Support at Home was meant to transform aged care, but its assessment and funding model has left older Australians waiting too long, paying too much and receiving services shaped by budgets rather than need.

After being announced as a ‘once in a generation reform’, the government’s much-vaunted Support at Home (SAH) program went live on 1 November 2025. It aimed to replace the Home Care Package program which had been providing services to assist older people to stay at home since 2013. Eligibility, level of care and service recommendations for that previous program were determined by a clinical assessor as part of an aged care eligibility assessment. The new SAH program landed with a thud and almost no older person has had a good word to say about it ever since.

At the operational and personal level, the teething problem period is now over and the jury is in. In the eyes of older people, their families and most aged care providers, SAH is inefficient, too expensive and is failing to meet the needs of older people. People are waiting too long for assessment and, once assessed and approved, are waiting too long for service. Almost all these problems had been anticipated but were ignored at the design phase.

But SAH is not just flawed at the operational level. The experience of the last six months confirms that it is questionable public policy and based on poor program logic, especially in the design of the assessment and funding allocation system.

Until SAH, aged care assessment and care planning in Australia (and internationally) had the same goal and followed the same process as other health, disability and other human services that are substantially funded by taxpayers. SAH has turned this process on its head.

Best practice needs assessment and care planning processes typically involve three steps:

Assess/identify/diagnose the person’s problems and issues

This step involves a clinician or a specialist assessor or a service provider talking with the older person and assessing them to identify their problems and issues. In health care, the end result is a diagnosis or diagnoses. In aged care, the end result is the identification of functional........

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