SUBMISSION ON THE INQUIRY INTO THE ADMINISTRATION OF THE NATIONAL DISABILITY INSURANCE SCHEME

Submitted by: Supporting Potential

Date: March 2026

Contact: Angela Harvey, Managing Director

About Supporting Potential

Supporting Potential is an NDIS quality and safeguarding consultancy that works with providers to improve the quality of services delivered to people with disability. Our work sits at the intersection of operational systems, regulatory compliance, workforce capability, and participant outcomes. We work provider-side, helping organisations build systems that reliably deliver quality, not just policies that exist on paper.

Supporting Potential is highly values driven. We will only work with Providers who genuinely want to help us achieve our vision of ‘improving the way the world is experienced by people with disability’. We see the challenges of the NDIS design failures in our daily work. Providers will often engage us when their incident data shows the same patterns month after month, and they have tried to fix it without impact. The issue often isn’t with the individual provider. The root cause is usually a system setting, a pricing constraint, a regulatory gap, or a workforce shortage, that the provider is expected to manage around but cannot resolve. We work at the point where policy meets operations, and that vantage point is what drove this submission.

We observed that most submissions to this inquiry come from one of two perspectives:

• the policy and advocacy perspective, which describes what the system should look like, or
• the operational perspective, which describes what it feels like to work within it.

Our position sits between the two. We help providers translate regulatory requirements into functioning systems, and that means we see both the intent behind policy settings and the operational reality of implementing them. When a design failure exists at the policy level, it shows up in our work as providers who continuously struggle to actively implement compliant systems that drive improved service quality. It doesn’t seem to matter how capable they are, because the system they are trying to comply with contains various contradictions and competing priorities.

That is why we built the review-mapping project. It wasn’t designed as an academic exercise, but an ongoing frustration that well intentioned providers, committing significant resources to improve quality were continuing to fail, despite differences in approach, aptitude and tenacity. We needed to understand which problems theirs were to fix and which were structural. We identified 7 root-cause design failures. It confirms the underlying question: these are problems that no individual provider can resolve, regardless of investment, capability, or intent, because they originate in the design of the scheme itself.

None of this absolves providers of their responsibility to deliver quality. Providers can and should be doing everything within their power to improve the services they deliver, and many are. But even the most committed providers, doing the right work with the right intent, will hit a ceiling that is not theirs to move. Resolving that requires effort on both sides, providers investing in their own capability, and government addressing the structural settings that constrain what that investment can achieve. The best outcomes for participants will come when providers and government work as genuine partners toward the same quality goals. Rather than operating as accidental adversaries within a system that sets them against each other.

Our Submission

This submission is built on a body of work we believe may be useful to the Committee’s deliberations and we have not seen replicated elsewhere. Over the past two years, we have tracked and mapped 528 formal recommendations from 40+ government reviews, including:

• The Royal Commission into violence abuse neglect and exploitation of people with disability,
• The NDIS Review
• 9 ANAO audits, and
• multiple other inquiries into the NDIS conducted between 2016 and 2025.

Our mapping suggests that the 528 recommendations can be consolidated to 7 root-cause design failures that have persisted across the entire decade of NDIS operation. These 7 root-cause issues have continued to be identified consistently through at least $680 million in review activity.

We then tested those 7 root causes against 371 discrete issues extracted from 42 public submissions to this inquiry. 94.6% of the issues map to the same 7 failures. The Committee is not hearing new problems. It is hearing the same problems, described by different people, in a new forum.

This submission addresses all five Terms of Reference:

1. On financial sustainability (ToR1), we present evidence that the pricing-compliance-viability feedback loop identified by multiple submitters is consistent with findings from the 2017 McKinsey Independent Pricing Review, the 2023 NDIS Review, and ANAO audit evidence, and we include the NDIA’s own acknowledgement of $2.4-4 billion in estimated annual integrity losses.
2. On claimant and provider compliance (ToR2), we highlight the genuinely novel structural argument from Intrepidus Law regarding the use of ss45/45A as a compliance mechanism without the procedural protections Parliament attached to the formal investigatory powers.
3. On performance monitoring (ToR3), we draw on ANAO audit findings, the NDIA’s own qualified performance opinion, and evidence from 42 submitters to show that the performance measurement framework does not yet capture the dimensions most relevant to the Committee’s questions, including decision-making quality.

4. On the NDIS Commission (ToR4), we present the ANAO’s “partly effective” assessment alongside evidence on the gap between current regulatory capacity and the scope expansion that mandatory registration will require.
5. On policy advice (ToR5), we draw the Committee’s attention to the absence of a formal government response to the NDIS Review recommendations and the cumulative regulatory burden of concurrent reforms.

Across all five Terms of Reference, our submission provides a cross-referencing layer that maps 371 issues raised by submitters against the 528 formal recommendations from prior reviews. Supporting the Committee with clear line of sight to which of its questions have been addressed by prior review activity, where implementation has stalled, and where the evidence before it contains findings that are genuinely new to the record.

Our purpose is not to restate what you already know, but to attempt to consolidation significant volumes of work and opinion from people who genuinely want to see the scheme deliver on its promise that people with disability would have choice and control over the supports they receive, funded based on individual need rather than rationed by program budgets.

1. Seven Root Causes

1.1. Australian taxpayers have funded at least $680 million in formal reviews, Royal Commissions, audits, and inquiries into the NDIS since 2016. These produced 528 formal recommendations that we have tracked and mapped.

1.2. They reduce to 7 root-cause design failures. Not 528 separate problems. Seven failures in the original design of the scheme that recur across the full body of review evidence.

