Aged care: Guide to self-managing home care

The CHSP often includes things like community transport, cleaning, meal delivery, meal preparation and help with showering.

A care needs assessment is required – by health professionals under the new single assessment service – but there is no financial assessment to determine how much you should pay for your services under the CHSP.

Approved service providers receive different pots of government money for different services. Not every provider can offer more than one service.

What do Commonwealth Home Support Program (CHSP) services cost?

For each type of service, there is a standard (maximum) fee, a part-pensioner discounted fee and a full-pensioner discounted fee.

Self-funded retirees pay the standard fee, which is an amount up to the full cost of the service delivered to the care recipient as determined by the provider.

Examples of discounted fees for part pensioners and pensioners might be $10–15 an hour for a cleaner, someone to take you shopping or to assist with showering.

Depending on the service, the standard fee set by the provider may be close to or more than you would pay if you found someone privately, such as through word of mouth.

Many people could and do remain at home for years, getting highly subsidised support services under the CHSP while paying very little. They might top up the care they need by paying privately for additional services they can’t access efficiently through CHSP.

According to the Department of Health, the average spend by the 800,000 CHSP users is about $2,600 a year. While about half use one of the CHSP service types (domestic, transport, personal care), about 6% use five or more.

Depending on a person’s care needs and the number of services received, they may find themselves dealing with more than one provider.

In some cases, quite a high degree of coordination of services may be involved. There is also the possibility that the provider’s CHSP funding will run out and they are unable to guarantee the same level of service for as long as a person may need it.

What CHSP services are available?

Commonwealth Home Support Program services provided in the community may include:

• Social support – social activities in a community-based group setting
• Transport – help to get out and about for shopping or appointments.

Services provided at home may include:

• Domestic assistance – household jobs like cleaning, clothes washing and ironing
• Personal care – help with bathing or showering, dressing, hair care and going to the toilet
• Home maintenance – minor general repair and care of your house or yard, for example, changing light bulbs or replacing tap washers
• Home modification – minor installation of safety aids such as alarms, ramps and support rails in your home.

Some CHSP services can be provided either at a community centre or in your home. 

These can include:

Food services

If you are finding it difficult to prepare meals, services may include meals at a community centre, help with grocery shopping, preparing and storing food in your home and delivering meals to your home.

Allied health support services

If you have particular health problems, for example, with speech or walking, or need help with ongoing problems resulting from an accident or illness, you may be able to access allied health services. They include:

• Physiotherapy (exercises, mobility, strength and balance)
• Podiatry (foot care)
• Speech pathology
• Occupational therapy (help to recover or maintain your physical ability)
• Advice from a dietitian (healthy eating).

Not surprisingly, demand for some of these highly subsidised care-related services is high. It can make it difficult to get help when you need it.

What happens when your care needs increase?

In time, the services offered by the CHSP may not be enough for your needs. It is generally at this point that a person is assessed for Support at Home.

Support at Home replaces the Home Care Package program, where individuals get a budget of money to cover a range of services depending on their care needs.

A government-approved provider is chosen by you to deliver the services.

Support at Home

Some key differences in the new system:

• There is a new fee structure, based on your financial circumstances and the services you access
• You will continue to be charged by your provider, but only after you have received services
• There are eight levels of care instead of four, to better match your needs, with additional funding for assistive technology and home modifications (where approved)
• Budgets will be allocated quarterly and, if not used, only $1000 a quarter will be carried over.

Like the former government-subsidised Home Care Package, a Support at Home package is a single coordinated package of subsidised services tailored to meet a person’s care needs within a set budget provided by the government.

There are eight levels of ongoing support available.

Estimated budgets are:

Level	Quarterly budget	Annual budget
1	$2,750	$11,000
2	$4,000	$16,000
3	$5,500	$22,000
4	$7,500	$30,000
5	$10,000	$40,000
6	$12,000	$48,000
7	$14,500	$58,000
8	$19,500	$78,000

In addition to the packages, there is separate funding for:

• Assistive technology and home modifications
• Restorative care
• End-of-life care.

Access to Support at Home and any of the additional funding starts with the government aged care gateway, My Aged Care.

