Personal care funding and equitable access under Support at Home

Abstract

The October 2026 change to personal-care contributions under Support at Home provides a current case for examining the relationship between affordability and access. This paper reviews Australian implementation guidance, older national policy research and a mixed-methods evidence synthesis on unmet support needs. It distinguishes a participant contribution from a service price and from the funding available to purchase care. Official guidance confirms that eligible personal care became a clinical support on 1 October, with no participant contribution where the service is approved and funding is available. That change directly addresses one cost barrier, but does not establish that approved hours, service availability or continuity have improved. The discussion develops a practical case-management review and proposes an evaluation that records unmet needs as well as delivered services. The study uses no client records and makes no clinical recommendations. Its conclusion is that contribution removal should be assessed together with budget adequacy, implementation accuracy and the participant's experience, rather than inferred to provide unlimited access.