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Billions of dollars unspent in home care, experts talk reform

Billions of dollars in unspent funds and workforce constraints are the largest gaps plaguing the government's new home care system, an expert panel has heard.

Aged care advocates and researchers gathered at the third Macquarie Aged Care Policy Forum to dissect the funding model of the Support at Home program, which is currently under design for mid 2023.

Estimates from aged care accounting specialists showed that $1.6 billion dollars of taxpayer funds have gone unspent in Home Care Packages (HSP).

According to StewartBrown lead partner Stewart Hutcheon, this is due to a lack of alignment between the way that care is funded and people’s specific needs.  

“Having millions sitting in balance sheets is wasting money that should be used for delivering services,” said Hutcheon.

“The government has implemented a program to reduce these unspent funds, but it’s going to take some time to reduce that number.”

On average, there are around ten thousand dollars in underutilised funds per home care recipient, which raises significant issues for providers, according to Hutcheon.

“One of the concerns is that some of these unspent funds are sitting on balance sheets as a liability."

“This is directly impacting their profitability and their suitability.

“I hope for the sector that with current reviews, changing policies and new systems, that everyone can get a system that will work and is going to be beneficial to all of the stakeholders in the sector.”

As one of the most significant reforms brought on by the royal commission, the Support at Home program will overhaul how home care packages are delivered and funded.

The unified program will replace the existing Commonwealth Home Support Program (CHSP) and the Home Care Package (HSP) program.

With major reform underway, the new plan must work for the growing number of older Australians locked out of home ownership, according to community housing coordinator Rob Lake.

“Twenty percent of people over 65 rent, and probably 10 per cent of them are in public and social housing, so being able to navigate and maintain support in your home is critical,” he said.

“A program established for Home Care perhaps ought, as a starting point, to consider the meaning of home, ditch assumptions about home ownership and find flexibility to work better with housing providers, older women and men.”

There are currently 204,000 people accessing home care packages as of September 2021, with some 800,000 home care packages to be released in the system in the next few years.

“As home care evolves, we are increasingly seeing the importance of it as a program,” said Lake.

“This has got a lot of potential and for a lot of people it will work well, but it’s not the only answer.”

A recent landmark report from the Older Person's advocacy network brought up similar issues in the current home care system.

According to the paper, long wait times for packages and workforce shortages were among the most common problems reported by older people during 2020-21.

The federal government has made home care the first pillar of reform in its five year plan to transform the aged care system.

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