NDIS New Framework Planning and NDIS Supports
Department of Health, Disability and Ageing Consultation October 2026
(02) 6232 0700 pca@palliativecare.org.au palliativecare.org.au
Contents
Key issues
This submission Palliative Care Australia (PCA) is the national peak advocacy body for palliative care and represents all those who work towards high-quality palliative and end-of-life care for those who need it. Working closely with consumers, our Member Organisations and the palliative care workforce, PCA aims to improve access to and promote palliative care.
PCA welcomes the opportunity to provide advice to the Department of Health, Disability and Ageing’s consultation on National Disability Insurance Scheme (NDIS) New Framework Planning and NDIS Supports.
Summary The Australian Government is undertaking the most significant reform to NDIS planning since the scheme’s inception. PCA supports more consistent assessments and flexible, individualised plans and budgets. However, the reforms must accommodate the needs of the many NDIS participants with life-limiting illness whose support needs will change over time, sometimes rapidly.
If NDIS participants with rapidly escalating support needs are forced to wait for lengthy administrative processes, many will need to enter hospital to receive care they would otherwise be able to receive in the community – at much greater cost to the taxpayer.
This consultation focuses primarily on community information needs, pending further information on and consultation about the Rules later this year.1 In this submission, PCA explains what is needed to safeguard timely, appropriate supports for people with life-limiting illness, their families and carers. Although the initial transition focuses on adults, this submission also addresses children’s needs as they are expected to transition by December 2030.2
Most importantly, PCA emphasises the need to retain and build on improvements made via the Priority Access Pathway, which was introduced in 2024 in response to major delays in responding to the needs of new NDIS participants approaching end of life. The introduction of that Pathway resulted in significant improvements in response times and is it critical those advances are not lost as the Scheme transitions participants to New Framework Planning.
Recommendations
Strengthening the NDIS Priority Access Pathway under New Framework
Planning
Recommendation 1
For participants accessing the NDIS via the Priority Access Pathway, PCA recommends that the Australian Government should:
- confirm what participants can expect regarding an expedited planning process
- maintain the commitment to delivering a participant’s first plan within 30 days
- ensure the Support Needs Assessment, Replacement Support Needs Assessment, Plan Variation and Plan Reassessment processes can be tailored for people with life-limiting illness and delivered within expedited timeframes.
The Australian Government should also adopt expedited decision-making for all NDIS participants with a condition where a trajectory of rapid decline is typical or reasonably foreseeable.
Tailoring the Support Needs Assessment process for people with life-limiting
illness
Recommendation 2
PCA recommends that the Australian Government should provide more information about:
- whether the Support Needs Assessment will be tested with people with life- limiting illness, for example with organisations represented on the National Disability Insurance Agency’s (NDIA) Neurodegenerative, Palliative Care and Rare Diseases Advisory Group
- whether NDIS support needs assessors assessing people with a life-limiting illness will be required to have an understanding of the needs arising from specific life-limiting illnesses
- how the assessment will capture both fluctuating/increasing support needs and likely future support needs where these can be reasonably anticipated, for example where someone has a degenerative condition
- how clinical expertise of treating health professionals will be taken into account for the ‘Core Needs Assessment’
- how it will avoid unfounded assumptions about the sustainability of informal supports arising from implementation of the Personal and Environmental Circumstances Questionnaire
- how relevant clinical information will inform ‘Targeted Assessments’, especially where no existing reports from health professionals are available, and who pays for this clinical information
- the framework for assessing evidence provided for Targeted Assessments
- when NDIS participants under 18 years old will transition to New Framework Planning and how the NDIA intends to tailor Support Needs Assessment tools and planning processes for children with life-limiting illness.
Recommendation 3
NDIS participants should be able to review and provide comment on a draft Support Needs Assessment report before it is submitted to the NDIA.
Recommendation 4
NDIS participants with life-limiting illness should be able to request a Replacement Support Needs Assessment if:
- the original assessment inadequately accounts for fluctuating support needs or increases in support needs that can be reasonably anticipated
- the participant’s support needs change significantly while awaiting approval of their Statement of Participant Supports.
Replacement Support Needs Assessments for people with life-limiting illness should have expedited timeframes (days not weeks).
Budget method rules
Recommendation 5
PCA recommends that the Australian Government provide more information about the role of the NDIA delegate in approving a NDIS participant’s plan; and specifically, whether they will have authority to change a participant budget to accommodate participants’ individual circumstances.
