Chapter 1Introduction
1.1The Aged Care Act 2024 (new Aged Care Act) is central to the government's response to the findings of the Royal Commission into Aged Care Quality and Safety (Aged Care Royal Commission). Ensuring high quality aged care services are delivered in a timely manner, and which meet the changing needs of care recipients in their home, is key to the success of this once-in-a-generation reform.
1.2The issue of endless wait times for aged care assessments and service delivery is not new. Waiting for care has devastating consequences for older people. The longer people go without the supports they need, the higher the risk of hospitalisation and earlier entry into residential care. With the implementation of the new Aged Care Act and the Australian Government’s commitment that by July 2027 no one will wait more than 90 days for a package, there is an urgent need to fully understand and address the causes of delays. Care cannot wait. We need to make the overall system more efficient, whilst ensuring the highest quality of care is delivered to all older Australians who need support.
1.3At the time of the referral of the inquiry, the Australian Government’s decision to postpone the release of 83,000 new Home Care Packages (HCPs) until 1 November 2025, had become a growing cause of concern. Calls for an immediate release of new packages had been made by many stakeholders including parliamentarians, service providers, advocacy groups and families.
1.4It is in this context that the committee commenced this inquiry into aged care service delivery. During the inquiry, the committee primarily focused on understanding the magnitude, causes and impacts of the wait times for HCPs. More broadly, the committee also explored the feasibility and adequacy of the systems put in place to deliver the aged care reforms on time, and to achieve the promised reduction in wait times for home care packages to three months by July 2027.
1.5Toward the end of the inquiry, on 3 September 2025, after the passage in the Senate of amendments to the Aged Care and Other Legislation Amendment Bill 2025, the Australian Government committed to immediately releasing 20,000 HCPs. There is no doubt that evidence received during the inquiry had an impact on the decision to release the 20,000 packages.
1.6This report presents the key findings of the committee and makes a series of recommendations aimed at ensuring the implementation of the reforms is timely, effective, monitored, and periodically reviewed.
Referral and terms of reference
1.7On 28 July 2025, the Senate referred the following matter for inquiry and report by 15 September 2025:
The implications for older Australians, their families, carers, service providers and state and territory health systems of the Government’s decision to delay the commencement of the new Support at Home program until 1 November 2025 while also withholding the release of any additional Home Care Packages, with particular reference to:
(a)the impact of the delay on older Australians waiting for support at home, including unmet care needs and the wellbeing of seniors and their carers;
(b)the capacity of the Commonwealth Home Support Programme to meet increased demand for support at home prior to 1 November 2025;
(c)the impacts on aged care service providers, including on their workforce;
(d)the impacts on hospitals and state and territory health systems;
(e)the feasibility of achieving the Government’s target to reduce waiting times for Home Care Packages to 3 months by 1 July 2027, in light of the delay;
(f)the adequacy of the governance, assurance and accountability frameworks supporting the digital transformation projects required to deliver the aged care reforms on time;
(g)the implementation of the single assessment system and its readiness to support people to access a timely assessment now and beyond 1 November 2025; and
(h)any other related matters.
1.8On 11 September 2025, the Senate granted an extension of time to report until 1 October 2025.
Conduct of the inquiry
1.9In accordance with its usual practice, the committee advertised the inquiry on its website and wrote to relevant individuals and organisations inviting submissions. The date for receipt of submissions was 22 August 2025. The committee received 149 submissions, which are listed at Appendix 1.
1.10The committee held one public hearing on 29 August 2025 in Canberra. The witnesses who participated are listed at Appendix 2.
Acknowledgement
1.11The committee would like to thank the organisations and individuals who provided evidence to the inquiry.
1.12In particular, the committee would like to acknowledge the individuals who shared their lived experiences. These personal testimonies have been vital in deepening the committee’s understanding of the impacts of the Support at Home program deferral and the withholding of the release of additional HCPs and have helped inform the recommendations of this report which aim to improve outcomes for older Australians and their loved ones.
Structure of the report
1.13This report comprises 9 chapters as follows:
Chapter 1 contains an introduction to the inquiry, and an overview of the current Commonwealth programs which provide support for older people to live independently at home; and an overview of updated government commitments and reports.
Chapter 2 examines evidence received in relation to the negative impacts of delays in older Australians being able to access appropriate care at home services.
Chapter 3 outlines the evidence received regarding the Single Assessment System.
