Aged Care reforms

The necessity to focus on “growing older with HIV” stems from the remarkable advancements in HIV treatments since the 1990s, coupled with overall improvements in population health. Modelling conducted in 2018 indicated that by 2027, the largest demographic of people living with HIV would be among those aged 55-59, with an average age of 52 years. Should the trend of annual notifications decline, this average age could rise to 54 years.

The broader Australian population is ageing as well, and projections suggest that the number of Australians aged 65 and over will grow to 6.66 million by 2041, marking a staggering 54% increase from the estimated 4.31 million in 2021. Notably, individuals aged 80 and over are the primary users of aged care services, and their numbers are expected to triple to over 3.5 million by 2062-63.

As the population ages, the economic, political, and social influence of older Australians is likely to strengthen, positioning them as a significant consumer class. This demographic evolution has informed policies aimed at ensuring that older Australians, including those living with HIV, are supported through a robust regulatory framework established by the new rights-based legislation.

Upholding rights and supporting carers

The recent legislation emphasises the rights of all older Australians, and this does not exclude those with HIV. It outlines clear pathways for protecting these rights, including formal complaints processes and enforcement mechanisms to address provider performance issues. Compliance with these obligations is mandatory for registered providers, ensuring quality and safety in aged care provision.

A critical aspect of the new legislation is the recognition of the essential role played by carers and supporters. Many individuals living with HIV rely on informal carers—partners, family, friends, and community members—who provide vital support alongside the formal health and social care services. The new Act acknowledges this caring role, highlighting its importance in the Statement of Principles accompanying the Statement of Rights for older individuals.

Every older person is presumed capable of making their own decisions under the new Act, but they are also empowered to designate a ‘registered supporter’—a trusted individual who can assist them in navigating their care decisions. This role can be particularly beneficial for older individuals with HIV, who may choose a peer supporter or navigator to help manage their care needs.

Carers, too, can benefit from understanding the principles of supported decision-making within the context of aged care. Programs like the Carer Gateway offer vital resources, including financial assistance, counselling, and respite services. Online community forums provide a platform for carers to connect, share experiences, and seek support.

Strengthening the Aged Care workforce

The successful implementation of the new legislation hinges on a well-trained aged care workforce. The introduction of an enforceable Code of Conduct for Aged Care and strengthened Aged Care Quality Standards aims to enhance the safety and quality of care for all service users, including those living with HIV. Community organisations like NAPWHA and its members play a crucial role in developing the professional capacity of aged care workers to better understand the unique challenges faced by older individuals living with HIV.

Aged care services

The aged care system is set to undergo significant changes, particularly regarding assessments and home-based care. The introduction of a Single Assessment System aims to simplify the process for older Australians seeking aged care services, allowing them to share their stories once and access the support they need without unnecessary delays.

Government-funded aged care service options can be categorised as: in-home support and care; flexible aged care; residential respite care; and residential aged care. While the government provides regulation and funding, the services themselves are delivered through a wide range of providers.

Home care services are delivered under either the Commonwealth Home Support Programme (CHSP) or the new Support at Home Program, which replaces the Home Care Packages program in 2025. The CHSP provides entry-level support for older Australians, facilitating independence and community engagement through services like personal care, domestic assistance, and social support.

The Support at Home Program introduces eight funding classifications to accommodate varying levels of care and support needs; and three short-term care pathways, namely the Restorative Care Pathway, the End-of-Life Pathway, and Assistive Technology and Home Modifications, with low, medium and high funding tiers based on assessed need. The Support at Home ‘defined service list’ provides clarity as to what services would be funded within three categories – Clinical, Independence and Everyday living. Clinical services, including nursing care, allied health services, care management, and restorative care management are fully funded by the government for all participants.

For some older individuals, residential care may be the most suitable option. The Australian National Aged Care Classification (AN-ACC) system evaluates the intensity of care required, guiding government funding allocations to providers. A resident that wishes to receive financial hardship assistance with their aged care costs needs to undertake an aged care means assessment.

Additionally, increasing numbers of aged care clients are exploring flexible care options, which provide targeted support without committing to long-term arrangements. Programs such as the Transition Care Program and Short-term Restorative Care Program facilitate early intervention, recovery and independence. The Multi-Purpose Services (MPS) Program combines Australian Government funding for aged care services with state and territory health services, thereby providing integrated health and aged care services for older people living in small communities in rural and remote areas.

Looking ahead

As Australia navigates the evolving landscape of aged care, it is vital for older individuals living with HIV to remain informed and engaged. The reforms set forth in the Aged Care Act 2024 lay the groundwork for a more inclusive and rights-based aged care system, ensuring that all older Australians, regardless of their health status, receive the support and recognition they deserve. As we look to the future, older people, including those living with HIV, will play an increasingly significant role in shaping the nation’s approach to aged care.

Source material

Age Care Act 2024 (No. 104, 2024), https://www.austlii.edu.au/cgi-bin/viewdb/au/legis/cth/num_act/aca202457/, accessed April 2025.

Aged Care Quality and Safety Commission (2024) Strengthened quality standards, https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards, accessed April 2025.

Aged Care Quality and Safety Commission (2025) Flexible care, https://www.agedcarequality.gov.au/providers/aged-care-service-requirements/flexible-care, accessed April 2025.

Australian Government (2025) Carer Gateway, https://www.carergateway.gov.au/#a1, accessed April 2025.

Bretaña, N.A., Gray, R., Law, M. and Guy, R. (2018) Aging of the HIV population in Australia: A modelling study, Journal Acquired Immune Deficiency Syndrome, 79(5): e115-e116.

Centre of Excellence in Population Ageing Research (CEPAR) (2022) New projections for Australia’s ageing population, https://cepar.edu.au/news-events/news/new-projections-australia-ageing-population, accessed May 2025.

Commonwealth of Australia (2023) Intergenerational Report 2023: Australia’s future to 2063, https://treasury.gov.au/publication/2023-intergenerational-report, accessed February 2025.

Department of Health, Disability and Ageing (2025) About the new rights-based Aged Care Act, https://www.health.gov.au/our-work/aged-care-act/about, accessed May 2025.

Department of Health, Disability and Ageing (2025) Single assessment system for aged care, https://www.health.gov.au/our-work/single-assessment-system, accessed April 2025.

Department of Health, Disability and Ageing (2025) Support at Home program handbook: Program details for 1 July 2025, https://www.health.gov.au/sites/default/files/2025-02/support-at-home-program-handbook.pdf, accessed April 2025.

Department of Health, Disability and Ageing (2024) Commonwealth Home Support Programme: Program Manual 2024-2025, https://www.health.gov.au/sites/default/files/2024-11/commonwealth-home-support-programme-chsp-manual.pdf, accessed April 2025.

Productivity Commission (2024) Report on Government Services 2024 – Aged care services, https://www.pc.gov.au/ongoing/report-on-government-services/2024/community-services/aged-care-services, accessed April 2025.