Fast tracked Plan Variations and Plan Reassessments
Recommendation 6
People with a life-limiting illness should be able to request fast-tracked decisions (actioned within days, not weeks) for Plan Variation or Plan Reassessment – not only when their circumstances change but in reasonable anticipation of a change in circumstances.
Ensuring disability support continues for people with life-limiting illness
Recommendation 7
The renewed NDIS support rules should retain the current wording from the NDIS (Getting the NDIS Back on Track No.1)(NDIS Supports) Transitional Rules 2024 ‘Schedule 2 – Supports that generally are not NDIS supports’, which states that NDIS supports may continue to be provided at the same time as sub-acute or palliative care services.
Detailed commentary
Following is more detailed commentary on each of the issues mentioned in the summary and recommendations above.
1. NDIS Priority Access Pathway
The NDIA’s introduction of the Priority Access Pathway (‘the Pathway’) in 2024 for people with terminal illness and disability was a significant advance.3 Its commitment to an access decision within five business days and a first plan within 30 days of becoming a participant drastically improved the NDIA’s previously unacceptably slow response to at least some people with life-limiting illness.
PCA welcomed Minister McAllister’s recent commitment that the NDIS Priority Access Pathway would continue at least until new access arrangements for the scheme are worked out, including an approach for people with degenerative conditions.4 However, limited public communication has created uncertainty about the Pathway’s scope and permanence, particularly as NDIS planning undergoes significant reform.
It is essential that the core features of the Pathway be maintained under New Framework Planning and extended to the new Support Needs Assessment process. The Pathway’s expedited approach should encompass access, Support Needs Assessments, Replacement Support Needs Assessments, First Plans, Plan Variations and Plan Reassessments. If NDIS participants with rapidly escalating support needs are forced to wait for lengthy administrative processes, many will need to enter hospital to receive care they would otherwise be able to receive in the community – at much greater cost to the taxpayer.
In addition, PCA understands the Pathway has to date primarily been used for people with disabilities arising from metastatic cancer (particularly brain cancer), childhood dementia and Motor Neurone Disease. The Pathway – or a similar process – should also provide access to other cohorts of participants who are likely to be approaching end of life. Access to a timely decision should reflect a person’s trajectory and support needs and not be determined purely by diagnosis.
Any expedited processes available to adults with life-limiting illness under New Framework Planning should also be available to children with life-limiting illness, acknowledging they will be transitioning to New Framework Planning at a later stage.
2. Support Needs Assessment rules
PCA welcomes the opportunity to provide feedback on what parts of the Support Needs Assessment rules require further explanation, questions and feedback about the draft Support Needs Assessment report template and the circumstances in which Replacement Assessments should be arranged.
Support Needs Assessments represent a significant change to NDIS planning, intended to “create a more consistent and person-centred approach to NDIS planning and funding decisions.”5 PCA understands the Support Needs Assessment will be made up of a Core Needs Assessment, a Personal and Environmental Circumstances Questionnaire and Targeted Assessments.
2.1 Taking account of changing needs
Support Needs Assessments must capture fluctuating needs6 and anticipate rapidly increasing support needs7 associated with rapid functional decline in people with life- limiting illness. This is true both for adults and children; in fact, for some children, the disabling impact of a condition can worsen as a child grows, even if the condition it arises from is static.8
Assessments which overlook these changes for adults and children risk inadequate plans, gaps in essential support, and increased administrative burden through repeated requests for Replacement Support Needs Assessments, Plan Variations or Plan Reassessments. It is, as yet, unclear whether the NDIA’s proposed Support Needs Assessment will capture fluctuating needs or anticipate future support needs.
2.2 Skills of Support Needs Assessors
Support Needs Assessors must also have the right skills, knowledge and experience. The amended NDIS Act allows assessments to be undertaken by NDIA staff, consultants engaged by the Agency or other people prescribed in the NDIS Rules.9 PCA understanding, through information released under FOI, that NDIS Support Needs Assessors will be required to hold tertiary qualifications in allied health or be health clinicians.10 The NDIA should explain how assessors’ skills and experience will be matched to participants’ needs. Assessors working with people with life-limiting illness should understand the relevant condition,11,12,13 its likely progression and, where appropriate, how their disability support can be delivered consistently with a palliative approach.
In relation to children with life-limiting illness specifically, assessors must have expertise in paediatric disability, development and life-limiting conditions. There must be paediatric-specific assessors and/or mandatory paediatric specific training and the requirement to give weight to input from medical, nursing and allied health professionals with experience in the child’s disability and paediatric disability.14
2.3 Core Needs Assessment – specialist medical advice
Specialist medical and allied health advice is essential to understanding health-related display supports and anticipating future needs.15 The NDIA should explain how
evidence from treating health professionals will inform the Core Needs Assessment and how it intends appropriate weighting to be applied to these reports. Currently health professional’s reports do not appear to be given appropriate weighting by the NDIA,16 despite the often substantial out-of-pocket expenses that people with disability incur to obtain those reports, at the NDIA’s request.
