Victoria's former Treaty Commissioner has warned that upcoming changes to Australia's aged care system risk becoming "yet another barrier" to closing the gap.

From November 1, the federal government will begin rolling out the Support at Home program, which will replace the existing Commonwealth Home Support Program (CHSP) and Home Care Packages (HCP) system.

The government says the changes respond to the Royal Commission into Aged Care Quality and Safety and are designed to provide a "simpler and more equitable system for older people that helps them to stay at home for longer."

Support at Home will replace both the HCP and Short-Term Restorative Care (STRC) programs. The CHSP will transition to the new system no earlier than July 1, 2027, and will continue as a grant-funded program until then.

Equity requires addressing structural racism

The Victorian Aboriginal Community-Controlled Organisation (VACCHO) says the reforms risk producing inequitable outcomes for Aboriginal communities by adding new barriers for Elders and undermining the role of Aboriginal Community Controlled Organisations (ACCOs) in delivering culturally safe care.

Writing in Croakey, VACCHO chief executive Jill Gallagher said that while the changes are promoted as "progress", they risk becoming "yet another barrier that deepens inequality instead of closing the gap".

She said true equity for First Peoples "requires an honest reckoning with the long-standing structural racism, discrimination and disadvantage that have shaped our lives".

"Equity demands remedy, and that means taking deliberate steps to address the harms of past government policies and not further compounding them with reforms like this," Dr Gallagher said.

The Gunditjmara Elder and former Treaty Commissioner argued the reforms would widen the gap for Indigenous peoples, saying a one-size-fits-all approach might suit the government but not Aboriginal and Torres Strait Islander communities.

She said such approaches have consistently led to poorer health outcomes, higher costs to the health system, and services that are not culturally safe.

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Financial burden for Indigenous Elders

While non-Indigenous Australians typically become eligible for aged care services when they can also access superannuation, Indigenous people — who are eligible for aged care from age 50 — face 15 years of paying fees and co-contributions without superannuation access, Dr Gallagher said.

VACCHO also pointed to Priority Reform Two of the National Agreement on Closing the Gap, which commits to strengthening the ACCO sector. They say the new system undermines that commitment, noting data shows Indigenous people retire with significantly less superannuation than non-Indigenous Australians. The absence of clear pathways for new ACCO-led residential aged care services, they argue, further weakens the sector, and many Elders may be left without essential supports such as meals, transport, cleaning, and daily non-clinical care.

Dr Gallagher said the government's expectation that Elders apply for financial hardship waivers is a "humiliating and unjust solution that will further stigmatise our Elders" — many of whom are Stolen Generations survivors.

"To add insult to injury, reparations previously given to many survivors of the Stolen Generations will also form part of the income assessment undertaken to determine the levels of co-contribution," she said.

"Reparations will never fully compensate them for the harm that was caused. And now, even those reparations become part of their disadvantage. Instead of receiving the care they deserve in their later years, they are being asked to hand back a portion of the very compensation meant to acknowledge those wrongs."

Need for a dedicated aged care pathway

VACCHO is calling for Indigenous Elders to be exempt from income-tested fees and co-contributions under the CHSP, and is urging the government to legislate a dedicated aged care pathway for First Peoples in line with recommendation 47 of the Aged Care Royal Commission.

"The Royal Commission spent years collecting evidence from Aboriginal and Torres Strait Islander Elders and their families. It concluded that we need our own dedicated aged care pathway," Dr Gallagher said.

"Our Elders have waited long enough and they cannot, and should not, be asked to wait any longer for the fair, equitable and culturally safe aged care that they so rightly deserve."