Submission 50

Senate Community Affairs Legislation Committee Inquiry into the National Disability Insurance Scheme Amendment (Integrity and Safeguarding) Bill 2025

Shirley Humphris 5/2/2026: family member of a child participant

This submission asks the inquiry to consider amendments to the NDIS Act that offer protections for participants. A focus will be on procedural fairness that is missing from some aspects of the NDIS Act.

The amendments would also include mitigating harms caused by loss of supports due to providers leaving the market. The lack of procedural fairness for providers means their business may face collapse.

Of course, combatting large scale fraud must be addressed but this must be skilfully administered to avoid harm.

The evidence given at the 2024 hearing by lawyers warned that sections of that Bill were harmful and could result in deaths. This is happening now1 and this 2025 Bill on the table is an opportunity to rectify the mistakes of the 2024 Bill.

It remains deeply concerning that the NDIS Act remains “incomplete and uncertain” when so much is removed to delegated legislation. The information sent by DHDA for consultation on the Support Needs Assessment Rules is scant with little new information. Transparency is urgently needed.

This submission also proposes that an amendment should empower the NDIS Commission to investigate and, if necessary, apply penalties to NDIA actions that breach the APS Code of Conduct, the NDIS Act, and failure to be a Model Litigant at ART.

This submission asks for consideration of amendments to the NDIS Act at:

• s32L
• s32K
• s45
• s46
• s47A & s48
• s99

This amendment Bill is before parliament and is an opportunity to rectify harms of the lack of procedural fairness of debts and rejected claims denied the right of appeal. Any assessment of a participant must also be given appeal rights and be fit for purpose.

NDIS Act s32L Support Needs Assessment

As this is an active petition, awaiting the Minister’s response, this part of the proposed Support Needs Assessment (SNA) will be discussed first. Petition Request: We therefore ask the House to amend the NDIS Act at s32L to add at 4) That s32L a new part 4c) now reads: “must have regard to any professional reports that the participant submits.”

Submission 50

Parliament must consider whether Principles at s17A are upheld with regard to potentially substandard needs assessments. This petition was submitted to parliament on 27/10/24. The Minister should have responded within 90 days. At the time of this submission there has been no response.

The Participant’s Own Clinical Information

At NDIS Act s32L there is no legislated right to allow the participant to submit their own clinical reports to the assessor. That reports may (optional) be used from the file is unlikely. Statements from NDIA in Webinars, were clear that reports will be unnecessary. The past CEO, Ms Falkingham, stated at Estimates that her staff don’t have time to read reports. One NDIA planner stated that the then CEO “threw us under a bus that day, my staff do read reports”. This statement from Ms Falkingham may not have been accidently said. The high rate of cuts to plans2 was likely the result of this highest level “excuse” for very many planners to now just not bother to read reports. That shocking statement from the then CEO has now seemed to pave the way for a policy to disallow participants to be able to submit their own medical information to the assessor. The narrative being, well they didn’t have time to read them anyway for old framework plans, so whats the point of including them now. That reading time cannot be spared for a plan of 2 to 3 years of support to the most disabled in the community is unconscionable. In addition, concerning reports of incomplete files are common and the inclusion of reports on file is only optional by law.

There is the legislated MUST for the reports NDIA request to be included, even if the assessor were to determine they are inaccurate.

OTSi Occupational Therapy have found that consideration of professional reports is international standard practice. If the legislation at NDIS Act 32L does not give the right to a participant to present their reports to the assessor, this government will stand alone internationally to use unqualified assessors with no appropriate clinical reports.

Since this petition was submitted (30/5/25) there has been further information on some SNA detail:

2 https://www.thesaturdaypaper.com.au/news/2026/01/10/exclusive-one-third-reassessed-ndis-plans-see-cuts-funding

Submission 50

The Base Tool I-CAN

The selected tool I-CAN has been found by The Australian Psychological Society APS and Institute of Clinical Psychologists to be unvalidated for purpose 3 At best this tool has been described as useful only as a part of an assessment by clinically qualified assessor. Clinicians do not use one standard tool for everyone, they choose a tool appropriate for their client, if any. This tool was being used by some in 2021 yet was not chosen as part of the 4 tools allocated for the Independent Assessments (IA) proposed by the previous government. IAs were abandoned.