#	Design failure	First identified	Years unresolved	Risk level	Reviews that identified it
1	No clear line of sight on what is and isn’t funded and how funding contributes to meaningful outcomes. “Reasonable and necessary” is deliberately broad but undefined in practice, creating inconsistency, appeals, and inequity.	2017	9 years	High	JSC Psychosocial (2017), Tune Review (2019), NDIS Review (2023)
2	Support coordination is a design failure, not just a conflict of interest. The role was never properly scoped: no qualifications, no independence requirement, no outcome measures, no position within a participant’s support circle.	2018	8 years	High	ANAO (2018), Tune Review (2019), JSC SIL (2020, called URGENT), Royal Commission (2023), NDIS Review (2023)
3	No proactive quality monitoring. The safeguarding model is reactive. The Commission acts after harm is reported.	2016	10 years	Very High	ANAO Transition (2016), JSC SIL (2020), JSC Q&S Commission (2021), NDIS Review

| 4 | Behaviour support is a compliance mechanism, not an outcomes framework. BSPs became the vehicle to authorise restrictive practices, creating a market for plan production rather than restrictive practice reduction. 68% of participants were not consulted about their plans. Median plan quality scored “weak.” | 2017 | 9 years | Critical | IPR (2017), JSC Q&S Commission (2021, called URGENT), NDIS Commission BSP Quality Audit (2022), Royal Commission (2023), NDIS Review (2023) | | 5 | SIL/housing applies individual funding to group economics, and nobody is responsible for housing. NDIS is an individual entitlement but SIL operates on ratio-based group economics. States exited housing responsibility. SDA has a 15,000+ person waitlist. | 2019 | 7 years | Critical | Tune Review (2019), JSC SIL (2020), NDIS Commission Own Motion Inquiry (2022-24), Royal Commission (2023), NDIS Review (2023), Grattan Institute (2024) | | 6 | The system was designed for a “default participant” who doesn’t exist. Urban, English-speaking, single stable disability, individual decision-making, able to self-advocate. First Nations participants are 54% less likely to access services. Women are 13 percentage points under-represented. CALD communities are ~50% under-represented. | 2017 | 9 years | High | JSC Psychosocial (2017), Tune Review (2019), JSC Q&S Commission (2021), NDIS Review (2023) | | 7 | The complaints model assumes a consumer relationship that doesn’t exist. It presumes the person knows what good looks like, can compare, can walk away, and has no ongoing dependency. Disability support is the opposite. Complaints grew from 1,422 (2018-19) to 29,054 (2023-24), a 20x increase. | 2021 | 5 years | High | JSC Q&S Commission (2021), Royal Commission (2023), Boland Review (2024) |

1.3. These are not 7 opinions. They are 7 findings that emerge from the evidence when you consolidate 528 recommendations and track which problems each one was trying to solve. This consolidation may assist the Committee in organising the evidence it has received whilst being able to clearly see the previous attempts to resolve the root cause.

1.4. Two cross-cutting themes run through all seven: workforce (the people expected to deliver quality are undervalued, under-qualified, and under-supported) and digital systems (the infrastructure meant to enable quality monitoring, data sharing, and accountability does not work as designed).

2. Context

2.1. The evidence before this Committee sits within a broader context. Successive governments have commissioned substantial review activity into the NDIS since 2016, producing formal recommendations that remain largely unimplemented.

2.1.1 Documented review costs

Review	Years	Cost	Recommendations
Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability	2019-2023	$527.9M	218
NDIS Review (Bonyhady/Paul)	2022-2023	$18.1M	26 + 138 supporting actions
NDIS Review: implementation design and consultation	2023-2025	$129.8M	(implementing above)
McKinsey Independent Pricing Review	2017	$5-15M est.	25
Tune Review (NDIS Act Review)	2019	Not disclosed	29
Mason Review (Commission effectiveness)	2023	Not disclosed	29
ANAO performance audits (9 completed, NDIS-specific)	2017-2025	$550K each ($5M total)	56
JSC inquiries (13 NDIS-specific since 2017)	2017-2025	Parliamentary operations	68
Robertson Review (Ann-Marie Smith)	2020	Not disclosed	Per-review
Boland Review (Irabina)	2024	Not disclosed	Per-review
Total		$680M+	528 formal recommendations

Sources: 2019-20 Federal Budget (Royal Commission); 2022-23 Federal Budget (NDIS Review); 2023-24 MYEFO (implementation funding); ANAO Annual Report 2023-24 (audit costs).

2.2. The Royal Commission cost $527.9 million, comprising $379.1 million through the Attorney-General’s Department and $148.8 million through DSS, NDIA, and the NDIS Commission. It heard from nearly 10,000 people and made 218 recommendations.

2.3. The NDIS Review cost $18.1 million and produced 26 recommendations with 138 supporting actions in December 2023. A further $129.8 million was committed in the 2023-24 MYEFO for implementation: $54.7 million on budget access, $49.7 million on home and living, $11.6 million on foundational supports, $10.2 million on market repair, and $3.6 million on early childhood.

2.4. As of March 2026, no formal government response to the 26 NDIS Review recommendations has been published. No recommendation-by-recommendation accept, reject, or in-principle determination exists. This is the standard response format used for the Tune Review (29 recommendations), the JSC Quality and Safeguards inquiry (30 recommendations), and the Royal Commission (218 recommendations). A joint response from all governments was promised by end of 2024 via the Disability Reform Ministerial Council. It has not been published. In effect, $129.8 million has been committed to implement recommendations the government has never formally said it accepts.

2.5 The ANAO recycling pattern

2.5.1. The auditor-general’s own recommendations show a pattern of reiteration across successive audits. This is significant because the ANAO is the body Parliament relies on for independent assurance.

ANAO Report	Year	Recs	Status (as of 2024)
No.24 2016-17: Transition of Disability Services Market	2017	9	Recycled
No.13 2017-18: Decision-making Controls, NDIS Access	2018	4	Recycled / partly implemented
No.50 2018-19: NDIS Fraud Control Program	2019	6	4 of 6 not fully implemented
No.14 2020-21: Decision-making Controls, Participant Plans	2021	3	All 3 partly implemented
No.43 2022-23: Management of Assistance with Daily Life	2023	15	Recycled / stalled
No.23 2023-24: Management of Complaints by NDIA	2024	2	In progress
No.41 2024-25: Effectiveness of the Board of the NDIA	2025	3	Recycled
No.48 2024-25: NDIA Claimant Compliance	2025	4	In progress
No.2 2025-26: NDIS Commission Regulatory Functions	2025	10	Stalled / echoes earlier reviews
Total		56	50 recycled or stalled

2.6. Three reiteration chains illustrate the pattern:

2.6.1 Access decision quality (2018 to 2021): ANAO Report No.13 (2017-18) recommended quality assurance for access decisions. Report No.14 (2020-21) restated the same recommendation for participant plans. Both remain “partly implemented” in 2024.

