Senate Community Affairs Legislation Committee, , 2:57:21 to 3:14:54
Department officials are questioned on the existence and dates of cost-benefit analyses for the Support at Home transition.
Topics: Social services, Government spending
Speakers: Penny Allman-Payne, Sonja Stewart, Greg Pugh, Julia Atkinson, Hon Anne Ruston, Dorinda Cox
Um I'm now going to welcome representatives from the Department of Health, Disability, and Aging. Uh thank you very much for appearing before the committee today. Um as there is limited seating it looks like you already know this, but I'm going to read it anyway. Um I ask officials to treat this session like an estimates hearing, where you only come to the table when relevant lines of questioning are underway. Uh the Senate has resolved that an officer of a department of the Commonwealth or of a state shall not be asked to give opinions on matters of policy, and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution does not preclude questions asking for explanations of policies or factual questions about when and how policies were adopted. Commonwealth officers appearing today are also reminded of the Senate order specifying the process by which a claim of public interest immunity should be raised and a copy of the order is available from the secretariat. Uh for those of you that are at the table, for the Hansard record, could you please state your full names and the capacity in which you appear today?
Sonya Stewart, Deputy Secretary of the Aged Care Group.
Uh hi, uh Greg Pew, First Assistant Secretary of the Access and Home Support Division.
And Julia Atkinson, Assistant Secretary, Home Support Operations Branch.
Uh um do you any of you have an opening any opening remarks that you'd like to make before we go to questions?
>> No, thank you, Chair.
Okay. Uh I might kick us off. Um in estimates last year, you told us that you didn't have any modeling or plan for how CHSP will go into Support at Home. Um we've certainly heard from numbers of witnesses today that they have no information that they've received from the department um or the government about uh the the potential transition of CHSP to Support at Home. Uh and as you would have heard, we just heard from the Inspector-General that they haven't been given any either. Um so, I guess my question is since we last spoke, has the department done any modeling in relation to um transitioning CHSP to Support at Home?
So, I might uh start off with the answer to that question. Um and to the extent that it goes to in terms of government intentions and um what government has said. So, my understanding is um in November 2023, it was then that the government announced that the Community Home Support Program would move into Support at Home and that announcement was quite specific in terms of being no earlier than the 1st of July 2027. And so, I do understand that there might be um questions around that date as it's starting from the 1st of July 2027. However, it was quite clear uh that it was no earlier than. The other uh thing that I think is important in terms of government commitment is um uh that has been said many times is supporting older people to stay in their home for as long as they can and as long as that they want to and that's been a real uh tenant and focus of of these reforms. Uh the 1st of November 2025 when the new act started, did uh commence this journey in terms of Community Home Support Program into Support at Home and Ms. Atkinson can talk about that in terms of registration, um quality standards, uh changes as I understand it to the service provision list. And um I think the uh Yeah, I think I might just leave it at that, but I think um in terms of the context, I'm sorry, the other thing I would say is that um there has been and continues to be consultation uh particularly with the advisory council and the council of elders around uh the transition of this program, which is um as you would be aware, government's biggest grant program into it. So, I might I'd like to just ask Ms. Atkinson to talk about um what happened on the 1st of November cuz I think that is important in terms of part of that journey and then um specific more information.
>> Um Ms. Atkinson, before you respond, um I understand the government's intentions. I understand what the government said. The committee's all aware of the dates and when the government said not before. We know all that. The question that we're trying to get an answer to as a committee is has the government or has the department modeled Support at CHSP into Support at Home? So, we've got data in our submissions that tells us that delivery of CHSP is significantly more cost-efficient than same services delivered under Support at Home. We've got information in our submissions that says that there's 800,000 people on CHSP. Now, if they're transitioned to Support at Home, there are questions around are you going to transition them all at once? Uh are those people going to have to pay more? What is the impact then on the cost to the taxpayer and the government in delivering those services? The question is very clearly about modeling, not planning. Yeah. So, I I
would start by saying that um we don't usually provide um details of the advice that we're providing to
>> asking for the details. I'm asking have you done the modeling? Point of order,
Chair. Sorry, like I was just pulled up for not allowing witnesses to complete their answers. Can I hear the rest of Ms. Stewart's answer? I think if we're going to all respect witnesses in being able to do that. Um I'm I'm sure that she wanted to continue her answer before you intervened. Uh
thanks, Senator Cox. If you could go to the modeling though, please, Ms.