The head of Australia’s peak body of psychologists and disability experts have warned the NDIS’s new assessment tool hasn’t been tested on a variety of disability types – including diverse autistic needs – which may lead to “tragedies” occurring, if more research is not conducted.

“APS members had also raised concerns that the I-CAN is “not particularly good at understanding the sorts of requirements and support needs for people in [some disability] categories” including those with acquired brain injury and psychosocial conditions. Gough warned that if the I-CAN were to be implemented broadly without further research and validation, there could be consequences.”

The president of the Institute of Clinical Psychologists, Dr Marjorie Collins, shared Gough’s concern that the I-CAN has not be validated for use with a wide range of disability groups. The I-CAN has not been tested on very many populations at all,” she said, adding to roll it out to all adult NDIS participants without further testing would be “reprehensible”.

The interview with Summer Foundation George Taleporos, Prof Thompson lead SNA researcher, gave assurances of reliability and validity at odds with the findings of the Australian Psychological Society APS and Institute of Clinical Psychologists A stretch of academic findings, it seems, from Prof Thompson who has a 5-year contract with NDIA to use NDIS participants as subjects in unethical research with no consent. NDIS DCEO Verlin has confirmed that Participants will have no opt out and there will be no pilot.

Furthermore, this tool is to be changed for NDIA purposes. The Centre for Disability Studies, I-CAN owners, submission 100 to the Senate Inquiry Bill 2024 noted “CDS recognises that the Commonwealth may want appropriate control of the assessment tool used for determining reasonable and necessary budgets for NDIS participants and would be happy to discuss suitable arrangements” They were actively proffering their services in 2024 and alterations to suit government support notion. The procurement of this tool is with a 5-year contract.

The Assessor

NDIA proposes using non-clinically qualified NDIA staff. Occupational Therapists have commented that the type of assessment using I-CAN would require considerable skill learned throughout university and professional development. That it cannot be a short course 4 NDIA claim assessors will be trained and qualified, but they are not referencing clinically qualified, and training is likely an in-house course as CDS only train those clinically qualified.

Submission 50

Professor Jason Thompson was asked in the information Webinar if Melbourne University endorses the use of non-allied health as assessors and said “Our job is not to decide on the delivery mechanism, its really to do the research … we don’t have an endorsement role” from the audio transcript. That comment is quite strange because any research requires the research method to be an integral part of the research not a hands-off, nothing to do with us. Again, in interview with Summer Foundation George Taleporos, Prof Thompson gave assurances of reliability and validity at odds with the findings of the Australian Psychological Society APS and Institute of Clinical Psychologists. Professor Thompson, who has a 5-year contract with NDIA is to use NDIS participants as subjects in unethical research with no consent. NDIS DCEO Verlin has confirmed that Participants will have no opt out and there will be no pilot.

Appeal Rights

The proposed Support Needs Assessment has many aspects that are of dubious accuracy. The compulsory base test has not been validated for many disabilities; the use of non-clinically qualified assessors; the strong implication of exclusion of the participants reports: and the legislated compulsory inclusion of reports commissioned by the NDIA, whether or not these reports are appropriate for the participant.

All these inconsistences with best practice demonstrate that the Support Needs Assessment and resulting reasonable and necessary budget should have the right of appeal. It is a measure of protection against harm for a poor process of assessment and demands procedural fairness and the application of the Objects and Principles of the Act.

Currently only the replacement assessment, by the same process, will be permitted. The consultation has not even advised how the Rules will make a replacement decision available.

Submission 50

Another parliamentary petition is closed and due to be presented to parliament soon. This petition asks the house to call for a NDIS Joint Standing Committee Inquiry into the Support Needs Assessment.

The Review Recommendations

The Review recommendations are the antithesis of the proposed SNA, therefore an Inquiry is a must.

“Action 3.4* The National Disability Insurance Agency should introduce new needs assessment processes to more consistently determine the level of need for each participant and set budgets on this basis.