2.6.2 Fraud controls (2019 to 2025): ANAO Report No.50 (2018-19) recommended fraud risk assessment, data analytics, and financial impact measurement. Six years later, Report No.48 (2024-25) restates the same three themes. The NDIA agreed to all of them both times.

2.6.3 7 of 9 not implemented: The ANAO’s own submission to this inquiry (Submission 57) states that 7 of 9 recommendations from the Fraud Control and Participant Plans audits were not fully implemented as of mid-2024.

2.7. The Committee may wish to note that the ANAO’s own evidence to this inquiry confirms a pattern of agreed recommendations remaining unimplemented across a seven-year period. Three additional ANAO audits are currently in progress (Assistive Technology, Fraud Fusion Taskforce governance, and Payment Claims Compliance).

3. How the current submissions align with the previous evidence base

3.1. We extracted 371 discrete issues from 42 public submissions to this inquiry and mapped each one to the Committee’s five Terms of Reference and to the findings of those prior reviews. We then tested each issue against the identified 7 root-cause design failures.

3.2. 94.6% of the 371 issues map to the same root causes that the prior reviews already identified. The JCPAA submissions do not describe new problems. They describe the same problems persisting. This level of alignment reinforces the strength of the evidence before the Committee and confirms that the concerns raised by submitters are well-grounded in the existing record.

3.3. The evidence base across the 371 issues is strong:

• 115 data-supported (31%),
• 38 legal (10%),
• 36 research-based (10%),
• 26 case studies (7%),
• 139 anecdotal (37%).
• Only 17 issues (5%) appear to be unsupported assertions.

3.4. The NDIA’s own submission (No. 042) confirms many of these findings, including a qualified ANAO opinion on performance statements, “partly effective” compliance frameworks, and estimated integrity losses of 6-10% of scheme payments ($2.4-4 billion annually).

3.4.1 How the 371 issues distribute across the Committee’s Terms of Reference

Term of Reference	Issues	Submitters	Dominant pain point(s)
ToR1: Financial sustainability risks	123	38	PP01 (funding clarity), PP05 (SIL economics)
ToR2: Claimant and provider compliance	151	41	PP01, PP03 (quality monitoring), plus genuinely novel s45 finding
ToR3: Performance monitoring and reporting	207	All 42	PP03, PP06 (intersectionality), PP07 (complaints)
ToR4: NDIS Commission regulatory performance	147	40	PP03, PP04 (behaviour support), PP07
ToR5: Department policy advice	76	32	PP06, cross-cutting (cumulative reform burden)

Note: Issues can map to multiple Terms of Reference. ToR3 drew contributions from every single submitter.

3.5. Twenty issues (5.4%) did not map to the existing 7 pain points. These cluster into three gap themes that, appear to support the accidental adversary observed relationship between the Government and NDIS Service Provider. They may warrant elevation if the Committee’s report confirms them:

3.5.1. Administrative burden and reform fatigue (27 issues, 17 submitters). The cumulative cost of concurrent reforms on providers. No single entity models the total compliance burden of registration changes, new practice standards, NDIS Act amendments, Getting Back on Track implementation, Navigator design, Integrity and Safeguarding Bill, and Support Lists under s10, all landing simultaneously.

3.5.2. Institutional governance (26 issues, 14 submitters). The NDIA and Commission themselves as the problem, not just the system they administer. Decision-making culture, internal accountability, Board oversight described as “inconsistent” by the ANAO.

3.5.3. Provider viability beyond SIL (34 issues, 17 submitters). Pain point five captures SIL economics. This gap theme extends the viability crisis across allied health, support coordination, behaviour support, and plan management. The pricing model may be fundamentally broken across all service types, not just SIL.

4. Genuinely new observations

4.1 Most of what this inquiry heard has been said before. Three findings have not.

4.2 The section 45 due process argument. Intrepidus Law (Submission No. 038) identified a structural issue no prior review had captured. Parliament designed formal investigatory powers with procedural fairness protections, including investigation warrants under Part 3A Division 8, post-payment reviews with right of reply, and criminal prosecution safeguards. But the intention and application have not necessarily aligned in practice:

4.1.1. In May 2023, the NDIA received advice that post-payment debt recovery was not systematically viable.

4.1.2. In early 2024, it shifted to pre-payment reviews as its main compliance mechanism, relying on ss45 and 45A of the NDIS Act.

4.1.3. Sections 45 and 45A were designed for administrative processing, not investigation. There are no appeal rights under these provisions. The NDIA can hold, cancel, or release claims indefinitely with no recourse for the affected party. Submission No. 038 argues that the s45 mechanism is being used as a substitute for formal fraud investigation, circumventing every procedural protection Parliament built into the investigatory powers.

4.1.4. This is a qualitatively different argument from “compliance is slow.” It is a structural critique that the Agency has found a legislative mechanism to exercise investigatory power without any of the safeguards that Parliament attached to investigatory power. Our research suggests that no prior review, inquiry, or audit has identified this structural problem.

4.1.5. Submission No. 038 documents a case where a psychology provider employing 40+ staff went into liquidation after more than $600,000 in claims were locked indefinitely under

s45 manual claim review. The lock was triggered by anonymous tip-offs. The provider was given no notice of the allegations, no opportunity to respond, no timeline for resolution, and no appeal rights.

4.1.6. The anonymous tip-off system has no safeguards against malicious, vexatious, or false reports. A competitor could trigger a payment lock to force a rival out of the market. A violent spouse could destroy a partner’s financial independence by reporting their NDIS business. There is no right of reply, no presumption of innocence, and no accountability for false reports.

4.3 Coercive planning practices as a safeguarding concern: Parents of Deaf Children (Submission No. 037) documented families being threatened with loss of supports, warned against seeking review, subjected to heightened scrutiny after raising concerns, and in some cases threatened with referrals to child protection authorities.

4.3.1 This is presented as coercive conduct by government officials toward families of children with disability. It meets the threshold for a safeguarding concern but falls outside the NDIS Commission’s jurisdiction. The Commission regulates providers, not the NDIA. There is no regulator for harm caused by the Agency’s own administrative decisions.

