Submission to the Disability Discrimination Act Review
Aged care, disability discrimination and the Disability Discrimination Act 2
The Aged Care Act 2
Rights in the Aged Care Act 2
Examples of failure to meet disability needs in Aged Care
Direct disability discrimination examples 3
Indirect disability discrimination examples 3
Disability Standards and Guidelines
Disability Standards 5
Australia’s Disability Strategy 2021-2031 5
Recommendations
The Disability Discrimination Act 5
Australia’s Disability Strategy 5
Appendix 1. The Aged Care Act 2024 Statement of Rights, Sections 23 and 24 6
References 9
Aged care, disability discrimination and the Disability Discrimination Act
This submission draws on the lived experience of persons with disabilities receiving aged care. It draws attention to aged care not co-designed with the aged with disabilities, care incorporating ableist assumptions, direct and indirect discrimination.
It responds to Consultation Question 51 of the Disability Discrimination Act 1992 Review, “Are there any other issues with the Disability Discrimination Act that should be considered as part of this review? ”
There is no Disability Standard for Aged Care. Aged Care is not addressed in the Australian Disability Strategy.
This submission proposes addressing the need for a Disability Standard for Aged Care, and the addition of Aged Care to the Australian Disability Strategy.
The Aged Care Act
The Objects of the Aged Care Act 2024 include to “ in conjunction with other laws, give effect to Australia’s obligations under the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of Persons with Disabilities; …
(i) uphold the rights of individuals under the Statement of Rights; and
(ii) assist individuals accessing funded aged care services to live active, self-determined and meaningful lives; …
(iii) ensure equitable access to, and flexible delivery of, funded aged care services that put older people first and take into account the needs of individuals, regardless of their location, background and life experience; …
iv) support individuals accessing funded aged care services to effectively participate in society on an equal basis with others, thereby promoting positive community attitudes to ageing; …
v) facilitate access to integrated services in other sectors where required; and
c) enable individuals accessing funded aged care services to exercise choice and control in the planning and delivery of those services…”1
Rights in the Aged Care Act
There is a Statement of Rights in Section 23 of the Aged Care Act.
Section 24 removes the Statement of Rights in Section 23 from the jurisdiction of courts and tribunals.2
Any breaches of rights must be dealt with by negotiating with providers, and by lodging complaints with the Aged Care Quality and Safety Complaints Commissioner.
Reports from those with lived experience of the complaints process describe experiences that are either disability friendly nor trauma informed and that do not lead to timely resolution.
Attempts to secure quality care in residential aged care have led to reprisals. If family or loved ones of a resident with disability try to address inadequate or harmful treatment with providers they may experience reprisals. Providers may allege the family members are ‘aggressive’ and deny or limit visitation. Given the potentially short time left with a loved one, family members and partners face invidious choices.3
1 Aged Care Act Future compilation published on 29 July 2025 p.34 2 Section 23 and 24 are listed in Appendix 1
Examples of Failure to Meet Disability Needs in Aged Care
Direct Disability Discrimination Examples
Allied Health and Therapy
In the Aged Care Rules 2025 Division 2 Section 8-12 those with disabilities receiving Support at Home (SAH), which replaced Home Care Packages on November 1, 2025, are excluded from receiving allied health and therapy if required due to their disability, and not due to age-related reasons. “ …(c) the service is for the management of conditions related to age-related disability or decline…”
The exclusion covers 13 services unable to be accessed using Support at Home by those with disabilities not age-related: podiatry, social work, speech pathology, diet or nutrition, Aboriginal or Torres Strait Islander Health, physiotherapy, psychology, exercise physiology, occupational therapy, counselling or psychotherapy, and music therapy.
Indirect Disability Discrimination Examples
Lifetime Cap of $15,000 on Home Modifications
The Support at Home Program Manual – a Guide for Registered Providers lists the lifetime cap for home modifications as $15,000.
13.3 AT-HM funding…
…Funding for high-tier home modifications will be capped at $15,000 per lifetime (this does not include any additional supplement a participant may be eligible for). Lifetime caps of the home modifications high tier will be monitored by Services Australia.
