Concerns regarding automated decision-making and psychosocial disability supports

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1186

S U B M I S S I O N Securing the NDIS for Future Generations Bill 2026

S U B M I S S I O N T O S E N A T E I N Q U I R Y Submission on the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Senate Community Affairs Legislation Committee

S U B M I T T E R C A P A C I T Y D A T E NDIS Participant/Disability May 2026 Legal Advocate

P R E L I M I N A R Y About this submission

My name is . I am an NDIS participant and Disability Legal Advocate and Consultant. My professional work primarily consists of assisting in Guardianship proceedings in the NSW Civil and Administrative Tribunal (NCAT) and in Administrative Review Tribunal (ART) Social Security proceedings, however I have assisted participants in the conciliation stages of the ART in relation to NDIS proceedings. I also make this submission in my personal capacity, as a 37 year old female with Spina Bifida, Autism and a long history of Psychosocial Disability, and as someone who has lived inside the planning, review and appeals processes of this scheme for almost a decade. I have previous experience on the NDIA Participant Reference Advisory Group and in a number of NDIA Focus groups and consultation activities through Participant First. I am a previous Chair of Voices for Central Coast Disability, an early ILC initiative, and I currently sit on the boards of two National Peak Disability Representative Organisations (DROs) People with Disability Australia (PWDA) and Women with Disabilities Australia (WWDA). I write to the Committee here in the first capacity only. My board roles have their own engagement channels and will provide their own submissions on this Bill, however I list them as part of my lived experience, advocacy credentials and as an indicator of my insight into the Disability Representative Organisation co-design process or lack thereof.

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This submission works from the text of the Bill and the existing National Disability Insurance Scheme Act 2013. I have drawn on both my knowledge of the operation of the Act as well as on my own planning experience, payment claim experience and tribunal experience to illustrate how the proposed amendments will operate for a participant with a Disability such as Spina Bifida, with real world implications discussed alongside the operation of the proposed provisions.

I make ten substantive submissions, each followed by recommendations. A consolidated list of recommendations appears at the end.

I would like to be direct: I oppose this Bill in its current form. It requires deferral and adequate time for consideration and co-design with the Disability Community. However, if the Bill proceeds, these recommendations are the minimum required for the provisions I address here to be safe for participants, protect due process and review rights and to ensure adequate safeguards against Ministerial overreach.

S E C T I O N 1 Automated decision making

Provisions

Schedule 3, Part 2, item 11 of the Bill inserts new Division 5 of Part 1 of Chapter 4 of the Act (sections 59B to 59E). Section 59B authorises the CEO to arrange for computer programs to take administrative action under designated provisions. Subsection 59B(4) extends this authorisation expressly to evaluative administrative action, namely the exercise of a discretion, the making of an evaluative judgement, and the formation of a state of mind. Subsection 59B(5) treats action taken by a computer program as action taken by the CEO. Section 59D provides for standard operating procedure instruments to govern evaluative automation.

Concern

A level of automation is already operating inside the Agency at the level of payment integrity and participant correspondence, before any of these provisions commence. Participants routinely report receiving letters that appear to have been generated for someone else, with names and details that do not match. Internal review processes, even with human oversight, already lose evidence: in my own recent internal review, the human reviewer overlooked a folio of around $5,000 of reports, including a functional capacity

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assessment, a continence assessment and a psychological assessment. The planner then turned down the supports the reports were submitted to substantiate.

In late 2024, an automated payment integrity flag denied a claim of mine for approximately $2,000. My mother had recently died and I had inherited a large volume of boxes that made my home unsafe to navigate by wheelchair. I engaged a registered provider that specialises in supporting people with disability with large household tasks, paid from my self-managed daily support hours, consistent with the flexibility provisions of the Act. The claim description contained the word ‘storage’ and the system flagged and denied it. The decision was not internally reviewable. Resubmitting under a different description would, on the basis of prior agency conduct, have placed my self- management status at risk. I paid the $2,000 personally. That is a participant debt by another name, created by a partly automated process, in circumstances where the underlying claim was lawful and reasonable to inhabit my home safely. I have heard many stories similar to mine, where a refusal to approve a claim is in itself a debt on the participant.