4.4 Language deprivation as harm: Deaf children are being assessed as not requiring communication supports because they have cochlear implants or hearing aids, without functional assessment. The NDIA conflates the presence of technology with the achievement of outcomes. Language deprivation during critical developmental windows has documented, irreversible consequences.

5. Findings by Term of Reference

This submission offers findings and suggestions rather than formal recommendations. We are a consultancy contributing evidence-based analysis, not a review body with a mandate. The suggestions below are framed as matters the Committee may wish to consider, organised by the Term of Reference they address. Where a suggestion falls within the Committee’s direct remit, such as transparency, reporting, or accountability mechanisms, it is marked as an accountability measure. Where a suggestion addresses a root-cause design failure that requires structural reform beyond the Committee’s direct remit, it is marked as a referral to the responsible Minister. We have drawn this distinction because our analysis shows that accountability measures alone will not resolve design failures that have persisted across a decade of review activity. Five of the seven root causes identified in this submission have never been the subject of a structural response, only of further measurement and reporting. Our goal with this submission is to help you change that.

ToR1: Management of financial sustainability risks

Root cause:

• Pain point 1: No clear line of sight on what is and isn’t funded and how the expenditure leads to quality of life outcomes for people with disability.
• Pain point 5: Sil / Housing has applied an individualised model to group economics without addressing the compounding socio-economic factors.

The suggested design failure: The NDIS pricing model does not cover the cost of compliant service delivery. The price cap was set without a reliable model of what compliant delivery actually costs, creating a reinforcing loop: thin margins destabilise providers, destabilised providers trigger compliance intervention, compliance intervention further destabilises them, providers exit, supply reduces.

How long this has been known: The McKinsey Independent Pricing Review identified pricing model failures in 2017. The Tune Review raised concerns in 2019. The NDIS Review confirmed them in 2023. For SIL and housing specifically (Pain Point 5), 7 separate reviews since 2019 have identified the mismatch between individual funding and group economics.

What this inquiry confirms: 123 issues from 38 submitters. The NDS State of the Disability Sector Report 2025 reports 81% of providers cannot sustain at current prices and 77% deliver unfunded services averaging nearly $500,000 per provider. The NDIA’s own submission (No. 042) acknowledges estimated integrity losses of 6-10% of scheme payments ($2.4-4 billion annually) and that an incorrect error rate was used in compliance reporting.

Additional perspective from Supporting Potential for consideration: The Committee should also note that cost reconciliation alone will not resolve this, if the exercise is limited to measuring the current model against itself. When services are funded on a line-item basis with limited avenues to innovate or deliver supports differently, any costing study built on existing infrastructure will inevitably confirm that current pricing is insufficient, without revealing whether a different approach to delivery could achieve better outcomes within a sustainable cost envelope. The NDIA’s Supported Independent Living Quality Supports Pilot was theoretically designed to test exactly this kind of alternative approach, but no findings have been published. Noting the type of provider invited to participate, this may also bias the output. Meaningful costing work needs to be built from the ground up in collaboration with providers, starting from what good support actually looks like and working back to what it costs, rather than benchmarking a model that both sides already know is broken, and participants continue to feel the impact.

Work of this kind has already been commissioned. The Independent Health and Aged Care Pricing Authority (IHACPA) was funded to conduct NDIS pricing reform work, and its final report, “A fresh approach to NDIS pricing,” was completed. On 26 August 2025, the Senate ordered production of this report. The government claimed public interest immunity and did not table it. That order remains outstanding. The Committee may wish to consider that a parliamentary accountability body is well placed to pursue the outstanding Senate order, particularly given that pricing reform decisions are proceeding without the evidence base that the Senate sought to make public.

Suggestion 1 (accountability): The Committee should require the NDIA to publish a reconciliation showing the actual cost of compliant service delivery by service type, benchmarked against current NDIS price limits, and updated annually. The NDIS and Commission should produce a joint annual report that highlights spending in each area to pre-defined scheme quality indicators.

Suggestion 2 (referral): The Committee should refer to the Minister the question of whether the SIL funding model allows for structural redesign to address the mismatch between individual funding and group economics, including vacancy risk allocation, ratio-based staffing costs, and the absence of any entity responsible for housing supply. Seven reviews since 2019 have identified this design failure. Adjusting the price within the current model will not resolve it.

ToR2: Claimant and provider compliance with NDIS claim requirements

Root cause:

• Pain point 1: No clear line of sight on what is and isn’t funded and how the expenditure leads to quality of life outcomes for people with disability.
• Pain point 3: No proactive quality monitoring

The design failure: “Reasonable and necessary” remains undefined in practice (Pain Point 1), creating a compliance framework where providers and participants cannot know with certainty whether a claim is valid before submitting it. Plans do not state with precision what supports are funded. The “Core Flexible” budget design creates a compliance trap when the NDIA has internally decided specific supports are not justified but has not communicated that decision.

How long this has been known: The JSC Psychosocial Disability inquiry identified the “reasonable and necessary” definition gap in 2017. The Tune Review raised it in 2019. ANAO fraud control recommendations from 2019 (Report No.50) are restated in the 2025 claimant compliance audit (Report No.48). The ANAO told this Committee (Submission 57) that 4 of 6 of its fraud control recommendations were not fully implemented as of mid-2024.

What this inquiry confirms: 151 issues from 41 submitters. The NDIA acknowledges its compliance frameworks are “partly effective.” Self-managed participants face claim rejections with zero explanation and personal financial liability.

What this inquiry adds: Intrepidus Law (Submission No. 038) identified a genuinely novel structural issue: ss45/45A pre-payment reviews are being used as quasi-investigatory powers without the procedural protections Parliament attached to the formal investigatory powers under Part 3A Division 8. There are no appeal rights under ss45/45A. A psychology provider employing 40+ staff went into liquidation after $600,000+ in claims were locked indefinitely with no notice, no right of reply, and no timeline. No prior review identified this structural problem.

Suggestion 3 (Accountability): The Committee should examine whether the use of ss45 and 45A as a compliance mechanism is consistent with Parliament’s intent, and whether procedural fairness protections (notice, right of reply, review rights, time limits) should be legislated for pre-payment reviews.

