Transition Care Program (TCP) at SALHN

The Transition Care Program (TCP) is for older people who have been in hospital but need support to recover and time to make a decision about the best place for them to live in the longer term. Transition Care may be provided either in your own home or in a 'live-in' setting. This setting is part of an existing aged care facility. You can only access transition care directly from hospital. 

Please view the Southern Transitional Care Program Flyer (PDF 276KB).

What types of services are provided?

Transition Care provides short term care that supports people to maximise their independence, function and confidence. The program:

  • focuses on your own goals and what you want to achieve
  • offers a range of therapies (such as physiotherapy and occupational therapy), using a low intensity approach, to help achieve your goals
  • provides assistance with personal care and nursing support as required
  • is short term only (up to 12 weeks)
  • provides time for you to make choices about your future care.

How does the assessment work?

To receive transition care, you will need to be assessed and approved as eligible by an Aged Care Assessment Team (ACAT) while you are still in hospital.

A staff member (TCP Coordinator) from the Transition Care Program will also meet with you to discuss the program, your suitability for the program and complete required paperwork.

Usually these assessments take place at your bed side and a carer or family member is invited to provide extra support for you. You will be provided with information to assist you to make a decision on whether transition care is right for you. 

What if I’m already receiving services through a different program? 

If you are already receiving a Home Care Package or Commonwealth Home Support Program services, your place is held until you complete your transition care program. 

How long can I stay on the program? 

Transition Care services can be provided for up to 12 weeks, however on average people stay on the program for about 8 weeks. The length of your program will depend on your progress during Transition Care and your individual care needs. Your progress is reviewed regularly whilst you are on the program. If you require ongoing supports at the end of the program, we will discuss longer term care with you. 

Who pays for Transition Care Program services? 

The Australian Government pays for the bulk of aged care in Australia. But as with all aged care services, it's expected you'll contribute to the cost of your care if you can afford to do so.

The TCP Coordinator who visits you in hospital will have a discussion about contributing towards the cost of your care. What you pay is negotiated based on your capacity to pay and agreed upon between you and the TCP Coordinator. The rate is set before you receive the relevant services.

No person will be excluded from the Transition Care Program if they are unable to contribute a fee to the care package.

Contact details

Phone: 7117 5313
Fax: 8124 1466
Email: HealthFMCTransitionCareProgram@sa.gov.au

For further information, see SA Health Transition Care Program