Aged care reforms bring changes to home care but will Australians be better off?

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Major changes are on the way in home care services for older Australians, but there are concerns that not everyone will be better off.

Mariana Aliberti, 86, from Blacktown in Sydney's west, knows well how a little help around the home can make a big difference. 

Recently home from hospital after suffering a fall, Mrs Aliberti received meals-on-wheels three times a week as well as home cleaning and personal care.

"I manage, because I am lucky that I have family," Mrs Aliberti says. "But some people, they don't have family, and they need more help than me." 

From July, many home-care services will be streamlined into one national program called the Commonwealth Home Support Program. It includes new "consumer directed care packages" that are said to give more control to the people who use the services.

Ian Yates, Chief Executive of the Council on the Ageing (COTA), says "the person needing the services and their families have much more say, choice and control about what kinds of services they get, where they get them, and who they get them from."

But the introduction of new means-tested fees means some people will pay more towards the cost their care. 

But Charmaine Crowe from the Combined Pensioners and Superannuants Association (CPSA) says the difference in cost could be dramatic.

"We're going to see home care fees basically double for most people. The other worry for people is that they won't be able to get enough home care hours," she said.

Under the new system each person is allocated a set budget according to their level of need, as determined by an independent assessment team. The money will still go to service providers, but the person receiving the service will need to decide how the  budget is spent, and make sure they stay within their budget.

The government says it will make the system fairer, but there are concerns some people will be worse off.

Danielle Robertson's private home care service provider, Dial an Angel, says many people will quickly reach their budget cap.

"They'll then have to tip in the money to top it up. They might need to take money out of their super funds or family members might have to chip in or if they just have government funded care it may be minimal.." she said.

Ms Crowe says that could be more expensive for taxpayers in the long run.

"The risk is if we don't have enough home care, we're going to see more people in emergency departments, and we're also going to see people moving prematurely into nursing homes, which also comes at a great cost, especially when it’s against the will of the person."

Australia's aged care system currently costs around $14 billion each year. Of the 1.1 million people who currently use aged care services, around three-quarters receive services at home.

The changes to home care services are part of the "Living Longer, Living Better" reforms, which were introduced by the then Labor government in 2012.

The reforms have the support of both parties, and come with some increase in funding.

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