Suggestion 4 (Accountability): You cannot close a gap you do not measure. The scheme measures activity (hours billed, complaints received, plans approved) not outcomes (lives improved, harm prevented, consistency achieved). A simple metric to begin with would be the AAT overturn rate. It is currently sitting at 76%, a goal should be less than 20%

The NDIA should then be required to provide reasons for all claim rejections, including those for self-managed participants, this would facilitate continuous learning from Providers. Additionally, publishing data on rejection rates, reasons, time to resolution, and correction rates will improve transparency and accountability.

Suggestion 5 (Referral): Publish operational definition of “reasonable and necessary” with worked examples by disability type. Mandate decision-reason letters that reference the definition.

ToR3: Monitoring, measurement, and reporting of NDIA performance

Root cause:

• Pain point 1: No clear line of sight on what is and isn’t funded and how the expenditure leads to quality of life outcomes for people with disability.
• Pain point 3: No proactive quality monitoring

• Pain point 6: A system designed for a default participant that doesn’t exist

A note on scope. This Term of Reference drew 207 issues from all 42 reviewed submissions, the only ToR to which every submitter contributed. However, the majority of those issues are complaints about NDIA operational performance rather than about how that performance is monitored, measured, and reported. We address the operational issues under the Terms of Reference where they sit most naturally (decision-making quality under ToR2, Commission oversight under ToR4, policy design under ToR5). What follows focuses on the performance measurement and reporting framework itself, which is what this Term of Reference asks about.

The design failure: The NDIA does not measure the things that matter most to the NDIS Community or the Australian Taxpayer. It does not measure the quality of its own decision-making. It does not report outcomes disaggregated by the cohorts most at risk of exclusion. It does not track whether the supports it funds lead to quality-of-life improvements. Its performance framework measures activity and throughput, not whether participants are better off or whether the Agency’s own decisions are sound.

How long this has been known: Performance reporting weaknesses have been flagged by the ANAO in every audit cycle since 2017-18. Across 9 completed audits, 50 of 56 ANAO recommendations are tagged as recycled or stalled. The NDIS Review (2023) called for an outcomes-focused performance framework. The JSC Quality and Safeguards inquiry (2021) raised concerns about the absence of proactive monitoring. The ANAO’s assessment of the Board’s oversight of performance was “inconsistent” (Report No. 41, 2025).

What this inquiry confirms: The NDIA’s 2023-24 performance statements received a qualified ANAO opinion. The NDIA’s own submission (No. 042) acknowledges that an incorrect error rate was used in compliance reporting, making performance appear on-track when it was not. Call centre resolution statistics count “operator emailed another team” as resolved. Participant outcome data is collected by NDIA planners rather than independently. Whole cohorts, including people with dementia, psychosocial disability, and progressive conditions, are invisible in published reporting.

The AAT overturns 76% of appealed NDIA decisions, and in 63% of cases the NDIA agrees to change its decision before the hearing. There is no feedback loop from review outcomes to initial decision quality. The NDIA does not publish data on why its decisions are overturned, which decision types are most frequently wrong, or what it has changed as a result.

What this inquiry adds: The evidence presented to the Committee reveals something that the performance framework is structurally unable to surface. Across the 42 reviewed submissions, a significant cluster of issues describe harm caused not by providers but by NDIA administrative decisions. Submitters raised these issues under ToR4 (the Commission) because the Commission is the safeguarding body, but the Commission has no jurisdiction over the NDIA. These issues had nowhere to go, which is itself evidence that the performance framework has a blind spot.

Three mechanisms are visible in the submissions:

• Unqualified decision-makers overriding clinical evidence. NDIA planners and delegates without clinical expertise routinely dismiss, lose, or override allied health assessments (Submissions 001, 007, 012, 022, 023). OTSi (Submission No. 023) identifies the Life Skills Profile (LSP-16), a 30-year-old clinical tool, as the NDIA’s preferred assessment instrument for psychosocial disability despite it never having been designed to assess functional capacity or support needs under the NDIS Act. From mid-2026, centralised assessments using in-house NDIA assessors will replace

longitudinal clinical knowledge with one-off structured interviews (Submission No. 022), a change Professionals Australia argues increases the risk of unlawful decision-making.

• Evidentiary exclusion creating foreseeable harm. When clinical evidence is excluded from planning decisions, the downstream harms are predictable and documented: skill regression, crisis escalation, involuntary hospitalisation, practitioner withdrawal from high-risk cases, and culturally unsafe service delivery for First Nations participants (Submissions 008, 017, 022, 023). OTSi documents a case (“Jason”) where repeated occupational therapy recommendations regarding exploitation risk and decision-making support were documented but not reflected in NDIA planning decisions, leading to unsuitable housing, exposure to restrictive practices, mental health deterioration, involuntary hospitalisation, and a Community Treatment Order. The preventive investment that could have avoided this outcome was displaced by a far costlier crisis response.

• Administrative settings creating exploitation conditions. No system alerts exist for unusual billing patterns. A provider billed a participant approximately $900-$1,000 per week without informed consent; complaints to the plan manager and NDIA produced no action (Submission No. 005). Funding periods intended as a discretionary safeguard for participants at risk of exploitation are being applied universally, contrary to the Explanatory Memorandum, creating funding cliffs for participants in 24/7 support (Submission No. 036).

Parents of Deaf Children (Submission No. 037) identified a gap in the accountability architecture that sits squarely within this Term of Reference. The Commission regulates providers, but there is no regulatory pathway for harm caused by the NDIA’s own administrative decisions. When a planning decision causes developmental harm to a child, there is no regulator to investigate and no performance measure that would surface the pattern.