This should support the allocation of a reasonable and necessary budget at a whole-of-person level (see Action 3.3). This would require structured, reliable and valid assessment processes to enable Needs Assessors to accurately identify support needs and intensity. This should also include an assessment of what risks might be present in the participant’s life and what safeguards could be put in place in response.” NDIS Review Final Report p 93 Emphasis added

“These changes must be designed transparently with people with disability and other relevant experts (see Action 3.8).

  The new approach to information gathering to inform budgets would require a support needs
   assessment. The assessment should be completed by a skilled and qualified Needs Assessor who is
  a trained allied health practitioner or social worker, or similar, with disability expertise. They
   should spend multiple hours completing the assessment. This would include reviewing any existing
   information provided by the participant and trusted professionals and then meeting with the
   participant to understand their goals, strengths, circumstances and level of support needs. This
 may also involve meeting key people in the participant's life, where appropriate. This process may
   also be carried out over multiple sessions at the participant's request. In complex cases, a multi-
    disciplinary team could be involved. The assessment meeting(s) should take place in an environment
  where themperson (sic) with disability feels most comfortable.” NDIS Review Final Report p 88
  Emphasis added

S32L (2) as required by the Review, the supports must be for the whole person as it is not unusual for participants to have more than one impairment. At 32L (2) the Notes5 from s 34(1) 1aa must be added for the legislation to be consistent with s34 and of course for the whole person to be supported.

s32K the methods of translating the support needs assessment into a budget remains an unknown black box. This is not what the Review recommended. Submissions are called for Rules, with no transparency in the information from DHDA.

“While everyone agrees the process needs significant reform, we are acutely aware of the anxiety that comes with change. Previous attempts at reform — most notably the introduction of Independent

5 Note: For the purposes of paragraph (aa):

(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and

(b) a participant’s disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.

Submission 50

Assessments in 2021 — were not done in consultation with the disability community and, as a result, provoked considerable anxiety and anger. These were a short-cut algorithm driven approach to planning that was never validated or transparent. Our proposed approach to the participant pathway (see Recommendation 3) is fundamentally different to Independent Assessments. People with disability, as well as experts, must be involved in implementing our new approach to ensure budget setting is fair and can be trusted.” NDIS Review Final Report p. 36

s 45 & s45A

Explanatory Memorandum: “New subsection 9A(2) will provide that the CEO must publish an approved form, or a representation of the form, on the Agency’s website. The amendment addresses the practical difficulty of publishing an approved form for a claim that is to be submitted through an online system, such as the my NDIS Provider Portal. Claiming processes through online systems are not amenable to publishing in a Word or PDF format. Where a form is to be submitted through an online system, the CEO may publish a representation of the form on the NDIA’s website.”

• redacted if nothing about the exemption is legible.
• redacted: s22(1)(a)(ii) - irrelevant if you can make out the exemption code and/or reason, using whatever you can actually read.
• Never invent an exemption code you can’t actually read.redacted alone is always safer than a guessed code.

There are also concerns that NDIA appear to experience numerous IT difficulties which could be problematic for particulars set in legislation, including Rules. The IT needs fixing not the participant’s difficulties who already has enough hoops.

S45(3A) The requests for “information” should have limitations of information set in law so that there is no breach of privacy, for example support work shift times not shift notes, a psychologist’s appointment times, not appointment notes.

Any refusal of a claim MUST be a reviewable decision, with an amendment to s99. This is procedural fairness and protects against an uneducated claim refusal from a particular delegate. That most ART appeals for funding are resolved in the participants favour demonstrates that NDIA’s decision making is not above reproach. How many incorrect decisions are compelled by current inadequate law to remain.

It must always be remembered that funding is already deemed reasonable and necessary. Onerous and exhaustive processes on participant claims seem counterproductive of time, effort and potential harm.

s46 (1) A participant who receives an NDIS amount, or a person who receives an NDIS amount on behalf of a participant, must spend the money in accordance with the participant’s plan.

