​​

What is the AT-HM Scheme?

The AT-HM Scheme provides separate funding for eligible assistive technology and home modifications for Support at Home participants.

​

It recognises that AT and home modifications often involve costs that do not fit neatly within a participant's ongoing Support at Home budget and may require different levels of clinical assessment, advice, prescription and implementation support.

​

For Occupational Therapists, the scheme affects both how interventions are funded and how recommendations progress from an identified need to an implemented solution.

​

Understanding that pathway is important before assuming that identifying a need, obtaining funding and prescribing a specific intervention are the same step.

​

What is the Occupational Therapist's role in AT-HM?

Occupational Therapists play an important role within the AT-HM Scheme, particularly where a person's needs require clinical assessment, prescription or advice.

​

The OT's role is not simply to prescribe a piece of equipment or home modification. It is to determine whether an intervention is appropriate for the person, their goals, functional needs and environment.

​

Depending on the intervention and level of clinical support required, an Occupational Therapist may be involved in:

• assessing functional needs and goals

• identifying environmental barriers or risks

• considering alternative strategies

• determining whether AT or home modifications are appropriate

• completing further assessment or trials

• prescribing and documenting recommendations

• liaising with providers, suppliers, builders or other professionals

• supporting implementation, fitting or installation

• reviewing whether an intervention remains safe and appropriate.

 

The level of OT involvement should be proportionate to the complexity and risk of the intervention.

​

Does every AT item require an Occupational Therapist?

Different types of assistive technology require different levels of clinical support. Some lower-risk interventions may require relatively limited advice, while more complex or higher-risk interventions require greater assessment, clinical reasoning and prescription.

​

For OTs, this is important because the presence of AT does not automatically mean that a comprehensive OT assessment or prescription is required.

​

Equally, funding approval for an item does not remove the need for appropriate clinical assessment where the intervention requires it.

​

The question should be:

What level of clinical support is required for this person and this intervention? rather than: Does this item always require an OT?

​

AT-HM funding tiers and additional funding

AT-HM funding is structured separately from a participant's ongoing Support at Home budget, with funding available according to the participant's assessed AT and home modification needs.

​

In practice, an OT may become involved at different points in this process.

​

Sometimes sufficient funding is already available for the necessary assessment, trials and intervention.

​

In other situations, the OT may identify that the person's needs are likely to exceed the funding currently available.

​

This creates an important clinical distinction:

Identifying that additional funding is required is not the same as prescribing the final solution.

​

An OT should not be expected to provide certainty about a specific intervention where the clinical work required to reach that recommendation has not yet occurred.

​

What happens when an OT cannot prescribe yet?

This is one of the most common practical challenges within the AT-HM pathway.

​

An OT may have enough information to identify that:

• a functional need exists

• intervention is likely to be required

• the current funding or approval is insufficient

• further assessment, trials, quotes or consultation are required.​

 

But they may not yet have enough information to responsibly prescribe a specific solution.​ These are different stages of the clinical process.

​

Documentation should therefore accurately represent what has and has not been established.

​

Evidence supporting the need for additional AT-HM funding should not inadvertently read as though a specific product, modification or solution has already been assessed and prescribed.

​

The detailed clinical work can then occur once the appropriate funding and approvals are available.

​

Practice resource: [AT-HM Documentation Bundle →]

​

What should OTs document for AT-HM?

There is no single document that is appropriate for every stage of an AT-HM pathway.

​

The information required when identifying a need for additional funding is different from the information required when providing a completed AT prescription or detailed home modification recommendation.

​

Documentation should reflect:

• the purpose of the document

• the level of assessment completed

• the complexity and risk of the intervention

• the recommendations and justification relevant for the intended audience

• what the reader needs to understand or action.

 

This distinction can help OTs avoid both over-documenting relatively straightforward interventions and under-documenting complex or higher-risk recommendations.