Chapter 4 examines the operation of the Commonwealth Home Support Programme.
Chapter 5 explores the workforce capacity and readiness of the aged care sector to deliver the transformation of at-home care service provision from 1 November 2025. It also examines the digital readiness of the Australian Government and service providers.
Chapter 6 explores the proposed co-payment model of the Support at Home Program, and the financial implications for older Australians.
Chapter 7 examines the evidence received in relation to the additional care needs of older Australians with a disability or chronic or complex health condition. It also examines the operation and limitations of the End-of-Life Pathway.
Chapter 8 explores foundational concerns submitters raised in relation to whether the new Aged Care Act will deliver rights-based aged care.
Chapter 9 provides the committee’s concluding comments and recommendations.
Commonwealth programs as at October 2025
1.14Eligible older Australians can access home support services through Commonwealth funded programs. These include:
the Commonwealth Home Support Programme (CHSP) which is designed for those who need a low level of support to keep living independently, and who only need one or two services; and
Home Care Packages (HCP) Program for those with greater or more complex care needs, particularly when support is required on an ongoing basis.
Commonwealth Home Support Programme
1.15As noted above the CHSP is an entry-level in-home aged care support program that helps older people to live independently in their homes and communities. It also provides respite services to enable carers to take breaks.
1.16The CHSP replaces four previous programs: the Commonwealth Home and Community Care (HACC) program; planned respite from the National Respite for Carers (NRCP) program; the Day Therapy Centres (DTC) program; and the Assistance with Care and Housing for the Aged (ACHA) program.
1.17The CHSP is available across the country and funds a large variety of service providers to deliver care and services to clients. Trained assessors determine what each person requires through face-to-face assessments in the home. There are currently more than 1200 CHSP providers in Australia, including government, non-government and not-for-profit organisations.
1.18CHSP providers receive government funding through grant agreements, and then provide subsidised services to clients.
1.19Clients pay a contribution or fee if they are able to do so, but are not expected to cover the full cost of such services. Providers are expected to have publicly available client contribution policies that outline how fees are determined.
1.20Clients unable to contribute to the cost of services are not denied access to services, and providers are expected to have arrangements for such clients.
Home Care Packages Program
1.21For older Australians requiring greater assistance or more complex care to remain living at home, the HCP Program is available. HCPs provide a coordinated mix of care and services that can include help with household tasks, aids and equipment, minor home modifications, personal care, and clinical care.
Funding
1.22HCPs are jointly funded by the Australian Government and the care recipient. The funding structure includes a government subsidy paid to an aged care provider based on the package level, and contributions made by the care recipient. These contributions are as follows:
Basic daily fees of up to $13.14 (from 20 March 2025) may be requested by providers, based on a care recipient’s HCP level.
Income tested fees of up to $37.70 (from 20 March 2025) may be required to be paid by some care recipients. Services Australia is responsible for formally assessing whether care recipients are required to pay this fee, and the amount to be paid. There are annual and lifetime limits on the amount to be paid by care recipients.
Additional fees may also be required to be paid by care recipients for extra services and care that isn’t otherwise covered by their HCPs.[10]
1.23There are four levels of HCPs and each package level receives a different subsidy rate. The package levels are outlined below.
Table 1.1Home Care Packages funding
Package level | Level of care needs |
Level 1 | Basic care needs – $10,931.75 per year |
Level 2 | Low care needs – $19,224.55 per year |
Level 3 | Intermediate care needs – $41,847.25 per year |
Level 4 | High care needs – $63,440.65 per year |
Source: My Aged Care, https://www.myagedcare.gov.au/help-at-home/home-care-packages, (accessed 11 August 2025)
Uptake
1.24The Department of Health, Disability and Ageing (the Department) reported that 299, 765 people had access to an HCP at 31 March 2025. Of those people, 289,481 were in an HCP while the remaining were assigned an HCP but considering whether to take up their offers.
1.25In the March 2025 quarter, there were 39,983 approvals for an HCP, and 18, 557 people entered an HCP for the first time.
1.26There were 35, 613 HCPs released in the March 2025 quarter, an average of 2,739 per week.
1.27The Department also noted that at 31 March 2025, 87,597 people were waiting in the NPS for an HCP at their approved level.
1.28The Department heard that at 31 March 2025, there were 28,527 people in the National Priority System (NPS) waiting for their approved package with an approval date of on or before 12 September 2024.
1.29As at 31 March 2025, there are 922 approved HCP providers with home care services.
