In-home aged care update – Webinar

Transcript

Department of Health and Aged Care

In-Home Aged Care Update

Thursday, 5 December 2024

Presented by:

 

Chair:

Erika Barnett
Acting Assistant Secretary, Assessment and Home Care Transition Branch, Department of Health and Aged Care 

 

Speakers:

 Julia Atkinson
Acting Assistant Secretary, Aged Care Assessments Branch, Department of Health and Aged Care

Katherine Koesasi
Director, Assessment Policy, Aged Care Assessments Branch, Department of Health and Aged Care

Rowena Sierant
Director, Assistive Technology and Home Modifications Scheme, Support at Home Reform Branch, Department of Health and Aged Care

Biravena Kumarakuru
Change Manager, Support at Home, Assessment and Home Care Transition Branch, Department of Health and Aged Care

Michelle Smith
Director, Support at Home Change and Transition Projects, Assessment and Home Care Transition branch, Department of Health and Aged Care

Jasmine Snow
Acting Assistant Secretary, Support at Home Reform Branch, Department of Health and Aged Care

 

[Opening visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘In-home aged care update’, ‘December 2024’, ‘agedcareengagement.health.gov.au’, ‘5 December 2024’]

[The visuals during this webinar are of each speaker presenting in turn via video, with reference to the content of a PowerPoint presentation being played on screen]

Erika Barnett:

Good afternoon and thank you for attending today’s webinar. Today we’ll be sharing an update on in-home aged care. 

To get us started I would like to begin by acknowledging the traditional custodians of the lands on which we are virtually meeting today. I’m based in Canberra on the lands of the Ngunnawal people and I recognise any other people or families with connections to the lands of the ACT region. I wish to acknowledge and respect their continuing culture and the contribution they make to the life of this city and region. I’d also like to extend that acknowledgment out to any other Aboriginal or Torres Strait Islander people who may be attending today’s event.

I’m Erika Barnett. I’m the Acting Assistant Secretary of the Assessment and Home Care Transition Branch at the Department of Health and Aged Care. I’m joined today by a few speakers. So Julia Atkinson who’s the Acting Assistant Secretary of the Single Assessment System Branch, Katherine Koesasi who’s a Director in the Single Assessment System Branch, Rowena Sierant, Director of the Assistive Technology and Home Modifications Scheme in the Support at Home Reform Branch, Michelle Smith who’s a Director in the Assessment and Home Care Transition Branch and Biravena Kumarakuru who’s a Support at Home Change Manager in the Assessment and Home Care Transition Branch. Jasmine Snow who’s the Acting Assistant Secretary of the Support at Home Reform Branch will also be joining us as a panellist in the question and answer session later today.

We are recording today’s webinar so it can be shared for those that aren’t able to join us today. It will be available on the Department’s website in the coming days. To access the webinar slides you can scan the QR code or go to the website link listed on the screen.

[Visual of slide with text saying ‘In-home aged care update’, with image of QR code, ‘Scan here for webinar slides’, ‘health.gov.au/resources/webinars/in-home-aged-care-update-webinar’, ‘Please check your audio settings if you cannot hear the presentation’]

There’s no option for attendees to turn on their video or microphone today however you can lodge questions in the Slido box on the right hand side of your screen. We will attempt to respond to as many questions as possible at the end of the webinar today during our question and answer session but any questions outstanding will be answered in a new frequently asked questions resource after the webinar. Questions submitted during the registration process have also been considered for the Q&A session.

We have updates from a few areas across in-home aged care today. So today we’ll be providing an update on the Single Assessment System workforce, the Assistive Technology and Home Modifications Scheme as part of Support at Home and the steps that providers need to take to transition to the Support at Home Program from 1 July 2025.

[Visual of slide with text saying ‘Recent announcements’]

Before I hand over to our speakers I’d just like to briefly address some of the recent Ministerial announcements we’ve had in the past few weeks.

On the 18th of November the Minister for Aged Care, that’s Minister Wells, announced the establishment of the Aged Care Transition Taskforce. The Taskforce is going to be working collaboratively with the Department to guide the aged care sector to transition to the new Aged Care Act which comes into effect on 1 July 2025. They’ll be working to identify and address any implementation issues and provide expert advice to the Minister and the Department during transition.

The Transition Taskforce has oversight of a few key implementation areas that you can read there on the screen and the members on this Taskforce have a range of expertise in relevant aspects of the aged care system including people receiving care, approved providers, people who are in the workforce, regulation, expertise in service delivery, education and training, data and digital components of the system, clinical care and primary care as well. Our first meeting was held last week on the 20th of November and it was very productive and very insightful and we look forward to the next meeting later this month.

A couple of other announcements. On the 19th of November Minister Wells announced that there will be changes to the Support at Home everyday living service caps along with a grant opportunity to assist providers with IT changes. So that’s the proposed caps for cleaning and gardening of 52 hours per year and gardening services of 18 hours per year have been removed. This means there will be no limits on the hours of gardening and cleaning services that eligible participants can receive under the Support at Home Program within their package.

The Department has also committed to developing a grant to help providers with the costs of developing IT systems needed to implement the reforms. Eligible providers will be able to apply for up to $10,000 as a contribution towards their IT costs for making changes to prepare for 1 July.

We’re still currently working through the arrangements for that grant and they’ll be published soon.

All right. So let’s get into our speakers. I’d like to introduce again Julia Atkinson and Katherine Koesasi from the Single Assessment System Branch to give us an update on the Single Assessment System.

Julia Atkinson:

[Visual of slide with text saying ‘Single Assessment System update’, ‘Julia Atkinson, A/g Assistant Secretary, Aged Care Assessments Branch’, ‘Katherine Koesasi, Director, Aged Care Assessments Branch’]

Thanks Erika. I kicked off by not unmuting myself so that bodes well. Hi everyone. Good afternoon. As you’ve heard my name’s Julia. I’m the Acting Assistant Secretary of what used to be called the Aged Care Assessments Branch but is now called the Single Assessment System Branch. And I’m joined by Katherine Koesasi. Katherine is our Policy Director. 

So today we’re going to give you an update on the Single Assessment System. Today we’ll cover a bit of a brief overview on what we mean by the Single Assessment System. We’ll also provide a brief overview of the key changes for older people, assessors and home care providers under this Single Assessment System workforce. And we’ll be giving you a high level overview of the key dates and where you can go for further information.

[Visual of slide with text saying ‘Single Assessment System for aged care’, ‘agedcareengagement.health.gov.au’]

Okay. So a Single Assessment System for aged care. We’re establishing a Single Assessment System to make it easier for older people to enter aged care and to access different services as their needs change over time. The system as a whole has three distinct components. The first is the Integrated Assessment Tool. The Integrated Assessment Tool rolled out on the 1st of July 2024 and it replaced what used to be used which was the National Screening and Assessment Form. The Integrated Assessment Tool is the form, the tool, the set of instruments that the assessors use to guide their assessment of older people and a lot of research was put into improving that resource so that we could have more consistent and accurate assessments for older people.

The second component is the Single Assessment System Workforce. This will be ready to commence services by next week. And from July 2025 we will also be progressively introducing First Nations assessment organisations. These are to provide a bespoke, culturally safe pathway for older Aboriginal and Torres Strait Islander people on top of the pathways available through the broader Single Assessment System.

Okay. So how did we get here? 2021 we had a Royal Commission into Aged Care Quality and Safety inquiring into the quality of aged care services in Australia and whether those services were meeting the needs of the community and how we could improve those services in the future. And the Royal Commission found that in the assessment space what we were seeing was older people being passed between assessors and assessment organisations as their needs changed. And this was resulting in a lot of poor outcomes for older people in that part of the system including really inconsistent assessments in some cases, inefficient delivery of services for assessment organisations who were doing their best but working within an inefficient framework, quite a complex system for older people to navigate and their families, and also a degree of duplication as different assessment organisations trying to help the same person often repeating tasks.

