The Queensland Aboriginal and Islander Health Council is urging governments to take immediate action to address major gaps in Australia's aged care reforms.

QAIHC warns that the current system is failing Aboriginal and Torres Strait Islander Elders and placing community-controlled health providers under increasing pressure.

In a statement on Monday, the Council noted that Elders continue to face significant disadvantage under a new Support at Home co-payment model, which "fails to recognise long-standing inequities including limited access to superannuation, lower rates of home ownership, and greater reliance on government payments".

The concerns were highlighted during QAIHC's recent two-day Elder Care Workshop, where Interim First Nations Aged Care Commissioner Andrea Kelly spoke about the widening gap between what communities need and what the aged care system is currently designed to deliver.

The Council's acting chief executive Paula Arnol said the reforms introduced in November 2025 will worsen inequities unless governments involve communities in designing solutions.

"The current reforms are not addressing the realities faced by many Aboriginal and Torres Strait Islander Elders," she said.

'These reforms could make the gap worse instead of closing it'

QAIHC General Manager of Sector Development, Gregory Richards, said Elders endure financial barriers and services that do not meet their cultural needs.

"Without real collaboration and support for community-controlled providers, these reforms could make the gap worse instead of closing it," he said.

Five years after the Royal Commission into Aged Care Quality and Safety, and two years after her appointment, Commissioner Kelly continues to serve in an interim capacity; a situation she said sends a troubling signal about the level of government commitment to reform.

The interim commissioner rejected the idea that Aboriginal and Torres Strait Islander Elders are choosing to leave aged care programs, pointing out that many are forced out by barriers in the system.

QAIHC Board Director for Central Queensland, Matthew Cooke, said the situation highlighted a broader lack of government commitment and understanding to addressing the needs of First Nations Elders.

He said it was unjust that the First Nations Aged Care Commissioner role remained on an interim basis, rather than being established as a permanent and empowered statutory position.

Community-controlled care providers under growing pressure

QAIHC noted that community-controlled aged care providers - often the most trusted and culturally safe services for Elders - are facing growing administrative, regulatory and financial pressures under the "reform" agenda, and that many lack the resources to absorb these burdens, placing their long-term viability at risk.

"In contrast, large for-profit providers are better positioned to adapt, raising concerns about widening gaps in service quality, cultural safety and accessibility," QAIHC said.

The Council warned that the transition from the Commonwealth Home Support Programme (CHSP) to the new Support at Home model is also "reducing flexibility and removing low-barrier, preventative supports that many Elders rely on to remain independent".

IUIH Executive Director Aged Care, Matt Moore, said the federal government has been "advised since October 2023 - and again in October 2024, before the new Aged Care Act passed the Parliament - what service program design and funding model was appropriate for First Nations elderly".

'I have great fears for our Elders'

Goolburri Deputy CEO, Trent Adams, said while Goolburri was working towards adapting the new modelling, it was inherently placing larger risks on organisations with compliance and liability.

"In the short, it is affecting corporate governance models and requiring companies' board of directors to be involved operationally," he said.

"The Commonwealth Home Support Programs have a foundation and good track record and needs to continue. Support At Home is not a mature enough system to meet the needs of such a vulnerable cohort with such a growing demographic population.

"With an ageing Australian population, I have great fears for our Elders that they will fall through the cracks or be forced out of the system as it's not designed for our people."

QAIHC and sector partners are urging governments to take immediate steps to prevent further harm, calling for the establishment of a permanent First Nations Aged Care Commissioner as a statutory office-holder; close work with communities to design services and their funding; and the provision of long-term, reliable funding for Indigenous providers.

QAIHC and sector partners also urged governments to provide funding to the Aboriginal Community Controlled Health Organisation (ACCHO) sector to deliver mentorship programs for Members to become registered aged-care providers; allow flexible, early support programs; and make cultural safety and community leadership central in aged care.

"Without urgent change, these reforms intended to strengthen aged care risk will cause lasting harm to the very people they are meant to support," Ms Arnol said.

Shadow Assistant Minister for Health and Aged Care, Arrernte woman Senator Kerrynne Liddle said the federal government "talks about respect for Elders at every event, but what vulnerable people need is real action that matters to them".

"The government's aged care reforms are failing Aboriginal and Torres Strait Islander people and risk further widening the gap, rather than closing it," Senator Liddle told National Indigenous Times.

The evidence is in, and it is evidence not ideology, that needs to respond to the reality for vulnerable people."

'We know there's so much more to do'

A spokesperson for federal Minister for Age Care, Sam Rae, told National Indigenous Times the government's aged care reforms are "building a high-quality, safe, respectful and sustainable system that puts older First Nations Australians - at the centre of their care, now and into the future".

"Under our reforms, every older First Nations Australian has a right to aged care services that meet their physical and cultural needs, but we know there's so much more to do.

"We know that CHSP services are vital to so many in First Nations communities, and the Government will make sure that the crucial services the CHSP delivers continue for every older Australian who needs them well into the future.

"We take concerns about inequity of access very seriously, and are considering ways in which we can make the system more equitable for First Nations Australians in aged care."