Waiting periods
1.30Following assessment and determination by an aged care assessor as to which HCP level a care recipient is entitled to, eligible care recipients are placed on the NPS to wait for an HCP to be assigned to them.
1.31At the time of drafting this report, the Australian Government reported that people assessed as having an urgent need for care, and approved as a high priority, are being assigned their approved level HCP within a month. For those with a medium priority, and an approval date in June 2025, the estimated wait time for assignment for an HCP is between 9 to 12 months for all package levels.
1.32The Australian Government also reported that for those who had been assigned an HCP at their approved level in June 2025, the average wait times have been as follows:
Table 1.2Estimated wait times for Home Care Packages
| | | |
Level 1 | <1 month | 10 months | 4 months |
Level 2 | <1 month | 10 months | 9 months |
Level 3 | <1 month | 11 months | 8 months |
Level 4 | <1 month | 11 months | 6 months |
All Levels | <1 month | 10 months | 7 months |
Source: My Aged Care, https://www.myagedcare.gov.au/help-at-home/home-care-packages, (accessed 11 August 2025)
Aged Care Act 2024
1.33In November 2024, the Australian Parliament passed the Aged Care Act 2024 (Aged Care Act, new Aged Care Act) which replaced the Aged Care Act 1997, the Aged Care (Transitional Provisions) Act 1997 and the Aged Care Quality and Safety Commission Act 2018.
1.34The Aged Care Act was passed with a commencement of 1 July 2025 unless otherwise proclaimed. In June 2025 the Australian Government recommended that the Governor-General, Her Excellency the Honourable Sam Mostyn AC proclaim commencement of the new Aged Care Act to be 1 November 2025.
1.35The Department stated that the deferral of commencement was ‘in response to sector feedback for more time to prepare systems, train staff, and support older people through transition’.
Support at Home Program
1.36Under the new Aged Care Act the HCP Program and the Short-Term Restorative Care Programme will be replaced by the Support at Home (SAH) Program. The CHSP will also join the SAH Program no later than 1 July 2027, but the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) will remain as a separate, specialised program.
1.37The Department stated that the SAH Program will ‘introduce new classification levels, an increased focus on early intervention, and offer higher levels of care for people with complex needs’.
1.38The Department noted that:
From 1 November 2025, it is forecast that over 1,000 providers and 306,000 older people will transition to the new program. By 2035, the Support at Home program is expected to support around 1.4 million people.
Overview
1.39SAH services will be jointly funded by the Australian Government and the individual receiving care. There will be three service categories:
Clinical Care – The government will cover 100 per cent of costs;
Independence Supports – Recipients will contribute 5–50 per cent of costs; and
Everyday Living – Recipients will contribute 17.5–80 per cent of costs.
1.40The SAH Program will have eight classifications for ongoing services and four classifications for transitioned HCP recipients. Each classification will have a quarterly budget for participants to access government-funded services based on their assessed needs.
1.41Each participant will have a single service provider. The provider will be responsible for delivering direct care services or arranging a third party to do so. They will also provide care management, which ensures participants receive care that aligns with their preferences and needs. Participants may have the option to self-manage aspects of their care.
1.42Part pensioners and Commonwealth Seniors Health Card holders will pay between 5–50 per cent of their independence services based on an assessment of their income and assets, and between 17.5–80 per cent for everyday living services based on an assessment of their income and assets.
No-worse-off principle and co-contributions
1.43A no-worse-off principle will apply to people who were either receiving an HCP, in the NPS or assessed as eligible for an HCP on or before 12 September 2024. This will ensure that these participants make the same contributions or lower, than they would have under HCP arrangements. These participants will also receive the same package level under SAH, including any unspent funds.
Classifications and budgets
1.44As noted above, the SAH Program will have eight new classifications for ongoing services and four classifications for people transitioning from the HCP Program. Each classification will have a specific budget for participants to access services.
1.45A new participant’s classification and budget will be determined at assessment based on their needs.
1.46Annual ongoing SAH budgets will be broken into quarterly budgets. Participants can carry over unspent funds of up to $1,000 or 10 per cent of the quarterly budget, whichever is greater.
1.47The quarterly budgets for each new classification are outlined below.