So the Single Assessment System has specifically been established in response to recommendation 28 coming out of the Royal Commission into Aged Care Quality and Safety. And the Royal Commission recommended that we establish this Single Assessment Workforce and that the workforce be empowered in trying to do all of the assessments that are needed across home and residential care.

Okay. So the Single Assessment System will make it easier for older people to access aged care and to adapt their services as their needs change. Key elements of the new system include creating a single pathway for older people through their aged care assessment, supporting older people to not have to repeat their story multiple times, ensuring access to assessments in regional, remote and rural areas. And this is something that the system does now but we want to confirm that we will continue to do that and improve that access over time. We also have a very sharp goal of reducing wait times for access to aged care assessments for older people. And the Government is aware that we have long wait times in some areas particularly for comprehensive assessments for Home Care Packages. So one of our goals in the Single Assessment System is to address that issue.

Okay. So as I mentioned earlier the Integrated Assessment Tool or IAT was introduced in July 2024. It provides the foundation for the Single Assessment System reforms. And the IAT has been developed and designed to help enable changes that will be introduced iteratively or over time and these changes include this switch to a Single Assessment workforce starting from next week. We are also introducing clinical attendance arrangements to support the Single Assessment workforce. And this is about making sure that we’ve got that clinical attendance and clinical oversight when it’s needed but that we’re able to be flexible and responsive in the way that we deliver that clinical oversight and attendance.

We’ve also introduced a new triage delegate role and we’re introducing an IAT algorithm to support consistent outcomes for clients by confirming their assessment pathways and assessment outcomes support and match their needs. So to be clear it’s an algorithm that we’re hoping will support the decision making process that assessors will undertake but assessors will be the key person helping guide that process as the expert and they’ll be required to do that in collaboration with the client, the older person.

[Visual of slide with text saying ‘Single Assessment System workforce’, ‘agedcareengagement.health.gov.au’]

So building on that overview that I’ve just given the next section of the presentation just provides a little bit more detail about the Single Assessment workforce.

So what is it? What is the Single Assessment workforce? So as I said from next week, Monday 9th of December, we will be switching into new contractual arrangements with assessment providers and under those arrangements we’ll be setting up a system in which aged care assessment organisations will be funded to deliver aged care needs assessments and/or residential aged care funding assessments. So aged care needs assessments, organisations delivering these, they will have a mix of both clinical and non-clinical assessment staff. Aged care needs assessments essentially is a new term that we’re using to replace old terminology we used to call ACAT and RAS organisations. Aged care needs assessment organisations will be doing both clinical and non-clinical or as you might otherwise call them home support assessments which result in approvals for Commonwealth Home Support Program and comprehensive assessments and these can result in approvals for Home Care Packages, flexible care aged care programs, residential respite or residential permanent entry. And so that is the new arrangement. There won’t be just one organisation can only do CHSP approvals and nothing else. Under the new arrangement those needs assessment organisations will be doing that whole scope.

Under the new arrangements some assessment organisations will also be conducting residential aged care funding assessments. And for those who are familiar with that system they’ll know those as AN-ACC assessments. So not all assessment organisations will be required to deliver AN‑ACC assessments but some will and some will deliver AN-ACC assessments or aged care funding assessments and needs assessments.

So to get into a little bit more detail on all of that I’m going to welcome Katherine Koesasi to tell us a bit more about what the Single Assessment System workforce is. Over to you Katherine. 

Katherine Koesasi:

Thanks Julia.

Okay. Good afternoon everyone. As mentioned earlier my name’s Katherine Koesasi and I’m one of the Directors in the Single Assessment System Branch. So the Single Assessment System workforce refers to the aged care assessment workforce which from December 2024, so this month, will bring together assessors from the Regional Assessment Service or RAS, Aged Care Assessment Teams or ACATs, and the Australian National Aged Care Classification, so AN‑ACC. State and territory Governments will continue to deliver aged care needs assessments as part of the Single Assessment System and they’ll retain 100% of in-hospital assessments. So the Single Assessment System will replace the Regional Assessment Service, so RAS used for the Commonwealth Home Support Program, Aged Care Assessment Teams, so ACATs which were used for the Home Care Packages Program, the Short Term Restorative Care Program, the Transition Care Program, residential respite and entry into residential aged care, and the Independent Australian National Aged Care Classification, so AN-ACC assessors used for residential aged care funding.

Following an open tender process 17 organisations were awarded contracts to deliver the Single Assessment System. This is in addition to the state and territory Governments who retain a central role. So eight of the organisations will be delivering both aged care needs and residential aged care funding assessments. Seven organisations will be delivering aged care needs assessments only. And two organisations will be delivering residential aged care funding assessments only.

Assessment organisations will be aligned to service areas which are mapped to Aged Care Planning Regions or ACPRs as you can see on the screen. There will be 22 service areas under the Single Assessment System and each service area will map up into an ACPR.

This diagram provides a visual summary of what we’ve spoken about so far today. If we focus on the Single Assessment System flow on the right hand side it highlights the Single Assessment pathway with an older person being assessed by an assessment organisation that conducts both aged care needs assessments and residential aged care funding assessments with the combined workforce of clinical and non-clinical assessors.

When Support at Home begins on 1 July 2025 the Single Assessment System for aged care will already be in place to assess older people for the program.

For this to operate smoothly several key changes are required as part of the Single Assessment System workforce.

For older people there will not be many changes in the introduction of the Single Assessment System workforce. For example assessments will continue to be done in person, at their own home or in hospital if required. There will be no changes to aged care eligibility requirements. There will be no changes to the processes for applying for an assessment with My Aged Care, referrals to urgent services, in-hospital assessments, residential aged care funding assessments or reassessments.

The Single Assessment System is flexible and will adapt to the changing needs of older people without having to change assessment organisations. During assessment older people will be supported by the same assessment organisation even if they identify a change of needs.

There are a couple of points where older people may notice changes however and they include if an older person is having a home support assessment by a non-clinical assessor that assessor can call a clinical assessor by phone or videoconference to discuss questions that require clinical judgment. If a clinical assessor is not available right away they will call back or arrange a follow up assessment to ask the remaining clinical questions. If an older person is having a comprehensive assessment by a clinical assessor they can change to a home support assessment if required.

For the assessment workforce this phase of the Single Assessment System will bring together assessors into one workforce known as the Single Assessment System workforce. There will be a simplification of terminology under the Single Assessment System workforce. For example all references to ACAT, RAS, Assessment Management Organisations or AMO, AN-ACC or RFA organisations will be removed and replaced with assessment organisation. The term aged care assessor will be used to describe individuals who conduct aged care assessments including both aged care needs assessors and residential aged care funding assessors.

Aged care needs assessor is the term that will be used to describe clinical aged care needs assessors and non-clinical aged care needs assessors who are completing aged care needs assessments. Residential aged care or RAC funding assessor is the term that will be used to describe an assessor who is completing a RAC funding assessment using the AN-ACC assessment tool.

For aged care needs assessors clinical attendance will be introduced to support assessors where needed. And assessors will be provided with access to training aligned to their clinical qualifications to support them to successfully transition to the Single Assessment System.

For home care providers some of the changes you might notice include changes to contacts for assessment organisations in some geographical areas. We’ll publish a searchable map shortly which will make it easy for you to see the organisations operating in your area.

