As details of the sweeping aged care reforms emerged in the lead-up to their rollout late last year, alarm bells rang loudly across the sector about the devastating real-world consequences these changes would inflict on older Australians.
Prominent voices, including Professor Kathy Eagar AM and former Inspector General of Aged Care, Ian Yates AM, were among the first to warn publicly and privately that the new Aged Care Act and the planned absorption of the long-standing Commonwealth Home Support Program (CHSP) into the new Support at Home (SAH) program risked creating a more bureaucratic, costly and inaccessible system.
What was sold as simplification and modernisation has instead delivered confusion, longer waiting lists, higher prices for basic services and a clinical, packaged care focus that threatens the very community-based supports older people rely on to age in place with dignity.
Four months on from the reforms’ troubled implementation, a formidable “super group” of industry leaders, academics, advocates, unions and service providers has now banded together in a determined effort to force the government to correct course. The newly formed CHSP Alliance, launched this week with 40 foundation members, represents one of the most powerful coalitions the aged care sector has seen in decades.
From peak bodies such as the Australian Nurses and Midwives Federation, Dementia Australia and the Australian Association of Gerontology, through to major providers like Meals on Wheels Australia, Anglicare, Brotherhood of St Laurence and Carers Australia, and consumer voices including National Seniors Australia, Consumers Health Forum and the Older Persons Advocacy Network, the Alliance is united behind a single, uncompromising demand: keep CHSP as a standalone program and rebuild it as the true primary tier of Australia’s aged care system.
A system under strain
Co-Convenor Paul Sadler, also Chair of Meals on Wheels Australia, pulls no punches when describing the government’s approach.
“Folding CHSP into SAH is poor policy,” he said. “It misses the fundamental design differences between an individual budget funding model such as SAH and a grant-funded model such as CHSP. SAH is so unstable that it is incredibly risky for the 835,000 older people currently using CHSP to be transferred into it anytime soon, and preferably not at all.”
The Alliance’s critique is scathing and evidence based. CHSP has operated successfully for 40 years, first as the Hawke-era Commonwealth-State Home and Community Care (HACC) Program and later transferred to full Commonwealth responsibility in 2015.
It currently funds 1,265 providers operating from 3,652 outlets across every state and territory, delivering 115 million services a year to more than 800,000 older Australians.
These are not high-intensity clinical packages. They are the practical, preventative supports that allow people to remain independent: Meals on Wheels, community transport, home modifications, social connection programs, neighbourhood centre activities, digital literacy support, and assistance for older people experiencing homelessness.
Crucially, CHSP has always relied heavily on not-for-profit organisations and the extraordinary contribution of volunteers.
“CHSP currently leverages substantial support from communities around Australia,” Sadler explained. “For example, there are 35,000 volunteers involved in Meals on Wheels provision embedded in around 590 locations right across the nation. An individual funding model can never achieve that, as by definition the individual is placed as more important than the community.”
The case for a three-tier model
Yet the new Aged Care Act and the SAH rollout appear determined to ignore this reality. The government’s preference for an individualised, consumer-directed funding model has already produced measurable harm.
Meals under SAH are 40 per cent more expensive than under CHSP, according to evidence presented to a Senate inquiry. Navigation through My Aged Care has become even more labyrinthine, assessment queues have lengthened, and the preventative focus that kept many older people out of higher cost care has been diluted.
Regional, remote and culturally and linguistically diverse communities, groups that CHSP has historically served better than any other part of the system, are particularly at risk.
The Alliance’s vision is both simple and ambitious: restructure aged care into three clear tiers, mirroring the highly successful model of the Australian health system. Residential aged care remains the tertiary tier. SAH becomes the secondary tier, equivalent to specialist medical care or district hospitals. CHSP is formally recognised and properly funded as the primary tier, the local, affordable, no-wrong-door entry point equivalent to visiting a GP.
