National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 110
SUBMISSION TO THE SENATE COMMUNITY AFFAIRS LEGISLATION COMMITTEE
Inquiry into the National Disability Insurance Scheme Amendment
(Securing the NDIS for Future Generations) Bill 2026
Submitted by: Title: Organisation:
Date: 24 May 2026 Contact:
- Introduction and standing
-
I make this submission in my professional capacity as
. I hold this role across : a geographically isolated region with a substantial rural and remote population, a thin provider market, limited specialist services, and no metropolitan safety net.
-
My clinical background includes years of practice as a remote area nurse in the and prior work as an Emergency Department clinical nurse on the . I have spent my career in settings where the failure of disability and community support systems does not remain abstract — it presents at the nursing station, often in crisis.
-
This submission addresses three categories of provision in the Bill that will, in my
considered professional view, cause direct and foreseeable harm to people with disability and to the acute health system: the proposed children’s pathway changes (including the Thriving Kids program); the narrowing of eligibility criteria and the definition of NDIS supports; and the proposed shift toward block funding models. Together, these provisions will drive a predictable and measurable cost-shift from the NDIS onto public hospital Emergency Departments and acute medical wards — costs that will be borne not only by NDIS participants but by every patient competing for scarce beds in an already stretched system.
-
My position is that the Bill in its current form should not be passed. The provisions I identify below require substantial amendment. If they are enacted as drafted, the acute health system in regional and remote Australia will be required to absorb the human and financial cost of decisions made in the name of NDIS sustainability.
-
Children with behavioural needs and Emergency Departments Proposed Thriving Kids pathway and children’s eligibility criteria (Schedule 1)
-
The proposed Thriving Kids pathway, and the associated amendments tightening
children’s eligibility criteria, will divert a significant cohort of children with disability away from individualised NDIS supports. The Bill frames this diversion as an investment in early intervention and ‘thriving.’ The clinical reality is otherwise. Children with complex behavioural presentations — particularly those with autism, intellectual disability, ADHD, and co-occurring psychiatric conditions — do not have mild or time-limited support needs, and they do not resolve with a short-term early intervention episode.
-
When these children lose access to NDIS-funded Positive Behaviour Support,
therapy services, and community-based crisis response, the support vacuum does not remain
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 110
empty. It fills with Emergency Department presentations. This is not a risk or a projection: it is what already happens when support fails. The Bill, if enacted, will increase the frequency and severity of those presentations.
-
Emergency Departments are not therapeutic environments for children in
behavioural crisis. They are high-stimulation, high-noise, unpredictable spaces that are acutely dysregulating for neurodivergent children. The ED presentation itself commonly worsens the child’s distress. The management options available in an acute setting — physical restraint, pharmacological sedation, isolation rooms — carry iatrogenic risks that are entirely avoidable when adequate community-based supports are in place. There is no clinical or ethical justification for exposing a child to these risks when the cause is a preventable support gap.
-
These presentations consume emergency nursing and medical resources that are
already critically stretched. They frequently result in hospital admissions that are clinically unnecessary if the underlying support need had been met. In the , where there is no paediatric psychiatric inpatient unit and the nearest specialist children’s mental health services require a flight to , these admissions can extend to days or weeks. The child is harmed. The family is in crisis. The bed is unavailable for the next patient.
-
The eligibility criteria for the Thriving Kids program, as proposed, rely on concepts
of ‘mild’ and ‘moderate’ disability that are clinically unworkable for children with complex behavioural profiles. These children’s needs are not mild. Their impairments are not discrete. The proposed definitions do not account for the compounding interaction of co-occurring conditions — which is precisely the clinical profile of the children most likely to present to Emergency Departments when supports are withdrawn or denied.
-
I note further that proposed subsections 34(1)(E) and 34(1)(F), by establishing a
hierarchy that privileges ‘published, peer-reviewed, and generalisable’ research over practitioner-specific and participant-specific evidence of effectiveness, will systematically disadvantage children with complex behavioural presentations. The evidence base for Positive Behaviour Support in community settings is substantial; but the evidence for individual- specific support configurations is necessarily generated by practitioners and families working with that child. These provisions will make it harder, not easier, for practitioners to justify the individualised packages that keep children with complex behavioural needs safe in the community.
Recommendation 1: The proposed Thriving Kids pathway eligibility criteria must be revised to require comprehensive multidisciplinary functional assessment across all domains, with explicit provision for co- occurring conditions and complex behavioural profiles. Children presenting with significant behavioural disturbance must not be excluded from individualised NDIS support on the basis of diagnostic category or assumptions about mild functional impact.
Recommendation 2: Proposed subsections 34(1)(E) and 34(1)(F) should be opposed. The evidence hierarchy as drafted will suppress access to supports for children with complex presentations, where evidence is by necessity practitioner- and participant-specific. Lived experience evidence and practitioner-generated outcome data must carry equal weight.
- NDIS participants stranded in acute medical beds Block funding provisions, erosion of individualised support, and repeal of Section 31
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 110
-
I wish to be unequivocal: NDIS participants being stranded in acute medical beds is
not a future risk. It is happening now, in my hospitals. It is one of the most significant and least-discussed contributors to bed block in regional acute hospitals across Australia, and the provisions of this Bill will make it substantially worse.
-
The mechanism is straightforward. When an NDIS participant is admitted to hospital
for an acute episode, they arrive with a support package designed for their community environment. That package — the workers, the accommodation, the routines — does not accompany them into hospital. From the day of admission, discharge planning begins: which supports must be in place before this person can safely return to the community?
-
For participants with complex support needs — significant cognitive impairment,
high physical dependency, challenging behaviour, or complex care requirements — the answer depends on flexible, responsive support coordination. Acute illness routinely changes a participant’s needs. Surgery changes them. A fall, an infection, a decompensation: each can permanently alter the support picture. A plan variation may be required before discharge is safe. An alternative provider may need to be sourced. A new accommodation arrangement may be necessary.
