The AT-HM Scheme Explained for OTs: Getting Safety Devices Funded Under Support at Home

The AT-HM Scheme and What It Means for OTs in Aged Care

Since 1 November 2025, the Assistive Technology and Home Modifications (AT-HM) scheme has been the primary funding pathway for assistive technology under Australia's Support at Home program. For occupational therapists, care coordinators, and allied health professionals working with older clients, it represents a significant shift in how safety and communication devices can be funded - and how your clinical recommendations feed into that process.

The most important change from the old Home Care Package system is that AT-HM funding sits in a completely separate pool from the client's main support budget. Under the previous system, a personal alarm or communication device had to come out of the same budget that paid for personal care hours, nursing visits, and cleaning support. Now those two funding sources are independent. A client can receive the full value of their AT-HM allocation for a safety device without reducing a single hour of their personal care or allied health support.

That matters for your recommendation. When you assess a client and determine they need a safety device, you are no longer asking them to trade off care hours to fund it.

This guide is written for OTs, care coordinators, and AT advisors working with clients who are on, or eligible for, the Support at Home program. It covers what the AT-HM scheme funds, when an OT or AT advisor assessment is required, what that assessment involves for safety and communication devices, and how to navigate the end-to-end process from your recommendation to device delivery.

Who Can Access the AT-HM Scheme

The AT-HM scheme is available exclusively through the Support at Home program. To access it, a client must:

• Be aged 65 or over (or 50 or over if they are Aboriginal or Torres Strait Islander)
• Be living at home - not in a residential aged care facility
• Be an Australian citizen or permanent resident
• Have been assessed through My Aged Care and approved for the Support at Home program
• Have AT-HM funding recorded in their Notice of Decision letter following that assessment

A client who has been approved for a Support at Home level does not automatically receive AT-HM funding - it is assessed separately during the same aged care assessment process. The assessor determines whether the client's needs include assistive technology, home modifications, or both, and records the appropriate tier in the Notice of Decision. That tier sets the funding available for the device you recommend.

AT-HM funding is upfront and separate. According to the AT-HM scheme page on My Aged Care, clients can begin accessing this funding as soon as it is available - they do not need to wait for their main Support at Home services to be activated first. This means a client awaiting allocation for their support level can still access a safety device through the AT-HM pathway without delay.

If your client is not yet registered with My Aged Care, that is the first step. You can make a referral on their behalf - more on that below.

Understanding the Three Funding Tiers

The AT-HM scheme has three funding tiers. Each has a maximum amount, a 12-month access period, and different assessment requirements. The My Aged Care AT-HM scheme page sets out what each covers:

• Low tier - up to $500: Simple, low-risk items that do not require an OT or specialist assessment. Examples include non-slip mats, handheld showerheads, simple grab rails, and basic kitchen aids. The client's Support at Home provider can typically arrange these directly.
• Medium tier - up to $2,000: Items that require an assessment by an OT or AT advisor before they can be funded. This tier covers safety devices, personal emergency alarms, communication devices, some mobility aids, and other equipment where a clinical assessment is needed to confirm the device is appropriate for the client's specific needs. Personal alarm and safety communication devices typically sit in this tier.
• High tier - up to $15,000: Complex or high-value equipment and home modifications that require a full specialist assessment. Examples include sophisticated communication systems, major bathroom modifications, ramps, hoists, and powered mobility equipment. Higher amounts can be approved with supporting clinical evidence.

The 12-month access period can be extended to 24 months for complex home modifications where the process takes longer to complete. Clients with a progressive condition may access AT-HM funding over 24 months, extendable to 48 months if the condition requires it. If a client has needs that cross multiple tiers - for example, a simple grab rail (Low) and a personal alarm (Medium) - both can be funded concurrently within the same AT-HM allocation.

For most safety and communication devices, the relevant tier is Medium. This is where your role as the prescribing OT or AT advisor comes in.

Where Safety and Communication Devices Sit on the AT-HM List

The AT-HM List is the official reference document for what can and cannot be funded under the scheme. It is published by the Department of Health, Disability and Ageing and is available as a downloadable document on health.gov.au (updated February 2026).

Safety and communication devices fall within the Communication and information management products category of the AT-HM List. Within that category, the relevant subcategory is Distant communications - which covers devices that enable a person to communicate with others when not physically co-located, including two-way voice communication, SOS alerting, and emergency monitoring functionality.