We’re introducing clinically qualified staff into triage roles who will undertake a short triage process as soon as possible once they’ve received referrals for an aged care needs assessment. These clinically qualified staff have the experience and expertise to assess and determine the needs of an older person. This will ensure older people with lower needs are not over-assessed and those with complex needs have access to a comprehensive assessment. The process for referrals will remain the same.

[Visual of slide with text saying ‘Key milestones’, ‘agedcareengagement.health.gov.au’]

Okay. In this next section we’ll look at key milestones within the Single Assessment System.

The first key milestone within the Single Assessment System was the release of the new IAT which occurred on the 1st of July this year.

The Single Assessment System workforce will commence services from 9 December 2024. Over the weekend of the 7th and 8th of December 2024 there will be some updates to the My Aged Care Assessor Portal and also to the Aged Care Assessor App to get ready for Monday 9 December. Private organisations will ramp up their clinical assessment capacity from the cutover weekend. And from the 1st of July 2025 we will be progressively introducing new First Nations assessment organisations.

Okay. I’m now handing back to Julia to talk to you about some further information. 

Julia Atkinson:

[Visual of slide with text saying ‘Further information’, ‘agedcareengagement.health.gov.au’]

Thanks Katherine. Okay. So just to wrap up our section on the Single Assessment System for today you can find more information about these reforms by accessing the QR code that’s shown on the slide there. We will be updating our website on Monday the 9th of December and this will include some useful resources including a fact sheet for older people to help them understand what these reforms mean to them. We will also be publishing a refreshed searchable map where you’ll be able to find details of the assessment organisations operating in your area either by browsing around the map or by entering your home address.

[Visual of slide with text saying ‘Where to go for further information’, ‘Visit the Single Assessment System for aged care page on the Department of Health and Aged Care website’, ‘Visit the My Aged Care website to learn more about the assessment process’, image of QR code, ‘Single Assessment System web page’, ‘agedcareengagement.health.gov.au’]

You can also find more useful information on the assessment process on the My Aged Care website. And that concludes this section of the presentation. Thank you very much for listening. And I’ll pass back to Erika.

Erika Barnett:

Thanks Julia. Thanks Katherine. So I can see quite a few questions coming in on Single Assessment already but just a reminder to people to pop those questions into Slido and we’ll look to those at the end of the presentations.

I’d now like to move on to the Support at Home Program and introduce Rowena Sierant who’s going to discuss the Assistive Technology and Home Modifications Scheme. Thanks Rowena.

Rowena Sierant:

[Visual of slide with text saying ‘Assistive Technology and Home Modifications (AT-HM) Scheme’, ‘Rowena Sierant, Director, Support at Home Reform Branch’]

Thank you Erika and good afternoon everyone. My name is Rowena Sierant. I’m one of the Directors in the Support at Home Reform Branch. And today I’ll be sharing with you an update on the Assistive Technology and Home Modification Scheme or AT-HM Scheme as we like to call it. I’ll give you an update on the scheme, the AT-HM list and the AT Loans Scheme and the Loans Scheme Trial that we are currently conducting.

As just a brief overview the AT-HM Scheme is being introduced as an integral part of the broader Support at Home Program. The scheme will provide upfront access to equipment, products and home modifications with separate funding to the ongoing services that will be available under Support at Home. Following an aged care assessment eligible participants will be able to access products, equipment and home modifications without having to save their funds from their budget as they do now under Home Care Packages. These supports will help reduce the risk of falls and other injuries for older people in their homes, enabling them to age in place and delay or avoid entry into residential aged care.

Support at Home providers will manage and deliver the Support at Home participants’ ongoing budget and services as well as their AT-HM Scheme funding. And they can engage a third provider to deliver these services but will remain responsible for the quality and safety of those services in those cases.

Under the AT-HM Scheme there will be three funding tiers for AT funding and a further three funding tiers for home modifications.

A participant will be allocated a low, medium or high funding tier based on their assessed needs through the single assessment process that Julia and Katherine have just spoken about.

If assessed and approved for both the assistive technology and home modifications the amounts are additive. So participants can receive both allocations at the same time.

The assistive technology and home modifications funding will cover prescription where it’s required, the product or equipment that the participant needs and any wraparound services to ensure safe use of these products and equipment in the person’s home. If a participant’s AT‑HM needs change they can seek reassessment of their assistive technology and home modifications funding tier through a support plan review. And there is no limit to how many times this can occur over a 12 month period. The final funding tiers will be confirmed when Support at Home starts from the 1st of July 2025.

An integral part of the AT-HM Scheme is the AT-HM list. And that will outline the products, equipment and home modifications that Support at Home participants can access through the scheme. The list was developed using the Australian Adopted Assistive Product Classification and Terminology Standard and draws from internationally agreed instruments such as the Convention on the Rights of Persons with Disability. The AT-HM list has also been informed by subject matter experts and broader sector consultation over previous months.

You will be able to access the full AT-HM list via the Department’s website shortly. We are hoping that that will be available within the week up on the Department’s website.

The AT-HM list defines what products are available under the scheme and it groups these into categories for products and equipment. The groups will be for assistive technology, managing bodily functions, self-care, mobility, domestic life and communication and information management. And for home modifications there is a section that is specific to home modifications.

This is an example of what one part of the list looks like. Here we have the proposed example from managing bodily functions. As you can see it outlines the items that can be provided under that category as well as providing guidance on whether the item requires some level of advice or prescription.

As I said we’ll be publishing the full list shortly on the Department’s website.

So how does it work? Well all assistive technology and home modifications on the AT-HM list are categorised in terms of the level of skill or qualification that is needed to provide recommendations for the safe and effective use of the product, equipment or home modification. And these supports are broken into three categories.

There will be those that are low risk, and this is for simple and relatively low cost daily living products usually available off the shelf and they don’t need clinical assessment to select the items.

There will be under advice category and this is for assistive products that are generally accessible but would benefit from some level of written or professional advice to ensure that they are selected, installed or used effectively. And then there will be those items in the prescribed category. This is for more complex and often more costly products or combinations of products that are configured, personalised and/or adapted precisely to meet an individual’s support needs and home modifications.

The Department will be providing advice on proposed prescribers who can assist in this part of the process and that will include occupational therapists, physiotherapists, rehabilitation therapists, social workers, nurse practitioners, dieticians and nutritionists, Aboriginal and Torres Strait Islander health practitioner and workers, counsellors and psychotherapists, and sometimes medical practitioners where that is applicable.

Home modifications will be accessible by prescription only.

As part of the AT-HM Scheme a National Assistive Technology Loans Scheme will be delivered and this is really to support a sustainable equipment model and address a lot of the feedback that came through in the Royal Commission.

The AT Loans Scheme is anticipated to commence from July 2025 with a staged rollout across the country. Clients assessed as requiring medium to high cost assistive technology will be able to access these pieces of technology through the Loans Scheme. Home modifications will not be available through the Loans Scheme in the first instance. It is expected that eligible equipment for the Loans Scheme will be defined and identified in the AT-HM list and it is also expected that the scheme will leverage existing state and territory programs to support the provision and setup of suitable loaned equipment as well as repairs and collection of equipment when it is no longer needed. Participants will also be able to swap equipment in and out of the Loans Scheme as required to manage their changing needs over time. And this will be particularly beneficial for older people with progressive conditions.

The AT loans list will include standard medium to high cost risk items that can be re-used. These items will require prescription from appropriate allied health professionals to ensure the appropriateness of the assistive technology and support the older person to live safely in their home. And this slide gives you a representation of some of the pieces of technology that we expect would be available through the AT Loans Scheme.

To help us to understand the design of the AT Loans Scheme the Government has funded a trial.

