Seven ways to tackle Support at Home issues
Concerned the incoming home care program will unintentionally bring trouble for older Australians and their carers, aged care executive Adrian Morgan has compiled a list of suggestions to prevent a negative impact.

In five months, the new Support at Home program will commence, but Adrian Morgan, general manager of Brisbane-based home care provider Flexi Care, told Community Care Review he is concerned unintended but major consequences will arise if moderate changes to the program are not implemented.
Under current program settings, there is no consumer contributions for clinical support, however, participants will pay up to 50 per cent for independence related services, such as showering, getting dressed and taking medications, and up to 80 per cent for every day living related services, such as cleaning, meal preparation and accompanied shopping.
Mr Morgan published seven proposals that he believes can improve the upcoming transition to Support at Home without undermining the program, and in some cases, save the government money.
Mr Morgan’s suggestions, in order of importance, include:
- the reclassification of personal care
- allow people to carry forward 25 per cent of one quarter’s funding in unspent funds to the following quarter
- allow up to 15 per cent of the funding to be available for care management to enable the continuation of quality assistance
- use the Independent Assessment Tool to determine the overall support level (from 1 to 8) but automatically pre-approve individuals with all the common home support services
- reclassify accompanied shopping, currently treated as an everyday living service attracting a contribution of up to 80 per cent, to the same category as social support, which has a 50 per cent maximum
- provide people being supported with palliative care who live longer than four months to continue to receive predictable supplementary funding
- reduce the maximum consumer contributions to 30 per cent for independence services and 50 per cent for everyday living services, at least for the first few years of the program
“The personal care issue, which I’ve got as my first priority, this is very significant,” Mr Morgan told CCR.
“If you’re a self-funded retiree, this is going to start to become very expensive. Although there’s a percentage of people who could afford it – there’s no doubt about that – there’s also a very large cohort of people who are self-funded retirees who are not wealthy, who will struggle with payments, particularly where the services are required many times a week.

“What it would mean in practice is that these people won’t go ahead with the services, and then they run all the risks that are associated with it. So, for example, if they’re not bathing regularly or cleaning regularly, they run the risk of skin integrity issues, urinary tract infections, and both of those can send people to hospital.
“If people try to shower themselves when they really need support, and a lot of people do, they end up falling, there’s another hospital admission. Sometimes those are life-changing events, and they happen.”
Another major problem that Mr Morgan notes is accompanied shopping being treated as an everyday living service.
Mr Morgan told CCR he is concerned people are viewing accompanied shopping as just going to buy groceries, when it is an opportunity for older Australians to go out into the community and make social connections.
“It’s the experience of looking at things outside your house, because a lot of people in the older age group, particularly the older, older age group, [they] don’t get out at all, except for this one outing for the fortnight,” he said.
“I think it’s misunderstood that it’s about getting groceries, because if that’s all it was, I wouldn’t be raising the concern I am.
“The other thing that the accompanied shopping does is for some people it’s exercise, it’s activity, it’s actual movement, moving around the community and doing things, for some people, that’s the only time that this happens.”
Mr Morgan emphasised these proposals are all moderate and would not cost the government extra money, and some proposals, such as two and four, would save money, as there wouldn’t be as many independent forms delaying people. Although moderate, Mr Morgan said that if the proposals were not considered, the existing SaH program could cause serious harm to people needing to access specific services.
Mr Morgan told CCR he is also concerned that even well-informed consumer advocates and representatives don’t seem to have the true story of what is going on with the transition to SaH including in relation to the Commonwealth Home Support Program.
“It’s not straightforward for people in terms of what the impact is going to be,” he said to CCR.
“The one that jumps out at me is some people think that everybody who is getting CHSP services on the 12th of September last year, will be grandparented for the payments. Well, they’re not. The only people who are grandparented are the ones who are already on the home care package waiting list.
“I think there’s going to be an awful lot of very cross people when they realise they’re not covered by the grandparenting arrangements and they’re facing potentially hundreds of dollars a week in payments if they’ve got high needs.”
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