Reablement a focus of Support at Home manual

The Support at Home program manual for 1 July 2025 has been published by the Department of Health and Aged Care – with providers expressing relief on LinkedIn at its availability but also voicing concern about intersecting budgets and claiming rules, and convoluted rules for participant statements.

In a post on LinkedIn, Feros Care reform manager Ben Happ commended the department in its attempt to connect the strengthened standards to relevant elements within the program manual and the anchoring of wellness and reablement into the new home care service model.

The manual defines wellness as a philosophy informing how providers are expected to work with participants to promote greater independence and autonomy, namely, avoiding “doing for,” when “doing with” can support a participant to undertake an activity with less assistance and build on their skills.

Reablement – a key focus of the upcoming Positive Ageing Summit – is outlined as maintaining or regaining skills, improving functional capacity, improving confidence and enhancing capability so participants can resume everyday activities.

In its attempt to embed wellness and reablement in the new SaH program, the manual outlines key components and actions providers need to implement, including:

• promote independence
• identify the participant’s goals
• consider physical and psychosocial needs
• encourage active participation
• focus on strengths
• support participants to reach their potential
• provide individualised support
• regularly review.

While applauding this focus on wellness and reablement, Mr Happ highlighted that there has been some added complexity for participant statements and noted that the prescriptive AT-HM and defined services list could be challenging to communicate effectively.

The key points highlighted in the manual regarding participant statements include:

• monthly statements outline the funding available, services delivered, contributions made by the participant and remaining funding available for a calendar month period
• providers must issue monthly statements to participants no later than the last day of the following month
• providers must issue a final statement to participants upon cessation of ongoing services, the Restorative Care Pathway and/or the End-of-Life Pathway.

The manual also includes a list of what information needs to be itemised in the monthly statement – however it also noted that information related to inclusions for monthly statements is subject to consultation in April and subsequent finalisation of the rules.

Mr Happ also raised the questions of how the continuity of care principle will be applied in relation to bad debtors and how providers and participants can manage no shows and late cancellations – two things which were left out of the manual. Other topics which are not covered in detail in the manual include the following:

• legislation from the Commonwealth, states or territories
• provider registration and deeming
• the strengthened Aged Care Quality Standards
• program assurance
• provider reporting requirements
• other governance requirements, for example, Serious Incident Response Scheme and worker screening
• technical specifications for Commonwealth or provider-specific systems
• provider-specific operational processes and procedures.

The manual does outline the government’s policy, legislative context, operational requirements and guidelines for the delivery of SaH, along with the responsibilities of providers under the Act, and includes details of the following:

• governance of the program including the person-centred legislative framework, aged care system governance, program assurance and the Supported Decision Making framework
• an overview of the SaH program
• entry into the program including assessment and accessing a provider
• care management
• participant budgets and contributions
• service delivery for ongoing services
• the self-management approach
• exits, changing providers and temporarily stopping services
• short-term pathways for restorative care, end-of-life support and assistive technology and home modifications
• provider claiming and payment arrangements
• program linkages including interactions with the Commonwealth Home Support Program.

Jennene Buckley of Enkindle Consulting noted that while manual may be initially welcomed by providers, once providers have a chance to read it, they will be feeling equally frustrated that they cannot move forward with their major implementation actions until the government provides more solid final guidance.

Ms Buckley said Enkindle Consulting believes the top 5 items that providers need to action are waiting on final government guidance, SaH business rules and the Aged Care Rules including:

• new pricing so all clients HCP budgets to  be reset for 1/7/2025 – waiting on pricing guidance from Government.
• new client service agreements to be rolled out with clients revised budgets and pricing  – waiting on further guidance and final aged care rules.
• new subcontractors’ agreement to be rolled out to existing contractors – waiting on final guidance and final Aged Care Rules.  
• newly format monthly statements meeting the ongoing and short term budgets  and business rules – waiting on guidance and any specified formats .
• re-configured Client Management System to manage the complexity of the funding, business rules and multiple budgets -waiting on final specifications

“Whilst we believe that the manual is the right step forward and has some really helpful case studies and continues to build knowledge of the intent of future state, what concerns us is without a final set of Guidance, Final Aged Care rules, Final SaH business rules and templates, providers ability to move ahead with their transition activities remains a challenge,” she said.

“As part of providers planning, we encourage providers regardless of their size, to have a level of dedicated resources, outside of ‘business as usual’ from April-September, as this will be a sprint to the finish line!!” she added.

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