(Cth) Remove the Time Limit on Support at Home End-of-Life Funding

Amy O’Brien, Philip Alex, Brentyn Ramm & Genevieve Lancaster
16 hours ago
7 min read

Author: Amy O’Brien, Philip Alex, Brentyn Ramm & Genevieve Lancaster | Publish date: 26/5/2026

P: In Australia, individuals are limited to a maximum of 16 weeks of funding under the Support at Home (SAH) End-of-Life (EOL) pathway.
S: The Minister for Health and Ageing should repeal the maximum time limit for the SAH EOL pathway outlined in Section 80-57 of the Aged Care Rules 2025 (Cth).
E: Inspector-General of Aged Care: 'the department should remove the 16-week maximum for delivery of care under the Support at Home End-of-Life Pathway.'

Problem Identification:

Section 80-57 of the Aged Care Rules 2025 (Cth) states that the maximum period of funding for the SAH EOL pathway classification level is 112 days (16 weeks).

The Inspector-General of Aged Care warned that people who, 'against expectations, outlive the 16-week maximum' for SAH palliative care support risk 'having critical services withdrawn.' According to Camilla Rowland, former CEO of Palliative Care Australia (PCA), the 16-week time limit ‘“may inhibit access to people whose life expectancy is less predictable”’. PCA and HelloCare, a media platform devoted to aged care, further stated that the time limit raises ‘serious concerns about its impact on care continuity’ with ‘potentially reduc[ed] support when it is most needed’.

Context:

SAH EOL care is designed to support people who ‘want to remain at home’ during the final stages of life. Palliative Care VIC stated that the SAH EOL pathway provides ‘a total of $25,000 … over a 12-week period’, but remaining funding can be accessed until the 16-week mark.

DoHDA outlined that an individual is eligible for SAH EOL care if:

‘they are 65 years or older (or 50 years or older if they are an Aboriginal or Torres Strait Islander person, or homeless or at risk of homelessness)
a doctor or nurse practitioner estimates their life expectancy as 3 months or less [and]
they scored 40 or lower on the Australian-modified Karnofsky Performance Status (AKPS).’

Abernethy et al. (2005) explained that AKPS scores range from 100 (normal function, no evidence of disease) down to 0 (death), where a score of 40 or below is predictive of reduced survival.

Palliative care researchers observed that at-home end-of-life care aligns with patient preferences, and is associated with higher rates of at-home deaths and decreased healthcare utilisation, including fewer hospital admissions and emergency department visits.

Arguments:

Camilla Rowland argued that ‘“in many life-limiting illnesses, it's very hard to identify specifically the last three months because people's illnesses progress at different rates.”’ PCA highlighted that some illnesses or conditions are characterised by ‘less predictable trajectories and … fluctuating and/or protracted end-of-life clinical and functional support needs, which may last longer than 12 to 16 weeks.’ Whilst the AKPS is a useful indicator of functional decline, Orlovic et al. (2023) demonstrated that prognostic accuracy is lowest in the ‘weeks’ to ‘months’ timeframe that the SAH EOL pathway relies on. They further noted that for these patients, the accuracy falls to just 32%, compared to 74% for those with under 14 days to live and 83% for those with more than a year. For instance, one carer reported that her husband, whose prognosis was less than a year to live, survived stage 4 lung cancer for over 6 years. Orlovic et al. (2023) further stated that ‘unpredictable disease trajectory … can make identification of the end-of-life and prognostication challenging’.

The DoHDA explained that individuals can request a Support Plan Review beyond the 16-week period to continue SAH EOL services. However, PCA noted that ‘due to delays in confirming eligibility’, individuals may face disruptions in care. PCA further noted that re-assessment delays can mean people receiving EOL care ‘die before their needs are formally re-classified’, leaving care provided during this period unfunded. HelloCare highlighted that 'reassessments for additional services can take six months to a year, leaving patients vulnerable during sudden changes in need.’ Camilla Rowland stated that ‘“if supports are reduced, or if there’s a delay in reassessment, or uncertainty about how the return to an ongoing classification will be handled, people may end up in hospital or aged care facilities.”’ HelloCare noted that ‘the rigid cap disregards these variations [in support needs], potentially reducing support when it is most needed and creating uncertainty and stress for older people and their carers.’

Advice/Solution Identification:

PCA has called for the removal of the time limit on SAH EOL care funding. They said that ‘this would provide certainty that supports will be ongoing’ for patients who outlive this timeframe.

Precedent:

There is international precedent for removing time limits on SAH EOL care funding. In the UK, patients can access home-based palliative care funds without a fixed duration cap, with continued eligibility determined by clinical need rather than estimated time remaining.

Public Support:

Broad Support:

Council on the Ageing (COTA) VIC - Raised concerns about the reduced flexibility of the new SAH EOL model and uncertainty for older Australians. However, they have not specifically called for the removal of the 16-week SAH EOL pathway time limit.

This list reflects publicly stated positions and should not necessarily be taken as endorsement of this specific brief.

News Coverage:

The Guardian - “Aged care waiting lists a ‘calculated denial of services’ that could be fatal, Senate inquiry warns”. This article discussed how limitations in access to services can have significant consequences for older Australians. By: Sarah Basford Canales | Wed 1 Oct 2025 - Read the article here.
ABC News - “Australians encouraged to have discussions about end-of-life care as new online tool launched”. This article discussed the tendencies for individuals and their families to not discuss end-of-life care until health emergencies occur. By: Niki Burnside and Rosie King | Sat 18 Oct 2025 - Read the article here.
Royal Australian College of General Practitioners - “‘Positive reform’: $25,000 budget for end-of-life care starts”. This article discussed the introduction of a $25,000 in-home end-of-life care budget, while highlighting concerns about the difficulty of accurately assessing life expectancy for eligibility purposes. By: Jolyon Attwooll | Wed 29 Oct 2025 - Read the article here.
HelloCare - “Older Australians receiving palliative care only in final days, new data shows”. This article discussed the gaps in access to end-of-life care for palliative care patients, leaving them with less time for comfort, planning and connection. By: HelloCare | Fri 5 Dec 2025 - Read the article here.
ABC News - “The importance of preparing for death and creating an end-of-life health care plan”. This news article discussed the importance of developing an advanced care directive and the role of palliative care organisations in facilitating and supporting end-of-life choices. By: Rani Fletcher | Tue 30 Dec 2025 - Read the article here.

Where to go to learn more:

(2025) The Support at Home End-of-Life Pathway Position Statement | Palliative Care Australia - Their position statement focused on raising awareness of the EOL pathway, and described the potential challenges associated with its implementation and offered resolutions to these challenges, including removing the time limit for SAH EOL care. View the position statement here.
(2026) End-of-Life Pathway | Department of Health, Disability and Ageing - This page outlined the SAH EOL pathway, including eligibility criteria, available funding, and the process for accessing the pathway for both existing and new SAH participants. View the page here.
(2026) Support at Home Levels 1-8 Explained (Funding & Hours) | St Vincent's Care - This page outlined the 8 SAH classification levels, including funding amounts, eligibility, and how short-term pathways such as the EOL pathway operate alongside ongoing classifications. View the page here.
Aged Care Act 2024 (Cth) - View the Act here.
Aged Care Rules 2025 (Cth) - View the Rules here.

Human Perspective:

Content Warning: Death

Margaret is 71 and has been caring for her husband Robert at home since he was diagnosed with motor neurone disease. When his condition deteriorated, their GP estimated he had three months or less to live, and Robert was made eligible for the Support at Home End-of-Life pathway. After 5 months, Robert had fortunately exceeded all expectations and was still holding on. As a result, he still required daily personal care, showering and mobility support. However, the pathway funding had been exhausted, and the family was told the support would cease. Margaret, already exhausted from months of caring, could not sustain these caring responsibilities alone. She felt abandoned by the system and frustrated by the difficulties she faced in trying to access the care Robert needed. Within weeks, Robert was admitted to the hospital, not because his condition had worsened, but because the care at home had collapsed. It was not the death Robert had wanted.

To protect the anonymity of those involved, this is a fictionalised account drawn from an amalgamation of real-life stories, experiences and testimonials gathered during the research process for this brief. Any resemblance to actual individuals is purely coincidental.

Conflict of interest/acknowledgment statement:

N/A

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Reference list:

Abernethy, A. P., Shelby-James, T., Fazekas, B. S., Woods, D., & Currow, D. C. (2005). The Australia-modified Karnofsky Performance Status (AKPS) scale: A revised scale for contemporary palliative care clinical practice [ISRCTN81117481]. BMC Palliative Care, 4(7). https://doi.org/10.1186/1472-684X-4-7

Aged Care Rules 2025 (Cth). https://www.legislation.gov.au/F2025L01173/latest/text

Department of Health and Social Care. (2022). Fast track pathway tool for NHS continuing healthcare guidance. United Kingdom Government. https://assets.publishing.service.gov.uk/media/62fd04148fa8f504bd845834/Fast-Track-Pathway-Tool-for-NHS-Continuing-Healthcare-guidance.pdf

Department of Health, Disability and Ageing. (2025). Support at Home program – End-of-life pathway. Australian Government. https://www.health.gov.au/sites/default/files/2025-12/support-at-home-program-end-of-life-pathway.pdf

Department of Health, Disability and Ageing. (2026, April 28). Support at Home program. Australian Government. https://www.health.gov.au/our-work/support-at-home

Department of Health, Disability and Ageing. (2026, May 21). Delivering services for Support at Home: End-of-life pathway. Australian Government. https://www.health.gov.au/our-work/support-at-home/delivering-services-for-support-at-home/end-of-life-pathway

Feliciano, D. R., & Reis-Pina, P. (2024). Enhancing end-of-life care with home-based palliative interventions: A systematic review. Journal of Pain and Symptom Management, 68(5), Article e356–e372. https://doi.org/10.1016/j.jpainsymman.2024.07.005

Gramenz, J. (2026, January 28). Support at Home levels 1–8 explained (funding & hours). St Vincent’s Care Services. https://www.svcs.org.au/home-care/support-at-home/information/levels-explained

Neeland, J. (2025, May 26). Looming aged care changes threaten a cruel reality for end-of-life support. HelloCare. https://hellocare.com.au/looming-aged-care-changes-threaten-a-cruel-reality-for-end-of-life-support/

O’Connor, T., Liu, W.-M., Samara, J., Lewis, J., & Paterson, C. (2024). ‘How long do you think?’ Unresponsive dying patients in a specialist palliative care service: A consecutive cohort study. Palliative Medicine, 38(5), 546–554. https://doi.org/10.1177/02692163241238903

Office of the Inspector-General of Aged Care. (2025). Progress report on the implementation of the recommendations of the Royal Commission into Aged Care Quality and Safety. https://www.igac.gov.au/sites/default/files/2025-09/2025-progress-report-on-the-implementation-of-the-recommendations-of-the-royal-commission-into-aged-care-quality-and-safety.pdf

Orlovic, M., Droney, J., Vickerstaff, V., Rosling, J., Bearne, A., Powell, M., Riley, J., McFarlane, P., Koffman, J., & Stone, P. (2023). Accuracy of clinical predictions of prognosis at the end-of-life: Evidence from routinely collected data in urgent care records. BMC Palliative Care, 22(51). https://doi.org/10.1186/s12904-023-01155-y

Palliative Care Australia. (2025). 2025 progress report on implementation of the Aged Care Royal Commission recommendations [Submission]. https://www.igac.gov.au/sites/default/files/2025-09/oigac-2025-progress-report-submission-palliative-care-australia.pdf

Palliative Care Australia. (2025). Aged Care Act Rules, final release [Submission]. https://palliativecare.org.au/submission/aged-care-act-rules-final-release/

Palliative Care Australia. (2025, October 2). Palliative Care Australia calls for action to unlock full potential of new end-of-life pathway [Media release]. https://palliativecare.org.au/mediarelease/palliative-care-australia-calls-for-action-to-unlock-full-potential-of-new-end-of-life-pathway/

Palliative Care Victoria. (n.d.). Support at Home program. https://www.pallcarevic.asn.au/page/606/support-at-home

Palliative Care Victoria. (2025, July 30). Funding shortfalls hit terminally ill Victorians. https://www.pallcarevic.asn.au/news/96/funding-shortfalls-hit-terminally-ill-victorians

Silva, J. (2017, December 6). A story about stage four lung cancer. Palliative Care Australia. https://palliativecare.org.au/story/a-story-about-stage-four-lung-cancer/