This trial is currently being run by EnableNSW through their existing aids and equipment program and is underway in two locations. One in Southwest Sydney Aged Care Planning Region and one in the Murray Riverina Region. And these locations were chosen deliberately to test the scheme in an urban location with a diverse population alongside a regional area with a large geographic spread of population. The trial began on the 29th of July this year and will run for approximately 12 months.

The purpose of the loans trial is to test key aspects of the Loans Scheme including the prescription framework and how wraparound services would work, what are the appropriate pathways, in particular do they differ between metropolitan and regional areas, an understanding of the compliance to relevant code of ethics and quality standards and guidelines, and for us to actually understand what the re-use of equipment, warehousing and storage needs would be of the scheme on an ongoing basis.

I will now take you through the prescriber and client eligibility for the AT Loans trial currently underway. As I said the trial sites are in the Riverina Murray area and the Southwest Sydney area. And people must reside in one of those two areas. They must not be permanently living in a residential aged care facility.

Eligible prescribers will include health professionals who prescribe equipment for communication, mobility and self-care. And eligible clients will include those who have been assessed and approved for a Home Care Package or a Short Term Restorative Care Package. CHSP clients are not eligible for this trial.

The metropolitan and regional aged care planning region were selected to help shape the scheme. The list of items available in the trial was reviewed and refined in line with current prescription trends, items that would meet most participants’ needs and items that can be refurbished and loaned. So it doesn’t cover the entire AT-HM list but has been deliberately selected to include those items that lend themselves to being loaned.

We are conducting a formal independent evaluation of the trial and that information will be used to finalise the design of the scheme as we go forward.

That concludes my presentation. Thank you for listening. And I’ll hand you back to Erika.

Erika Barnett:

Thanks Rowena. I can see a lot of home mods questions coming in too and assistive tech so that’s great. Keep popping those in and we’ll get to them at the end. So just going to go into our last presentation for today. So welcoming Michelle Smith and Biravena Kumarakuru from the Assessment and Home Care Transition Branch to present to you some change and transition readiness activities ahead of the Support at Home Program launching on 1 July 2025.

Michelle Smith:

[Visual of slide with text saying ‘Support at Home Change Transition and Readiness’, ‘Michelle Smith, Director, Assessment and Home Care Transition Branch’, ‘Biravena Kumarakuru, Change Manager, Assessment and Home Care Transition Branch’]

Thank you Erika and good afternoon everyone. My name is Michelle Smith, Director in the Assessments and Home Care Transition Branch. I am joined by Biravena Kumarakuru, Change Manager for the Support at Home Program.

Today we will be covering the readiness and transition approach we have taken for Support at Home, transition journey stages for providers in transitioning to Support at Home, what we are doing to get the sector ready for 1 July 2025, tools to support with transition activities and the Support at Home Transition Support Model.

In our September webinar we covered the Support at Home program design.

Key changes for both providers and participants include the new Support at Home service list where providers can only provide services on the service list. Participants’ budget allocation will be changed to quarterly including existing Home Care Package care recipients transitioning to Support at Home. Providers will be required to provide more information when submitting invoices for services delivered. As a result there may need to be changes made to internal processes and systems to capture the relevant information. 10% of a participant’s ongoing budget will be allocated for care management services and allocated to the provider’s pooled care management funds. There will be changes to participant contributions and providers will need to understand these changes. Providers will be required to assess their workforce and skills to ensure care management services are delivered by a care partner who is appropriately trained to deliver care management services.

As Rowena discussed earlier there will be a new AT-HM list that providers will need to review to determine if they will provide AT and/or HM services under the Support at Home Program. Providers will need to have processes in place to deliver these services, for example understanding how to source AT and/or HM supports. There are two new short term pathways. The restorative care pathway and the end of life pathway. Providers will need to decide if they will offer these services and ensure their workforce is ready to deliver these services under the Support at Home Program.

On the screen you will see a snapshot of the current provider landscape which we have assessed with feedback provided by some of you through various channels. We are targeting our readiness and support activities to all providers regardless of size, workforce and other resources available to them.

Some of the key concerns raised with us include providers will face system transition challenges including alignment with the changes to current HCP client financials and future Support at Home participants. We have heard that vendors do not have enough time and resources to meet requirements and that any dual system requirements will pose difficulties for compliance.

Service providers are setting up multiple listings of their services on the My Aged Care website as they have not been provided clear guidance or rules on how to use the system. This is in addition to technical issues with My Aged Care, with providers finding it difficult to receive support on GPMS, MAC and/or Services Australia systems. The cost of IT elements are substantial particularly for standalone, small and/or regional providers. Workforce shortages reduce opportunities for training as workforce needs to be available for face to face service delivery. Training is also costly for providers. Updating organisational processes, ICT systems, staff training and raising awareness among older people will require time, understanding and resources, and the importance of implementing reforms in a clear and cohesive manner.

I would now like to pass to Biravena to discuss what we are doing within the Department and with our delivery partners in response to the feedback and to support sector readiness.

Biravena Kumarakuru:

Thanks Michelle. Hello everyone. I’m Biravena Kumarakuru, Change Manager for the Support at Home Program. Over the past couple of months we’ve been working on the end to end changes for existing providers and clients. From this work we’ve identified the actions providers need to take to be ready for Support at Home and deliver services from 1 July 2025. We have separated these activities into five stages. So the first stage is to learn about the new Support at Home Program. Stage 2 is to prepare for transition. Stage 3 deliver services. Stage 4 receive payments. And Stage 5 facilitate changes in services. Stages 1 and 2 will occur before 1 July in the lead up to the Support at Home Program. Stages 3 and 4 will occur post 1 July and Stage 5 is an ongoing stage.

So with Stage 1, the first stage, it’s learning about the new Support at Home Program. Here providers need to understand the new Support at Home Program and changes they need to make to their business operations. So for example providers need to learn about the new Aged Care Act, Support at Home and worker obligations, their obligations and registration requirements which includes provider registration categories, obligations and conditions of registration, penalties under the new Aged Care Act, obligations for sub-contracted or third party providers and worker obligations, the Support at Home Program’s financial and payment mechanisms such as the new funding model, care management, fund administration, eligibility for supplementary grants, and the Support at Home Program services and requirements including the service list details, the assistive technology and home modification scheme provisions, access and delivery of restorative care pathway funding, access and delivery of end of life pathway funding, the assessment and waitlist process and the interface with other programs such as the Commonwealth Home Support Program.

Providers will also need to understand how Support at Home will impact your organisation’s business model. This includes determining the services that you will offer to participants, determining the workforce requirements including the role of the service delivery staff, workforce training requirements, education needs for the workforce to provide culturally safe, appropriate care and to support staff undertaking end of life care, the obligations under the Quality Standards for those working for providers registered into categories four and five and understanding the Support at Home Program financial and payment mechanisms.

Finally for Stage 1 providers will need to understand their organisation’s readiness for the Support at Home Program.

In preparing for transition here providers need to understand the actions they need to take to prepare and deliver services for Support at Home. So for example providers will need to modify their operations in preparation for Support at Home. This includes communicating with transitioning home care recipients on changes such as their budget, consumer contributions, budget management, care management funding and the availability and obligations of self‑management. Providers will also need to inform Short Term Restorative Care clients of the changes to the restorative care pathway under the Support at Home Program and that they may have access to the AT-HM Scheme. 

They also need to prepare for service delivery for participants, prepare financial and reporting systems, preparing your systems and processes to align with the new Aged Care Act regulatory model and undertaking workforce training and readiness ensuring your workforce has completed training on the Support at Home Program design, restorative care pathway, end of life pathway, the AT-HM Scheme, care management responsibilities, cultural competencies and contribution way of assistance. Providers will also need to ensure relevant care partners and service delivery staff hold relevant health qualifications.

