About the pathway
The Restorative Care Pathway is a short-term pathway in the Support at Home program.
An episode focuses on intensive allied health and/or nursing services, aimed at maintaining or regaining function and reduce or prevent further decline.
Participants must identify goals according to their assessed needs and will receive services to help reach them.
Funding
Each episode of restorative care provides a unit of funding of around $6,000 for up to 16 weeks of intensive services. This is separate to any ongoing Support at Home funding. For eligible participants, an additional unit of funding may be approved – providing up to $12,000 to use during an episode.
Participants can access 2 non-consecutive restorative care episodes ($6,000 each), with minimum 3 months between each episode.
Eligibility
An aged care assessment determines if an older person needs short term, targeted support through the Restorative Care Pathway.
They may be eligible if:
- they will be able to continue living at home without ongoing Support at Home services, or with no change to their ongoing services
- the pathway will likely address an issue that will improve from intensive, short term clinical interventions through a multidisciplinary team of allied health and/or nursing professionals
- the participant is motivated and willing to set goals and actively participate in interventions to increase independence.
A person cannot access the pathway if they are:
- receiving or are eligible for the End-of-Life Pathway
- have received 2 units of funding in the last 12 months
- receiving or are eligible to receive transition care
- receiving permanent residential aged care.
Transitioned STRC clients
Participants who transitioned from the Short-Term Restorative Care (STRC) Programme, will continue to receive care from their provider. You need to ensure services align with the Support at Home service list and AT-HM list.
Older people who have an active STRC approval and have not started an STRC episode before 1 November 2025, can use this approval for the Restorative Care Pathway. However, this only remains valid for 6 months from the date of the original STRC approval. After 6 months, they will need a reassessment to access the pathway.
Learn more about transitioning from STRC to the Restorative Care Pathway.
Goal plan
Creating a goal plan is a critical part of the Restorative Care Pathway.
A restorative care partner in your organisation must:
- work with the participant and their multidisciplinary team to identify goals that can be achieved within a maximum of 16 weeks
- detail the goals and services in their goal plan.
The goal plan replaces the care plan but still includes the same elements.
What services you can deliver
Restorative Care Pathway participants can access services approved in their aged care assessment or Support Plan Review, in line with the Support at Home service list.
Participants may be approved for assistive technology and home modifications funding (except for high tier home modifications).
For more information about Support at Home services.
Multidisciplinary team
A group of health professionals known as a multidisciplinary team delivers care during a restorative care episode. A restorative care partner will help coordinate the multidisciplinary team and services to be delivered.
Multidisciplinary teams are different for each participant, depending on their assessed needs and goals. For example, it could include physiotherapy, occupational therapy, and an exercise physiologist.
Medical professionals (like doctors or specialists) can be beneficial but are not a requirement. Participants will need to claim any required medical services through relevant government programs (such as Medicare) and pay any out-of-pocket expenses.
The multidisciplinary team should communicate or meet regularly to discuss progress, risks, or any changes to goals.
Restorative care management
A restorative care partner must deliver care management activities for each Restorative Care Pathway participant.
Their role is similar to a care partner in ongoing Support at Home services. However, they have extra responsibilities including:
- planning and reviewing goal plans
- applying a multidisciplinary approach to identify and select services
- coordinating assistive technology and home modifications
- reviewing outcomes, coordinating or completing assessments within their scope of practice
- completing and submitting exit plans.
Restorative care partners must:
- have the appropriate skills and knowledge for clinical coordination and oversight for short intensive periods of care
- be able to support complex goal planning and conduct evaluations if necessary.
Unlike ongoing services, you claim care management against a participant’s Restorative Care Pathway funding account. There is no cap on what can be claimed for restorative care management. Care management amounts should be agreed between the provider and participant, and proportionate and in the participant’s best interests.
You must agree on an individualised budget with the participant.
Participant contributions
Participants must contribute to the cost of their independence and everyday living services. Their contribution level is based on an income and assets assessment.
Clinical supports, like nursing or physiotherapy, are fully funded by the government. You cannot ask participants to contribute to these services.
Find out more about participant contributions.
Taking leave
There are no options to temporarily stop services in this pathway. Regardless of personal circumstances, an episode is limited to 16 consecutive weeks.
Exiting the pathway
The restorative care partner should begin exit planning at the start of a restorative care episode. This helps them and the participant review their goals and plan extra supports if needed.
Exit plans are based on the goal plan, which are developed in collaboration with the participant.
An exit plan should also:
- outline episode start and end dates
- describe goals and if they were achieved
- describe any services received
- describe any AT-HM items or services received during the episode
- contain any recommendations from the multidisciplinary team and details about the participant’s functional requirements.
If the multidisciplinary team or restorative care partner thinks a participant may need ongoing Support at Home services, or needs a higher level of support, they should document this. They can also request a Support Plan Review for the participant.
You must provide participants a copy of their goal plan and their exit plan for their records. These plans can be used as supporting evidence in future aged care assessments.
Find out more
Read:
- Chapter 14 (Restorative Care Pathway) of the Support at Home program manual
- Restorative Care Pathway Clinical Guidelines
- Restorative Care Pathway fact sheet for participants
- Guide to Restorative Care Pathway booklet – My Aged Care.