Table 1.3Budgets per classification
| | |
1 | $2,674.18 | $10,697.72 |
2 | $3,995.42 | $15,981.68 |
3 | $5,479.94 | $21,919.77 |
4 | $7,386.33 | $29,545.33 |
5 | $9,883.76 | $39,535.04 |
6 | $11,989.35 | $47,957.41 |
7 | $14,530.53 | $58,122.13 |
8 | $19,427.25 | $77,709.00 |
Source: Department of Health, Disability and Ageing, https://www.health.gov.au/our-work/support-at-home/support-at-home-ongoing-services
1.48Existing HCP recipients and those waiting on the NPS will be allocated a budget that aligns with their current HCP (or the level they have been approved for and are waiting to access). The indicative budget amounts for HCP recipients transitioning to SAH are:
Table 1.4Budgets for transitioned Home Care Package recipients
| | |
1 | $2,708 | $10,833 |
2 | $4,762 | $19,049 |
3 | $10,365 | $41,460 |
4 | $15,713 | $62,853 |
Source: Department of Health, Disability and Ageing, https://www.health.gov.au/our-work/support-at-home/support-at-home-ongoing-services
1.49HCP recipients will retain their unspent funds when they transition to the SAH Program, for use in their SAH quarterly budget.
Service providers and care management
1.50As noted above, from 1 November 2025, each participant will have a single SAH provider. This provider will be responsible for:
ensuring the care recipient receives services that meet their needs within their quarterly budget;
delivering care management to each participant; and
arranging and sourcing required assistive technology and/or home modifications through the Assistive Technology and Home Modifications (AT-HM) scheme.
1.51Staff members delivering care management activities will be known as ‘care partners’ and they will:
plan and coordinate services;
check with care recipients to ensure they feel well supported;
develop, review and evaluate care recipients’ care plans and quarterly budgets;
arrange clinical advice and support to address any changes in care needs or issues that may arise; and
provide support and education where needed.
Pricing arrangements
1.52Initially, SAH providers will set their own prices for services. From 1 July 2026, government-set price caps will apply. Prices must include the entire cost of delivering a service (e.g. administrative costs, staff travel and third-party charges).
1.53The Independent Health and Aged Care Pricing Authority (IHACPA) will provide pricing advice for the SAH service list to the Minister for Health, Disability and Ageing, who will then set the price for the services.
Funding
1.54Noting the fluctuating nature of care management needs, funding will be combined with other participants into a pool that the service provider can use. Ten per cent of each participant's quarterly budget will be set aside for care management delivered by their service provider.
1.55Providers will be required to deliver a care management activity at least once a month to each participant. Providers will have:
discretion to allocate a care partner to each participant; and
flexibility to help participants more when they need extra support.
1.56Providers will also receive additional funds for any participants who:
have been referred by a care finder;
are older Aboriginal and Torres Strait Islander people;
are homeless or at risk of homelessness;
are a care leaver; or
are a veteran with a mental health condition that the Department of Veterans’ Affairs (DVA) accepts is related to their service.
Short term pathways
1.57As part of the SAH Program, there will be three short-term pathway programs. These are outlined below.
1.58The Restorative Care Pathway will replace the Short-Term Restorative Care Programme. It will give participants access to intensive allied health and nursing care for up to 16 weeks. The pathway is designed to assist recipients in regaining independence and preventing the need for higher levels of ongoing care. An assessment will determine access to the Restorative Care Pathway. Those approved for the Restorative Care Pathway will be provided with $6,000 to support access to intensive allied health/nursing services to improve and regain function to help them remain independent for longer. Participants already accessing ongoing services may also be eligible to access the Restorative Care Pathway.
1.59The AT-HM scheme will give participants funding to access a defined list of assistive technology and home modifications, without needing to save up funds from their ongoing services budget. The three funding tiers for assistive technology include Low (under $500), Medium (up to $2,000) and High (up to $15,000 though participants may access assistive technology that exceeds this amount with a prescribed need). The funding will cover the item as well as prescription from suitably qualified health professionals, when required, with wrap-around supports to ensure the items are used safely and effectively.
1.60AT-HM funding tiers for home modifications are Low (under $500), Medium (up to $2,000) and High (up to $15,000).
1.61The End-of-Life Pathway will give participants with three months or less to live access to more funding for in-home aged care services for 12 weeks. This aims to help older people remain at home if that is their preference. A total of $25,000 will be available per eligible participant over a 12 week period, with a total of 16 weeks to use the funds to provide additional flexibility.
