AT-HM Scheme OT Assessments
The Assistive Technology and Home Modifications scheme is how equipment, rails, ramps and bathroom changes are funded for Support at Home participants: a separate pool of money, in three tiers, sitting outside the quarterly budget. The higher tiers open with one document: an allied health assessment. Writing that document, properly, is what we do.
Separate money, with a key
The single most misunderstood fact about equipment and modifications under Support at Home: they do not come out of the quarterly care budget.
When the Support at Home program replaced Home Care Packages in November 2025, it separated the funding for things from the funding for services. Care hours, therapy and daily support draw on the quarterly budget. Equipment and home modifications draw on the AT-HM scheme, a distinct pool with its own tiers and its own rules. Families and even some coordinators still assume a walker or a rail competes with care hours. Under the current scheme, it does not.
The second misunderstood fact: the scheme scales its evidence with its money. Simple, low-cost items move on light evidence. The medium and high tiers, where bathroom modifications, beds and configured equipment live, generally require an assessment from an allied health professional, and above the high tier, clinical prescription evidence. No assessment, no unlock.
Scheme settings current as at August 2026: tiers of approximately $513 (low), $2,052 (medium) and $15,390 (high) apply from 1 July 2026, indexed. Settings are made by the Department of Health, Disability and Ageing and change; whether any item is funded for an individual is decided under the scheme’s rules at the time. Confirm current settings with the client’s registered provider before relying on them.
Three tiers, three levels of evidence
Simple, low-risk items: many rails, small aids, minor safety equipment. Light evidence, fast movement. We often specify these during a broader visit so safety improves while anything bigger is considered.
Configured equipment and mid-scale changes: shower commodes, specialised seating, more involved installations. Generally requires allied health assessment connecting the item to the person’s function.
Major items and home modifications: bathroom conversions, significant equipment, structural access work. Requires clinical evidence, and above this tier, prescription-level justification.
Figures are the 1 July 2026 settings, indexed over time. The tier an item falls into, and what evidence it requires, is set by the scheme, not by us.
Where AT-HM requests lose weeks
The scheme is new, and the stalls are already predictable.
- The item was chosen before the need was definedA brochure page and a price, with nothing connecting the item to the person’s function. The tier’s evidence requirement has to be met eventually, so the request waits until the assessment happens anyway.
- The evidence does not match the tierA high-tier bathroom conversion supported by a paragraph, or a low-tier rail buried in a clinical report nobody needed. Evidence proportionate to the tier moves fastest in both directions.
- Nobody assessed the home the item must live inThe commode that does not fit the bathroom, the bed that blocks the door, the ramp with no run. Equipment fails geographically more often than clinically, and only a home visit catches it.
- Equipment and modification were argued separatelyThe rail request and the equipment request describe the same bathroom without mentioning each other. One assessment covering both produces one coherent evidence set, and usually a smaller total ask.
- The interim was ignoredHigh-tier works take time. A request with no bridge, no equipment holding safety while construction is decided, leaves the person unsafe for exactly the period the paperwork covers.
How we build the evidence the scheme asks for
Confirm the route before the visit
Which tier the likely need sits in, what evidence that tier requires under current settings, and how our work slots into the registered provider’s process as an associated provider.
See the person, the task and the room in one visit
Function, strength, balance and how tasks actually go, in the rooms they go in, with the measurements any equipment or modification will depend on taken in the same visit.
Work the cheapest honest answer first
Task change, then simple equipment, then configured equipment, then construction, in that order, with the reasoning recorded, because that order is what proportionate evidence looks like.
Trial where it matters
For configured equipment we trial in the home wherever practicable. An hour with the real item in the real bathroom converts a guess into evidence a decision maker can rely on.
Deliver tier-matched evidence
Low-tier items specified briefly and fast; medium and high tiers with the full functional case, alternatives and consequence, written to our published evidence standard. Reports usually within 2 to 3 weeks, urgent items flagged sooner.
Stay through delivery
Equipment setup and training, builder liaison for modifications through our home modification service, and review once the item meets real life.
One assessment, three tiers, no wasted weeks
The situation
A man in his early eighties with severe osteoarthritis in both knees lives with his wife in a single-storey Fairfield home. He can no longer step the shower hob safely, the toilet is too low to rise from without pulling on the towel rail, and his walker does not fit through the ensuite door. His Support at Home care manager suspects “a bathroom job” and wants to know what the scheme will actually need before anything is promised to the family.
What we would do
Assess him at home: his transfers at the shower, toilet and bed, his grip and rising strength, the walker’s actual clearances, and his wife’s part in the routine, since she currently steadies him at every transfer. Measure the ensuite and the main bathroom both, because the cheaper answer is sometimes the other room. Trial a suitable over-toilet aid and shower chair while there.
What the report would set out
Three tiers, sequenced. Low tier, immediately: a properly placed rail set and non-slip treatment in the main bathroom, briefly evidenced, so safety improves within weeks. Medium tier: the trialled shower chair and toilet aid, specified against his rising strength and the room’s dimensions. High tier, if the family proceeds: the case for converting the main bathroom to level access, with the measurements, alternatives and consequence stated, and the interim arrangement holding safety until any build completes. Each tier’s evidence written to that tier’s requirement, in one document the care manager can act on in pieces.
Why the evidence would hold
Because the scheme’s own logic is respected: proportionate evidence per tier, alternatives worked in the honest order, items connected to observed function rather than a catalogue, and nothing promised about approval, which belongs to the scheme’s decision makers, not to us.
What this page is not promising
AT-HM assessments: your questions
Does AT-HM funding come out of the care budget?
Who decides whether an item is approved?
Can one assessment cover equipment and home modifications together?
What does the assessment cost, and who pays?
How fast can low-tier items happen?
My client had equipment under their old Home Care Package. Does anything change?
Do you cover CHSP or private clients for equipment too?
Refer for an AT-HM assessment
Care managers and families both welcome. Send an enquiry below or call 1300 316 664, and tell us what is failing at home; the tiers are our job to sort out.
The document that turns tiers into rails, ramps and bathrooms
Talk to our mobile OT team about AT-HM scheme evidence anywhere in Greater Sydney. Assessed and trialled in the home the funding is for.
Refer a client or call 1300 316 664