​

It also helps prevent a preliminary clinical opinion from being interpreted as a completed prescription.​

 

Practice resource: [AT-HM Documentation Bundle →]

​

Assistive technology trials and clinical reasoning

Trials can form an important part of AT prescription where an OT needs to determine whether an intervention is suitable for the individual person.

​

However, the level of assessment and trial required will vary.

OTs should use clinical judgement to determine what information is reasonably required to support a recommendation, taking into account factors such as:

• functional presentation

• intended use

• environment

• complexity

• potential consequences if the intervention is unsuitable.

 

The objective is not to create unnecessary steps for every AT recommendation. It is to ensure the clinical process is proportionate to the intervention and that recommendations can be reasonably supported.

 

Where the necessary clinical work cannot yet occur because funding, access or other information is unavailable, that limitation should be made clear.

 

What is the OT's role in home modifications?

Home modification recommendations require consideration of the interaction between the person, their occupations and the physical environment.

 

Depending on the scope and complexity of the modification, an OT may assess functional performance, identify environmental barriers, consider alternative strategies and provide recommendations regarding the functional requirements of the proposed modification.

​

The OT's role should also be distinguished from that of builders, tradespeople and other professionals responsible for areas such as construction methods, structural requirements and regulatory compliance.

​

Clear documentation of the OT's functional recommendations, scope and limitations is particularly important where recommendations will be interpreted or implemented by other parties.

​

AT-HM implementation and review

An AT-HM pathway does not necessarily finish when a report is submitted or equipment is delivered.

​

Depending on the intervention, appropriate clinical support may include implementation, fitting, education, checking that the intervention can be used as intended or reviewing whether it remains suitable.

​

The level of follow-up required should again reflect the complexity, risk and individual circumstances of the intervention.

​

For OTs, this means considering the full pathway from identifying the need through to implementation rather than viewing prescription as an isolated documentation task.

​

Common AT-HM questions from Occupational Therapists

 

Is AT-HM funded from the participant's ongoing Support at Home budget?

AT-HM has separate funding arrangements within Support at Home. OTs should clarify the participant's relevant AT-HM funding and the clinical support available before commencing work that depends on that funding.

​

Can an OT request additional funding without recommending a specific product?

An OT may identify that additional funding or clinical work is required before a specific recommendation can be made. Documentation should clearly distinguish evidence of the person's need from a completed prescription.

​

Do I need to provide a quote before additional funding can be considered?

The information available will depend on where the person is within the assessment and prescription process. There may be circumstances where a definitive quote cannot reasonably be obtained before further clinical assessment or trials have occurred.

​

Can I just use my initial OT assessment report?

An initial assessment may contain relevant evidence, but it serves a broader purpose. The key question is whether the information being provided clearly communicates what is required at the particular stage of the AT-HM pathway without creating unnecessary duplication or implying that clinical work has occurred when it has not.

​

Does every AT recommendation require a trial?

Not necessarily. The clinical process should be proportionate to the complexity and risk of the intervention and the information reasonably required to determine whether it is appropriate for the individual.

​

Does AT-HM approval mean the OT can immediately prescribe?

Funding availability and clinical prescription are related but separate considerations. Where further assessment, trials or information are required to determine an appropriate intervention, those steps still need to occur.

​

Practical AT-HM support for Occupational Therapists

The AT-HM Scheme requires OTs to navigate both clinical reasoning and the funding pathway surrounding the intervention.

​

Way Forward OT provides practical education and resources to help Occupational Therapists understand the scheme and translate its requirements into efficient, defensible community practice.

​

Continue exploring:

[AT-HM webinar →]
[AT-HM Documentation Bundle →]

 

About this resource

This information provides general education and practice guidance for Occupational Therapists. It does not replace current Australian Government Support at Home and AT-HM guidance, professional standards, organisational requirements or clinical judgement relevant to an individual person.

​

AT-HM program requirements and operational guidance may change. Refer to current Australian Government guidance where specific funding, eligibility, classification or program requirements affect practice.