The Support at Home program is a significant shift in how home care services are delivered in Australia, aiming to enhance the independence and well-being of older Australians. One of the major components of the program is its focus on restorative care, which integrates allied health services to help clients regain and maintain their independence. While this program is designed to provide a holistic, person-centred approach, there are some important aspects regarding coverage that clients and providers need to understand.

A key topic of interest is what is and isn’t covered under allied health services within the Support at Home program—especially when it comes to chronic disease management. While allied health professionals, such as physiotherapists, occupational therapists, and dietitians, play an essential role in the program, some chronic conditions are excluded from direct coverage, requiring individuals to continue utilizing chronic disease management plans under the previous system.

What Allied Health Services Are Covered?

Under the Support at Home program, the aim is to provide integrated care that supports older Australians in staying independent, improving their functional ability, and living well at home. The coverage for allied health under this program includes services that contribute to improving mobility, physical functioning, and overall quality of life.

The main allied health services covered include:

1. Physiotherapy: To improve movement, manage pain, and help with rehabilitation following illness or injury.
2. Occupational Therapy: Focusing on improving daily living skills, such as bathing, dressing, and managing household tasks, to ensure that individuals can live independently.
3. Speech Therapy: Assisting with communication challenges and swallowing disorders, often crucial for individuals with neurological conditions.
4. Dietary Services: To ensure older individuals have adequate nutrition, especially in cases of malnutrition, obesity, or other dietary-related health concerns.
5. Podiatry: Foot care, which is vital for maintaining mobility and preventing injuries, particularly for those with diabetic conditions.
6. Psychological Services: For mental health support, managing conditions such as depression, anxiety, and dementia.

These services are provided as part of the restorative care pathway, which is designed to help clients achieve improved health outcomes, regain lost functions, and ultimately maintain independence.

What Allied Health Services Are Not Covered?

While the Support at Home program offers significant support for rehabilitation and improving physical and mental well-being, there are certain services and conditions that are not directly covered under this program. Specifically, chronic disease management falls into a gray area, as the Support at Home program does not fully replace or absorb the chronic disease management plans that are still needed for individuals with ongoing conditions.

Chronic Diseases and the Need for Continued Use of Chronic Disease Management Plans

Many older Australians live with chronic diseases such as diabetes, cardiovascular diseases, arthritis, and chronic respiratory conditions, all of which require ongoing medical care, management, and monitoring. While the Support at Home program includes some allied health services aimed at rehabilitation and restorative care, it does not cover all the necessary interventions and support for managing chronic diseases over the long term.

For these conditions, individuals are **required to continue using the existing chronic disease management plans and funding through the Medicare system. Chronic disease management plans, which can be developed with the help of a GP, offer access to specific health services, including allied health visits, to manage long-term conditions.

Why Are Chronic Diseases Excluded?

The exclusion of chronic disease management from the Support at Home program can be somewhat confusing, particularly for individuals who would benefit from having all their health care managed under one system. However, the reason for this exclusion is rooted in the different objectives of the two programs.

• Support at Home is designed with an emphasis on restorative care, which focuses on improving or maintaining functional independence and supporting recovery from health setbacks. Its goal is to help people regain independence and stay at home for as long as possible, with a focus on rehabilitation and restoration of function.
• Chronic disease management, on the other hand, is focused on long-term management and monitoring of ongoing health conditions that are unlikely to be “fixed” or fully restored. For example, diabetes management requires ongoing intervention to control blood sugar levels, prevent complications, and maintain overall health, but it doesn’t necessarily involve restorative care.

Thus, people living with chronic diseases must continue to utilize Medicare-funded chronic disease management plans, which are specifically designed to address ongoing care for these long-term conditions.

What This Means for Clients and Providers

For clients who require both restorative care and ongoing chronic disease management, it’s essential to understand how the two systems intersect. Here’s how it works:

1. Dual Coverage: Many individuals will require both types of care—restorative interventions under the Support at Home program and chronic disease management through Medicare-funded plans. It’s important for clients and providers to coordinate these services to avoid gaps in care.
2. Coordination of Care: Providers should ensure that both programs are working in tandem, with case management to coordinate between the Support at Home program’s allied health services and the chronic disease management plans.
3. Continued Use of Medicare: For clients with chronic conditions, they will still need to access Medicare for their chronic disease management. This means that even if a client is receiving allied health support through the Support at Home program, their chronic disease management services (such as diabetes education or cardiac rehabilitation) will need to be accessed through their GP and the Medicare system.
4. Increased Complexity: Navigating both systems may require additional administrative effort, but it also ensures that individuals are receiving comprehensive care for both their chronic conditions and their restorative health needs.

Conclusion

The Support at Home program offers many benefits to older Australians, especially through the integration of allied health services aimed at improving independence and quality of life. However, it’s crucial to remember that chronic disease management is not directly covered under the program. Individuals with chronic conditions like diabetes, cardiovascular disease, and others will still need to utilize Medicare-funded chronic disease management plans to ensure their long-term health needs are met.

Navigating both the Support at Home program and chronic disease management plans may require careful coordination, but with proper case management and understanding of the different funding sources, older Australians can benefit from both restorative care and long-term disease management, leading to a more holistic approach to aging at home.