Stewart.
Yeah, thanks, uh Senator. So, um just in relation to your very first question, which estimates year are you referring to because I believe I've also been on the record at estimates saying we model uh multiple options relating to multiple policy and program decisions and we provide that to government uh as a routine course of advice. So, is there modeling that exists in relation to the Support at Home Program, this Commonwealth Home Support Program and then what future options for the transition of one program into the other could look like? Absolutely. Is it publicly available? No. Has a
cost-benefit analysis been undertaken as to the value of maintaining or transitioning CHSP to S- Support at
Home? Uh not in recent times as far as
I'm aware. When was the last cost-benefit analysis completed? I'll
have to take that one on notice. It may have been uh some ways back pre-Royal Commission times cuz as you know, the um uh the transition of Commonwealth Home Support Program uh into one integrated program has been on and off for some period of time. Uh but uh in recent times for as in my most recent memory, uh a cost-benefit analysis specifically related to this issue uh does not spring
to mind. Mhm. Would it be the case that given that we've now seen significant increases in costs under the Support at Home Program to participants, would it be prudent to be modeling what the current state of play would be in terms of cost-benefit analysis? So, I might um
just two parts to that question. So, uh I know that the topic of pricing in the Support at Home Program, cost of participants, co-contributions has been quite topical both in the evidence received today, but also in the submissions that have been given to this inquiry. Uh we've previously uh given evidence to estimates and and other forums of such that talks about the differences in the price constructs between the previous Home Care Packages Program and what we're seeing under the Support at Home Program. So, uh we do accept that because of the the differentiation in the way that that price is constructed, there has been an increase in the unit cost. But when you add all the component parts together, uh there's actually not that much difference at an average level. However, we are seeing uh some examples of where people are saying should this price have increased to this extent uh between the transition of the two programs. So, probably just um that uh just that clarification worth making at the start. Uh in answer to your question around what it whether it would be prudent, um absolutely, and doing a cost-benefit analysis for all these major program reforms is an essential component of what how we would transition.
So, are there plans to do an updated
cost-benefit analysis? Uh it's on um our forward work plan similar to the evidence that the Inspector-General
gave. And in terms of that forward work plan, when would you expect that cost-benefit analysis to be completed?
Uh I couldn't put a definitive date on it, Senator. It depends on which option we want.
>> Six months, 12 months, 2 years? Are we talking months or years?
>> Well,
I thought so. I think it's important um uh in terms of the way that we provide our advice about the you know, the planning and the implementation and then it is up to government to decide in terms of um how that implementation happens. I I would say that um their approach in terms of the major change to the act and the introduction of Support at Home was around being very older person-centric, was around being evidence-based and um drawing upon recommendations from task forces and the Royal Commission. So, it it it would be subject to that advice. I I would like, Chair, if I was able to just finish um part of the answer that you uh you asked me the question around uh transition of this program and I would like, if that's okay, for Ms. Atkinson to talk about what happened on the 1st of November 2025, please. Thank you. Sure. So,
>> it brief, Ms. Atkinson, please? Thank
you, Chair. So, 1st of November 2025, CHSP came under the new Aged Care Act. Uh so, this was a a significant um part of the ongoing reforms to in-home aged care and it aligns regulatory arrangements for CHSP both for providers and in terms of protections for older people with all other aged care um programs. Uh so, um that that is a large step forward. Uh as a part of that process, we also went through a range of standardization and alignment across what is CHSP today and what Support at Home looks like. So, one of those things is to look at the service list in Support at Home, the service list in CHSP and in every um opportunity uh that we we made alignment between those two lists and those lists now are materially very similar and that provides a level of consistency across the programs that as a preparatory activity such that should there be a transition in the future as we are talking about all day today that that that is in line and that's an example of the kind of kind of back end architectural changes that have gone into place already both the introduction of the act and the ICT reforms that were introduced at that time as well.