None of these patterns are visible in the NDIA’s published performance reporting. The performance framework does not measure whether clinical evidence was considered in a planning decision, whether an administrative decision caused foreseeable harm, or whether safeguarding risks were created by the Agency’s own processes. Until the framework measures these things, the Committee will continue to hear about them only through submissions like these

Suggestion 5 (Accountability): The Committee should require the NDIA to publish a redesigned performance framework that measures decision quality, participant outcomes, and cohort equity, not just processing volumes and timeliness. There should also be defined responses to not achieving targets as the NDIA continuously underperform on their Participant guarantee indicators without change or impact. At a minimum, reporting should include:

(a) a decision quality measure tracking overturn and variation rates on internal review and external appeal, disaggregated by decision type, region, and disability group, with a mandatory feedback loop where overturn rates exceed a defined threshold;

(b) independent collection of participant outcome data, not self-reported through NDIA planners;

(c) disaggregated reporting by First Nations status, CALD background, gender, remoteness, and disability type so that exclusion patterns are visible; and

(d) mandatory annual reconciliation of published performance data against ANAO findings, with public explanation of any discrepancies.

Suggestion 6 (referral): The Committee should refer to the Minister the question of whether a regulatory or oversight pathway is needed for harm caused by NDIA administrative decisions, not just provider misconduct. The evidence from Submission No. 037 (coercive planning practices, threats of child protection referral) and the structural gap between the NDIA’s administrative power and the Commission’s provider-only jurisdiction support this. The current architecture has no mechanism to investigate patterns of Agency decision-making that cause participant harm.

ToR4: Regulatory performance of the NDIS Quality and Safeguards Commission

Root Cause:

• Pain point 3: No proactive quality monitoring
• Pain point 4: Behaviour support is a compliance mechanism, not an outcomes framework.
• Pain point 7: The complaints model assumes a consumer relationship that doesn’t exist.

The design failure: The Commission was built as a reactive regulator in a sector where the conditions for effective complaints-based oversight do not exist. Participants may not know what good support looks like, cannot easily change providers (especially in SIL), and face ongoing dependency on the person they would be complaining about. The tools that were meant to support proactive safeguarding, such as Positive Behaviour Support, have become compliance mechanisms rather than an outcomes framework. Despite plans being submitted to the Commission and an ongoing priority to reduce restrictive practices, 68% of participants are still not consulted about their plans, the median plan quality scoring “weak” and both authorised and unauthorised restrictive practice numbers increase.

How long this has been known: The Mason Review made 29 recommendations on Commission effectiveness in 2023. The JSC Quality and Safeguards inquiry made 30 in 2021. Two independent reviews were triggered by preventable harm: Robertson (2020, after the death of Ann-Marie Smith) and Boland (2024, after unlawful restraint of children at Irabina, which led to Commissioner Mackey’s resignation). The ANAO assessed the Commission as “partly effective” in 2025.

What this inquiry confirms: 147 issues from 40 submitters. Only 7-10% of providers currently sit within formal regulatory oversight. The Commission itself acknowledges it has no documented strategy for market oversight or unplanned service withdrawal (Submission No. 002). NDS described the model as “predominantly reactive and disproportionate.” Multiple submissions describe complaint handling that is slow, opaque, and inconsistent. The Commission has undertaken Civil Proceeding with several providers in Federal court. Each financial penalty has been used as an advertising mechanism to ‘prevent harm’. But this strategy only works when harm is being knowingly perpetrated. The Commission has never used any of these as case studies for learning, or opportunities to review provider responses. There has also never been formal questions into the Commission’s role in some of the foreseeable harm matters. Did they have information available to them prior to harm occurring?

Supporting Potential insight: the missing whole-of-support oversight role. The NDIS funds individual services delivered by individual providers, each with their own sole remit. No single role is responsible for reviewing a participant’s supports, as a whole, assessing whether they are working together, and advocating with any authority for the best approach. This matters most where it is hardest, when:

• a participant requires supported or substitute decision-making,
• multiple providers are delivering concurrent supports with no coordination obligation, and
• the quality of one support depends on the quality of another.

Support coordination was meant to fill this role but was never designed to do it. Across 6 reviews since 2018, 8 design failures have been identified: no clear scope, no minimum qualifications, no independence requirement, no defined position in a participant’s support circle, activity measures rather than outcome measures, no capacity building requirement, no exit pathway, and overlapping boundaries with other coordination roles. Anyone can be a support coordinator. There are no guardrails on quality.

The Commission’s civil proceedings against Lifestyle Solutions illustrate the consequence. The SIL provider was penalised, but the proceedings did not examine the intersection of the other supports operating around those participants, or the role those supports should have played in safeguarding. No one asked whether the support coordinator identified the risks, whether the behaviour support practitioner’s plans were being implemented, or whether any single person in the participant’s support circle had both the visibility and the authority to intervene. The penalty fell on one provider. The systemic failure was that nobody had oversight of the whole picture.

The government is replacing support coordination with a Navigator model. No published design framework exists.

Suggestion 7 (accountability): The Committee should require the Commission to publish a quantified impact assessment of mandatory registration before it proceeds. Registration is a mechanism for oversight, not for quality or safeguarding. The current reporting framework is, by the Commission’s own acknowledgement, an honesty scheme where providers self-report incidents, complaints, and restrictive practices, and the Commission has no independent means of verifying what is reported or identifying what is not. Expanding this model to all providers will expand the Commission’s administrative footprint without necessarily expanding its ability to detect or prevent harm. The impact assessment should address:

• the projected compliance cost to providers who are already operating at a loss,
• whether the reporting mechanisms will be redesigned before the expansion proceeds,
• what the Commission will do differently with mandatory registration that it cannot do now, and
• the risk that mandatory registration drives further market exit without a corresponding improvement in participant safety.

Suggestion 8 (Accountability): The Commission should be required to publish a proactive monitoring framework, distinct from the complaints-driven model, for high-risk service settings (SIL, group homes, 24-hour supports), with mandatory unannounced welfare visits conducted by welfare visitors rather than auditors. The Committee should also seek a timeline from the Commission for implementing the Royal Commission’s six alternative safeguarding mechanisms: adult safeguarding functions, one-stop-shop reporting, OPCAT oversight, community visitor schemes, disability death review mechanisms, and reportable conduct schemes.

Suggestion 9 (Accountability): The Committee should require the Commission to publish, for each completed civil proceeding and enforceable undertaking, a de-identified case review that includes: what systemic factors contributed to the harm, what information the Commission held prior to the harm event, what the case reveals about gaps in the regulatory model, and what changes (if any) were or will be made to Commission practice as a result. Enforcement that produces penalties but no learning does not reduce harm.

