Given the growing number of people over the age of 65 years living in the Northern Rivers region, this may be of some interest to retirees, their families and friends.
Australian Government, Final report of the Aged Care Taskforce, 12 March 2024, excerpt:
Support older people to age in place
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Principle 1: The aged care system should support older people to live at home for as long as they wish and can do so safely.
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A strong preference for many older people and their families is for them to age in place and remain in their home for as long as they are able. This was reflected in responses to the stakeholder survey, with 90% of respondents supporting the principle.
The decision of whether an older person wishes to remain at home or enter residential aged care is driven by a wide range of factors. Consultation showed the top reasons for preferring to remain at home included comfort and privacy, a desire to remain independent, better mental and physical health outcomes and maintaining connection to community, friends and family. For other reasons, such as social connectedness, increasing clinical care and safety needs, some older people may choose to enter residential aged care sooner. While overall there is a shift towards ageing in place, it is important to meet each person’s preferences for their aged care and provide continuity of care when needs change.
Home care programs need an overhaul to meet future demand
The current home care programs are not ready to meet the needs of a rapidly growing cohort of older people. Home care currently involves 2 programs, the Home Care Packages Program and the Commonwealth Home Support Programme, that have evolved over time and with different design objectives. This has led to a system where:
• applicant assessments are inconsistent and not well aligned to actual need
• access to services is constrained and inconsistent, and many older people are not receiving an optimal mix of services
• services are priced and fees are charged inconsistently (see Appendix E for details)
• different funding approaches are impeding the sector from scaling up and diversifying
• there is a lack of clarity about what services should be available.
Those who can access home care under the current system can leave significant funds unspent, while others can wait for months to access services. This is due to existing program constraints, limited availability of services and appropriately skilled workers, as well as behavioural and attitudinal factors. In the Home Care Packages Program, unspent funds as at 30 June 2022 totalled $2.3 billion.16 Prices across the programs are inconsistent and inefficient due to variable price setting arrangements. This undermines the predictability and sustainability of funding and can cause confusion when comparing packages with other participants.
There are also obvious signs of lack of scale and diversification of providers. As the population ages, these issues will need to be addressed to deliver a rapid scaling up of services to meet demand.
The Support at Home Program is an opportunity for generational change in how home care is delivered
It will also be important to make sure home care better meets older people’s needs, while enabling program
scalability and pricing signals that ensure funds are used consistently and in line with program intent. In
addition, home care must provide value for money, transparency and better quality services.
The new Support at Home Program, to be introduced in stages from July 2025, is an opportunity to address
these critical issues in the current home care programs.
As the Support at Home Program is implemented, it will be important to ensure the new arrangements
deliver on the intent of the design and meet the expectations of older people, their families and carers for:
• greater choice and control
• easier and more timely access
• flexibility to adjust services over time as needs change
• better value for money through controls on unreasonable administration fees
• better clarity and transparency around fees and how funding is used.
It is also important that the new arrangements deliver for providers, acknowledging the need for:
• more predictable and sustainable funding that meets the costs of quality service delivery
• recognition of the costs associated with complying with regulatory requirements
• flexibility to adjust services on the ground as participant needs change
• improved use of a qualified and skilled workforce to increase service availability
• appropriate and adequate implementation timeframes.
Support at Home Program inclusions and exclusions need to be more clearly defined than under current programs
The Taskforce was asked to provide advice on program inclusions and participant contributions for the
Support at Home Program. In developing this advice, the Taskforce considered the diverse needs, goals and
circumstances of participants, the intent of the program and the role of other service systems. The
importance of prevention, flexibility and reablement also played a key role in discussions.
The Taskforce notes the Support at Home Program needs much clearer specifications than current programs about what it will and will not fund. The lack of clarity and consistency in inclusions and exclusions in current home care programs has led to confusion between providers and participants. This affects participants’ ability to make informed choices about their care, diminishes value for money in the programs, and could also mean that funds are not used according to the policy intent of home care.
Read and download the full report at:
https://www.health.gov.au/sites/default/files/2024-03/final-report-of-the-aged-care-taskforce_0.pdf
With Aging in Place recommendations on pages 16 to 18.