Personal emergency alarms classified under ISO 9999 code 22 29 06 (Personal emergency alarm systems) are listed under the prescribed category of the AT-HM scheme. Devices with GPS localisation capability are classified under ISO 9999 code 22 29 12 (Localisation and tracking systems). When recommending a specific device, referencing the relevant ISO 9999 classification code in your documentation helps confirm the device's eligibility and gives your recommendation a stronger basis.

Check the AT-HM List before writing a recommendation - it is updated periodically. If you are uncertain whether a particular device type is listed, your client's Support at Home provider should also be able to confirm eligibility - they are responsible for sourcing listed equipment and will know the current applicable categories.

Your Role: What the Medium Tier Assessment Involves

For Medium tier items, an assessment from an OT or AT advisor is required before the client's Support at Home provider can source the device. This assessment does not need to be lengthy or complex - but it does need to establish a clear clinical rationale for the specific device recommended.

The assessment should address:

• What the client can and can't do: mobility, fall risk, memory and daily task management, how they communicate, and whether they can manage a device on their own
• Home environment: whether the client lives alone, how often they are home without support, any specific risks in the home or garden
• Specific needs the device will address: fall detection, emergency call capability, two-way communication with family, GPS location for clients who wander, 24/7 monitored response
• Why this device suits this client: why it fits their physical and cognitive needs, and why alternatives (such as a standard smartphone) would not work for them
• ISO 9999 classification code: note the applicable code(s) for the device - for a personal emergency alarm, ISO 9999 code 22 29 06 (Personal emergency alarm systems) applies; for devices with GPS tracking, code 22 29 12 (Localisation and tracking systems) also applies

The written recommendation does not need to be a lengthy clinical report. A clear, structured letter or assessment form that documents the above points is sufficient for most providers to proceed with sourcing the device. Your client's Support at Home provider may have a preferred format or referral template - check with them before writing your recommendation, as this can save time for everyone.

Under Support at Home, OT assessment visits count as Clinical Care - which means the government covers the cost in full. Your client pays nothing for the visit.

The End-to-End Process: From Referral to Device

For clients who are already on Support at Home and approved for AT-HM funding, the process from your recommendation to device delivery typically follows these steps:

• Step 1 - Confirm AT-HM approval: Ask the client for their Notice of Decision letter. This will confirm whether AT-HM funding has been approved and at which tier. If the client does not have a copy, their Support at Home provider will have access to this information.
• Step 2 - Contact the provider: Notify the client's Support at Home provider that you intend to conduct an AT-HM assessment for a Medium tier device. This flags the recommendation early so the provider can prepare to source the device once your recommendation is received.
• Step 3 - Conduct the assessment: Assess the client as described above and produce a written recommendation that names the specific device, the clinical rationale, and the applicable ISO 9999 classification code.
• Step 4 - Submit the recommendation to the provider: The provider receives your recommendation and uses it to source the device from an approved supplier. They manage the procurement, delivery, and set-up on the client's behalf.
• Step 5 - Device set-up and review: Once delivered, the device is configured with the client's emergency contacts, monitoring preferences, and any personalisation. A brief follow-up - either at a subsequent visit or by phone - to confirm the client is using the device comfortably is good practice.

Turnaround times vary by provider, but most straightforward Medium tier requests are fulfilled within a few weeks of the recommendation being received. If urgency is a factor - for example, a client who has recently had a fall - note this in your recommendation and communicate it directly to the provider.

Referring Clients Who Are Not Yet on Support at Home

If you are working with a client who clearly needs a safety device but has not yet been assessed for Support at Home, the starting point is a referral to My Aged Care for an aged care assessment.

As a health professional, you can make this referral on your client's behalf - with their consent. There are two options:

• Online: Use the Make a Referral tool on the My Aged Care health professionals page. This is available directly from within some GP systems via the e-Referral option.
• By phone: Call My Aged Care on 1800 200 422, Monday to Friday 8am-8pm and Saturday 10am-2pm.

My Aged Care has also published a Support at Home guidance booklet for health professionals that outlines the referral process, what assessors look for, and how to follow up on a referral you have submitted.

Once a referral is made, an assessor will contact the client to arrange a home visit. The assessment covers the client's health, daily routines, home environment, and support needs. If the assessor determines the client is eligible for Support at Home and has needs that the AT-HM scheme can address, AT-HM funding will be included in the Notice of Decision that follows.

The assessment itself is free. For clients who may be hesitant about the process, it helps to explain that the visit is not an inspection - it is designed to understand their situation and identify the support they need to stay safely at home.

