It is time for nationally equitable access to assistive technology and home modifications in Australia: An equity benchmarking study

Abstract

Australians with disability have inequitable access to assistive technology (AT) and home modifications (HMs). This is inconsistent with human rights obligations and fails to capitalise on internationally recognised potential return on investment. Co-designed with a consortium of AT stakeholders, this study quantifies the public provision of AT and HM in Australia by identifying all publicly funded national and state-/territory-based schemes and reporting and comparing available data on the spend per person. An environmental scan and data survey identified 88 government funders administering 109 schemes. Data were available for 1/3 of schemes. Economic evaluation of available cost and participant data estimated the annual AT/HM and wrap-around support spend per person per scheme and organisational costs. Data demonstrated significant AT/HM spend variability across schemes, for example a 50-fold difference between Aged Care ($51) and National Disability Insurance Scheme (NDIS, $2500). Modelled costs are presented for a $16 billion national scheme where all Australians with disability are funded NDIS-equivalent. These foundation data demonstrate substantial service provision gaps and an urgent need for change in disability policy. A cost model and policy principles have been proposed to achieve economies of scale and equity in the provision of AT and HM.