My Aged Care will refer you to an assessment organisation, which will arrange a face-to-face meeting to determine eligibility for a Support at Home funding level.

If Support at Home funding is approved and then assigned, you will be asked to choose a government-approved provider to assist with the delivery of approved services.

What does Support at Home cover?

Under Support at Home, services are categorised as:

• Clinical supports: includes nursing and allied health
• Independence: includes personal care and support to access the community
• Everyday living: includes domestic assistance and meal preparation.

Between the categories, there are 14 service types and about 49 services that the government will subsidise.

What will I pay for a Support at Home package?

How much you must pay for a service depends on the service you receive as well as your financial situation.

There will no longer be a daily rate charged, regardless of whether you use a service or not.

Co-contribution amounts vary by service category:

• Clinical supports: no contribution required
• Independence: moderate contributions (5–50%)
• Everyday living: highest contributions (17.5–80%).

An income and assets assessment is still required to determine the contribution you make.

For example, a full pensioner can expect to pay 17.5% towards an everyday living service such as a cleaner, while a fully self-funded person would pay 80% of the service cost.

There is a lifetime cap of $135,000 (indexed) for participant contributions.

Service prices

There is no longer a case management or administration cost, which could previously be as much as 35% of a home care package.

Instead, providers can charge a flat 10% of the Support at Home budget.

How providers are making up for the potential drop in revenue is by increasing the cost of the service they are providing.

Currently, the cost of a service is set by individual providers. However, from 1 July 2026, fixed price caps on services will come into effect. These will place limits on how much providers can charge in total for individual services.

No worse off

If you were receiving a home care package as of 12 September 2024 or you were on the National Priority System awaiting a home care package or assessed as eligible for a home care package, then you will make the same contributions, or lower, than you would have had under the current Home Care Package program arrangements.

Your existing home care package is still operating as it was, with services being delivered.

These transitional arrangements have been put in place to ensure continuity of care.

Self-management of home care

For many, the sure way of saying who comes into your home and at a time that suits you is to handpick someone and negotiate directly how much and when.

The self-management of home care packages and Support at Home packages is slowly gaining momentum. It is something that the disability sector has had for a while now under the National Disability Insurance Scheme.

Anyone allocated a Support at Home package must still sign a service agreement with a provider to access the money. Examples of self-managed providers include Home Made Support, Just Better Care, Let’s Get Care, Plan Care and Trilogy.

Like all support at home providers, there is a maximum package management charge of 10%.

Controversially, self-managed providers are also charging 10% for every invoice they process.

The idea is you find your own workers either through one of the online platforms, such as Mable or Hireup, or other networks, such as friends and neighbours or allied health providers.

Often the rates set by the individuals will be lower than those charged by the full-service providers.

It is up to the approved provider who they will pay on your behalf. It is a government requirement that they have an Australian Business Number, a police check and insurance.

Workers found on the online platforms will have all of these, due to it being a condition of joining the platform. Most workers on the platform will also have references that have been checked.

The fee you pay covers the cost of compliance, financial reconciliations and government reporting.

How does self-management work?

Once you choose a provider, this is what happens:

• The provider prepares a care plan and a care budget based on the approved package
• When you have an expense (such as a new walker) or care worker invoice, you may need to check with them to make sure it will be paid
• You hire the care worker, or cleaner or purchase equipment as needed
• You collect invoices, receipts and supporting documentation if required
• You email (or send) the invoices or receipts to the provider, or you may arrange for your support worker or service to invoice the provider directly
• The provider will assess your month’s claim against allowable costs in your care plan and check available funds
• The provider will reimburse you by transferring money into your bank account or by paying your supplier, as per your instructions
• Payments and reimbursements are limited by the funds available in your client account
• The provider will send you statements explaining payments and reimbursements, their fees, received government subsidies and the running balance of your care funds. Your monthly statement will indicate what funds you have available and, therefore, how much you can claim the following month.

The bottom line

Support at Home is a significant change from the previous Home Care Package arrangement. It remains to be seen whether it achieves the government’s aim of creating quality care that better suits the needs of older Australians.