Why current funding arrangements are failing
To get funding for assistive technology outside the NDIS, people with disability have to find their way through a complex maze.
Around 60 funding programs are spread across different state and federal government departments and not-for-profit organisations. With such a complex system, some people fall through the cracks – and support for those who can get funding is inconsistent and inequitable.
Misunderstandings are common. For example, people who are excluded from the NDIS are sometimes referred to the Australian Government’s Continuity of Support Programme (CoS), which was intended to bridge the gap between state-based disability services and the NDIS. However, the CoS is for ongoing care and services, and doesn’t cover episodic expenses like assistive technology.
However, most people can get funding through one of the following programs:
‘Catastrophic injuries’ are spinal cord injuries, traumatic brain injuries, multiple amputations, severe burns and permanent traumatic blindness. People who acquire a disability through catastrophic injury are covered by the NDIS but only if they were able to get in before they turned 65.
The National Injury Insurance Scheme was meant to sit alongside the NDIS. It was meant to provide lifetime care and support to people who acquired disability through catastrophic injury, irrespective of their age. Right now this scheme is only available in Queensland. There has been no commitment to extend it to other states and territories. So everywhere else, people over 65 who are left with disability after a catastrophic injury must turn to the aged care system for support.
State-based aids and equipment programs exist, but they fall well short of people’s needs.
These programs are underfunded and aren’t keeping pace with the rising cost of assistive technology. Older people often have to pay part of the cost of their assistive technology which they can’t always afford.
Some of the people who need support still can’t get it. For example:
- State programs don’t cover people in residential aged care. These people are left to fund assistive technology themselves or rely on the minimal, and often inappropriate equipment their aged care facility has available.
- Most state programs won’t support anyone who is already on, or is on a waiting list to receive a Home Care Package through the aged care system.
- Long waiting lists that exist under most state programs stop people from getting support when they need it.
While existing programs are falling well short of peoples’ needs, their future is also very unclear. We don’t know whether State Governments will keep funding them once the NDIS is fully established.
People with disability who are over 65 have to rely on the aged care system for support.
This funding is delivered through either the Commonwealth Home Support Program (CHSP) or a Home Care Package. Unfortunately, the aged care system doesn’t offer specialist disability expertise and doesn’t include as much funding for assistive technology as the NDIS.
The Commonwealth Home Support Program is the entry level program that exists under the aged care system. It is usually accessed by people who have less significant needs for support, or people who are waiting for more support to become available through a Home Care Package.
The CHSP provides a small amount of funding for assistive technology. Each year, people can get up to $500 for aids and equipment, or up to $1000 with supporting evidence from an occupational therapist.
At the moment, this funding is only available in some regions and only covers some types of assistive technology.
There’s also confusion between the CHSP and state-based aids and equipment programs. The CHSP guidelines say that service providers should try to use state-based programs ‘where appropriate’. The support offered under these programs is inconsistent though, and some people aren’t eligible. We don’t know whether and how often CHSP service providers are actually accessing CHSP or state-based assistive technology funding for their clients.
Because the CHSP only provides a small amount of funding for assistive technology, most older people with disability are turning to the Home Care Packages Program to try and access the support they need. A Home Care Package provides funding for a coordinated mix of aged care services.
But Home Care Packages still don’t provide enough support to meet the needs of many older people with disability. While NDIS funding is tailored to each person’s individual needs, each Home Care Package is funded at one of four set levels. This means that many older people with permanent and severe disability are forced to trade off one vital service to be able to afford another. Even at the higher levels (3 and 4), Home Care Packages simply aren’t designed to meet all of their support needs.
Long waiting lists are also stopping people from accessing a Home Care Package when they need it. The Australian Government has announced an extra 34,000 Level 3 and 4 packages over four years, but at 30 June 2019, almost 120,000 people were still waiting for a package.