And also preparing your ICT systems and integration such as changes to IT systems in alignment with ICT technical specification to submit itemised invoices to Services Australia and the systems to monitor each participant’s quarterly budget, expenditure to mitigate risks of overspend or running out of funds.

Also in Stage 2 providers will need to register under the correct registration categories to deliver and claim for services. This includes validating registration categories assigned during the deeming process and if required providing additional information.

Stages 3 and 4 as I mentioned occur post 1 July 2025. Once Support at Home has begun Stage 3 is the start to deliver service stage. Here providers are operationally ready and start to deliver services for Support at Home. So for example implementing new care management responsibilities including allocating eligible participants to appropriate care management funds and services, delivering Support at Home services to new, current HCP participants and ensuring compliance with registration conditions and mandatory obligations under the new Aged Care Act.

And Stage 4 is the receiving payments stage where providers have delivered services and are ready to receive payments. So for example generating and issuing monthly statements for participants for services used against their care plan, submitting service claims to Services Australia including care management funds for participants and subsidy claims for AT-HM services.

The final stage is the facilitate changes in service phase. This stage is ongoing and focused on ensuring providers receive notifications when there is a change in a participant's care needs or when they’re no longer needing to provide Support at Home services for a participant. For example the transfer process if a participant was moving to another provider and understanding the processes for exiting the Support at Home Program if needed.

We will be publishing a provider transition readiness checklist which will outline all the actions providers will need to take in each stage of the transition.

We have a series of readiness activities to support you with your transition. I just spoke about the provider transition checklist and we will be publishing this on the Department’s website before the end of the year. We have also developed a transition support model which I will talk to you about shortly. We will have knowledge articles and a program manual for Support at Home which is expected to be released in March 2025. We’re also working with our Department representatives located in each state and territory who will deliver education and support to providers on the ground in their local areas. We will be sending targeted correspondence to existing recipients around March or April to explain what the changes will mean for them. This will include what it means for their funding, participant contribution and services. Training will also be made available for providers. We are working through our approach and developing content and will provide more information in the new year.

Once we transition to the new Support at Home Program we will continue to support you through a dedicated support model to provide support as you start to provide services under the new Support at Home Program. We’ll also update and develop support tools based on feedback we receive and provide additional training based on your feedback.

Some tools to support providers with the transition are already available on the Department’s website including the Support at Home Program Handbook which helps providers understand more about the Support at Home Program design, the Support at Home service list, web content on the Support at Home Program including frequently asked questions, recordings of previous webinars and Q&A sessions and guidance for providers in their communication with older people, families and carers. Other support activities that are currently in development and to be released iteratively include the Support at Home Program Manual which is a detailed operational guide that will outline the policies and processes for the end to end delivery of Support at Home, technical information on the IT systems and specifications including user guides, training modules and resources and other web content and targeted communication.

Our transition support model aims to help providers and participants effectively transition into the Support at Home Program. For providers we are working closely with the Department’s local network to support you with the transition activities. We will provide locally engaged staff in each jurisdiction with the tools to support you and be a feedback mechanism if you have any questions or concerns that you may want to raise. We will have more targeted resources and tools available on the Department’s website. Your feedback on whether you need more information or support resources is valuable to us and we encourage you to provide feedback through your local network representatives or via the email listed on this screen. 

We will be establishing a community of practice in 2025 which will be a channel to discuss transition activities in the lead up to the Support at Home Program going live from 1 July. Once we transition to Support at Home we will use the community of Practice to discuss operational enquiries.

For existing HCP participants we will be sending out letters to their registered addresses with further information that is important for them to know amidst the transition to Support at Home. Services Australia will also send letters about the new contribution rates next year. We will inform providers of the timing of this letter so that you have visibility of all correspondence. We will also have resources available specifically designed for older people, carers and families. We will also support providers by supplying resources to assist with conversations you need to have with your clients. 

Participants can also continue to leverage existing resources such as the aged care peak bodies and the My Aged Care Contact Centre for further support.

In addition to our Support at Home supports there are some existing programs already in place for aged care providers who may be interested in seeking support. The Business and Workforce Advisory Service allows eligible aged care providers to apply for free, independent and confidential advice to improve your operations. We have engaged consulting firm EY to provide this service for eligible residential aged care and home care providers. The services are designed to assist providers to better understand challenges and opportunities affecting resourcing, liability and profitability. Providers will receive these insights through a variety of formats including written reports, verbal advice, interactive workshops and deep dives with boards. You can find out more on the website on the left hand side of the screen.

The Rural, Remote and First Nations Aged Care Service Development Assistance Panel is also available. This service provides free professional support to aged care service providers who are in rural or remote areas or who provide care to a significant number of older First Nations people. Panel members can assist in provider capability and support through one on one assistance to review and build sustainable business and clinical practices, sector development through various training and education programs and resources aimed at building capability within providers in regional and remote areas, capital infrastructure project management through project management support and guidance for capital infrastructure work to ensure compliance and success. Find out more on the website on the right hand side of the screen.

That concludes our presentation. Thank you for listening. I’ll now hand back over to Erika.

Erika Barnett:

[Visual of slide with text saying ‘Next steps’]

Thanks Biravena. Thanks Michelle. So before we get into our Q&A session today I just want to highlight the next steps for the Support at Home Program. So as was mentioned earlier we will be publishing the provider checklist and the AT-HM list shortly. We’re working closely with our colleagues across various areas of aged care reform to best prepare you for the upcoming changes, continuing to engage providers and peak bodies to work out how to deliver the right information to support you and your transition to the new Aged Care Act. Services Australia are due to release their IT specifications before the end of the month and we’ll continue to support older people, families and their carers with the transition through additional Support at Home resources, some targeted webinars in early 2025 as well as face to face sessions across the nation in 2025 focused on the broader aged care reforms. To access the existing resources on the Support at Home Program you can scan the QR code on the right hand side of the screen. 

One other thing I’d also like to draw your attention to is the Aged Care Reforms Sector Pulse Survey which is currently out. So please send us your feedback on the implementation of the reforms and your support throughout the process via the QR code on the screen there as well. That one’s open until Friday the 13th of December.

Okay. So that wraps up our presentation. We’re going to get into a couple of questions and answers now. Bring everyone in.

Just a reminder any questions that get left unanswered today – and there is quite a lot and we did get quite a few before the session – they’ll be addressed in an updated frequently asked questions after the session like we’ve done for previous webinars.

Okay. All right. So I’ll probably just draw on a couple from the Single Assessment System questions to start since that was our first presentation. So Julia there’s a question here just around the number of entities that will be working together as part of the Single Assessment System. It says:

Q:        The Department’s awarded contracts to 17 organisations. Who are the other seven? How does that work with the states basically?

Julia Atkinson:

Yeah. Thanks Erika. And good question. And I think I saw the question flow through and there was a suggestion are they not all participating. All of the states and territories are continuing on in the Single Assessment System. The numbers don’t quite add up because states and territories –we’ve been negotiating one on one, so Government to Government. States and territories were also eligible to participate in the tender and some chose to. One state was successful in increasing their market share through the tender and so they are one of the 17. And I hope that clarifies things. 

Erika Barnett:

That’s great. Thanks Julia. There’s another one here that’s:

Q:        What’s the future of the current ACAT teams? Will some or all of the state and territory ACATs continue in the community or only continue to deliver hospital based assessments?