The lifetime cap indirectly discriminates against those with disabilities which require home modifications above $15,000 across a lifetime e.g., many bathroom modifications are above $15,000. The cap is cumulative and some ramps would be in excess of $10,000. Grab rails can be several hundred dollars each.
Persons with post-Polio, Multiple Sclerosis or Parkinsons Disease, for example, may be unable to remain living at home because $15,000 is not sufficient for home modifications.
Exclusion of Air-Conditioners and Air-Conditioner Services from Support at Home Services
One-size-fits-all requirements prevent SAH funds being used for Heating, Cooling and Ventilation (HVAC) even if medical prescriptions indicate HVAC is necessary for safety and survival.
Disabilities with thermoregulation disorders resulting in the need for HVAC include multiple sclerosis, post-Polio, Parkinson’s disease, and ME/CFS.
Those with Diabetes require heating in cold weather as cold induced lower blood circulation can lead to gangrene and amputations.
Lack of Access to Rooms with Individual Temperature Controls in Residential Aged Care
Building guidelines for residential aged care do not require rooms to have individual temperature controls. They do not make clear to the reader the need for those with certain disabilities to have individual room temperature control due to thermoregulation disorders. The example given in the guidelines of a response to temperature control is of a nurse giving a resident a cardigan when it is cold – not a design response and not a focus on the needs of those with thermoregulation disorders. There is no discussion of the life threatening impact of inappropriate temperatures on those with certain disabilities.
4 [https://www.health.gov.au/sites/default/files/2025-09/support-at-home-program-manual-a-guide-for-registered- providers.pdf](https://www.health.gov.au/sites/default/files/2025-09/support-at-home-program-manual-a-guide-for-registered- providers.pdf), p172
5 [https://www.health.gov.au/resources/publications/national-aged-care-design-principles-and- guidelines?language=en](https://www.health.gov.au/resources/publications/national-aged-care-design-principles-and- guidelines?language=en)
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Lack of access to individual rooms in residential aged care
Individual rooms will be required for those with disabilities where noise or light trigger responses such as unmanageable pain or seizures. There appears to be no planning for the provision of such environments where required.
The Kantar Report discussed the possibility of individual rooms and individual temperature controls being reserved as ‘extras’ for those who can pay more. 6
Extra time allowed to organise Assistive Technology
Rules provide for extra time to organise Assistive Technology for some disabilities and not others. The defined extra time is available on notification by the registered provider “if a medical practitioner has certified, in writing, that the individual has been diagnosed with any of the following conditions”: cerebral palsy; epilepsy; Huntington’s disease; motor neurone disease; multiple sclerosis; Parkinson’s disease; post-polio; spinal cord injury; spinal muscular atrophy; stroke; other acquired brain injury; muscular dystrophy or muscular atrophy.
Other disabilities with similar needs are not eligible for the extra time.
Failure to accept persons with disabilities into home care or residential aged care
There are reports to lived experience aged care advocates of aged with high care needs due to disability not being accepted as clients by some home care and residential aged care providers. It appears some providers consider the needs of such clients cannot be sufficiently met through available funding. 7 It is suggested such high care clients are considered less profitable.
There is growing tragedy as older persons with disability are stranded in hospital beds, not provided with the support to stay at home and unable to enter residential aged care.
Ableist assumptions in Support at Home contribution fee design: everyday living fees
Ableist assumptions in aged care fail to understand relationships between safety and well-being, disability and everyday living tasks. Support at Home, which has replaced Home Care Packages, requires recipients to pay ‘contribution’ fees. The percentage charge for such fees is highest for “Everyday living expenses”.
Persons whose disabilities require support with everyday living tasks – laundry, cleaning (e.g. after a colostomy bag breaks), washing the dishes (poor eyesight or lack of strength leaves food on the plates) – pay the highest level of co-contribution fees.
For some with neuro-muscular disorders the effort of managing everyday living can be exhausting. A load of washing might take a day with rests in between tasks such as sorting the washing and putting the washing in the machine. For some with ME/CFS washing the dishes may be too much.
When everyday living tasks are not completed due to the inability to access services with high contribution fees, problems such as falls, infections or food poisoning may result.
