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The latest data shows people applying for a Home Care Package could be waiting up to 15 months before they receive a package at the level they need.
NSA Chief Executive Officer, Chris Grice, called this situation "appalling" after it emerged an 86-year-old South Australian man had applied under the Voluntary Assisted Dying Scheme to end his own life after experiencing a prolonged wait, in pain, for the care he needed. Independent member for Mayo, Rebekha Sharkie, who brought this situation to light agreed, calling it "shameful".
The wait times for Federal Government's Home Care Packages have been steadily increasing, ringing alarm bells among seniors and their families.
However, the situation is worse, because reported wait times only account for the time from receiving an approval letter to the time a person receives a package. What isn't counted is the time taken between application, assessment and approval.
The average time taken between application and assessment is 22 days. In-hospital, wait times are much lower with assessment generally very prompt because people often present as a higher priority; but in the community, half of the people applying for home care are waiting more than 40 days for an assessment to occur. This does not include the time taken between assessment and approval.
When introducing the new Aged Care Bill to Parliament, Minister for Aged Care, Anika Wells, said the new Support at Home program, which would replace Home Care Packages from 1 July 2025, would reduce wait times. The minister set a wait time target of three months by July 2027.
Doubt has been cast on how strongly the government is committed to a three-month target, with Senator David Pocock saying the target was "good marketing" after it was revealed in a Senate inquiry there was nothing in the Aged Care Bill requiring the target to be met.
Mr Grice said the Bill contained no strict timeframes for the Home Care Package approval process.
"As the Royal Commission heard all those years ago, people were receiving approvals for care long after they were assessed, in some instances they died waiting. Everyone agreed it shouldn't happen but here we are again, having the same conversation, about the same situation."
If sufficient packages are made available, a three-month target should be achievable, because wait times already reached this level in the past. At the end of February 2023, wait times reached a low of one to three months for all four packages, which shows this time frame is possible, even with a backlog of approvals. Unfortunately, since then, wait times have rapidly expanded. (Remember though - this does not include the time taken between application to approval which means actual wait times will be longer than 3 months).
Wait times
For people with a medium priority, the expected wait time for an approved Home Care Package (starting from the date on the letter of approval) is:
- Level 1: 1 - 3 months
- Level 2: 3 - 6 months
- Level 3: 9 - 12 months
- Level 4: 12 - 15 months
*Last revised 30 September 2024
There are four levels of care a person can be assessed for. Added to this, a person can also be assessed as medium or high priority. This impacts greatly on how long a person waits for a package.
According to the Department of Health and Aged Care, the current average wait time across the whole Home Care Package program is five-and-a-half months. For people with the highest priority, the wait is currently less than a month, and an average of nine months for people with 'medium' priority. But this is across the four package levels, which can have a substantial impact on wait times.
The government MyAgedCare website lists the wait time for someone with a medium priority at the end of September 2024 as 1-3 months for a level 1 package, and 12-15 months for a level 4 package. The last time the wait times for level 4 packages were this high was October 2021.
The issue is not only the increasing wait times for packages but also the increasing the number of people waiting.
The number of people waiting for a package at their assessed level reached a low of 28,665 in June 2023. Over the year previous, an additional 40,684 people were given access to a package (10,171 a quarter), increasing the total number of packages held to 277,612. This is where things stall. In the nine months after June 2023, there were only 284,429 people on packages, an increase of only 6,817, or 2,272 a quarter.
Unsurprisingly, the number of people on the wait list started increasing during this time, with the Department of Health and Aged Care telling a Senate inquiry that around 76,000 people were on the wait list at the end of September 2024 (up from the low of 28,665 in June 2023). This includes people who do not yet have a package and those on an interim package which is lower than their assessed need.
Though the total number of Home Care Packages continues to increase, it's at a much slower rate with more and more people applying for support.
While the 273,306 people on packages in March 2024 is a staggering 90,000 more than when the Royal Commission into Aged Care Quality and Safety gave its report in early 2021, it's clearly not enough to meet growing demand.
The Royal Commission recommended the Home Care Package wait list be cleared by immediately increasing the number of packages available and keeping it clear by allocating packages within one month of assessment. However, the then-Coalition government accepted this recommendation only 'in principle', releasing a fixed number of packages and pointing to issues of service availability in some regions and workforce issues.
The Coalition policy has seemingly changed since then, with Shadow Minister for Health and Aged Care, Senator Anne Ruston, telling The Australian that the opposition was focused on ensuring no-one approved for a Home Care Package waited more than 30 days.
Unless the new Act stipulates timeframes for the assessment process, which it currently does not, any promise from either the government or the Opposition about wait times will be hollow, because the assessment process is separate from wait times. A point that National Seniors made clear in its submission to the recent Senate inquiry into the draft Aged Care Act.
Following from the Aged Care Taskforce, the current government is proposing replacing Home Care Packages with Support at Home, which will involve a new classification system, quarterly budgets, a defined service list with capped prices, and contributions based on the types of services received. If these changes pass the Parliament, they are proposed to start from 1 July 2025.
The logic of these changes is that by increasing user pay for some people and for certain services, government will be able to redirect its limited resources to provide a greater number of packages overall, thus reducing wait times. This is to avoid raising taxes or creating a levy, which the Royal Commission recommended, but both sides quickly rejected.
It is unclear yet if the Federal Government will have the support of the Opposition to pass these and the many other changes in the draft Aged Care Act.
