Support at home program concerns mount with no mountains moved – inspector-general of aged care reiterates calls for change 

Three months into the new act and the growing pains of the Support at Home (SaH) program show no signs of abating. The Inspector-General of Aged Care, Natalie Siegel-Brown, and her team have again publicly voiced concern about the inherent structure and rollout of the program. In frank messaging this week, her office has raised flags, starting with the gap in what the Royal Commission called for, the creation and establishing of a single consolidated aged care program, and the government’s alternative response. They highlight that in breaking out channels in accessing care, with in-home care to be under the banner and delivery of the Support at Home program, accessing care may have been compromised. The office of the Inspector-General has named what many advocates have been voicing, that SaH, in its construction and implementation has the high potential to “leave some older people without access to the care they need to stay at home.”

Inspector-general’s latest concerns

It is helpful to note that Siegel-Brown and her Office’s latest comments fall within the context of previous concerns raised by government to government. September 2025 saw her Office release a progress report on the implementation of the recommendations of the Royal Commission, within which, SaH saw significant examination and concern. For the Office to publicly comment again so quickly is telling.

In a move to clearly articulate and break-down key points, Siegel-Brown and her Office released the following messaging:

“Why is the Inspector-General concerned?”

·        “Demand continues to exceed available home care packages”

·        “People assessed as having higher care needs often wait 9-12 months for services to start”

·        “Prolonged wait times can contribute to avoidable deterioration, hospitalisation and premature entry into residential aged care”

·       “ There are serious risks co-payments for non-clinical care could see people forego essential care”

·        “Hardship provisions are confusing and difficult to navigate.”

Championing “truly living”

Siegel-Brown’s approach has been heartily received by advocates and seniors across the country, not so in merely vocalising what they have been experiencing for months but in the balancing of the professional and personal. Far from politicising the issue, the messaging within her reports has maintained a vision to centralise the examinations for constructive and progress-oriented results.

September’s report saw Siegel-Brown note, “this report has not been written with the intention of finding the ‘gotcha’ moments in the government’s implementation of the recommendations from the Royal Commission. Indeed, the government and I ultimately share the same goal: a future where every older person in this country does not merely ‘exist’ in aged care but truly lives as they age; connected, valued and supported. That aim underscores the human rights lens through which this report has been formulated.”

Advocates and provider leadership have publicly noted they are keenly looking to the government’s response to Siegel-Brown’s reiterated concerns this week, in pursuing meeting the moment for reform in the close shadow of the new act.

“’Big rocks’”

This week saw Siegel-Brown again point to her Office’s finding In September, to reorient reform to centre on the new act’s endorsed vision from the Royal Commission, “total transformation.” She notes how the Royal Commission’s final report, “called on the government to move the ‘big rocks’ and deliver meaningful change.” And as concerns surrounding SaH mount, it is evident from growing messaging that from the perspective of advocates and Siegel-Brown, ‘big rocks’ seem only to be added on to the pile.

The Office of the Inspector-General has pointedly raised their concern regarding the SaH implementation in how it is affecting, in real-world implementation, seniors across the country who are experiencing financial hardship.

Many advocates and industry leaders, along with findings from the Royal Commission, agree that it is appropriate to safeguard sustainability measures into aged care, that people contribute to the cost of their care in circumstances where they can afford to do so. However what has been growing evident is that many seniors, who fall within the hardship allowance, are facing sizable obstacles or ‘big rocks’ in their way to claiming it.

This week, Siegel-Brown directly noted this misalignment of policy and real-world experience, “while people granted ‘hardship’ will not need to contribute to the cost of their care, these provisions are difficult to navigate.”

“Maze-like”

Following on from her Office’s review of the My Aged Care website, where they formally reviewed the website as being “maze-like”, the difficulty for those in particularly vulnerable situations have been acknowledged when it comes to SaH.

The new pricing structure of SaH introduced co-payments, where non-clinical care (as decided by government) to include activities like showering and cleaning, means a contribution to costs is required.

Exemptions are embedded within the SaH program, seniors who qualified for hardship provisions are fully covered but as Hello Leaders has heard from numerous seniors, and so too has Siegel-Brown’s Office, “the Inspector-General is consistently told many people find the application process complex and difficult to manage.”

“For people without adequate support, or with cognitive decline, these difficulties are magnified.”

Long-time advocates such as Peter Willcocks and academic Kathy Eagar have been consistently predicting impacts for months. The new co-payment structure, and demarcation of showering as “non-clinical” will have significant harmful real-world potential.

Siegel-Brown’s Office affirms these concerns, “the Inspector-General is concerned fear of out-of-pocket costs and administrative complexity could place older people experiencing financial hardship (whether they have been recognised as such by the government or not) at risk of foregoing essential care services they are entitled to.”

Wider ramifications

Siegel-Brown’s Office has again sought to shape the concerns with SaH in the framework of the greater impacts and fallout of getting the SaH’s implementation ‘wrong’.

While the government announced the intention of SaH, in terms of wait time to be an average 3-months, the staggering ballooning of wait times has proven this expectation and implementation to be void. Back in September Siegel-Brown noted the concerns of ballooning wait times to likely impact quality of life, premature entry into residential care and increased pressure on hospital systems.

As the very public dispute between the state’s health ministers and Canberra has intensified, the issue of strained hospitals, and ability to serve all demographics of Australia has reached a fever-pitch. The indignity and unnecessary presentation of seniors to hospitals must gain greater attention from Canberra is a sentiment shared by provider leadership, industry experts and seniors across all states.

As numerous provider heads have noted, particularly Juniper’s Russell Bricknell, the efficacy of ensuring seniors are able to stay at home longer, and stay there healthier has powerful financial and ethical implications for the nation at large. While costs per day of hospital care vary, economists have been clear, investing in timely and accessible support at home services, as well as low-cost loans to help providers bed build at pace, these measures have the potential to dramatically reduce the billions needing to be poured into the healthcare system, particularly for patients that do not need, nor want, to be there.

Siegel-Brown and her Office affirms, “prolonged wait times and a delay in access to care can result in people needing greater support than what they were initially assessed for or staying in hospital for extended periods because they lack suitable discharge options.”

Reform

Advocates are clear, the classification of services, such as showering, should not be within the “non-clinical” category. My Aged Care requires significant overhaul to streamline and ‘de-maze’. Accessing hardship eligibility confirmation and connecting this information from client to provider to government needs significant work.

And simply trying to find information on how SaH is meant to work has left thousands of seniors and loved ones, as well as provider staff perplexed. Seniors particularly have been increasingly frustrated at the lack of clear and succinct information on how the program functions, what to expect, with pervasive confusion as to how to make sense of new invoices from providers. Providers too have been seeking guidance on compliance, assurance on government subsidies and cash-flow management as they adjust to the new program.

For all those in the sector, particularly the vulnerable at its heart, the need for re-assessment and addressing reform towards SaH is paramount. As Support at Home is the vehicle through which the critical branch of care at home is to be delivered, advocates, industry leaders and seniors alike are calling for immediate examination and improvement.

As Siegel-Brown’s Office notes, “Support at Home has the potential to improve the delivery of home care, but careful attention needs to be paid to its implementation, particularly the impact on older people experiencing financial hardship.”