Overview of the New Program

The new Support at Home program is due to commence in November 2025. One of the significant changes is the introduction of a co-contribution requirement for clients entering the program. The Department has defined which services will require contributions, and the percentage rates that apply.

Contribution Rates and Service Types

Co-contribution rates will vary depending on:

• Whether the person is a full or part pensioner, or a self-funded retiree
• The type of service being accessed:
• Clinical – No contribution required
• Independence – Minimum 5% for full pensioners; increases for part pensioners and self-funded retirees
• Everyday Living – Minimum 17.5% for full pensioners; increases for part pensioners and self-funded retirees
  

Assessment and Care Planning

Each person’s individual care needs will be assessed by an independent body. Based on this, a provider will develop a care plan, which may include a mix of service types.

Based on the developed care plan, the provider will need to work out the various charges for each of these services. However, working out the co-contribution will not be an easy process to begin with as the person receiving the services needs to be assessed as to the level of co-contribution they will be required to pay.

Role of Services Australia (Centrelink)

The assessment process mirrors that of those wishing to access residential aged care:

• Clients must submit income and asset information to Services Australia (Centrelink)
• Centrelink will determine the required co-contribution levels across service types
• Both the client and the provider will receive a letter detailing the outcome
  

Claiming Payments and Package Deductions

When a provider submits claims via the PRODA system, the cost of services is deducted from the client's package, but the provider will only be paid minus the client’s co-contribution.

Key Considerations for Providers

So, what are the key elements a provider should consider when signing up a new client under the new co-contribution system?

Again, this process is similar to that in place for years for those entering residential aged care. In the case where someone contacts a provider and wishes them to deliver services they have been assessed for, it is suggested that the following steps be taken:

• Request a copy of the Centrelink co-contribution assessment
• If not yet completed, clients may optionally share asset/income info for an initial estimate
• An estimate tool is available via My Aged Care, but should be used cautiously as outcomes can differ significantly from Centrelink's final assessment.
• Ideally, wait for the official Centrelink letter before entering into any agreement.s
• Providers can begin services without the assessment, but this poses a financial ri.sk
  

Discussing Affordability and Setting Up Payments

Once the assessment has been received and the co-contribution is known, the next phase of the process needs to be completed. That is, the amount of co-contribution needs to be worked out in dollars per week/fortnight/month.

A conversation needs to be had with the prospective client about the affordability of this and whether they have the means to pay. If the answer is yes and the amount is affordable, then the following will need to be set up.

• Some form of direct debit or payment system is set up for the amounts to be paid.
• An agreement on whether this will be paid weekly, fortnightly or monthly.

If a direct debit system is not set up, the provider must rely directly on the person making payments. This carries a risk of debts accumulating over time and the possibility of bad debts.

Options for Clients Unable to Pay

If the person cannot afford the co-contribution (and this is likely to occur where a full pensioner is renting, approximately 20% of those on full pensions), then two courses of action are possible.

• The client can apply for hardship provisions to Services Australia (Centrelink), and if successful, their co-contributions will be nil or reduced.
• The provider may forgo some or all of the co-contributions.

This is a business decision to be made by the provider. However, caution should be exercised when applying for hardship with Centrelink. It is rare that they provide them, and in my experience, they take a long time to make a decision.

Therefore, how a provider should proceed when making this decision is part of how the business operates.

A Cultural and Operational Shift

The new Support At Home co-contribution system has home care providers entering a new way of signing up, engaging and dealing with new clients. Will the system be easy to navigate and operate? I think it won’t be easy for both the providers and clients, as this is a significant change to how the culture of home care has operated in the past. There will be many issues arising from the change, including:

• The period to sign up and commence services will be much more extended.
• The ability of clients to pay their contributions will be tested, and there will be times when those who have been making regular payments will not be able to do so due to other financial pressures and issues that arise.
• In some cases, clients will defer or cancel services because they are not willing to pay the co-contribution. This will have a two-fold effect: providers will lose money, and clients will go without services.

In the end, we can see how the new system pans out, and hopefully, those in control will make adjustments to overcome any problems encountered.