Senate Community Affairs Legislation Committee, , 5:58:09 to 6:06:03
Officials analyze the $727 million underspend in the Support at Home program, citing workforce availability and service delivery constraints.
Topics: Social services, Government spending, Employment
Speakers: Mr Greg Pugh, Senator The Hon Anne Ruston, Mr Blair Comley, Ms Sonja Stewart, Ms Jasmine Snow
Yes.
You made a change on the 1st of November that said you can only carry over, let's say 10 per cent, because it's probably a real a more real figure, you can carry through 10 per cent. Since the change, what has been the difference in package expenditure in relation to that carryover? So my understanding is that we've seen very little change in terms of people that you know the the the amount of money that people are spending. Is that correct or isn't that correct?
I don't have the precise utilisation figures in front of me. But um if what you're referring to is the final budget outlook, which documented a um over a billion dollars worth of uh underspends in outcome three. Happy to provide further detail in relation to the support at home component.
Yeah.
Yeah. So in the final budget outcome, uh there was 1.4 billion dollars underspent against the aged care services program.
How much was that?
1.4 billion.
1.4?
Yeah. But just let me go through that because it there's a there's a few steps here. Um there are two primary components of that. One was support at home, the other was residential aged care. Um I'll leave residential aged care out of it for the time being. There is a difference between then what was in the final budget outcome and what was in our annual report that came out yesterday, and the difference is around uh 200 million, I think. So what our annual report shows is about a 1.2 um billion dollar underspend across the aged care services program. In relation to support at home, uh that's $727 million worth makes up that. Is the component that released a support at home?
$727 million.
$727 million? That's right.
And what's that period relate to?
That relates to, I believe it's the um well, it's 25-26, and then that would be support at home. So that's from the 1 November to the 30th of June 2026. And there are a couple of reasons. I think utilization is one of the reasons that we talked about. We also know that there was an additional 83,000 places released into the system. So 20,000 in the lead up to 1st of November, 20,000 in the period between the 1st of November and the 31st of December, and then 43,000 from the 1st of January to the 30th of June 2026. I believe our analysis shows that a large portion of that has been the ability of that those 83,000 places to be absorbed. So you know there's no deliberate intention from anyone to understand the money's there and it's available for use. That has just been the outcome of the first eight months of the programme.
So your contention is that the lion's share of the reason for the lack of utilisation of packages is the inability of the sector to be able to provide the services that people want, not that there's been any other behavioural change.
Yeah, that not my evidence at all. I said it was one component which is that, and then there would be other components which would be workforce availability, service um delivery constraints, those sorts of things. So that would be a that there are all contributing factors, Senator?
Okay. So far the factors that you've put to me that are likely to be contributing to the underutilisation of packages are things that you can blame somebody else for. You know, it's the sector's inability to be able to provide the services, it's staffing, it's resourcing, it's whatever. And no time have I heard anything come out of your mouth to suggest that there is any potential structural changes that have occurred within how people are receiving their care in the home that may be contributing to their utilisation of packages. My question to you is have you at any time over the period that support at home has been in operation, sought to find out what those contributing factors are in any way that can be validated?
Can I just um in terms of the response to Mr. Hugh's question? I do acknowledge the perception that um of yours that he was blaming others, but that's not the intent, it was around um just the the actual market conditions. I mean we are very aware that this is a brand new program and we're not one year in and um getting um uh thousands of people across to the program, getting new service agreements done, um, communicating clearly about the changes that were happening, um, getting people um there was a number of people um that were grandfathered in, but also getting ready in terms of co-contributions. There was work um and learnings, and I acknowledge Liz Heffron Webb here from the Commission for us around pricing transparency and um actions that the Department and uh the Commission undertook together to ensure that older people had that um transparency around the prices um in their local area and providers putting that on onto the system. So there were a number of um there were a number of factors that contributed uh to that.
Can I just say, Senator, um we we are spending a lot of effort on this question of utilisation and what's driving it? It's a very important factor because one, we want people to access the services, but we also need to understand from a forward-looking perspective whether the level of utilisation that we're seeing is a permanent or a transitional factor, because it's very important in terms of the overall um program. And there's probably a third factor that Mr. Pugh didn't mention, which is we see an observed behaviour that whenever you give someone a package, it takes them a while to ramp up to their full service offering. That's not necessarily about availability of workforce, it's also about literally just finding the right providers, working out what works for you, that just takes time. So we see higher utilisation, for example, in the second quarter of someone having a package than a first quarter on a consistent basis. Um we have been engaging with the sector, we've been talking to them to explain what they think is driving the lags, and we're putting a lot of effort to try and understand that what is the right the bet the balance between these three drivers that we've identified as to what is likely to drive the utilisation and a particular part of that last bit is because of the significant uptick in the number of packages, the proportion of packages that are brand new packages versus existing rolled over packages is higher than it was previously. And so that's again why we have to understand that, because as we move to this financial year, the ratio of new packages to existing packages will be lower, and we have to understand that for the purposes of forecasting.
Just um just to supplement the Secretary's point as well. The support at home programme turns one on Sunday. Um that will give us one four years worth of utilisation data. We then need to wait another couple of months because there's a 60-day time frame in which we have then to people to make their claims, providers make their claims and to get that full uh one-year uh analysis undertaken. So we'll be in a better place around what Mr. Homley's talked about around establishing a trend versus a you know a once-off uh around the start of next year.