Regional aged care models risk being collateral damage under the new Support at Home system, with co-contribution rules and transport pricing threatening both consumer access and provider viability, warns Staying in Place coordinator Helen Morton.
Staying in Place is a community-run, provider-partnered home care model that uses local coordinators and local workers to deliver flexible supports, so older people can remain in their own homes and towns.
From Saturday, pensioners will face a 17.5% co-contribution on everyday living supports such as cleaning, gardening and basic home help – a hit that Helen believes will see rural clients cut back on essentials.
“In the country, people don’t live in small, low-maintenance units,” she said. “They’re on large blocks with firebreaks that have to be cleared. These are not optional services – they’re safety.”
Under Support at Home, care management drops to 10%, with providers recovering the remainder via increased service fees. That’s manageable only if clients use their full Package, Helen said – but if people pull back because of co-contribution, “regional models will be squeezed.”
Transport policy puts regions at disadvantage
Thin market grants, meant to support rural delivery, also go to primary metro-based providers and can’t be used to offset client co-contributions – leaving associate community partners like Staying in Place exposed.
Helen also called out transport pricing as “metropolitan by design.” A single “price per trip” means a three-hour city specialist visit and a six-hour country round trip are billed the same – except the regional client pays more and drains their Package faster. She wants to see a cap on co-contributions and Package drawdown to metro-equivalent trip times.
Despite the risks, the Staying in Place model – now active in 55 WA communities and around 20 in the east – remains strong. Helen says her teams will “work around” the policy but warns Canberra must build equity into its reforms.
“If the Government wants parity,” she said, “limit transport co-pays to city rates – and let thin-market funding cushion rural consumers, not just the providers.”
The Department of Health, Disability and Ageing says it’s developing a regional, rural and remote (RRR) aged care policy framework and workplan, with a draft due in 2025-26. Will it tackle these gaps?
