In the wake of the Australian Government’s aged care reforms, which took effect on 1 November 2025, the sector finds itself at a crossroads. Two ongoing Senate inquiries, one into the transition from the Commonwealth Home Support Program (CHSP) to the Support at Home Program, and another examining the Support at Home Program itself, have become focal points for widespread discontent.
Submissions to these inquiries reveal a chorus of voices from providers, advocates and experts, underscoring long-standing frustrations that predated the reforms and have only intensified in the three months since their implementation.
At the heart of these concerns lies the submission from the Inspector-General of Aged Care, Natalie Siegel-Brown, whose analysis paints a stark picture of potential risks to the system’s preventative foundations.
Her views, however, resonate with broader sector grievances, from flawed assessment tools to funding shortfalls, illustrating a reform process that many argue has fallen short of its promises.
The Inspector-General’s warning
The Inspector-General’s submission to the inquiry on the CHSP transition stands out as a comprehensive critique, emphasising the program’s role as the government’s key mechanism for enabling older Australians to age in place. Supporting more than 838,000 people in 2024–25 with entry-level services such as domestic assistance and social support, the CHSP accounts for just 8 per cent of total aged care expenditure while serving more than half of all clients.
Siegel-Brown argues this makes CHSP a highly cost-effective tool for preventing escalation to more intensive and expensive care options, including residential facilities or hospitals.
However, the proposed integration of CHSP into the Support at Home Program, slated for no earlier than 1 July 2027, raises serious concerns. The Inspector-General warns that without careful handling, the transition could erode the program’s flexibility and preventative focus. She highlights the risk of shifting to a fee-for-service co-contribution model, which may deter vulnerable individuals from accessing early interventions, particularly in regional and remote areas.
Such outcomes, she argues, contradict the Aged Care Act 2024’s emphasis on upholding rights to independence, autonomy and social connection.
Key recommendations from Siegel-Brown include greater transparency around the evidence base for the transition, including modelling assumptions and unmet demand data by service type and region. She calls for independent analysis of the $15,000 lifetime cap on home modifications, questioning whether lifting the cap could avert costly premature residential admissions.
She also recommends a cost-benefit review of expanding CHSP to offset tertiary care expenses, the removal of the 16-week limit on the Support at Home End-of-Life Pathway to avoid penalising people who outlive initial prognoses, and the retention of block funding for providers operating in thin markets to ensure equity, particularly for First Nations communities.
These warnings echo pre-reform anxieties raised by sector stakeholders, who cautioned that the changes would prioritise cost containment over client needs. Three months on, with assessment waiting lists still hovering around 116,000 as of late 2025, Siegel-Brown’s concerns have only intensified. She warns the transition risks compounding delays and pushing people into higher-cost care prematurely.
From assessments to funding gaps
While the Inspector-General’s submission offers a systemic perspective, other contributions to the inquiries reveal significant operational turmoil. Collectively, they paint a picture of reforms that have not only failed to resolve existing issues, but in some cases have made them worse.
Before November 2025, repeated warnings were raised about the Integrated Assessment Tool (IAT), an algorithm-driven system designed to standardise needs assessments. Providers and assessors criticised its opaque, so-called black box design, where human overrides were prohibited, raising concerns about accuracy and clinical relevance.
Post-reform, these fears appear to have been realised. Submissions and sector commentary describe cases where individuals with clearly high needs, including people living with dementia or severe mobility limitations, have been allocated lower funding levels than expected. Families are reportedly forced into stressful support plan reviews or appeals to rectify decisions.
One provider reported assessment rejection rates jumping from near zero to 38 per cent, attributing the increase to the algorithm’s rigidity. Comparisons to past government failures, including Robodebt, have emerged, alongside renewed calls for clinical oversight and transparency in the tool’s methodology.
Funding arrangements have also drawn widespread criticism. Interim packages released at just 60 per cent of assessed value, intended as a temporary stopgap, have become near-standard practice. This leaves many clients under-supported for weeks or months, particularly those transitioning from CHSP, where service levels are often higher than interim Support at Home funding allows.
Rural and remote providers have warned of viability risks in the absence of adequate regional loadings, raising the prospect of service withdrawal in thin markets.
Co-contributions have added another layer of concern. Full pensioners who were previously subsidised under CHSP are now facing new charges, prompting fears that some will forgo essential services altogether. This undermines the reforms’ stated equity objectives.
End-of-life care has proven especially contentious. Rigid funding caps and time limits are clashing with real-world needs, creating ethical concerns about administrative hurdles imposed during periods of acute vulnerability.
These issues are not isolated. They point to a reform rollout marked by delays, insufficient training and data mismatches between systems. Providers report absorbing unfunded costs related to IT upgrades and workforce changes, with the government’s $10,000 transition grant widely viewed as inadequate.
As one submission to the inquiries observed, the promise that existing clients would be no worse off is increasingly difficult to sustain. Hourly rates are rising, interim funding is falling short, and people with high and complex needs are at growing risk of reduced care.
Rising voices
The growing body of inquiry submissions, including 31 to the CHSP transition inquiry alone, reflects a sector that was vocal before the reforms and is now demanding urgent corrective action.
Pre-November warnings about assessment failures and funding design have evolved into post-reform alarm, driven by tangible impacts such as extended wait times, service disruption and mounting pressure on providers and families.
The Productivity Commission’s recent findings on ballooning waiting lists, alongside the Australian National Audit Office’s forthcoming CHSP review, have intensified calls for accountability.
The Inspector-General’s emphasis on preserving CHSP’s preventative role offers a potential pathway forward, urging the government to ground future changes in evidence and outcomes that support older Australians’ preference to remain at home.
However, as providers such as Flexi Care and advocates across the sector have warned, systemic weaknesses in assessments and funding threaten to destabilise the entire aged care framework.
With Senate hearings commencing on 6 February and final reports due later this year, the submissions serve as a stark reminder that aged care reform must deliver dignity, access and efficiency, not just policy ambition.
Without meaningful course correction, the system risks perpetuating cycles of regret, higher costs and unmet need, far removed from the compassionate, rights-based vision promised under the new Act. For older Australians and their families, the stakes could not be higher.