6 https://www.health.gov.au/sites/default/files/2024-03/consumer-contribution-to-aged-care-services-report.pdf 7 https://www.sahealth.sa.gov.au/wps/wcm/connect/b4d9edfe-c75f-41e6-bce3-ca06b3c025e7/Proposal+from+the+South+Australian+Government+-+Plan+to+unblock+aged+care.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-b4d9edfe-c75f-41e6-bce3-ca06b3c025e7-ptYA2H2
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There is no provision for those in receipt of Support at Home to appeal contribution fee percentages based on medical reports that specific support with everyday living tasks is clinically required.
Disability Standards and Guidelines
Disability Standards
The Disability Discrimination Act 1992 (DDA) is supplemented by a series of Disability Standards and Guidelines. These provide more detail on rights and responsibilities about equal access and opportunity for people with a disability.
Standards are legally binding regulations set by the Attorney-General under the DDA.
Guidelines (or ‘Advisory Notes’) are issued by the Commission to help people and organisations understand their rights and comply with their responsibilities under the DDA and accompanying Standards.
Standards and Guidelines can be made in the areas of employment, education, public transport services, access to premises, accommodation and the administration of Commonwealth laws and programs.
8 https://humanrights.gov.au/our-work/disability-rights/disability-standards
There is no Disability Standard for Aged Care. It is important that the need for a Disability Standard for Aged Care be assessed in partnership with those with disability receiving aged care and those stranded in hospitals unable to access aged care.
Australia’s Disability Strategy 2021-2031
Australia’s disability strategy has seven outcomes. Aged care is not an outcome and is not mentioned in the Health and Well-being outcome.
It is important for those with disabilities and their families that the question of how best to provide aged care that respects each person’s rights and needs is included in Australia’s Disability Strategy.
Recommendations
The Disability Discrimination Act
It is recommended that the need for a Disability Standard for aged care be addressed in partnership with those with disability in receipt of aged care and those stranded in hospitals unable to access aged care.
Australia’s Disability Strategy
It is recommended that
- Aged care be added to Australia’s Disability Strategy 2021-2031.
- Aged care be added as an outcome in Australia’s Disability Strategy 2021-2031
- Those with lived experience of aged care and disability co-design the inclusion of aged care in Australia’s Disability Strategy 2021-2031.
Appendix 1. The Aged Care Act 2024 Statement of Rights, Sections 23 and 24
Part 3—Aged care rights and principles9
Division 1—Aged care rights
23 Statement of Rights
Independence, autonomy, empowerment and freedom of choice
(1) An individual has a right to:
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(a) exercise choice and make decisions that affect the individual’s life, including in relation to the
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(i) the funded aged care services the individual has been approved to access;
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(ii) how, when and by whom those services are delivered to the individual;
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(iii) the individual’s financial affairs and personal possessions; and
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(b) be supported (if necessary) to make those decisions, and have those decisions respected; and
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(c) take personal risks, including in pursuit of the individual’s quality of life, social participation and intimate and sexual relationships.
Equitable access
(2) An individual has a right to equitable access to:
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(a) have the individual’s need for funded aged care services assessed, or reassessed, in a manner which is:
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(i) culturally safe, culturally appropriate, trauma-aware and healing-informed; and
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(ii) accessible and suitable for individuals living with dementia or other cognitive impairment; and
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(b) palliative care and end-of-life care when required.
Quality and safe funded aged care services
(3) An individual has a right to:
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(a) be treated with dignity and respect; and
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(b) safe, fair, equitable and non-discriminatory treatment; and
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(c) have the individual’s identity, culture, spirituality and diversity valued and supported; and
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(d) funded aged care services being delivered to the individual:
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(i) in a way that is culturally safe, culturally appropriate, trauma-aware and healing-informed; and
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(ii) in an accessible manner; and
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(iii) by aged care workers of registered providers who have appropriate qualifications, skills and experience.
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(4) An individual has a right to:
9 Future Law Compilation Aged Care Act 2024 published on July 29 2025
(a) be free from all forms of violence, degrading or inhumane treatment, exploitation, neglect, coercion, abuse or sexual misconduct; and
(b) have quality and safe funded aged care services delivered consistently with the requirements imposed on registered providers under this Act.
Respect for privacy and information
(5) An individual has a right to have the individual’s:
(a) personal privacy respected; and
(b) personal information protected.