A Safety Device OTs Can Recommend with Confidence

When a client needs a safety and communication device under the AT-HM scheme, what you are looking for is straightforward: a device listed under the AT-HM prescribed categories, right for the client physically and cognitively, and something they can actually use without screens or menus.

The KISA Guardian is a personal emergency alarm and monitoring device purpose-built for older Australians on Support at Home. It is classified under ISO 9999 code 22 29 06 (Personal emergency alarm systems) and ISO 9999 code 22 29 12 (Localisation and tracking systems), and is funded under the AT-HM scheme in the prescribed category - making it straightforward to reference in your clinical recommendation.

For the purposes of your written recommendation, the KISA Guardian covers the full range of risk factors you would typically need to document:

• Fall detection: Automatic fall detection triggers an alert even if the client cannot press a button or call for help after a fall
• Emergency SOS: Large tactile SOS button on the back of the device for client-initiated emergency calls - always labelled SOS
• Contact buttons: The front buttons connecting to nominated contacts can be labelled with text, a photo, or braille - making them easier to identify for clients with low vision, limited literacy, or cognitive impairment
• Two-way voice communication: Loud, clear speaker enables direct voice contact with emergency contacts or the monitoring team, without requiring the client to hold or look at a screen
• GPS location tracking: Family members and carers receive an SMS alert with the client's location if an SOS is triggered - particularly relevant for clients with dementia or a risk of wandering
• 24/7 Australian-based monitoring: The device connects to a 24/7 monitored response service staffed by trained Australian-based operators, who assess the situation and contact the right person - a family member, carer, or emergency services
• Worn around the neck: The device is worn on a lanyard - not a wrist strap - making it accessible for clients with limited dexterity or arthritis who may struggle to press a small wrist-worn button
• Contact alerts: When an SOS or fall detection event occurs, an SMS alert is sent simultaneously to up to five nominated contacts, then the device calls them in sequence until one answers - giving families and care teams immediate visibility
• No screen, no menus: The interface is designed for clients with cognitive impairment - no passwords, no navigation, no settings to manage after initial setup

The device costs $698, with an ongoing care plan at $55 per month from the second month - covering 24/7 monitoring, unlimited two-way communication, GPS tracking, and fall detection. Alternatively, the annual bundle - device plus 12 months of the full care plan and accessories - is $1,418. Within the Medium AT-HM tier (up to $2,000), both the device-only cost and the annual bundle fit comfortably within the approved funding amount. Your recommendation can note the device price as part of the documentation to confirm it falls within the tier limit.

If you have questions about the AT-HM process or want to discuss a specific client's situation, the team at KISA's Support at Home page can help.

Frequently Asked Questions

Do all AT-HM items require an OT assessment?

No. Low tier items - up to $500, covering basic safety aids like non-slip mats, grab rails, and bath boards - do not require an OT or AT advisor assessment. These can be arranged directly by the client's Support at Home provider. Medium tier items (up to $2,000), which include personal alarms, safety communication devices, and some mobility aids, do require an assessment from an OT or AT advisor before the provider can source the device. High tier items (up to $15,000) require a full specialist assessment. For most safety devices, Medium tier applies.

Can a client access AT-HM funding while waiting for their main Support at Home services to start?

Yes. AT-HM funding is separate from the main support budget and can be accessed as soon as it is available following the aged care assessment - the client does not need to wait for their support level to be activated with a provider first. This means if a client's primary concern is safety and fall risk, a device can often be sourced and set up well before their regular care services begin.

What happens if my client's AT-HM funding is not enough for the device I am recommending?

If a device exceeds the approved tier amount, a few options exist. Additional funding above the standard High tier maximum ($15,000) can be approved with supporting clinical evidence - so a detailed assessment documenting complex needs can support a higher allocation. Alternatively, some clients may choose to contribute the difference privately if the device cost is modest. Your client's Support at Home provider can advise on the pathway for seeking additional approval, as this process varies by case.

What should my written recommendation include to minimise delays?

A clear, well-structured recommendation reduces back-and-forth with the provider and speeds up sourcing. Include the client's functional needs and risk profile (fall risk, isolation, cognitive status, mobility), the specific device you are recommending by name and model, the relevant ISO 9999 classification code(s), why the device is appropriate for this client, the funding tier you believe applies (Low, Medium, or High), and the device price. Some providers have a preferred template - it is worth asking your client's provider what format they prefer before writing the recommendation.