Suggestion 10 (Referral): The Committee should refer to the Minister the question of whether the behaviour support framework should be redesigned as an outcomes system rather than a compliance mechanism. The current model funds plan production (hours billed) rather than skill and regulation development or restrictive practice reduction. Both authorised and unauthorised restrictive practice

numbers continue to increase despite plans being lodged with the Commission. No published data exists on whether BSPs reduce restrictive practices at the scheme level, nor has any published modelling been undertaken for trends in prescribing restrictive practices. The Committee may wish to recommend that the Commission be required to publish annual restrictive practice outcome data, not just lodgement volumes, and that any redesign include mandatory participant consultation as a condition of funding.

Suggestion 11 (Referral): The Committee may wish to refer to the Minister the question of whether the Navigator design addresses the 8 original failures within Support Coordination design, or whether it inherits them. The barn door was left open with behaviour support, and it became a compliance mechanism rather than an outcomes framework. The same learnings of defining skill sets and mechanisms for who can provide support will need to apply to Navigators. Otherwise we risk the replacement model being built on the same assumptions that previously failed.

ToR5: Policy advice provided by the Department of Health, Disability and Ageing

A note on scope. 76 issues from 32 submitters were mapped to this Term of Reference. Approximately a third are about NDIA operational performance or Commission regulation that submitters traced back to the Department as the policy lead. What follows focuses on the quality of the Department’s policy advice itself and whether it accounts for operational reality, if the legislation it has advised on is producing its intended effects, or if the Department’s current structure allows it to provide coherent advice across the disability ecosystem.

The design failure: There is a persistent gap between policy intent and operational reality, and the Department’s advice does not appear to account for it. The system was designed for a “default participant” who does not exist:

• urban,
• English-speaking,
• single stable disability,
• individual decision-making, and
• able to self-advocate.

Policy settings structurally exclude cohorts that do not fit this default. But the design failure under this Term of Reference is broader than cohort exclusion. The Department advises on legislative and policy changes that are implemented without adequate testing of whether they work on the ground, without transition planning for participants who will lose existing supports before alternatives are ready, and without cumulative impact assessment across concurrent reforms.

How long this has been known: First Nations access barriers were identified in 2017 (JSC Psychosocial Disability). The Tune Review raised intersectionality concerns in 2019. The NDIS Review recommended alternative commissioning arrangements in 2023. Despite 8 reviews raising these issues over 9 years, First Nations participants remain 54% less likely to access services, women are 13 percentage points under-represented, and CALD communities are approximately 50% under-represented. These are not implementation failures. They are design failures that have survived every review because the policy settings that produce them have not been changed.

What this inquiry confirms: Twenty-five issues describe access settings that exclude specific cohorts by design:

• episodic disability (PMDD, where psychosocial access approval rates collapsed from 66% to 25%),

• progressive conditions (young onset dementia, where access rates remain very low despite universal eligibility),
• Deaf children (exited from the scheme despite ongoing language needs),
• children under 9 (diverted from statutory access decisions through Early Connections), and
• psychosocial disability more broadly.

Twenty-seven issues from 17 submitters raised the cumulative burden of concurrent reforms. The Getting Back on Track Act 2024 introduced three concurrent compliance tests (s10, s46, s45A) without corresponding infrastructure improvements. Registration changes, new practice standards, NDIS Act amendments, Navigator design, the Integrity and Safeguarding Bill, and Support Lists under s10 are all landing simultaneously. No government body is modelling the total compliance cost or the potential return on investment.

The legislation itself is producing unintended consequences that the Department’s advice does not appear to have anticipated. Examples include:

• Section 10 Support Lists create categorical exclusions contrary to the individualised funding model the NDIS was built on.
• Funding periods intended as a discretionary safeguard for participants at risk of exploitation (per the Explanatory Memorandum to the Getting Back on Track Bill) are being applied universally, creating funding cliffs for participants in 24/7 support.
• Thriving Kids has no clear statutory pathway. NDIS rules for s33D have not been released. Submitters describe participants losing supports now while the alternative systems these reforms promise are not yet operational.

What this inquiry adds: Two structural issues that go beyond individual policy failures. First, as of March 2026, no formal government response to the 26 NDIS Review recommendations has been published. $129.8 million has been committed to implementation without a recommendation-by-recommendation accept, reject, or in-principle determination. This is the standard response format used for the Tune Review, the JSC Quality and Safeguards inquiry, and the Royal Commission. Its absence for the NDIS Review means Parliament cannot assess which recommendations the government accepts, which it rejects, and which it is implementing in modified form.

Second, the May 2025 Machinery of Government change moved disability into a health department. DSS retained disability employment, income support, and housing. The disability ecosystem is now fragmented across two portfolios. Several submitters raised concerns that this risks reframing disability within a medical model, and that the Department’s capacity to provide coherent policy advice across the full ecosystem, including housing, employment, and income support, is structurally diminished. The NDIS-to-aged-care transition illustrates the gap: $2,500 in assistive technology per NDIS participant compared to $51 in aged care, with months of operational instability during the transition.

Suggestion 12 (accountability): The government should publish a formal response to the 26 NDIS Review recommendations in the standard accept/reject/in-principle format. Until this exists, Parliament cannot hold the government accountable for its implementation commitments, and the $129.8 million allocated to implementation proceeds without a public record of what is being implemented and why.

Suggestion 13 (accountability): The Department should be required to conduct and publish a cumulative regulatory impact assessment across all concurrent NDIS reforms before implementing additional changes. The assessment should model the total compliance cost on providers by size and region, identify which reforms can proceed concurrently and which require sequencing, and confirm that alternative

support systems (foundational supports, Thriving Kids, Navigators) are operational before existing supports are withdrawn.

Suggestion 14 (referral): The Committee should refer to the Minister the question of whether the Department’s current structure, following the May 2025 Machinery of Government change, allows it to provide coherent policy advice across the full disability ecosystem. With employment, income support, and housing retained in DSS while disability services sit in Health, the Department advises on a system whose critical dependencies fall outside its portfolio. The Committee may also wish to consider whether disaggregated NDIS outcome reporting should be mandated by First Nations status, CALD background, gender, remoteness, and disability type. Exclusion patterns have been identified across 8 reviews over 9 years. Without routine disaggregated data, there is no mechanism to measure whether the Department’s policy advice is closing these gaps or reinforcing them.

