The proposed $15,000 lifetime cap on home modifications under the new Support at Home program has raised concerns among experts in the field. According to Home Modifications Australia (MOD.A), this cap could potentially force older individuals into residential care prematurely, leading to financial stress and an increase in preventable hospitalizations due to falls.
MOD.A, the national peak and industry body representing home modification providers for the aged and people with disabilities, is advocating for a more flexible approach to funding under the Support at Home program. The program, set to launch on July 1, 2025, offers three funding tiers for the new home modifications scheme, as outlined in the Support at Home program handbook.
The funding tiers include a 12-month cap of $500 in the lowest tier, followed by $2,000 in the medium tier, and $15,000 in the high tier. However, access to high-tier home modifications will be limited to $15,000 per lifetime, in addition to any supplementary funds, according to the handbook.
Support at Home aims to enable older individuals to remain in their homes for longer periods, but the proposed $15,000 lifetime cap could significantly impede this objective, noted Steve Pretzel, director of MOD.A. The organization is urging policymakers to reconsider this cap to ensure that older individuals receive the necessary support to age in place safely and comfortably.
“It will have a significant impact on older individuals, potentially forcing them to leave their homes and enter residential care prematurely. This could lead to them disregarding important recommendations to preserve capped funding, out of fear of running out. Additionally, it may create financial strain for many,” stated Mr. Pretzel in an interview with the Australian Ageing Agenda.
Furthermore, Mr. Pretzel highlighted that the cap could also pose risks to caregivers, as they may struggle to provide care in a home that has not been properly adapted. This could result in an increased need for personal care services, as individuals may struggle to perform daily activities independently. Moreover, preventable falls could lead to a rise in hospital admissions.
Following the publication of the handbook, MOD.A conducted an online survey to gauge the potential costs of various complex home modifications. The survey also aimed to gather insights from professionals involved in prescribing and delivering home modifications regarding the potential impacts of such a cap on older Australians.
The survey gathered 60 responses, primarily from occupational therapists who recommend home modifications for providers of home modifications or Home Care Packages. The results revealed that 64% of projects cost less than $2,000, while over 10% (1,800 projects) exceeded $15,000.
Home modification differs significantly
Home modifications can vary greatly depending on the individual’s needs and the layout of their home, according to Mr. Pretzel. Some individuals may only require minor supports, such as grab bars in the shower or a threshold ramp to prevent tripping. Others may need more extensive modifications, like ramps or widened doorways to accommodate wheelchairs or walkers.
Two key themes among those receiving home modifications are a strong desire to remain in their own homes and maintain independence. Many individuals have lived in their homes for years, creating a sense of familiarity and comfort. They value the memories and relationships they have built in their homes.
Furthermore, individuals prioritize the dignity of independence. They prefer modifications that allow them to maintain their independence, such as a level access bathroom that enables them to shower safely on their own. This preference reflects their desire to avoid relying on others for assistance with daily tasks.
Eight suggestions for enhancing policy effectiveness
Despite the current proposal, Mr. Pretzel from MOD.A remains optimistic that a more flexible approach to funding home modifications can be developed before the introduction of Support at Home in July. The organization has put forward eight specific recommendations to address various issues:
- Resolve the tension between capped and needs-based funding.
- Recognize the economic benefits of avoiding health care costs and premature entry into residential care.
- Review the need for and amount of any funding cap for home modifications.
- Develop a more appealing Home Equity Access Scheme.
- Provide access to funding beyond the designated limit for home modifications.
- Eliminate costs for prescription, coordination, and wrap-around services from the funding limit for home modifications.
- Ensure that independent assessors are adequately skilled in identifying indicators for necessary home modifications.
- Ensure that any funding limits are responsive to changing cost factors.
Mr. Pretzel stated, “The program handbook mentions that funding tiers are subject to finalization, and MOD.A is actively engaged in ongoing discussions with the department.”
8 recommendations to improve policy
Despite the current proposal, Mr Preztel said MOD.A was optimistic that between now and the introduction of Support at Home in July a more flexible approach to funding home modifications could be worked out.
The peak has put forward eight specific recommendations:
- Resolve the tension between capped and needs-based funding
- Recognise the economic benefits of avoided health care and premature entry to residential care
- Review the need for and quantum of any home modifications funding cap
- Devise a more palatable Home Equity Access Scheme
- Access to funding beyond the designated home modifications limit
- Remove prescription, coordination and wrap-around services costs from the home modifications funding limit
- Ensure independent assessors are appropriately skilled in identifying home modifications indicators
- Ensure any funding limits are response to changing cost influences.
“The program handbook itself contains reference to the funding tiers being subject to finalisation and MOD.A is engaged in ongoing dialogue with the department,” Mr Pretzel told AAA.