On 1 July 2025, Australia’s aged care system will lurch into a new era with the Support at Home program, a scheme trumpeted as a lifeline for older Australians to live independently at home.
Yet, this so-called reform, riddled with flaws, threatens to betray the very people it claims to serve. Home care providers like Adrian Morgan, General Manager of Flexi Care Inc., are sounding the alarm, warning that the program’s punitive design could shunt vulnerable seniors into hospitals or residential care, or worse, leave them to languish in neglect.
The government’s deafness to these cries, drowned out by its obsession with cost-cutting, is nothing short of a scandal. Why are ministers plugging their ears while a crisis looms?
A betrayal masquerading as reform
Support at Home replaces the Home Care Packages (HCP) Program and Short-Term Restorative Care Programme, offering eight funding levels from $11,000 to $78,000 annually. It touts early interventions like assistive technology and palliative care, with providers setting prices until government caps kick in during 2026.
Clinical care, such as nursing, is contribution-free, but “Independence” services, like personal care, demand up to 50% co-contribution, and “Everyday Living” services, such as shopping or cleaning, a staggering 80%. These means-tested fees, drawn from the $36.2 billion aged care budget for 2025–26, are poised to crush pensioners and self-funded retirees already scraping by.
Adrian Morgan, a veteran of the aged care sector, is scathing in his critique. “What it’s trying to achieve is to enable older people to live in their own homes for longer,” he says. “But parts of the design will have the exact opposite effect.”
His seven proposals, aired at the Invox home care conference on 29 April 2025, expose a program that risks driving seniors into crisis. From exorbitant contributions to inflexible funding and glacial reassessments, Support at Home is a masterclass in bureaucratic bungling.
A financial stranglehold on the vulnerable
The program’s consumer contributions are a financial guillotine. Pensioners, surviving on less than $30,000 a year, and self-funded retirees teetering near the poverty line face crippling costs. Morgan singles out those reliant on personal care as the hardest hit.
“People new to the system, high users of personal care, and without discretionary income stand to lose the most,” he warns. At $100 per hour, a 50% contribution for multiple weekly sessions could spiral into thousands annually, forcing seniors to skip hygiene support critical to their health.
The consequences are dire. “They could develop infections, rashes, or suffer social stigma from poor hygiene,” Morgan says. Worse, those attempting to shower unaided risk falls, a leading cause of hospitalisations among older Australians.
Accompanied shopping, slapped with an 80% contribution at $95 per hour, is another casualty. For many, it’s their only social and physical outing. “It’s not just groceries; it’s connecting with the community,” Morgan explains. Priced out, seniors face isolation, depression, and declining mobility.
Professor Kathy Eagar, a titan in aged care financing, slams the funding model’s deceit. The $78,000 top package includes consumer contributions, not extra funds. “People could be paying $30,000 or more a year,” she says, predicting a surge in unregulated “black market” care as desperate seniors seek affordable alternatives, risking safety and quality.
A nightmare of inflexibility: A case study in crisis
The program’s rigidity is epitomised by a recent case at Flexi Care. Morgan recounts the story of an elderly woman whose daughter, her primary carer, provided daily personal care.
When the daughter was suddenly hospitalised, the woman’s needs escalated overnight. Under the HCP system, Flexi Care swiftly reallocated funds to provide professional support, averting a crisis. Under Support at Home, this scenario becomes a nightmare.
The program requires reassessments for new services, with wait times stretching six months to a year. “This person would be left vulnerable, unable to look after herself,” Morgan says. Without immediate care, she faces malnutrition, hygiene decline, or falls, potentially leading to hospitalisation, premature residential care, or even death.
The 10% carry-over rule for unspent funds compounds this inflexibility. Morgan advocates for 25%, noting, “Older people’s needs are volatile. A little more room to balance changes would prevent crises.” Without this buffer, urgent needs, like podiatry for sudden foot pain, go unmet, as seniors queue for reassessments.
Care management, capped at 10%, is equally starved. Morgan pushes for 15%, critical for those with cognitive issues or limited English. “In a crisis, hours of care management are needed,” he says, citing the hospitalised carer case. Skimping here risks neglect, as providers can’t monitor or adapt care plans.
Cruel caps and false economies
Support at Home’s handling of palliative care is downright heartless. Funding stops after four months, a policy Morgan brands “cruel.” “Pulling support at the most critical time could devastate families and older people,” he says, imagining someone days from death losing care.
He proposes ongoing funding, as medical timelines are unpredictable. The cap of 5,000 restorative care places per quarter is equally baffling. “Why delay restorative care when evidence shows timely intervention improves outcomes?” Morgan asks. Those beyond the cap face worsening conditions, undermining the program’s reablement rhetoric.
The government’s $18.8 billion savings projection, Eagar argues, is a fantasy. “I don’t believe they’ll achieve these savings,” she says, noting that only 13% of those over 85 have significant superannuation. Morgan agrees, warning that hospitalisations and residential care, far costlier than home support, will erase any savings.
Public hospitals, with 20% of beds already occupied by those awaiting care, brace for worse.
A government tone-deaf to desperation
The government’s refusal to heed warnings is infuriating. “I can’t see evidence they’re listening,” Morgan says, echoing providers like Nick McDonald and experts like Eagar.
The 2023 Aged Care Taskforce, steered by Minister Anika Wells, leaned on Kantar Public’s survey, which showed 9% of respondents understood the changes yet backed co-contributions. This marketing-driven farce, costing $396,000, prioritises spin over substance.
Briefings by the Department of Health have sparked anger among seniors once they grasp the reality, Morgan notes, yet ministers remain fixated on fiscal restraint.
The government’s claim of a “no-worse-off” principle, as Minister Mark Butler previously stumbled to defend on ABC Adelaide, is laughable. When pressed on whether pensioners could face $100 weekly costs, Butler dodged, admitting the system’s complexity.
A Last Chance to Avert Disaster
Morgan’s proposals are a lifeline: reclassify personal care as clinical, cap contributions at 30% for “Independence” and 50% for “Everyday Living” services, pre-approve common services, and extend palliative funding.
These tweaks, he insists, won’t break the budget but will save lives.
Delaying implementation to 2026, clearing assessment waitlists, and engaging providers and consumers directly are non-negotiable. The incoming government, post-election, must ditch the spin doctors and face reality.
Support at Home could be a beacon of hope, but its current form is a betrayal of Australia’s 4.2 million seniors. Morgan’s warning rings clear: “These are curable flaws, but without change, we’re marching towards preventable crises.” The clock is ticking, and the government’s silence is deafening.