Julia Atkinson:

Yeah. So another great question. So I suppose to kind of clarify again ACATs are of the past and a wonderful past collaboration that has been but will be moving into the Single Assessment System as aged care assessors. State and territory Governments – as I said we’ve been negotiating with states and territories bilaterally but also in one instance through the tender as well. And states and territories are going to continue to play a central role in the system. They will continue to deliver all hospital based assessments. They will also continue to deliver a large share of community based assessments. So future for ACAT teams I won’t speak to in greater detail because that’s an organisational question really when it comes down to it around how organisations set themselves up. But future of the participation of the states and territories in the assessment system, 100% in hospitals and also an ongoing large role in community based assessments. Yes. 

Erika Barnett:

That’s great. Thanks Julia. Now I’m just going to do one more assessment one. I think this one is important. Not that any questions aren’t important but this one’s important from a client point of view I think.

Q:        What does getting an assessment look like for people needing an assessment in the transition period, ie people currently on the waitlist for a RAS or ACAT assessment? Will they still receive that assessment, and do they retain their spot in the queue?

Julia Atkinson:

Yeah. Fantastic question and definitely can see how that’s front of mind for those who are waiting for an assessment. So can confirm we are well aware of where there are people waiting and waitlists and we’ve got a good handle on that on our systems. There’s a process in place that I will not try to speak to in great detail because I’ll butcher it. We’ve got some very smart technical people working on data transfer. And so what we’re planning to do is as our organisations who are successful through the tendering process get up and running and confirm that they’re ready to roll we’ll be working to do some load balancing around where those waitlists sit in line with where market shares are awarded coming out of the tender and through negotiation with states and territories. So those currently waitlisted referrals won’t be lost. We’ve tracked them on the system and they’ll remain in the system to be assessed in that order. But to make that happen faster at a certain point if there’s still some sitting there ready to go we’ll be splitting that up and having other organisations help participate in moving those people who are waiting through to an assessment.

Erika Barnett:

That’s great. Thanks Julia. Might just move to a couple on home modifications then. So we’ve got one here.

Q:        When a participant has reached their lifetime cap of $15,000 for high tier home modification funding are they still able to access low and medium tier home modifications in subsequent years?

I’ll head to Rowena for that one I think.

Rowena Sierant:

Thanks Erika. So there’s a few questions I think on the funding tiers and how they work. So for the home modifications people can continue to access the low and medium home modification tiers as they need them. The assistive technology funding tiers work in the same way. So people can continue to access and continue to move between a low, medium or high tier if their needs change over time and as they need to. The assistive technology high tier – there was a question just about that which I thought I would just address – has a nominal cap of $15,000 but with evidence people can get more funding in that assistive technology high tier should they need it. So if they do need a specialised motorised wheelchair as the question asked for then they would be able to get that through the assistive technology higher funding tier.

Erika Barnett:

Thank you. There’s also one that seems quite popular I’m just pulling out here.

Q:        How will people be expected to pay the excess on their $15,000 cap? 

So the example given is changing a shower over or a bath arrangement for example can be very expensive especially in rural and remote areas. So how does that get handled in the model?

Rowena Sierant:

Yeah. So there’s a couple of elements to that. One is that we do have additional supplements that are available for people in regional and remote areas for both assistive technology and home modifications to address the issues of being able to actually get both assistive technology and home modifications in those areas. And so that will be available to people in those areas as they need it. We acknowledge that $15,000 will not necessarily cover every home modification that somebody would like to have or needs to have to their home and it’s really about the Commonwealth contribution to the home modification that the home modifications scheme will cover.

Erika Barnett:

Great. Thank you. Another one here about maintenance.

Q:        If an item of equipment requires ongoing or periodic maintenance will AT-HM have an annual budget allocation for those costs?

Rowena Sierant:

So there’s a couple of different ways that we think that maintenance will work. In the loans scheme if you have loaned equipment the loans scheme will cover the repairs and maintenance that you actually need on the loaned item. And that could actually be through taking it back and swapping it out or having those repairs done in the home depending on the repair that is required and the particular situation. For assistive technology that has been purchased you can continue to use your assistive technology funding tier for those repairs as needed and there will also be the capacity for people to access their Support at Home classification level funding to be able to cover repairs and maintenance if they have that available to them.

Erika Barnett:

That’s great. And maybe just one more from here and then we’ll do a few Support at Home ones, so broader Support at Home.

Q:        So who coordinates AT-HM and if so how will the coordination be funded?

Rowena Sierant:

So Support at Home will be rolled out with a single provider model in the first instance. And so it’s the expectation that the participant would work with their registered Support at Home provider to understand what their assistive technology and home modifications need and that it would be the provider that would source any low cost or low risk assistive technology that doesn’t need prescription and that would organise the prescription where that is required.

Erika Barnett:

Thanks Rowena. All right. Let’s get into some broader Support at Home ones. So Jasmine I might go to you for this one. There’s a couple of questions just asking for an update on pricing and costings. Would you be able to let us know where we’re at with that?

Jasmine Snow:

Thanks Erika. We don’t have any further advice on pricing to share with you today however I can confirm that advice on pricing will be provided before the end of the year and more detailed advice by the end of March 2025. So we’ve heard from participant representatives that pricing needs to be provided as soon as possible to support older people to be able to consider their budgets both in terms of the services they want to access and any associated contributions ahead of 1 July 2025. Stakeholders have also flagged potential impacts on investment and viability in the sector if price caps are set inappropriately and the benefits of taking some time to gather live data to make sure caps are appropriate. We’re looking really carefully at the nature of the advice to ensure that arrangements are implementable, support sector stability and viability as well as continuity and availability of services to Support at Home participants from 1 July 2025.

Erika Barnett:

Thanks Jasmine. Okay. So Michelle I think this one will fall into your space.

Q:        Providers are reliant on ICT system operators to update their systems for Support at Home but they haven’t been given information on how Support at Home will work on the ICT side. How will they manage budgets and claims to Services Australia?

Michelle Smith:

Sure. Thanks Erika and thanks for the question. As alluded to earlier by Biravena in the presentation we are anticipating that Services Australia will release technical specifications in iterations from their software developer portal from December 2024. So Services Australia will also update existing guides on the Aged Care Provider Portal early next year with changes to the claiming process. This should provide the information providers need about changing to your claiming processes and what changes you need to make in your internal systems.

Erika Barnett:

Thanks Michelle. So there’s one that’s just popped in as a recent one and I might take this one. So it is:

Q:        Where does the Transition Taskforce as announced by Minister Wells fit in with this process? Can providers contact the Taskforce with concerns or do these need to go through the Department?

So the Taskforce has representation across a number of peak bodies, individual organisations, that kind of thing. So if you’re a member of an organisation, if your representatives are on the Taskforce, you could feed up through them. We’re also running a Support at Home sector reference group regularly where we’ve been going through engagement with the sector. So some people are providing feedback that way but then of course direct feedback to the Department as well. If we haven’t included contact details that people can reach out to in the packs already we can put that in the frequently asked questions and make sure we’ve got that pathway for information to flow in. All feedback is definitely welcome and we will be passing it all up and using that feedback loop continuously to improve the information products we’re developing.

Okay. Let’s have a look for some other ones in the Support at Home space. This one sort of starts off with a bit of a comment. 

Q:        Providers are confident that they understand the steps required however the feedback that we’re getting is really that people need more information, detailed information especially on pricing and the amount of time it will take to be able to be ready. When will providers get the information?

So I think we’ve touched on a few things there already. So pricing we’ve already covered and I think Michelle we covered a lot of this in your presentation but is there anything else you wanted to add?