2.4 Core Needs Assessment for children
In due course, and before commencement of transitioning children and young people under 18 into the scheme, it will be important to revise arrangements for Support Needs Assessments for children with life-limiting illness. This should include, but not be limited to assessment of:
- mobility (where assessment will need to differentiate between mobility and support needs within the home versus accessing the community and activities with peers)
- maintaining health and preventing avoidable hospitalisations (such as respiratory health, nutrition/feeding and growth, skin and pressure care, continence and other complex health needs) and
- assistive technology and consumables.17
2.5 Personal and Environmental Circumstances Questionnaire
It is critical that the Personal and Environmental Circumstances Questionnaire accurately captures family and carer support, including not only what is provided currently but also its sustainability.18 The NDIA should explain how this information will affect Support Needs Assessment outcomes and therefore plans and budgets. Assessors must not assume that family members or carers can maintain or increase their contribution as a participant’s needs escalate.
If a Personal and Environmental Circumstances Questionnaire is implemented with children (when they transition to New Framework Planning), there should be a clear mechanism for identifying when a child’s care and supervision needs exceed those normally expected of a parent or caregiver.19
2.6 Targeted Assessments
PCA understands Targeted Assessments will be conducted where a more detailed assessment of a participant’s support needs is required, but that not all participants will be required to undertake a Targeted Assessment. We welcome the Australian Government’s commitment for the NDIA assessor to check if the participant has relevant reports from a medical or allied health professional in determining whether a Targeted Assessment is needed.20 However, the Australian Government should clarify
how information gaps will be addressed when reports do not exist, how treating professionals will contribute, and what funding will be available to obtain additional evidence. Participants should not face financial barriers to an accurate assessment.
2.7 Testing the Support Needs Assessment with people with life-limiting illness
PCA also notes that organisations represented on the Neurodegenerative, Palliative Care and Rare Diseases Advisory Group have offered support to the NDIA to test the new Support Needs Assessment with people with life-limiting illness.21 Testing with this cohort is essential to ensure assessments capture rapid or fluctuating functional decline and escalating support needs.
This is also the case for children. As Paediatric Palliative Care Australia and New Zealand advised PCA: Any proposed Support Needs Assessment process involving children and young people will need specific testing and validation across the different developmental stages, disability types and trajectories. Assessment tools must also allow support needs to be considered relative to age-appropriate developmental expectations.
2.8 Support Needs Assessment report template
PCA welcomes the NDIS Support Needs Assessment Report template’s identification of whether a participant’s qualifying impairment arises from a degenerative condition,22 although it remains unclear how a support needs assessor would arrive at this conclusion if they did not have access to a current medical diagnosis. Identification of a condition as ‘degenerative’ should also trigger assessment of anticipated support needs and expedited timeframes for Support Needs Assessment, Plan Variation and Plan Reassessment, as recommended above.
It is also unclear how the template will capture anticipated functional decline and associated increases in future support needs. For people with life-limiting illness, as outlined above, needs can change dramatically from week to week. Assessments must anticipate these changes to prevent gaps in essential supports and reduce avoidable requests for Replacement Support Needs Assessments, Plan Variations or Plan Reassessments.
In addition, from page 17 onwards, the template indicates that for targeted support needs, assessors will determine whether health professional recommendations meet evidentiary requirements under the NDIS rules. It will be important to ensure that assessors have specialist training and appropriate clinical frameworks to allow them to make such determinations with respect to a participant’s life-limiting illness. PCA recommends the NDIA consult on the specific framework Support Needs Assessors will use to evaluate evidence from treating health professionals.
PCA welcomes the Australian Government’s clear commitment to the Support Needs Assessor checking information with the participant at the end of the assessment discussion.23 However, in PCA’s view, this commitment does not go far enough.
Specifically, under the proposed arrangements, if the participant has concerns about the Support Needs Assessment report, the NDIA delegate will consider whether a new assessment is needed.24 Instead, there should be a less formal intermediary step whereby the participant is provided with the Support Needs Assessment report for comment before it is submitted to the NDIA delegate.25 This would ensure the information going to the delegate is correct in the first place and avoid unnecessary Replacement Support Needs Assessments.