The participant is not required to share their plan or even their funding amount with a provider. This clause is therefore an anomaly as the provider may not (and likely should not) have the plan. A plan may have considerable private information, even that which is totally irrelevant to that particular provider. A provider is not necessarily sufficiently educated to make such a decision. For example, a support not mentioned in the plan does not mean the support is unavailable as many supports are provided flexibly. We have even heard of Support Workers making judgemental conditions on what they will and won’t do under this clause. This clause must be amended to remove the responsibility of providers to spend according to the plan. It is impossible for the provider to comply when they do not, and for many reasons should not, have the plan.

Submission 50

Debts

The right to appeal a debt must be legislated. There must be a right for the debt to be revoked if a mistake, not only waived or written off, which has entirely different implications. It is possible this breaches the Privacy Act if incorrect information about a person remains on file. A recent report noted that 25% of wrong participant debts were revoked voluntarily by NDIA (so kind). Imagine the stress. An Insider said the numbers of debts revoked was actually much higher than this report. This is still not legislated. Consider even RoboDebt could be appealed.

S47A & s48

S47A Item 10 inserts new subsection 47A(1B)(aa) Provisions to avoid doubt stipulating that any variations under subsection 47A(1) may include an increase or decrease of the total funding amounts. The Explanatory Memorandum (p41) This amendment is “for the avoidance of doubt” and states, “limited circumstances in which a total funding amount may be reduced…some with limited circumstances” The statement gives an example of a compensation amount to consider. The body of the Act should use the words “limited circumstances” as rather than avoids doubt, the Bill as written increases doubt that this clause could be used to make ill-considered cuts to a plan. The reading of this clause implies consideration of cuts in equal measure to increases to a plan. Furthermore, making unannounced cuts to a plan does not afford the participant the right of reply of information to rebut the cut, to be prepared “With the participant” It may be better to strike the Bill amendment as, in its current form, it does not reflect the intent of the clause and could be misinterpreted by NDIA as a carte blanch attack on the plan, when the participant only asked for a simple change, noting 1/3 of reassessed plans have cuts to funding 6.

s47A Risk to life health and safety clause

At s47A (1AB) j (ib) the CEO is satisfied that the variation is necessary to prevent or lessen a threat to the participant’s life, health, or safety (whether current or future); This clause is for New Framework plans This vital clause is not replicated for Old Framework Plans Permitted variations—old framework plans (1A) (d)(i) the CEO is satisfied that the participant requires crisis or emergency funding as a result of a significant change to the participant’s support needs; Neither Noah nor Koa had a change in their own support needs, and they died due to policy application. Their life was at risk and urgent application of s47A (1AB) j (ib) is explicit and should be replicated for Old Framework Plans. it behoves the Agency to respond urgently where life is at risk or harm predicted.

S99 Reviewable decisions must be amended for procedural fairness to add

• The decision to refuse a claim
• The decision not to revoke a debt
• A decision to refuse a replacement support needs assessment
• A decision to refuse a review of a support needs assessment.
• A decision not to review a reasonable and necessary budget

Submission 50

The Commission

Broadly the increase of powers to the Commission for Quality and Safety of providers Services are very welcome.

It is clear from the very many reports of harm to participants, even deaths, by the Agency activity that better oversight is needed. The Agency is legislated to support, not harm.

Despite the APS Act, NDIA are known to flout the law and act without due diligence. Numerous instances are reported of plans built with minimal or no contact with the participant despite s33 (2). This planning is achieved by a so called “check in” often lasting just a few minutes and at an inconvenient time. An abuse amounting to deception. Instances of refusing to give time to collect reports are common. Plans with cuts are dropping unannounced.

Breaches of the APS Act Code of Conduct are dealt with internally by the CEO or their delegate. NDIA actions are not open to scrutiny for individuals. The Ombudsman, ANAO etc deal with systems, not individuals, and are not NDIA dedicated. Nothing assists individual accountability of the Agency.

The Commission should be legislated to empower it to act on harms by NDIA to the participant. Remembering that NDIS participants are, by definition those that have the greatest impact of disability in the community and are vulnerable to harm. Investigations should consider both policy and systems as well as individuals.

It is arguable that harms from deficit services are also indirect result of NDIA harm. For example, an inappropriate plan cut causes a provider to cut corners, and/or drops support. This is not an excuse for the provider to reduce care but a provider is put in a very difficult position by the Agency. They must decide to offer free service or abandon the participant maybe in hospital or even just leaving a participant with no care! When the Commission becomes involved, they could also look at the role of NDIA and act accordingly.

