Increase user contributions at home: task force

Older Australians receiving care at home will be required to pay more for services such as house cleaning and gardening under a proposal handed to government by a key aged care taskforce.

Older Australians receiving care at home will be required to pay more for services such as house cleaning, laundry and gardening under a proposal from a key aged-care taskforce.

As part of a major report into the sustainability of the aged-care system, the government’s task force recommends Labor increase user contributions for home-care services to reduce demand and provide more equitable access.

The taskforce, chaired by Aged Care Minister Anika Wells, has advised the commonwealth to overhaul the way it funds home-care services, with pressure on the sector forecast to grow.

About two million elderly people are expected to need home-care services by 2042, compared to about one million currently, according to the report, with the figures projected to grow annually by 44,000 over the next 20 years.

Under the current system, taxpayers fund the majority of the more than $4.4bn spent each year on home packages, which are split into two main categories.

The first, called commonwealth home support programs, gives older people access to entry-level support such as cleaning and gardening services, while home-care packages cover a more intense level of care.

Users of the home-care packages pay a flat, means-tested fee, regardless of how many services they use.

With older Australians likely to stay in their homes for longer, the taskforce recommended the government introduce co-contributions in a bid to reduce pressure on the home-care system.

“While government would continue to be the major funder for aged care, the taskforce believes greater participant co-contributions would enable home care to expand in an equitable way, provide greater access to ­better-quality and flexible services for participants, and support the expansion of a skilled workforce,” the report states.

Ms Wells said the aged-care system was “under stress” and there was “universal acceptance that something must change in order to ensure all Australians can age with the dignity, safety and high-quality care they deserve”.

Under the proposed model, user co-contributions would be highest for services such as general cleaning and gardening, while they would be lower for essential caring duties such as nursing assistance and allied health.

While the home-care sector is more viable than residential care, the taskforce said it faced emerging financial challenges, with just 69 per cent of home providers reporting a profit in 2021-22 – 10 per cent below the previous year.

Advocating for higher user contributions, the taskforce said older Australians were wealthier than previous generations, largely due to this cohort amassing assets including home equity, superannuation accounts and pensions.

At the same time, the taxpayer base is declining as a portion of the overall population.

The report found the current system was not aligned to actual need, with access to services “constrained and inconsistent” and a lack of clarity around what was ­actually available.

It noted the current system for home care was leaving significant amounts of funds unspent, totalling $2.3bn as of June 2022.

“This undermines the predictability and sustainability of funding and can cause confusion when comparing packages with other participants,” the report states.