Aged care: Sam Rae warns aged care providers they’ve got ‘no excuses’ ahead of new regime kicking off

The Aged Care Minister has issued a blunt warning to providers: there are no excuses not to be ready with a new regime that kicks in this week. After a four-month delay, the biggest change to the sector in a generation begins on Saturday, with many — including Minister Sam Rae — holding their breath for several unknowns. Mr Rae said the “big and sophisticated providers” that make up the majority of the sector “are well and truly ready.” While he acknowledges smaller providers are less confident, he says there should be no excuses now for anyone not to be ready. “If we had pushed ahead with 1 July . . . the providers would have been within their rights to say, ‘We haven’t really been given a good run up here. It’s been a bit rushed’. That’s why we deferred it,” he said. “(Now) they really have no excuses. And to their credit, the vast majority of providers have worked extremely hard and are ready for the first of November. “The stragglers who are looking to blame everyone left, right and centre are kind of on their own.” Under the landmark reforms, people being cared for at home will no longer pay fees simply for having a care package, but will instead pay a co-contribution based on what services they receive. There are no contributions for clinical care in the new Support at Home program. But there are still major concerns about how much those services will cost. Some estimates have suggested $50 to $100 an hour for “personal care” which can include help for basic tasks like showering and personal care. One of the controversial changes has been excluding personal care services, such as showering, from the free clinical care component. Council on the Ageing chief executive Patricia Sparrow said her organisation would continue to push strongly for showering to be included. For people who enter residential aged care after the new system starts, changes to the means assessment will mean about half of new residents pay more. Those who can afford it will now pay a hotelling contribution and contribute some of the costs of their non-clinical care. Providers offering higher quality services can also now charge a new fee for these optional extras. Russell Bricknell, chief executive of WA’s largest non-profit provider Juniper, said some of the changes would hit smaller providers harder and no one would really know until after Saturday the full impact. Ms Sparrow said it would be “a big moment for aged care.” “While no system is perfect from day one, the Act lays a strong foundation for building a system that can deliver quality care,” she said. “From November 1, we are going to closely monitor the impact of the changes to make sure Australians get what they were promised.” Mr Bricknell and Mr Rae both said their biggest worry about the overhaul was the new involvement of Services Australia, adding a further complication into IT systems that no one would be completely sure about until it went live. “That’s probably the biggest area of uncertainty, and we won’t know that for probably about a two-month window, because those payments happen after services are delivered,” Mr Bricknell said. Mr Rae said the top principle that informed his decision to defer the start date was making sure there were no interruptions to people’s continuity of care. “If we create a cash-flow issue for providers, which then flows onto the way they can pay their staff — even if it’s only for a matter of days or weeks — that’s when you start to be at risk of continuity of care issues. So the IT piece is really important,” he said. Mr Bricknell was also going to keep a close eye on how the new co-contribution arrangements for Support at Home influenced people’s choices about what services they wanted to receive. Alzheimer’s WA chair Warren Harding said the shift in focus to more care in the community would put additional responsibilities on providers offering services outside of aged care homes. “Community-based service providers are often smaller not-for-profits who may be in need of additional funding — particularly in rural and remote locations — and this is yet to be addressed,” he said. “Many small providers may have to rely on members’ equity, cash reserves and property assets to fund new levels of clinical care, more transparent care management planning, deeper staff training, (and) investment into new employer value propositions to attract and retain scarce talent.” The other ongoing issue plaguing the system is the lengthy waitlist for home care packages. The Government released an extra 20,000 packages over the past couple of weeks, after being forced by the Senate not to wait until November 1, and has promised 83,000 extra by mid-2026. At the end of September, there were 121,909 people who had been assessed as needing packages and waiting to receive them. A market analysis from KPMG published in June said demand was still outstripping supply across the sector. Mr Rae said every single person assessed as high priority received their care package within a month, but he did want to bring the wait time for medium-priority people down from an average of about 12 months. The Minister said the challenge was not just in allocating funding for packages, but making sure that once people had them they could actually access services, especially in thin markets and regional areas. “There’s always going to be a waitlist, but what I want to do is reduce the amount of time that people are waiting for care,” he said. “I want to get care to as many people as possible, but I want to get it to them in a timely manner as well.” For people remaining at home: For people already in an aged care facility before November 1: For people moving into an aged care facility after November 1: