The Rural Aged Care Gap

Australia’s aged care system was largely designed around urban and suburban service delivery. Providers cluster in areas where population density makes service delivery financially viable. The result is a significant and well-documented gap between what older Australians can access in cities and what is available in rural, regional, and remote areas.

This guide covers the specific barriers facing rural and remote older Australians, the programs that exist to address them, and practical steps to navigate the system when formal options are limited.

The Core Challenges

Workforce shortage

Home care depends on workers. In rural and remote areas, the pool of available support workers is smaller, there is more competition for workers between aged care providers, health services, and NDIS providers, and the work often involves significant driving time between clients. Workers in regional areas often earn similar wages to urban workers but face higher costs of living in some cases and longer hours.

The result is that rural providers frequently operate with understaffed rosters, struggle to fill shifts, and rely heavily on casual or agency workers, which directly affects service continuity.

Transport and distance

For a home care provider in a rural town, delivering a one-hour personal care visit 40 kilometres away costs significantly more than the same visit to a nearby suburb. Travel costs eat into provider margins and, in areas without the Rural and Remote Supplement, may make service delivery financially unviable.

For clients, distance from services also means:

  • Long transport times to medical appointments
  • Limited community transport options
  • Difficulty attending day programs or social activities
  • Isolation when driving ability decreases

Limited provider choice

In a city, a Support at Home participant might choose from dozens of registered providers. In a small rural town, there may be one or two. This reduces the ability to change providers if quality is poor, to request a specific worker, or to find a provider with specialist expertise.

Residential care distance

Waiting for a residential aged care place in a rural town often means a long wait, followed by a placement far from home, family, and community. Moving to a regional centre for residential care severs community and family ties for people who have lived in the same area their whole lives.

Programs Designed for Rural and Remote Delivery

Commonwealth Home Support Programme (CHSP)

The CHSP is the entry-level government funded home care program. It includes specific funding for rural and remote service delivery and includes flexible provisions for providers operating in areas where standard service models are not practical.

CHSP services available in most rural areas include:

  • Domestic assistance
  • Personal care
  • Social support
  • Community transport
  • Meals (including Meals on Wheels programs delivered to rural addresses)
  • Home maintenance

Access is through My Aged Care: 1800 200 422.

Support at Home (from 1 November 2025)

The Support at Home program is the replacement for home care packages. It is a national program available regardless of location, though the practical availability of providers to deliver against your budget varies considerably by area.

For rural clients, a key consideration is whether any registered provider in their area has the capacity to deliver the supports they need. If the only local provider does not offer the service you need (for example, nursing), you may need to access that specific service from a provider that travels from a nearby town.

Rural and Remote Supplement

The Rural and Remote Supplement is additional government funding paid directly to approved aged care providers in designated rural and remote areas. The supplement scales with remoteness, with Very Remote areas receiving the highest supplement.

This supplement helps providers cover the additional costs of rural service delivery and is one reason why some providers can afford to operate in thin markets. From a client’s perspective, the supplement is invisible; it affects the provider’s viability, not your individual budget.

Multi-Purpose Services (MPS)

Multi-Purpose Services are a distinctive feature of rural aged care. An MPS combines aged care and health services in a single facility, typically in a small rural town that cannot sustain separate hospital and residential aged care services.

MPS facilities can provide:

  • Residential aged care
  • Flexible respite care
  • Community aged care services
  • Primary health care
  • Some acute health services

If you are in a small rural town, there may be an MPS as the primary aged care and health facility. Your GP or local health service can advise.

National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP)

Discussed in detail in our guide to First Nations aged care pathways, NATSIFACP provides specific funding for culturally appropriate aged care services in Aboriginal and Torres Strait Islander communities. It operates in some remote areas where mainstream programs have no presence.

Practical Workarounds

When formal services are limited, these approaches help.

Combine CHSP and Support at Home services

There is no rule that says you can only use one program. Many rural clients access entry-level CHSP services (domestic assistance, social support) through a local provider and use their Support at Home budget for higher-level supports from a provider that travels from a larger town. Your support coordinator or My Aged Care can help structure this.

Use telehealth for allied health

Occupational therapy, physiotherapy, psychology, and speech pathology assessments and consultations are increasingly available via telehealth. For rural clients, this can dramatically improve access to services that would otherwise require a two-hour round trip.

Ask your provider whether they offer telehealth delivery. Many allied health providers now have dedicated telehealth infrastructure, and Medicare and aged care telehealth rebates are available for most services.

Engage a support coordinator

If your Support at Home plan includes coordination funding, use it. A support coordinator in your region will have knowledge of local providers, informal networks, and options that are not listed anywhere online. They can advocate on your behalf and problem-solve when standard options are not available.

Work with your GP as a navigator

GPs in rural areas often have a broader navigation role than in cities. Your GP may know which local services exist, be able to facilitate telehealth referrals, and advocate for priority access when your needs are urgent.

Explore local community and volunteer networks

In rural areas, informal networks often fill gaps that formal services cannot. Local councils, community organisations, churches, and neighbours frequently provide practical support. These are not substitutes for funded care, but they can supplement it meaningfully.

Meals programs, community transport, social groups, and volunteer visiting services often operate in rural communities through local government or not-for-profit organisations. Ask your aged care provider or local council what is available.

Plan ahead for residential care

If residential care is likely to become necessary, start researching options early rather than in a crisis. Identify which facilities in your region and the nearest regional centre have the care level you may need. Waitlists for rural residential aged care can be long, and being on a waitlist early provides more choice.

When to Escalate

If you have exhausted the options above and still cannot access adequate care in your location, you can escalate.

Contact your state or territory aged care peak body. These organisations advocate for aged care consumers and have relationships with the Department of Health and Aged Care. They can raise systemic access issues.

Contact the Aged Care Quality and Safety Commission. If you are not receiving services you are entitled to, or if care is inadequate, the Commission handles complaints.

Contact your local federal member of parliament. Federal MPs frequently advocate on aged care access issues for rural constituents. Their office can escalate access problems to the Department of Health and Aged Care.

Frequently Asked Questions

What aged care services are available in rural and remote Australia?

Services vary significantly by location. Most rural towns have some level of Commonwealth Home Support Programme (CHSP) services including domestic assistance, social support, and community transport. The Support at Home program (which commenced 1 November 2025) is available nationally, though the range of registered providers in remote areas is often very limited. Residential aged care is available in many regional centres but is scarce in smaller towns and remote communities. The National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) serves some remote communities specifically.

How does distance affect aged care assessment in rural areas?

Assessment wait times are generally longer in rural and remote areas because assessors must travel further or manage larger geographic caseloads. The Aged Care Assessment Team (ACAT) or regional assessment service may conduct assessments via telehealth for some people in remote areas, though this depends on the nature of the assessment and available technology. If you need an urgent assessment, contact My Aged Care on 1800 200 422 and explain your circumstances and location.

What is the Rural and Remote Supplement in aged care?

The Rural and Remote Supplement is additional government funding paid to approved aged care providers in designated rural and remote areas. It compensates for the higher cost of delivering care at a distance, including travel costs and workforce expenses. It does not directly increase a client’s individual budget but helps providers remain financially viable in areas where standard funding rates would not cover service delivery costs.

Can I get telehealth services as part of my aged care plan in a rural area?

Yes. Telehealth is increasingly used in aged care, particularly for nursing assessment, medication management reviews, and some allied health consultations. Many GP services are available via telehealth. Allied health services such as occupational therapy, speech pathology, and dietetics are increasingly delivered via video in rural and remote areas where face-to-face access is limited. Confirm telehealth availability with your specific providers.

What happens if there are no aged care providers in my area?

If no providers are operating in your area, contact My Aged Care on 1800 200 422. They maintain a list of providers by region and may be aware of options that are not easy to find independently. Some providers in nearby towns will travel to outlying areas for a fee. If there is genuinely no local provision, escalate your concern to your state or territory aged care peak body or the Department of Health and Aged Care.

Are there transport assistance programs for older people in rural areas?

Yes. The Commonwealth Home Support Programme includes a community transport sub-program. Some state governments also fund community transport for older residents. The My Aged Care website lists transport providers by region. Local councils, community organisations, and volunteer programs are often involved in rural transport. If formal transport is unavailable, ask your aged care provider whether transport to appointments can be included in your services.