-
This process is already fragile under the current scheme. Existing NDIA delays in
plan variation and provider-of-last-resort failures already result in participants waiting in acute medical beds for weeks — sometimes longer — while support arrangements are renegotiated. My nurses are providing acute medical nursing to people who are medically stable and waiting for their community life to be reorganised. Each of those days represents a bed unavailable for the next patient waiting in the Emergency Department. It represents an infection risk, a deconditioning risk, and a loss of dignity for the participant.
-
The Bill’s movement toward block funding models will compound this problem
severely. Block-funded services are allocated to regions or cohorts, not to individuals. They cannot flex in response to individual changed needs. They cannot be redirected to a specific participant who has been discharged from hospital with increased care requirements. They remove the one tool — individualised plan variation — that gives discharge planners any capacity to respond to clinical reality.
-
The proposed amendments to Section 31 of the NDIS Act compound this further.
The principles in Section 31 — that plans be individualised, participant-directed, flexible, and oriented toward choice and independence — are not aspirational flourishes. They are the legislative foundation on which discharge planners, social workers, and support coordinators negotiate rapid plan variations in response to changed clinical circumstances. Remove them from the Act and the NDIA has no legislative obligation to be responsive to individual need. That inflexibility will be paid for in hospital beds, in human suffering, and in costs that will fall on the state health system rather than the NDIS.
Recommendation 3: Block funding must not be applied to participants with high or complex support needs. For this cohort, individualised, flexible, participant-directed funding is not a preference — it is the operational mechanism that enables safe hospital discharge and prevents prolonged acute admissions. The Bill must explicitly preserve individualised planning for all participants with complex needs.
Recommendation 4: Section 31 of the NDIS Act must be retained in its current form and must retain direct application to NDIA decision-making. Its provisions are operationally essential to discharge planning in acute health settings and must not be repealed or diluted.
- The compounding effect of regional geography
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 110
-
Every problem described above is harder in the .
serve a population spread across a large geographic area with limited public transport, high rates of socioeconomic disadvantage, and a provider market that is already thin and fragile. There is no metropolitan catchment to absorb overflow. There is no private hospital sector capable of taking patients who cannot be managed in the public system. There is no tier of community-based disability support that exists independently of the NDIS.
-
When NDIS supports are withdrawn, reduced, or replaced with block-funded services that cannot respond to individual need, there is no alternative in this region. The acute hospital is the institution of last resort, and we cannot say no. We are the safety net. The Bill, as drafted, will increase the weight this region’s acute health system is required to carry, without providing a single additional resource to carry it.
-
The Committee should be aware that the effects of the provisions I have identified
will not be evenly distributed across Australia. They will fall most heavily on regional, rural, and remote communities — communities that already carry a disproportionate burden of unmet need and that have the least capacity to absorb additional demand on acute services.
- The false economy of cost-shifting
-
This Bill is framed as a sustainability measure. I wish to place on record that there is
nothing sustainable about transferring the cost of disability support onto the acute health system.
-
A single day in an acute medical bed in a public hospital costs the health system multiples of what a day of community-based NDIS support costs. An Emergency Department presentation by a child in behavioural crisis costs the health system more than a month of Positive Behaviour Support delivered in the community. A delayed hospital discharge of four weeks costs more than the annual support package whose variation was never actioned. These are not contested figures — the health economics are clear, and they are available to the Government.
-
The Government’s framing of eligibility cuts, block funding, and the erosion of
individualised support as measures to ‘secure the NDIS for future generations’ does not hold up to scrutiny when the full cost picture is examined. These measures do not reduce the cost of supporting people with disability. They relocate that cost to public hospitals, state governments, and families — and they do so in the most inefficient possible way, by allowing preventable crises to occur and then treating them acutely.
Recommendation 5: The Committee should require the Government to provide a full cross-portfolio fiscal analysis of the Bill’s provisions — including projected impacts on Emergency Department presentations, acute hospital admissions, and length of stay attributable to NDIS support gaps. The NDIS’s fiscal sustainability cannot be assessed in isolation from the health system costs that NDIS cuts generate.
- Summary of recommendations Recommendation 1: The proposed Thriving Kids pathway eligibility criteria must require comprehensive multidisciplinary functional assessment with explicit provision for co-occurring conditions and complex behavioural profiles. Recommendation 2: Proposed subsections 34(1E) and (1F) should be opposed. Lived experience and practitioner-generated evidence must carry equal weight to published research.
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 110
Recommendation 3: Block funding must not be applied to participants with high or complex support needs. Individualised, flexible, participant-directed funding must be preserved for this cohort. Recommendation 4: Section 31 of the NDIS Act must be retained in full, with direct application to NDIA decision-making. Recommendation 5: The Committee should require a full cross-portfolio fiscal analysis of the Bill, including projected health system costs attributable to NDIS support gaps. 7. Conclusion 23. The NDIS was built on the recognition that people with disability deserve individualised, flexible support enabling equal participation in community life. As a nurse who has worked across remote, regional, and acute settings, I can state plainly: when that support fails, people end up in hospitals. When they end up in hospitals, they are worse off — clinically, personally, and financially. When they remain in hospitals because support packages cannot flex to accommodate changed needs, everyone waiting for an acute bed is worse off too.
-
The Bill as drafted will increase all of these harms. It will do so in communities that
are already carrying more than their share, with fewer resources to absorb the impact. I urge the Committee to reject the provisions I have identified, and to insist on a genuine, co- designed approach to NDIS sustainability — one that accounts for the full cost of disability support gaps, rather than simply relocating those costs and calling the relocation reform.