CPSA appreciates that aged care reform across residential care and home care following the Aged Care Royal Commission is a difficult undertaking at a time of staff shortages and wage pressure. The Government has provisioned well for the reforms under way with a more than $5 billion a year increase in the aged care budget.
However, the start of the new Support at Home Program (also referred to as the In-Home Aged Care Program in these posts) will be put off for another year “in response to feedback and to allow time to further refine the design”, as Budget Paper No. 2 has it.
The “feedback” would be from CHSP providers protesting that they have no information to go on to get ready for the merger between the Home Care Packages Program (HCPP) and the Commonwealth Home Support Program (CHSP).
The reference to the “further refining” of the Support at Home Program might be amusing if it wasn’t so frustrating for CHSP providers who are deeply concerned about whether they’re going to be block-funded or not and who lack very basic information about a program that was until Budget night going to start on 1 July 2024. Almost casually, Budget Paper No. 2 informed us there would be another year’s delay.
Looking at the Budget measures relating to HCPP and CHSP, the additional time is going to be used not so much for further refining the new Support at Home Program as for starting the development of key components from scratch.
From Budget Paper No. 2:
The 2023-2024 year is going to be used “for the design, build, implementation and sustainment of the ICT changes necessary to enable the new Support at Home Program”. From this, it seems that this very vital component enabling providers to invoice the Department and for the Department to pay providers had, at the time of writing, been no more than a glimmer in an ICT engineer’s eye.
From 1 July 2023 to 30 June 2025, the Department will “establish a single aged care assessment system”. The single aged care assessment system to which the Department’s October 2022 discussion paper refers appears to be only in the early stages of development now.
From 1 July 2024 (the date on which the whole Support at Home Program was supposed to start), the Department is going to “run a trial to test products and services for a new assistive technologies loan program”. In other words, the equipment program may or may not have been designed, but it’s certainly not at the point where it can be tested. That point is just over a year away.
Surely, describing these three activities as “further refining the new Support at Home Program” is pushing the envelope a bit.
Budget night was also used to announce that a “new Aged Care Taskforce will be established to review aged care funding arrangements and develop options to make the system fair and equitable for all Australians”.
“The Taskforce”, Health Minister Mark Butler’s media release says, “will also inform the final design of the Support at Home program…”
Budget Paper No. 2 names this taskforce as the Aged Care Sustainability Taskforce and describes its function as providing “advice to Government on the creation and maintenance of a high quality and sustainable aged care system”.
The Taskforce’s main job will be to sort out how aged care (residential and home care) gets funded. To be more specific, the Taskforce is going to sort out client contributions to the cost of the care they receive, which are very different in the HCPP than they are in the CHSP. That’s another thing that needs to be “further refined”, shall we say, or rather: worked out from scratch.
It comes therefore as no surprise that merging the HCPP (250,000 clients) and the entry-level CHSP (more than 800,000 clients) has once again been postponed by one year. It’s now highly likely that the merger will not happen in the current term of government.
Might it be that the Department of Health and Aged Care is just very, very slowly coming round to the view that effectively merging the CHSP into something that very much resembles the current HCPP is not the great idea it was once thought it to be?
The Department was rightly criticised for not providing detail of what it was planning for its long-time-coming Support at Home Program. It now seems that the detail was simply not available even to itself.
It seems that the Department does not know how it is going to squeeze the larger CHSP into the corset of the much smaller HCPP.