“Primary care is first point of contact. It is accessible. It is affordable with no financial barriers,” the Alliance’s position paper states. “It offers comprehensive services including prevention, early intervention and continuity of care. It builds long-term relationships and refers to and coordinates with secondary and tertiary care as required.”
For the vast majority of older Australians, those needing six hours or less of support per week, CHSP providers should be able to register clients directly with My Aged Care without forcing them through a full aged care assessment. GPs would be empowered to socially prescribe entry-level services, bypassing bureaucratic queues entirely.
Evidence the system already works
This is not merely aspirational. The Alliance has four clear secondary goals to accompany its primary demand that CHSP remain separate: formal recognition of CHSP’s secondary tier role for those who need it, genuine consumer choice between CHSP and SAH for secondary-level support, far better integration with primary health care including GP social prescribing, and a new funding model that properly separates fixed and variable costs so providers can plan and deliver sustainable services.
“Reform of CHSP is essential,” Sadler said. “This includes implementing a new funding model to replace block funding and allowing GPs to socially prescribe entry-level aged care, thus avoiding the aged care assessment queue. We know SAH is a much more expensive way to manage people’s care than CHSP. On balance, the Alliance believes that redeveloping CHSP into a robust primary tier of the aged care system makes good policy and economic sense.”
The numbers are compelling. CHSP has the lowest level of complaints of any part of the aged care system. It delivers superior access in regional and remote areas compared with SAH or residential care.
It provides the best mainstream access for First Nations people and funds many highly valued culturally and linguistically diverse services in communities around Australia. It also excels at leveraging volunteer and community support, something no individualised funding model can replicate.
A critical moment for reform
Despite these proven strengths, the government has so far shown little willingness to change direction. The original decision to merge the programs was locked in during a budget process, and ministers have told the Alliance privately that any reversal must follow the same path.
In the May 2026 federal budget, the Alliance is seeking three urgent wins: rescind the decision to merge CHSP and SAH, announce a formal co-design process with the Alliance and the wider sector to revamp CHSP as the primary tier, and expand funding for CHSP services, particularly in regions and service types with extensive waiting lists.
The message to government is blunt and uncompromising.
“CHSP is cheaper for government, cheaper for older people and more effective than SAH,” Sadler said. “Putting all this at risk to fulfil a bureaucrat’s fantasy of a merged home care program would be, to put it mildly, misplaced.”
The calibre of the Alliance’s foundation members underscores how seriously the sector is taking this fight. Alongside co-convenors Professor Kathy Eagar AM and Paul Sadler are heavyweights including Professor Michael Fine, Professor Diane Gibson, Professor Sue Kurrle AO, Mr Adrian Morgan, Mr Mark Sewell, Ms Robyn Vote and Ian Yates AM.
Organisational members span unions, geriatricians, allied health professionals, local government, ethnic communities councils, Aboriginal and Torres Strait Islander ageing bodies, and major consumer and advocacy groups.
This breadth reflects a growing consensus that the current reforms are not just flawed in detail but fundamentally misguided in philosophy. The government’s insistence on forcing community care into a one size fits all individualised model ignores four decades of evidence that grant funded, community embedded programs deliver better outcomes at lower cost. It also disregards the lived experience of older Australians who value local, relationship based support over complex consumer directed packages.
The CHSP Alliance is not asking for the status quo. It is calling for genuine reform, reform that builds on CHSP’s strengths, modernises its funding and governance, integrates it properly with primary health care, and positions it as the foundation stone of an integrated aged care system fit for the next 20 years and beyond. The Alliance stands ready to work constructively with government on co-design.
The question now facing Canberra is whether it will listen to this unprecedented coalition of experts or continue down a path that prioritises bureaucratic neatness over what actually works for older Australians and Australian taxpayers.
With the May budget fast approaching, the clock is ticking. The CHSP Alliance has delivered a clear, evidence based roadmap. Ignoring it would not only be poor policy, it would be a profound failure of responsibility to the nation’s seniors.