These examples are some of harms that show NDIA push on with harsh applications of policy or even flouting the law:

• Disregard or lack of processes for urgent harm interventions
• Tick and flick s100 appeals. Keeping on hold (delay) for 90 days then no change. Escalations to ART were up 95% from 23/24 numbers.[7]
• Delays for cost cutting reasons that breach the Participant Guarantee
• Revocation of access without care of harm and time for evidence.
• S10 Rules applied inappropriately. Even ART have had mixed interpretations of this law.
• Planning and appeals that are brief cold calls breaching the law s33 (2) “with the participant”

Submission 50

• Compliance actions that cause distress and are inappropriate. Participants report being treated as criminals.
• Treated badly by NDIA and/or corporate lawyers at ART
• Funding periods applied without the individualised consideration required of the law. redacted Never forget funding periods led to the death of a four-year-old despite repeated pleading from parent and advocate. Seven urgent requests to use the plan funding at crisis time were made by mum and her advocate.
• Indiscriminate provision of Agency or Plan Management changes from Self-Management in new plans. The law requires careful consideration.
• Changes from self-management as “punishment” rather than safeguarding. Despite the warnings of s46 Note 1. it should be under scrutiny that these legislated provisions are not misused and result in harm. A sudden change to Agency Management can lead to loss of ALL supports. This happened to Noah who died alone with no support when his tracheostomy tube became dislodged.

Conclusion:

This submission discusses that the support needs assessment proposal departs in totality from the NDIS Review. Its base tool I-CAN is heavily criticised by the Psychologist Peaks as not validated for many disabilities. They call it out as having consequences and being reprehensible if implemented prior to validation. Occupational Therapy Peak OTSi and Verve OT have concerns of application by unqualified assessors and no certainty of medical reports available to the assessors. The application in practice will be new research, by Melbourne University without consent on disabled people. In view of numerous red flags and potential for harm this SNA cannot be implemented without a full inquiry, including the means of calculating the reasonable and necessary budget.

This submission calls for procedural fairness with the right to review: the SNA; the reasonable and necessary budget; claims rejection and debt revocation.

Other concerns found are the loading responsibility of “spend according to the plan” on providers who should not have the whole plan in many cases; accessibility problems for an online form only described in yet to be announced Rules; and open-ended requests for any amount of information for a claim that may breach privacy.

Examples of NDIA harmful overreach is described, recommending external oversight of individual participant harms must be given to the NDIS Commission to investigate and if necessary, apply penalties.

Submission 50

Recommendations:

• (1) amend the NDIS Act at s32L to add at 4) That s32L a new part 4c) now reads: “must have regard to any professional reports that the participant submits.

• (2) At 32L (2) the Notes10 from s 34(1) 1aa must be added for the legislation to be consistent with s34(1) and allow the assessor to assess impacts on the other impairments.

• (3) That this Inquiry refers the Support Needs Assessment and budget development to the NDIS Joint Standing Committee Inquiry before implementation.

• (4) 9 A (2) and 45A (3) amended to provide accessible options for claims

• (5) S45(3A) The requests for “information” should have limitations of information set in law so that there is no breach of privacy, for example support work shift times not shift notes, a psychologist’s appointment times, not appointment notes.

• (6) S46 (1) This clause must be amended to remove the responsibility of providers to spend according to the plan. It is impossible for the provider to comply when they do not, and for many reasons should not, have the plan.

• (7) s47A (1AB) j (ib) is explicit and should be replicated for Old Framework Plans. the CEO is satisfied that the variation is necessary to prevent or lessen a threat to the participant’s life, health, or safety whether current or future

• (8) S47A Item 10 inserts new subsection 47A(1B)(aa) Provisions to avoid doubt. This clause should be deleted as, according to the explanatory statement, it is not the intent of the section to give equal weight to increase or decrease of funding. The clause does not avoid doubt.

• (9) The Commission should be legislated to empower it to act on harms by NDIA to the participant or provider.

Note: For the purposes of paragraph (aa):

(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and

(b) a participant’s disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.