6. Implementation and Follow-Through

6.1 The evidence before this Committee is not new. That is the finding.

6.2. Australian taxpayers have funded at least $680 million in formal review activity into the NDIS since 2016. That work produced 528 recommendations. We consolidated every one of them and found they reduce to 7 root-cause design failures. We then tested the 371 issues raised in 42 submissions to this inquiry against those 7 failures. 94.6% map directly. The submitters to this inquiry are, overwhelmingly, telling the Committee things it has already been told.

6.3. The challenge is not diagnosis. The root causes have been re-surfaced and reformed, repeatedly, across a substantial body of independent review work. The challenge is that nothing structural has changed in response.

6.4. The ANAO’s own evidence illustrates the pattern. Across 9 completed audits, 50 of 56 recommendations remain recycled or stalled. Fraud control recommendations from 2019 are restated in the 2025 claimant compliance audit. Access quality recommendations from 2018 are restated in the 2021 participant plans audit.

6.5. Across the five Terms of Reference, the position is:

• Financial sustainability: the pricing model does not cover compliant delivery. The NDIA confirms integrity losses of $2.4-4 billion per year. The Senate ordered production of IHACPA’s pricing report and the government claimed public interest immunity. The evidence base for pricing reform is being withheld from Parliament.
• Compliance: the primary compliance mechanism has no appeal rights, and its use as a quasi-investigatory tool was not anticipated by the legislation that created formal investigatory powers with procedural protections. A provider employing 40+ staff went into liquidation.
• Performance reporting: the ANAO gave a qualified opinion. The NDIA used an incorrect error rate. Decision quality is not measured. NDIA administrative decisions are creating foreseeable safeguarding harm and no performance measure surfaces it.
• The Commission: “partly effective” by the ANAO’s assessment. Enforcement is used for deterrence but never for learning. The question of whether the Commission held information before foreseeable harm events has not been formally addressed. Registration is about to expand to all providers through a reporting framework the Commission acknowledges is an honesty scheme.

• Policy advice: $129.8 million committed to implement recommendations for which no formal government response has been published. Legislation is producing unintended consequences. The disability ecosystem has been fragmented across two departments. Co-design mechanisms do not reach the most vulnerable.

6.6. Each of these findings has been identified before. The NDIS has been reviewed more than almost any other Commonwealth programme, and the return on that investment, measured in implemented structural change, is poor.

6.7. This Committee exists to hold Commonwealth entities accountable to Parliament. The evidence suggests that the current accountability architecture, where recommendations are made, agreed to, and then quietly recycled in the next audit cycle, is not producing follow-through. The Committee may wish to consider whether a different mechanism is needed.

Suggestion 15: The Committee should establish a formal recommendation implementation tracker for the NDIA and the NDIS Commission, requiring both agencies to report progress against all accepted existing Government review recommendations, including the ANAO recommendations at six-monthly intervals, with automatic escalation to this Committee when recommendations remain unimplemented beyond two years of acceptance. The tracker should be public, cumulative, and distinguish between recommendations that have been implemented, those that have been agreed but not actioned, and those that have been restated in a subsequent audit.

Closing

This submission was built because the work already existed. We did not set out to write a parliamentary submission. We set out to understand why the same problems keep surfacing in NDIS reviews, and whether the formal review record, taken as a whole, pointed to root causes that individual reviews could not see in isolation. And it does. Seven times. They have been identified across $680 million in review activity, documented in 528 formal recommendations, and confirmed by 94.6% of the 371 issues raised in the 42 submissions to this inquiry.

We offer this to the Committee as a consolidation tool. The evidence base is strong. The diagnosis is not in dispute. The question this Committee is uniquely placed to answer is whether the accountability architecture that sits around the NDIS is capable of converting diagnosis into structural change, or whether the pattern of review, recommendation, agreement, and quiet non-implementation will continue.

The people most affected by that question are the ones least likely to be heard in processes like this. They are in group homes, in remote communities, in families making decisions under duress, and in services where the quality of their daily life depends on systems they did not design and cannot influence. They deserve better than another decade of the same findings.

We are available to the Committee should it wish to access the underlying data, methodology, or analytical frameworks that inform this submission.

Angela Harvey

Managing Director, Supporting Potential

VW

SUPPORTING POTENTIAL

Appendix

Methodology 8.1. We obtained all 42 public submissions to this inquiry and extracted the full text of each using automated PDF processing.

8.2. Each submission was analysed for discrete issues: specific problems, findings, or concerns raised by the submitter. Issues were categorised across 12 thematic categories (governance and oversight, quality and safeguards, pricing and funding, administrative burden, data and reporting, legislation and regulation, access and eligibility, financial sustainability, participant outcomes, workforce, market and supply, provider viability) and tagged with evidence type (data, case study, legal, research, anecdotal, or unsupported assertion).

8.3. Each of the 371 issues was mapped to one or more of the Committee’s five Terms of Reference using a combination of category-based mapping, keyword analysis, and manual review of submissions from the three government entities (NDIA, NDIS Commission, Department of Health).

8.4. Separately, each issue was tested against 7 root-cause pain points (plus 2 cross-cutting themes: workforce and digital systems) identified through our review-mapping project, which tracks 528 formal recommendations across 40+ reviews (2016-2025), including all 218 Royal Commission recommendations, 138 NDIS Review actions, 56 recommendations from 9 completed ANAO performance audits, and 116 from parliamentary inquiries and other sources.

8.5. The evidence base across the 371 issues is strong: 115 data-supported (31%), 38 legal (10%), 36 research-based (10%), 26 case studies (7%), 139 anecdotal (37%). Only 17 issues (5%) are unsupported assertions.

This submission is informed by independent analysis of all 42 public submissions to this inquiry (371 extracted issues), cross-referenced against 528 formal recommendations from 40+ government reviews, audits, and inquiries conducted between 2016 and 2025, including all 218 Royal Commission recommendations, 138 NDIS Review actions, 56 recommendations from 9 completed ANAO performance audits, and 116 from parliamentary inquiries and other sources. Full methodology and data are available on request.