Michelle Smith:

I think I’d just draw together to say that there is a provider transition checklist that we spoke about earlier that we’ll be releasing before the end of the year which will outline in detail the steps providers will need to take, the timeframes in which it would be appropriate and the supports that the Department will provide to assist providers in that transition space, in addition to the release of the program manual which we’ll be doing in March of next year post the release of specific guides and fact sheets that we will be putting out as well. So there will be a program of release of information starting with the provider checklist shortly. 

Erika Barnett:

Thanks Michelle. Just a recent one that’s popped in. It’s more of a general Support at Home Program question.

Q:        Can providers terminate Support at Home Service Agreements with participants who do not pay their contributions?

And I guess maybe we’ll just look at this from a general point of view on payment of contributions. Jas is there anything you want to comment on there?

Jasmine Snow:

I do know we’re doing some work that will sit obviously in the rules of the new Act to look at things like security of tenure for clients, arrangements for contributions. There’s nothing definitive we can share today but we will make sure that we push that information out as part of our broader suite of information for providers and for older people.

Erika Barnett:

Thank you. This is one for you Rowena.

Q:        Do AT retailers need to register as a Support at Home provider or are you expecting them to link in with the Home Care Package providers or Support at Home providers? 

 Rowena Sierant:

So we’re not expecting AT retailers to take on the job of a Support at Home provider unless they would like to. And if they were a Support at Home provider they would need to actually meet all of the requirements under the regulatory model. So we are expecting that they would actually link in to the provider or the prescribers as they currently do.

Erika Barnett:

Got lots of questions. I’m just trying to bring some to the top. Bouncing around a little bit. Okay. We’ve sort of touched on this a little bit already. It’s just around gap payments.

Q:        Will there be hardship arrangements for AT-HM where clients can’t make the personal contribution for their AT-HM they need?

Rowena Sierant:

So under the Support at Home Program we are looking at hardship arrangements more broadly. So there won’t be a hardship arrangement specifically to the AT-HM Scheme but there will be hardship arrangements more broadly in relation to the Support at Home Program itself. Jas may be able to give some more information on that.

Jasmine Snow:

I’m going to give the exact same answer. We expect it will mirror arrangements that are currently in place supporting the existing Home Care Package client cohort.

Erika Barnett:

Okay. So this one is to do with the care management side of things. It just goes to a popular one.

Q:        Under what circumstances will the Department reconsider the 10% care management cap?

Maybe we can talk about some of the groups that might be able to access extra care management support under the model with that one.

Jasmine Snow:

Yeah. Really happy to do that and kind of provide an avenue for feedback if that’s helpful. So as you’ve alluded to there there will be some additional care management supplements for older Aboriginal and Torres Strait Islander people, people referred by Care Finders, people who are homeless or at risk of homelessness, care leavers and approved veterans. So we’re mirroring essentially the arrangements for the existing veteran supplement for that last cohort. 

In terms of kind of avenues to provide thoughts on that 10% that’s been referenced the rules that sit under the new Aged Care Act – specifically I think it’s Release 2A – consultation is still open and it does close tomorrow. So there’s another avenue there for people to share views on a particular element of the program.

Erika Barnett:

Okay. Thank you. So Michelle this one’s been quite a popular one but I think we’ve covered it a bit in the previous question so happy just to refer to previous answers.

Q:        When will the final structures of the Support at Home Program be issued? There’s a lot of work providers need to complete which cannot be started until they know how the IT systems are being configured.

I think we’ve covered that already but let me know if there’s anything else you wanted to add for that popular question there.

Michelle Smith:

It is a popular question. Thanks Erika. I think the only other thing I would say is to reiterate the release of the program manual and ahead of that fact sheets specifically that are focused on certain elements and that will provide providers with enough information or the information that they require to make the assessments of what they need within their business models. Happy to hear any other feedback or questions come through and happy to respond following this webinar.

Erika Barnett:

That’s great. This is one just from the list.

Q:        So it’s been mentioned there will be information for participants to ease their transition into Support at Home. Will this information be available in multiple languages and if not will we be able to use the translation service for this information?

I think that’s in your space Michelle.

Michelle Smith:

Yes. Thanks Erika. And yes in a word. We’re working with our communications colleagues and subject matter experts in the Department to ensure the communications we put out will have an option for translation and access to interpreters.

Erika Barnett:

Thanks for that. And maybe I will just add as well just having seen a few of the comms in development at the moment we are also working on dedicated products for First Nations clients as well to make sure we’re providing information that’s tailored to the different needs of different groups. So absolutely.

Julia there’s quite a few questions here just generally on wait times and things like that. Did you just want to comment on those generally just to clear up a couple of those? Most of them are around I guess wait times in particular areas and how we might see that improving under Single Assessment.

Julia Atkinson:

Sure. Thanks. Thanks Erika. Yeah I can speak to that. So the Government is aware we’ve got some long wait times in particular areas across the country mostly for ACAT assessments. It’s not everywhere but it is in a few places and in some smaller areas for RAS assessments as well. Under the Single Assessment System part of what we have the opportunity to do here is to have more providers on the ground in every service area. And so in those 22 service areas that we see there will be more than one provider, so at least two, likely in most areas three or four, who will share all of the assessments in that area, so both the home support assessments and the simple non-clinical assessments. And what that will help us do is if we see a provider who’s struggling to keep up with demand for whatever reason – and it could be because demand is peaky, it could be because they’re going through some changes in their workforce, it could be for other reasons as well – we’ve got more than one provider on the ground who may be able to step up and go ‘Okay. We can take a little bit more at the moment’.

And so we are seeing this as a great opportunity to work on that wait time and to bring wait times across the assessment system back in line with community expectations and the service standard which is no more than ten to 40 days in a community setting. So the variation is based on the level of priority or urgency of a person’s assessment. In a community-based setting no one should be waiting more than 40 days for an aged care assessment. We’re aware that in many areas it is longer than that and in some areas it is a lot longer than that. So that is part of what we’re aiming to do and we’ll be working with all of our providers over the coming months to gradually work on those wait times and get them back within the service standard.

Erika Barnett:

Thanks Julia. Now this one’s a multipronged one that’s been sitting there for a little while. So I think the first part is about single assessment and there might be a question that’s a bit more in the Support at Home policy space that relates to CHSP transition. So first part is:

Q:        How will the referrals to CHSP and Support at Home providers work under the Single Assessment model and how will they determine if a client receives entry level CHSP or higher level Support at Home modifications?

And then I’ll read the last bit and we’ll see if we need to come back to it.

Q:        What services will be in and out of scope for CHSP providers after 1 July 2025?

So might start with the assessment side of that first Julia.

Julia Atkinson:

Sorry. Can you give that to me one more time Erika? There was something going on with my - - -

Erika Barnett:

It’s a multipronged one. Yep. Definitely.

Q:        How will referrals to CHSP and Support at Home providers work in the Single Assessment model and how do they determine whether a client gets those entry level services or a Support at Home kind of package?

Julia Atkinson:

Yeah. Okay. So similar to how assessors are today using the IAT. So the IAT, it’s one assessment tool for all types of care. And depending on how the older person answers some of those questions, it may trigger more questions to open up that are indicating a greater level of complexity. So under Support at Home – so Support at Home will be replacing the Home Care Packages Program along with some other smaller programs. So the main change we’d be seeing there is that instead of referring to a Home Care Package the assessor’s referral would be to a Support at Home classification or Commonwealth Home Support Program. The IAT will help them make that decision and there’s a recommendation algorithm. So it might say this person’s probably suitable for this program or this level of service under Support at Home and then the assessor will have to consider that and look at all of the information they have in front of them and the conversation they’ve had with the older person and make a decision of what level of care that person does need.

Erika Barnett:

Okay. And then Jasmine I might go to you for the last part of that question.