(6) An individual has a right to seek, and be provided with, records and information about the individual’s rights under this section and the funded aged care services the individual accesses, including the costs of those services.
Person-centred communication and ability to raise issues without reprisal
(7) An individual has a right to:
(a) be informed, in a way the individual understands, about the funded aged care services the individual accesses; and
(b) express opinions about the funded aged care services the individual accesses and be heard.
(8) An individual has a right to communicate in the individual’s preferred language or method of communication, with access to interpreters and communication aids as required.
(9) An individual has a right to:
(a) open communication and support from registered providers when issues arise in the delivery of funded aged care services; and
(b) make complaints using an accessible mechanism, without fear of reprisal, about the delivery of funded aged care services to the individual; and
(c) have the individual’s complaints dealt with fairly and promptly.
Advocates, significant persons and social connections
(10) An individual has a right to be supported by an advocate or other person of the individual’s choice, including when exercising or seeking to understand the individual’s rights in this section, voicing the individual’s opinions, making decisions that affect the individual’s life and making complaints or giving feedback.
(11) An individual has a right to have the role of persons who are significant to the individual, including carers, visitors and volunteers, be acknowledged and respected.
(12) An individual has a right to opportunities, and assistance, to stay connected (if the individual so chooses) with:
(a) significant persons in the individual’s life and pets, including through safe visitation by family members, friends, volunteers or other visitors where the individual lives and visits to family members or friends; and
(b) the individual’s community, including by participating in public life and leisure, cultural, spiritual and lifestyle activities; and
(c) if the individual is an Aboriginal or Torres Strait Islander person—community, Country and Island Home.
(13) An individual has a right to access, at any time the individual chooses, a person designated by the individual, or a person designated by an appropriate authority.
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24 Effect of Statement of Rights
(1) An individual is entitled to the rights specified in section 23 when accessing, or seeking to access, funded aged care services.
(2) It is the intention of the Parliament that registered providers delivering funded aged care services to individuals must take all reasonable and proportionate steps to act compatibly with the rights specified in section 23 in the delivery of funded aged care services, taking into account that limits on rights may be necessary to balance the following:
(a) competing or conflicting rights;
(b) the rights and freedoms of other individuals, including aged are workers of the registered provider and other individuals accessing funded aged care services;
(c) compliance with other laws of the Commonwealth, or of a State or Territory, including the Work Health and Safety Act 2011.
(3) Nothing in this Division creates rights or duties that are enforceable by proceedings in a court or tribunal.
Note: However, it is a condition of registration for certain registered providers that a registered provider must demonstrate understanding of the Statement of Rights and have in place practices to ensure that
the provider acts compatibly with the Statement of Rights: see subsection 144(1). A person may make a complaint to the Complaints Commissioner about a registered provider acting in a way that is incompatible with the Statement of Rights: see section 358.
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References
Aged Care Act 2024 (Cth)
Aged Care Act Rules 2025
Disability Discrimination Act 1992
https://www.ag.gov.au/sites/default/files/2025-08/DDA-Review-Issues-Paper.PDF
https://www.legislation.gov.au/C2004A04426/latest/text, 14 October 2024
https://www.health.gov.au/sites/default/files/2025-09/support-at-home-program-manual-a-guide-for registered-providers.pdf
https://www.health.gov.au/resources/publications/national-aged-care-design-principles-and guidelines?language=en
https://social.desa.un.org/issues/disability/crpd/article-3-general-principles
1 https://www.legislation.gov.au/C2004A04426/latest/text, October 2024
Convention on the Rights of Persons with Disabilities means the Convention on the Rights of Persons with Disabilities done at New York on 13 December 2006. Note: The Convention is in Australian Treaty Series 2008 No. 12 ([2008] ATS 12) and could in 2024 be viewed in the Australian Treaties Library on the AustLII website (http://www.austlii.edu.au). https://www.ag.gov.au/sites/default/files/2025-08/DDA-Review-Issues-Paper.PDF https://classic.austlii.edu.au/au/legis/cth/bill_em/ddb1992274/memo_0.html
https://www.health.gov.au/our-work/australias-disability-strategy
https://www.health.gov.au/sites/default/files/2024-03/consumer-contribution-to-aged-care-services report.pdf
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