staff time, more and more and more, is being taken up by bureaucratic hoops, and not by talking to older people, supporting their families, making plans, following up on how things are going.”

 “The job has changed very dramatically, and [care partners] they’re the ones most significantly impacted.”

In meetings, Morgan shares, “staff are saying every week, they’ll say ‘I spent half a day following up on various issues with assistive technology and communications’”.

“‘I’m spending a large portion of my working life doing paperwork and bureaucracy now’, consistently this is coming up in meetings. Every week the need to tackle the complicated and opaque bureaucracy of Support at Home is a massive time-waster”.

Responding to government vacuum

Another key not-fit-for-purpose indicator can be found with the increasing role of ‘government interpreter’ providers are needing to step into.

“There has been a substantial in-house resource shift in response to the Support at Home changes, individual conversations, over weeks and weeks and weeks”, Morgan tells.

“Older people have been caught up in the changes, and they haven’t understood what was/is going on, many of them got letters from the department they didn’t understand.”

He shares, “they have been coming to us, desperate for explanation.”

“[Seniors are scared] ‘What is this letter I’ve got?’”

“They’re actually quite worried, the confusion has been prolific, and so part of our role was and is effectively to be as reassuring as we could be to say, ‘well, let’s go through this together, I’ll explain what this means for you.’”

“At the end of the day, you’ve got to work through this with each person, one at a time, there was and is no one simple approach, there couldn’t be, there is no general message or shortcut”, Morgan shares.

“You had to pay attention to: Were they grandfathered, were they not grandfathered? If they were grandfathered, were they previously paying an income testing fee? If they’re not grandfathered, what percentage have they been allocated to pay by Services Australia? And have they heard yet from Services Australia? What percentage do they have? Every conversation was different.”

Stepping in to do more

Home care providers across the country have found that in the vacuum of confusion from the changes of Support at Home, with complicated and fractured information from government sources, the lift to meet that void, has been high-performing providers stepping in to do more.

“Providers, in looking at the reality of this, when we were going through this in preparing for November 1, we realised we were dealing with every client uniquely, they are all separate stories. And minutia matters.”

He shares, “home care providers have to have the conversation with everyone, many times more than one conversation, there are always more questions.”

“We are happy to answer them [questions]. Because that is what it took, and will take, to have seniors as well prepared as they could and can be for the changes that are happening.”

Illogical policy

Aged care leaders remain perplexed at the illogicality of the approach to home care scheme reform, and that it is seemingly seen to be effective. The grossly more expensive cost of daily hospital pales in comparison to funding home care measures to prevent seniors from presenting early to the acute healthcare setting.

“There’s no logic to that. That’s thousands of dollars a day in costs.”

Morgan says, “what it comes down to, what we’re seeing, is that a senior that needed something valued at $500 or $600 dollars, at most $800, in assistive technology, is refused this in reassessment, or has to wait so long, it isn’t there to support them from falling, and they end up in hospital, and can’t leave because they don’t have the assistive technology at home.”

“There is simply no logic”.

What is poor policy for seniors, for leaders seeking to provide great service, for taxpayers wanting efficacy for tax dollars must be honoured in guiding reform. The scheme’s ‘fruit’ argues it is not fit for purpose.

“If it’s to live up to its promise of what they told us it would be before it came in, so much reform is needed”, Morgan advocates. 

“They said it would be fairer, it would be better value for money, it would be easier. It would be simpler. There has to be a very serious overhaul and reset of the whole program for that to be achieved.”