Q:        Are there any services excluded for CHSP from 1 July 2025 onwards?

All good if we can’t answer that one and have to take it on notice.

Jasmine Snow:

I think we can kind of point attendees – so there’s a fact sheet we’ve recently put out. So that talks about the proposed changes to CHSP service list to align with Support at Home and it highlights how we’re making changes because we’re trying to align with Support at Home as I said but also because of the introduction of the new Act. So I’d probably suggest people just have a look at that fact sheet. It will give some further information to that point.

Erika Barnett:

Okay. That’s great. We’ll pop that one in the frequently asked questions then and make sure we’ve got a link to that fact sheet. This one’s quite a specific one on the Support at Home Program generally. 

Q:        The Support at Home Handbook indicates that participants will be assigned an interim allocation of 60% of their classification budget if wait times exceed service expectations. Can you provide a bit more detail? Will this apply to grandfathered clients and what are the expected timeframes?

Jasmine Snow:

Thanks Erika. Good question. On the first part if required arrangements will apply to both existing Home Care Package or grandfathered clients as well as new Support at Home clients. And then under Support at Home we are aiming for shorter average wait times from assessment to the point of receiving support with a target of three months from July 2027.

Erika Barnett:

Okay. Thank you. So Michelle and Biravena this might be in your space.

Q:        So what communications will the Department issue to support providers to communicate changes to their clients?

Michelle Smith:

I might hand to you Biravena.

Biravena Kumarakuru:

Thanks Michelle. So what we’re actually looking at doing is developing a video for existing HCP participants to explain to them what it will look like when they do transition to Support at Home. So what it means for them in terms of their package, individual contributions and explain the different scenarios for clients that were approved before the 12th of September, clients that were approved after the 12th of September, and then clients that were approved and waiting to receive a package. So we’re hoping that will address some of the questions that are being asked by existing HCP clients. With that also within the checklist we will also be providing resources to help providers to be able to answer questions to clients depending on the different scenarios. And there’s a section within the checklist that talks to grandparenting and they will provide some additional resources just to help providers have those conversations with their clients.

Erika Barnett:

Okay. Great. Thank you. This one’s more of a general one.

Q:        So when will CHSP participants get better access to providers as it’s often difficult to get providers?

Probably a broader program question I think.

Jasmine Snow:

Sorry. That just cut out on my end Erika.

Erika Barnett:

Sorry Jas. Can everyone hear me now?

Q:        So when will CHSP participants get better access to providers? It’s often very difficult to get providers.

Jasmine Snow:

That sounds a little bit like it might be about the arrangements for CHSP. If it is about whether or not CHSP existing clients can access Support at Home they will be able to if their needs change. It will kind of mirror arrangements in terms of for reassessment that you might see for somebody whose needs increase between the CHSP program and the Home Care Packages Program. If it is about kind of funding to CHSP providers to date we’ll probably need to pick that one up in our FAQs.

Erika Barnett:

Okay. No problem. Michelle I think this one’s in your space.

Q:        So will providers need to itemise the invoice submitted to Services Australia by the service for each client?

Michelle Smith:

I can talk to that at a high level I think and we can provide more information in the FAQs. But it is anticipated that providers will need to provide more information, more detailed information in their invoices to Services Australia. The extent to what that looks like at the moment I can’t provide but we will come back with more information on that.

Erika Barnett:

That’s great. Thank you. Another one for you Julia.

Q:        Will providers need to know the difference between clinical and non-clinical assessments to help with referrals back for review to increase the client’s access for more services?

Julia Atkinson:

So if I understand the question correctly I think what you’re asking is does the provider need to know what type of assessment the person might need. And the answer is no. So if you’ve got a client who you’re not able to kind of provide the level of service that they are needing based on their current approvals the reassessment process would be that they’d go back for reassessment and the assessment organisation would triage them. And the triage process is about a clinically qualified assessor talking to them and having a short conversation asking a set of predetermined questions to determine what level of assessment they do need. So that’s a piece of expertise that sits with our assessment organisations and they’ll be that extra kind of piece of framework in the new system to help guide the assessment organisation to triage that person to the right person within their organisation noting that in this new world all organisations will have both clinical and non-clinical staff on hand.

Erika Barnett:

That’s great. Thank you. There’s been a popular one sitting here for a little while as well which is:

Q:        Which providers have been approved to conduct the Single Assessment System?

I think I’ll just refer them Julia to your part of your presentation where you said you’ll be announcing that shortly and we’re going to have that map available where people can check that out from next week probably.

Julia Atkinson:

Yes. It will either be Monday or we are working with the AusTender team to potentially release it tomorrow. So keep an eye out. Monday at the latest because that’s when we commence but obviously those specificities remain kind of on lockdown until it has been announced officially by Government.

Erika Barnett:

Okay. Great. And then:

Q:        Where will the AT loan pool equipment sit? Is it with hospitals and community health teams or will the loan pool also be accessible for discharge planning?

Rowena Sierant:

I can probably answer that one Erika. So we are actually looking at a national assistive technology loan scheme being put in place and we have been working with our jurisdictional colleagues across the country to see if we can leverage the existing loan programs that they have in place and to augment and expand those programs to cover the older people under Support at Home. They will be able to get access to assistive technology and/or home modifications as they need them if they’ve been assessed as that being a need under the Support at Home process. So if they are a Support at Home participant they will get access to the AT-HM Scheme and they will get that funding upfront at the beginning of their period after their assessment.

It will also cover people who are coming in and out of hospital if they are a Support at Home participant. That’s the other part of the question that I saw. So that will mean that people coming out of hospital will be able to get access to that equipment to assist them to get home as quickly as possible.

Erika Barnett:

Okay. So we’ve only got a couple of minutes left. So there’s one in here Julia around an appeals process for the IAT. I think it’s probably just a more general question about the general assessment process rather than the IAT itself. Is there any information we can point to on that?

Julia Atkinson:

So I’ll speak at a very high level and perhaps if there’s more detail that could be provided Katherine may. But I suppose at the moment with aged care assessments for Home Care Packages and residential care we’ve got a reconsiderations process. So assessments under the Aged Care Act 1997. If you’re not satisfied with the outcome of the assessment in the first instance you should talk to the assessment organisation and see if it can be resolved but if it can’t be resolved there is that process of reconsiderations through the Department that can be considered. From the commencement of the new Aged Care Act that reconsideration process will also apply for assessments for CHSP as it will be coming under the Act. So I think the short answer is yes. There’s a reconsiderations process. It exists today for all Act covered assessments and will be expanded into simple assessments or non-clinical assessments under the IAT in the future. But obviously in the first instance if those disputes or disagreements can be resolved in talking with your assessment organisation that’s usually the fastest way to resolve something. Yeah. But those avenues are there.

Erika Barnett:

So I think we’re approaching time so we’ll probably wrap up there. Like I mentioned before a lot of great questions, a lot of interest. We will make sure we’re going through all of those, capturing all of the details in some frequently asked questions and then of course Biravena and Michelle have taken us through the forward schedule for engagement with the sector and our older people and their supporters into early next year. So we are looking forward to getting that information out to you soon. And want to thank everyone for their interest.

I’ll just see. There’s a slide we can bring up at the end here for more information on Support at Home. So we’ll leave that up for you there if you want to scan that. That’s where you can hop in and see the most up to date information on what’s going on with Support at Home as well as links to any further webinars or published information. Thank you everyone. That brings us to the end of our time together today and thank you again for joining us.

[Closing visual of slide with text saying ‘Thank you’, ‘Visit our website’, image of QR code, ‘health.gov.au/support-at-home’, ‘agedcareengagement.health.gov.au’]

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