2.9 Replacement Support Needs Assessments
If not designed appropriately, the proposed Support Needs Assessment process could represent a point-in-time assessment which may overlook rapid future increases in support needs. To mitigate this risk, PCA recommends that participants with life-limiting illness be able to request a Replacement Support Needs Assessment where:
- the original assessment inadequately accounts for fluctuating support needs or reasonably anticipated increases in support needs
- the participant’s support needs change significantly while awaiting approval of their Statement of Participant Supports.
Replacement Support Needs Assessments for people with life-limiting illness should be expedited through a priority pathway to ensure urgent support needs are addressed promptly. Lengthy administrative processes risk people with life-limiting illness not receiving supports at all.
3. Budget method rules and draft participant plan
3.1 Budget method rules
PCA understands new framework budgets will be calculated from Support Needs Assessments using a prescribed budget method, with a NDIA delegate reviewing and approving the participant’s plan.26 However, it remains unclear how much budget calculation will be automated and whether delegates will have the ability to amend prescribed or template budgets to meet individual needs.
The palliative care sector has serious concerns about use of automation in budget setting, given well-documented (and ongoing) experiences of inadequate support allocations under the Support at Home aged care program.27
PCA welcomes NDIS delegate review of NDIS plans and budgets. However, the effectiveness of this safeguard depends on delegates having authority to change budgets that inadequately reflect individual circumstances. PCA recommends the
Australian Government clarify the extent of automation in budget setting and whether NDIA delegates will have authority to override calculated budgets to meet individual support needs.
3.2 Draft NDIS plan template
The proposed NDIS participant plan template does not clearly outline provisioning for future changes in support needs. NDIS plans for people with life-limiting illness should clearly anticipate future support needs within the current budget to avoid unnecessary Plan Variations and Plan Reassessments.
4. Plan Variation and Plan Reassessment rules
People with life-limiting illness can experience fluctuating and rapidly escalating support needs. Timely decisions are critical because participants may die before eceiving essential supports. Plan Variation and Plan Reassessment decisions must therefore be expedited (actioned within days, not weeks) both when circumstances change and when increased needs are reasonably anticipated.
Currently the NDIA has a timeframe of 21 days to decide to vary a plan28 and 90 days to decide whether to reassess a plan.29 For many people approaching end of life, these timeframes will be too long, and will result in participants deaths, with unmet needs, before decisions are made.
PCA acknowledges the NDIA has a process for crisis or emergency plan variations, through which participants can receive funding more quickly. However, the relevant guideline specifies that this funding needs to be either a once-off support or for a specific time period.30 This would not cover the needs of people with life-limiting illness whose support needs may change rapidly and then fluctuate and deteriorate over a longer period of time. PCA recommends therefore that the NDIS Priority Access Pathway for people with life-limiting illness continues under New Framework Planning including expedited Plan Variation and Plan Reassessment decisions.
Finally, as Paediatric Palliative Care Australia and New Zealand has advised, when the Australian Government is designing New Framework Planning for children it should acknowledge that childhood itself is characterised by growth and developmental change. The new assessment process should include mechanisms to identify participants whose support needs are reasonably expected to change and establish planned review points or triggers for proactive reassessment.31
For progressive conditions, clarity is needed about how the assessment process will translate known clinical trajectories into timely changes in plans, particularly where significant equipment, home or vehicle modifications require substantial lead time.32
5. NDIS Support Rules
PCA understands the Australian Government is proposing to consolidate the current 36 NDIS support categories into 18 to align with needs assessment and budgeting under New Framework Planning.33 PCA welcomes confirmation that “These changes do not remove supports from NDIS participants.”34
PCA understands the Australian Government also intends to clarify which supports are excluded from NDIS Supports and that the Rule will continue to list what the NDIS will not fund including “supports that are the responsibility of other systems (like health or education).”35 It is unclear, aside from the five specific examples provided, whether any further changes will be made to Schedule 2 of the NDIS (Getting the NDIS Back on Track No.1)(NDIS Supports) Transitional Rules 2024.
It is critical to retain the current Transitional Rules’ clarification that NDIS supports may continue alongside sub-acute or palliative care services.36 Substantial anecdotal evidence indicates disability supports have previously been denied by the NDIA on the mistaken assumption that palliative care services would provide them. This risk is heightened by amendments commencing in February 2027 requiring the CEO to be satisfied that a support is not one that would be more appropriately provided or funded by another scheme or one or more existing government service systems.37
The current clarification in the Transitional Rules is therefore an essential protection. The revised NDIS Support rule must continue to make clear that receiving palliative care does not remove a participant’s need for, or entitlement to, NDIS disability supports.
