Home Care merger: delayed to the never-never

Article published 1 December 2023

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The two main home care programs were supposed to have merged by July 2023, but it's still not happened and perhaps never will.

THE federal Aged Care Minister has announced that the merger of the two main aged-care-at-home programs is now probably two federal elections away. The merger will happen “no earlier than 1 July 2027”, said the ministerial media release.

In other words, it could be even later.

You get a sneaky feeling that what this really means is that the current Government is not going to worry anymore about merging the two main home care programs.

The two Home Cares

Ever since home care went federal in 2015, the previously state-and-territory-run schemes have continued unchanged. The funding has come directly from Canberra since then. Otherwise, no fundamental change.

This collection of state-and-territory home care schemes is known as the Commonwealth Home Support Program (CHSP). It provides home care to 800,000 people.

But right from the start, the plan was that the CHSP and the federal home care scheme should merge. The federal scheme is called the Home Care Packages Program (HCPP) and provides care to 250,000 people.

The CHSP and the HCPP overlap. Both provide lower levels (cleaning, meals etc) of support to older people to help them remain at home. However, the HCPP provides low-level care to only 113,000 people, which is more than seven times fewer than the people served by the CHSP.

In addition, the HCPP provides clinical and nursing care at home, which is something the CHSP does not do.

Merging the two Home Cares

So, merging the two programs makes sense, or at least merging the overlapping parts of the two programs, makes sense.

The difficulty is that the way the two programs are set up is very different. Chalk-and-cheese different.

The CHSP is in large part community-based. It charges personal contributions where it can, but every provider can do their own thing in this regard. CHSP providers receive a lump sum in Government funding (usually referred to as ‘block-funding’). It’s up to providers to maximise the services they provide with that funding and the personal contributions from care recipients who are able to pay.

The HCPP works with mostly for-profit and large not-for-profit providers, who compete for business. Personal contributions in the HCPP can be quite punishing, especially if a care recipient is on a low income. Funding is per individual care recipient, who (technically at least) determines what their package funding is spent on.

Another complication is that the Department of Health and Aged Care has always insisted the seven-times-larger CHSP (816,000 people on low-level care) should be merged into the HCPP (113,000 people on low-level care). That’s one way of eliminating the overlap, but it makes you wonder.

It also means that CHSP providers, who operate fundamentally differently from HCPP providers, have to change from being community-based organisations to becoming businesses.

It is patently unrealistic and unfair to demand a community-based care provider to become a business operator.

The department has never explained why the currently 1,334 CHSP providers must fundamentally change the way they operate.

Is the merger off?

Now, the Government seems to have come to the conclusion that it would be on a hiding to nothing trying to turn CHSP providers into something they are not and can’t be.

The Government says it is delivering the merger “in two stages”, the first stage being the merger of the small Short-Term Restorative Care Programme into the HCPP.

However, its statement that the CHSP “will transition to the new program no earlier than 1 July 2027” is strictly the promise of a second stage on the never-never.

The new program was initially to start in July 2023 before being postponed to July 2024, then to July 2025. Technically, that last date will be achieved by moving the Short-Term Restorative Care Program into the new program.

However, it’s clear that adding another two years’ delay (to July 2027) for the main programs to merge and doing so a year-and-a-half out from July 2025, when it was supposed to happen, surely can only mean one thing, namely, that it is never going to happen?

It’s a pity that amongst all those announcements of delays and postponements so many CHSP providers have thrown in the towel at the prospect of having to operate in ways they couldn’t.

It’s also a pity for the people they provided care to, who have experienced stress and disruption unnecessarily.

Also read:

Why one home care program works and the other home care program doesn’t


For more information please email our media contact at media@cpsa.org.au

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