Government commitments
1.62In November 2024, following the passage of the Aged Care Act, the then Minister for Aged Care, the Hon Anika Wells MP announced that:
The bill passing now means the Albanese Government can deliver 107,000 homecare packages in the next two years, a record number, the largest ever homecare package release ever. Support at Home will create 83,000 additional packages in the 2025-2026 year, building on our existing announcement of an additional 24,000 packages in the 24-25 year.
1.63However, in July 2025, the Minister for Aged Care the Hon Sam Rae MP was quoted in The Australian as saying that the deferral of the commencement of the Aged Care Act has consequences for funding for the SAH Program. MrRae stated:
We recognise that the deferral of the Act has implications for those who are receiving or eligible to receive home care, and that the consequence of deferral is that new funding for Support at Home packages will commence rolling out at a later time.
Release of packages
1.64On 3 September 2025, during the Committee of the Whole debate of the Aged Care and Other Legislation Amendment Bill 2025, Senator David Pocock moved requests for amendments on sheet 3413 to provide for the release of 20,000 additional home care packages in accordance with the Commonwealth aged care system.
1.65The request was put and passed and all Government senators, by leave, recorded their votes for the noes.
1.66Also on 3 September 2025, the Minister for Health, Disability and Ageing the Hon Mark Butler MP and the Minister for Aged Care and Seniors the Hon Sam Rae MP announced that the Australian Government would immediately release 20,000 Home Care Packages. Further, the Australian Government committed to releasing 20,000 SAH packages between 1November 2025 and the end of the year, with the remaining (of the previously announced 83,000) packages being released in the first half of 2026.
New government commitments and reporting data
1.67During the course of this inquiry, the Australian Government provided updated data regarding the NPS wait list that was different to the information contained in the Department’s submission or made available during the public hearing. Both figures are referred to in this report.
Updated waitlist data
1.68On 3 September 2025, Senator the Hon Jenny McAllister, during debate on the Aged Care and other Legislation Amendment Bill 2025 and the Aged Care (Accommodation Payment Security) Levy Amendment Bill 2025, confirmed that at 31 July 2025 there were 108,924 people on the NPS waiting for an HCP. Senator McAllister provided the caveat that ‘usual quality assurance checks’ have not yet been applied to this number.
1.69On 4September 2025, in response to an Order for the Production of Documents, the Minister for Aged Care and Seniors wrote:
At 31 July 2025, there were 108,924 people waiting for a home care package at their approved level. This data has been sourced from the Aged Care Data Warehouse and may not reflect final figures once additional quality assurance checks are made prior to publication.
1.70On 4 September 2025, the Department also provided additional answers to questions taken on notice at the committee’s hearing on 29 August 2025, which contained this updated figure.
Inspector-General of Aged Care Progress Report
1.71On 4 September 2025, the Inspector-General of Aged Care tabled the 2025 Progress Report into the Implementation of the Recommendations of the Royal Commission into Aged Care Quality and Safety (Progress Report).
1.72The Progress Report found that while ‘there is no doubt that one of the greatest and most impressive reforms has indeed been achieved – namely the preparation and passage of the Aged Care Act 2024’, ‘a number of actions that would have seeded transformational change have not yet been delivered’.
1.73The Progress Report noted that the Aged Care Royal Commission recommended the government create ‘an entitlement to aged care’ but that the Australian Government has chosen not to accept this recommendation. As a result, the new Aged Care Act:
…retains a rationed system: the new Support at Home program will eventually aim to achieve average waiting periods of 3 months. This is not the model of timely access to care that the Commissioners called for.
1.74The Progress Report also noted the introduction of co-payments for non-clinical services and stated that:
…co-payments are contrary to the Royal Commission’s intent. While the Inspector-General understands the reality of the budget constraints, she holds genuine fears that the manner of implementing co-payments may set up a scenario where vulnerable older Australians will forego care: either because they cannot afford it or because they are worried about the cost. This will be a keen area of monitoring for the Inspector-General going forward.
1.75The Progress Report lists a number of ‘reform actions requiring ongoing monitoring, and potentially intervention, to guard against poor outcomes for all older Australians’. Some of these issues have also been raised in evidence by submitters and witnesses, and will be explored further in this report. These issues are as follows:
rights-based, person-centred care;
the introduction of co-payments;
equity and access for Aboriginal and Torres Strait Islander elders and communities;
parity of support for disability when moving from the National Disability Insurance Scheme to aged care services; and
workforce quality, sustainability and detractions from care.