Approved, and still waiting

In October the Australian government published two numbers about the same program. On 8 October the Department of Health, Disability and Ageing reported that 6,436 people died in 2025–26 after being approved for Support at Home and before the funding arrived: about seventeen a day. On 26 October the Commonwealth Ombudsman reported on the software that decides how much help each of them is approved for, and found that "a reasonable person would, in my view, lack confidence that the system is in fact fair and consistent."

Support at Home is the main program for older Australians who need substantial help to keep living in their own homes: cleaning, meals, help with showering and dressing, nursing, equipment. It replaced the home care packages on 1 November 2025, when the new Aged Care Act came into force. At 30 June, 106,977 people had been approved for it and were waiting. The department's own report puts the wait at seven to eight months for people in the "standard" category and about a month for the urgent; on average, the time from application to the first service was 306 days. The minister, Sam Rae, has called every death in the queue a tragedy and pointed out that people waiting die at a lower rate than older Australians generally. Both things are true. The 6,436 had each been assessed, in writing, as needing help at home.

Three gates

Between an application and a carer at the door there are three gates, and October's figures say something about each.

The first is the assessment. An assessor gathers information and the Integrated Assessment Tool, an algorithm, turns it into a funding level. The Ombudsman found that under the law its decisions cannot be overridden even when they are clinically inappropriate, that the department had been telling providers and the public that they could be, that nothing is published about how the tool decides, and that this sits uneasily with the Robodebt royal commission's recommendations on automated decisions. According to The Weekly Source, only 0.6% of assessments between December 2024 and March 2026 were audited or reviewed. The department disputed several findings and rejected a broad human override; ministers said they accept or accept in principle the remaining recommendations, an independent review of the tool reports in the first half of 2027, and an escalation pathway for complex cases opens on 11 January.

The second is the budget. Approval puts a person in a national priority queue to receive funding "as soon as it becomes available", and how much becomes available is set by government: 83,000 extra places in 2025–26, the minister says, and 32,000 more rolling out this year. Earlier in the year, when demand ran ahead, people were given interim funding of 60% of their assessed budget; by 30 June all of it had been converted to full places.

The third is the start. A funded place is not yet care. At 30 June, 38,775 people had been assigned a place and had not started services, and the number who began care in the June quarter, 26,581, was a quarter lower than in the quarter before. At Senate estimates on 28 October the department said $727 million of Support at Home funding had gone unspent between November 2025 and June 2026.

What the queue measures

Put together, the gates describe a system in which money, places and people are not meeting. Some of the wait is a budget decision. Some of it is an algorithm whose working cannot be checked. Some of it is a shortage of providers and workers able to turn a funded place into a visit. Each is fixable separately, and each is being argued about separately: the places in the budget, the tool in the Ombudsman's office, the workforce in the sector.

What all three have in common is who carries the interval. While the gates open, the help is given anyway, by a wife who does the showering or a daughter who gives up a shift, or it is not given at all. In September the ABC reported on a $4,500 lift chair that arrived two weeks after the man it was approved for had died. A waiting list for something a person has been assessed as needing is a budget line with people on it; October showed it is also an administrative line, and a labour market.

Three things will show which gate the government is working on. The Senate committee inquiring into Support at Home reports on 24 November. Whether the $727 million is carried forward or lost will be a question for the next budget update. And the government's own target, an average wait of three months by 1 November 2027, will be judged by the department's quarterly wait-times reports. The question in each case is the same: how long the interval is, and who fills it.

Sources: Department of Health, Disability and Ageing, aged care demographics report (8 Oct 2026) and Support at Home program data, April–June 2026 (27 Oct 2026); Aged Care Act 2024 wait times report, second report, quarter 4 (11 Aug 2026); Commonwealth Ombudsman, Automation and oversight in aged care (26 Oct 2026), via SBS News and The Weekly Source; joint statement of the Minister for Health and Ageing and the Minister for Aged Care (26 Oct 2026), via SBS News; evidence to Senate Community Affairs supplementary budget estimates, 28 Oct 2026, via The Weekly Source; ABC News, 22 September and 8 October 2026; Minister for Aged Care on ABC News, 8 Oct 2026.