6. Communication about the NDIS Rules
The Australian Government must clearly communicate the rules and their implications for people with life-limiting illness to participants, families, carers, disability support workers, service providers, health professionals, health services and peak bodies.
The NDIA should use trusted channels, including peak bodies, consumer and carer networks and providers supporting this cohort. Information must be accessible in multiple formats, including but not limited to Easy Read and Auslan.
NDIS Hospital Liaison Officers should inform health services about the Priority Access Pathway. Communication should also reach health professionals through PCA, the Australian and New Zealand Society of Palliative Medicine, the Royal Australasian College of Physicians’ Australasian Chapter of Palliative Medicine, the Royal Australian College of General Practitioners, Palliative Care Nurses Australia, Palliative Care Social Work Australia, Occupational Therapy Australia and Paediatric Palliative Care Australia and New Zealand.
References
1 Department of Health, Disability and Ageing (2026) New Framework Planning Rules: Consultation paper – August 2026, 4
2 Department of Health, Disability and Ageing (2026) New Framework Planning Rules: Consultation paper – August 2026, 5
3 PCA (2024) Breakthrough for better access to palliative care for people with disability
4 Mark Butler MP, Senator Jenny McAllister, Sam Rae MP (2026) Priority aged care support for Australians with MND
5 Department of Health, Disability and Ageing (2026) New framework planning – support needs assessment, 1
6 Dementia Australia (2026) Submission to the March 2026 NDIS New Framework Planning rules consultation. 4
7 MND Australia (2026) Submission to the March 2026 NDIS New Framework Planning rules consultation, 2
8 Advice provided to PCA by Paediatric Palliative Care Australia and New Zealand (PaPCANZ)
9 NDIS Act 2013, see subsection 32L(4A)
10 NDIA (2026) APS 6 Support Needs Assessor Position Description, 5
11 MND Australia, Submission to the March 2026 NDIS New Framework Planning rules consultation, 3
12 Parkinson’s Australia (2026) Submission to the March 2026 NDIS new Framework Planning rules consultation, 3
13 Dementia Australia (2026) Submission to the March 2026 NDIS New Framework Planning rules consultation, 4
14 Advice provided to PCA by PaPCANZ
15 MND Australia, Submission to the March 2026 NDIS New Framework Planning rules consultation, 2
16 Senate Community Affairs Legislation Committee (2025) Official Committee Hansard: Estimates: Thursday 27 February 2025, 7
17 Advice provided to PCA by PaPCANZ
18 See Parkinson’s Australia (2026) Submission to the March 2026 NDIS new Framework Planning rules consultation, page 4 and 6, for the importance of formal supports to the sustainability of informal supports.
19 Advice provided to PCA by PaPCANZ
20 Department of Health, Disability and Ageing (2026) New Framework Planning Rules: Consultation paper – August 2026, 7
21 NDIA (2026) NPRAG meeting summary March 2026
22 NDIA (2026) Support needs assessment report example, 7
23 Department of Health, Disability and Ageing (2026) New Framework Planning Rules – Consultation Paper – August 2026, 7
24 Department of Health, Disability and Ageing (2026) New Framework Planning Rules – Consultation Paper – August 2026, 7
25 Also recommended in MS Australia’s submission to the NDIS Proposed New Framework Planning Rules consultation in March 2026, 4
26 Department of Health, Disability and Ageing (2026) New Framework Planning Rules – Consultation Paper – August 2026, 9
27 Anne Connolly and Ninah Kopel (2026) Inside the aged care algorithm deciding support for older Australians
28 NDIS Act 2013, see subsection 47A(4)
29 NDIS Act 2013, see subsection 48(3)
30 NDIS (2026) Our Guideline – Plan Variations, 14-15
31 Advice provided to PCA by PaPCANZ
32 Advice provided to PCA by PaPCANZ
33 Department of Health, Disability and Ageing (2026) NDIS Supports Transitional Rules: Consultation Paper, 6
34 Department of Health, Disability and Ageing (2026) New Framework Planning Rules – Consultation Paper – August 2026,12
35 Department of Health Disability and Ageing (2026) New framework planning – NDIS supports, 4
36 NDIS (Getting the NDIS Back on Track No. 1)(NDIS Supports) Transitional Rules 2024, see Schedule 2 – Supports that are generally not NDIS supports, table row 12, item (r) and following note
37 NDIS Amendment (Securing the NDIS for Future Generations) Bill 2026, see changes to insert subsection 34(1)(g)