Thank you. I guess one of the things that's come out very clearly in evidence from other submitters and certainly in the submissions that we're receiving um that we haven't talked about from or we haven't heard from people today there's a very clear through line that providers and older people have no certainty whatsoever and in fact Ms. Atkinson you just said should the transition happen. So it would appear that there's no clarity around when a transition is going to happen if it's going to happen at all and I guess one of the reasons why I'm keen to understand the committee's keen to understand if there's going to be more cost benefit modeling. We're not asking you what advice you're giving to government. We're trying to understand timelines here because it's very clear that the sector doesn't have one older people don't have one and people are the system because there is no certainty and what we're trying to do here is get some level of clarity from the department and and we're not getting any. So has there been discussion about whether CHSP is definitely transitioning? Has there [clears throat] been discussion around if it is happening when it is happening? Is there is there any clarity that you can give older people and the sector in our hearing today?
Senator I and I should just quickly correct my evidence. I said should government policy absolutely is that there will be a transition. The the statement from government which has been consistent is that it will occur no sooner than 2027 and the detail of that transition obviously are for a decision
So I I acknowledge the uncertainty and and as you would be grateful for the submissions that have been provided and as we're working through them and that is a consistent theme. One of the things to consider is that this system has undergone such significant generational change and so it's around you know staging in terms of what happens first and what is the timely order and acknowledging that the bulk of the people some I think 830,000 older Australians are receiving services and a higher number of providers some of whom also provide residential and supported home already. In terms of those key messages from government it started some years ago when it was making the announcement about the importance and the policy position about older people being supported at home this being older person centric and that it's no no earlier than July 2027 and November 2025 was a key date where that change did start and providers you know have started to think about what that would look like. It is a matter for government to make the decision about when the transition happens and how it happens. However today it has been older person centric thinking about the plan thinking about communication thinking about support thinking about the evidence and while it is their decision that is the process by which that they have done it today.
So I guess just to clarify because I absolutely take your point about staging but I mean no no sooner not before July 2027 that could be July 2040 that could be July 2050 it could be July 2028 like that's a nothing date really and I guess what I'm trying to understand and what providers and older people are trying to understand and I and I appreciate that you're not the government and it is a decision of government so maybe I'll just ask this question before I go to Senator Ruston has advice been given to the government on possible time frames for this to
happen? So we continue to give advice to government about a range of options and I won't go into the specifics of what
would it be fair to say that the government has been given advice on a range of options and a range of timelines and they just haven't made a
decision. I didn't go into the specifics of that I just said that we're giving them advice about a range of options.
Okay that's very clear as mud but thank you I appreciate the position you're in and we will ask have to ask the minister at estimates.
Senator Ruston Okay just to that point when are you when is your what is your time frame to decide what the program is going to look like like what what is going to occur after some period after the 1st of July 2027? When when is that going to happen? When will we know what it looks like?
So the some of the consultation has already started and some of the things that I'm hearing look to be very consistent to some of the submissions that this committee is receiving.
>> That wasn't my question. My question was when will we know? I'm I'm not I'm not asked about the the program when will we know what the program is?
Can I can I just ask that Ms. Stewart again be allowed to answer her questions. She was interrupted by Senator Ruston I think she was going to continue on to actually go to that
point. Senator Cox I'm satisfied that the questioning is order is in order.
Yeah and um what I was attempting to do was talk about the process that we have been using in terms of the consultation. So it'll be a decision of government in terms of when that happens. So