As Australia moves toward major aged care reform, one unexpected trend is emerging:
More older Australians are choosing to return to the Commonwealth Home Support Program (CHSP) rather than transition into the new Support at Home (SaH) program.
This shift has raised concerns among providers, advocates, and policy analysts, especially because the SaH program was designed to simplify and modernise home-based aged care. Instead, confusion — particularly around co-payments — is driving some seniors away from the new system entirely.
This article breaks down why this is happening, what it means for older Australians, and what families should understand as reforms continue to unfold.
A Shift Driven by Confusion: What Providers Are Seeing
During a recent sector workshop, Helen Miller from LiveBetter Community Services highlighted a growing pattern:
Older people who were expected to move into Support at Home are instead opting to stay with, or return to, the CHSP.
Why?
The most common reason is a misunderstanding about Support at Home co-payments.
Many older adults — particularly those on middle incomes — fear that SaH participation will require higher out-of-pocket costs than they can manage. For some, the fear alone is enough to trigger a withdrawal from the SaH program before even beginning services.
This trend indicates that communication about SaH, funding arrangements, and co-payment expectations is not reaching consumers clearly or consistently.
CHSP vs. Support at Home: What’s Driving the Preference?
Helen Miller notes that CHSP was never intended to replace SaH, nor is it designed for people with high or complex needs. Yet seniors are returning to CHSP for several key reasons:
- Misunderstanding About Co-Payments in SaH
The Support at Home program includes means-tested contributions.
For many consumers, this causes:
- Fear of unpredictable costs
- Concerns about affordability
- Worries about long-term financial pressure
- A belief that SaH is “too expensive”
However, Miller emphasises that fully funded pensioners often face similar cost structures in both programs, while concerns are more concentrated among middle-income seniors.
Still, without clear guidance, many consumers make decisions based on assumption rather than accurate information.
- CHSP Feels Familiar and Less Risky
CHSP is well-established, stable, and widely understood by older Australians.
Seniors are more likely to choose:
- The program they already know
- The one their friends or neighbours use
- The one with predictable fees
In times of reform, familiarity feels safer.
- SaH Is Designed for People Who Need Multiple Services
Support at Home is meant for individuals requiring several services or ongoing support.
CHSP, in contrast, is a “entry-level” program.
When consumers who only need one or two lighter supports (e.g., domestic help, gardening, occasional transport) hear about SaH co-payments, they often decide:
“I don’t need that much help — CHSP is enough.”
This results in people staying in lower-level services even when they might benefit from a higher level of support.
- Financial Uncertainty Hits Middle-Income Seniors Hardest
According to Miller:
- Pensioners generally experience minimal difference between CHSP and SaH
- Middle-income seniors feel most financially exposed
- Those with modest assets but not enough for private support face the highest anxiety
This group is at risk of dropping out of the system entirely, which may lead to unmet needs, safety risks, and declining independence.
The Need for Evidence-Based Advocacy
Miller stressed that the industry needs data, not assumptions, to properly understand this trend.
Evidence will be critical in conversations with Ageing Australia, particularly in advocating for:
- Clearer fee explanations
- Transparent co-payment structures
- Better communication to older Australians
- Policy adjustments that prevent people from withdrawing prematurely
Without accurate information, the reform risks unintended consequences — including reduced access to care for the people who need it most.
Why This Trend Matters for Older Australians
The pattern of returning to CHSP has several implications:
- Older adults may miss the level of support they truly need.
Some seniors decline SaH because of financial worries, not because CHSP is a better fit.
This may lead to:
- Increased falls
- Reduced mobility
- Social isolation
- Carer strain
- Earlier entry into residential care
- The reform’s goals could be undermined.
Support at Home was built to:
- Simplify home care
- Improve fairness
- Increase flexibility
- Deliver person-centred services
If consumers hesitate to join, these goals become harder to achieve.
- Families may struggle to understand the best option.
The complexity of comparing program types, eligibility, and fee systems can be overwhelming — especially for older adults navigating the process alone.
- Financial miscommunication may create unnecessary fear.
Many seniors believe SaH will cost far more than CHSP, even though this is often not true.
Better communication could prevent avoidable drop-outs.
What Families Should Do When Choosing Between CHSP and SaH
Here are key steps families can take:
✔ Get clear information early
Avoid making decisions based on assumptions or hearsay.
✔ Compare the programs side by side
Understand differences in:
- Fees
- Service levels
- Flexibility
- Support options
✔ Evaluate the older person’s needs realistically
If only light help is needed, CHSP may be suitable.
If needs are growing, SaH may provide more stability and choice.
✔ Seek guidance before opting out
Leaving the SaH pathway without understanding the consequences may limit future options.
✔ Monitor changes over the coming months
The government continues to refine SaH, and updates may influence which program is best.
The Road Ahead: The Sector Continues to Watch and Learn
As Miller highlighted, this is a developing situation requiring continuous monitoring.
Key questions moving forward include:
- Will clearer communication reduce SaH withdrawals?
- Will middle-income Australians continue to face financial strain?
- Will CHSP capacity remain sustainable as demand rises?
- Will additional reforms be introduced in response to evidence?
Providers, consumers, advocates, and policymakers will all play a role in shaping how the next stage of reform unfolds.
How SSCA Supports Families Through This Transition
Choosing the right aged care program can be overwhelming.
Differences in services, fees, eligibility, and timing make the process stressful — especially during major reforms.
Support Services Connect Australia (SSCA) offers a free care finding service to help individuals and families:
- Understand CHSP, Support at Home, and home care pathways
- Compare providers and service options
- Understand fees and co-payments
- Match needs with the right provider
- Make confident decisions within required timeframes
With over 25 years of experience in the aged care system, SSCA helps families navigate complexity with clarity and confidence.