Refer approved people into interim support automatically, not on request
Interim entry-level support exists for people waiting for ongoing care. It is optional and depends on someone thinking to arrange it. Making it automatic on approval saves no time at all, and changes what the waiting is like.
Steps this would change
Rationale
This proposal saves zero days and is on this site anyway, because a database that only values speed would be measuring the wrong thing.
The access process has a median of 347 published days from first contact to first service. About 189 of those are waiting for a funded budget to be assigned. That wait is rationing, not process, and no procedural reform removes it.
What a procedural reform can change is whether the person waits with help or
without it. Entry-level support under the Commonwealth Home Support Programme
exists for precisely this gap. In the process map it is modelled as optional
and marked off the critical path, which is exactly right and exactly the problem:
it does not change when ongoing support starts, and it depends on someone —
an assessor, a family member, a GP — thinking to arrange it.
The proposal is that approval for ongoing support automatically generates a referral to interim support, which the person may decline. The change is to the default, and defaults are the cheapest policy instrument in existence.
The argument for it is not efficiency. It is that the risk during the wait is not evenly distributed across the wait. A person who falls in month four of a twelve month queue does not receive their home care package late; they receive it in a residential facility, permanently, at several times the cost to the Commonwealth and at an enormous cost to them. Interim support is the intervention that changes the probability of that, and it is currently opt-in.
Who acts: the Commonwealth alone, by changing an administrative default.
What is being traded away
It consumes capacity that is also rationed. Entry-level support is not infinite. Automatically referring everyone approved for ongoing care will increase demand on a program that has its own limits, and the effect may simply be to move the queue rather than to serve more people. If interim support becomes congested, people with no prospect of ongoing care — who are its intended clients — wait longer. That is a real transfer and it should be costed before anyone claims this is free.
Opt-out defaults produce services people did not want. Some people approved for ongoing support genuinely do not need anything yet, are managing with family, and would find an automatic referral intrusive rather than helpful. The decline must be easy and must not affect their place in the queue, and older people are reasonably suspicious that refusing an offer will be recorded as not needing help.
It relieves pressure on the thing that actually needs fixing. This is the serious objection. A 347 day wait is politically survivable if the people waiting are receiving something. Making the wait more bearable reduces the urgency of making it shorter, and the department's stated aim of three months by 2027 is the commitment that matters. If this proposal is adopted instead of that, it has done harm. It is offered as something to do during the wait, not as an answer to it.
Precedent
The Commonwealth Home Support Programme already exists, is already funded, and already serves exactly this purpose. The proposal is about the default, not the program.
Sources
- Department of Health, Disability and Ageing, published Support at Home wait time data and stated aim of a three month wait by 2027
- My Aged Care, published guidance on the Commonwealth Home Support Programme