Section 59B authorises further expansion of automation into evaluative judgement, including discretions about supports, while these baseline integrity problems remain unresolved and several categories of automated action remain non-reviewable. This is concerning given that automation may contain implicit bias and may hallucinate. The note to subsection 59B(1) confirms that automation can also be deployed without a section 59B arrangement where the action does not involve an administrative decision being made, which leaves a wide field of automated activity outside the safeguards in sections 59B to 59E entirely.

Section 59E does not cure this concern but in fact heightens it. Although it requires the CEO to take reasonable steps to ensure automated administrative action is action the CEO could validly take, subsection 59E(3) provides that failure to comply with that safeguard does not affect the validity of the automated action. The safeguard is therefore procedural and weak: it does not give participants a direct invalidity consequence where automation has been used outside appropriate bounds. In practical effect, no one is procedurally accountable to the participant for an error caused by the breach.

Recommendations

R E C O M M E N D A T I O N

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Subsection 59B(4) should be amended to exclude evaluative administrative action from automation. The exercise of discretion, the formation of evaluative judgement, and the formation of states of mind about a participant should remain with a human decision-maker.

R E C O M M E N D A T I O N Every action taken under subsection 59B(5) should be a reviewable decision under section 99 of the Act, regardless of whether the underlying provision would otherwise be reviewable. The current carve-out at the note to subsection 59B(1) for action that does not involve an administrative decision being made should be removed.

R E C O M M E N D A T I O N Commencement of Schedule 3, Part 2 should be deferred until the Agency has demonstrated, through published audited data over a full annual planning cycle, that existing automated systems are operating correctly under human oversight. Expansion of automation in advance of that demonstration is premature.

R E C O M M E N D A T I O N The Bill currently provides that a standard operating procedure instrument is a notifiable instrument. This should be amended so that it is a disallowable legislative instrument, subject to consultation with disability representative organisations, and tabled with the explanatory statement identifying the categories of evaluative action to be automated.

S E C T I O N 2 Tightening the meaning of permanence

Provisions

Schedule 1, Part 8, items 88 to 94 of the Bill insert new subsections 24(5) and 25(1B), and new section 25A, of the Act. New paragraphs 24(5)(a) and 25(1B)(a) provide that an impairment is not permanent, or likely to be permanent, unless the person has undertaken all appropriate treatment. Section 25A defines appropriate treatment as evidence- based, reliably expected to materially improve the impairment, and regularly undertaken in Australia. Subsection 25A(2) provides that treatment may be appropriate treatment

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regardless of whether the person’s individual circumstances restrict the person from accessing the treatment, with a note stating that individual circumstances include financial circumstances and geographical location. Item 94 applies the amendments to any access decision made on or after commencement, whether or not the person is a participant before commencement.

Concern

I have lived the consequences of a permanence test administered without regard to the lifelong, episodic and treatment-intensive nature of disability. My spina bifida is congenital. My spine did not form correctly. No surgery or intervention will ever cure it. When I applied for the Disability Support Pension in 2014, I was held not to have a permanent and significant impairment because I was an active patient in a neurorehabilitation unit following a routine spinal surgery for tethered cord syndrome, a complication common in adults with spina bifida. The surgery produced significant cerebrospinal fluid leak. I had four spinal surgeries inside twelve months. Throughout that period I was assessed as not having a permanent or stable condition, despite my congenital disability.

The consequences were not abstract. I was without income for almost two years. I did not hold a healthcare card. I spent approximately $400 per month on medication. I exhausted my savings and lost my home. In-home care at the time was means tested and could not be accessed without an underlying support payment. My mother moved in to provide full-time care. Our relationship had a history of domestic violence. I became physically dependent on her for daily care and to leave the house. She became abusive again when I raised the possibility of her moving out. I sought an Apprehended Violence Order through a justice system that did not understand the nature of coercive control inside a domestic care relationship. Those conditions were created by a permanence test that treated active treatment as evidence against permanence. The same logic now appears in the proposed subsections 24(5) and 25(1B), but in relation not to income support, but the right to care. This is arguably just as consequential.

Most progressive and lifelong physical disabilities involve ongoing treatment. People with spina bifida commonly undergo spinal fusion, orthopaedic surgery, bladder Botox, lymphoedema treatment, and other interventions over the course of a lifetime. The proposed test asks the CEO to determine whether further treatment is unlikely to materially improve, reverse, or alleviate the impact of the impairment. That is an open- ended question that imports clinical judgement into a question of legal eligibility. It invites

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the same outcome I lived through in 2014: a person with a clearly permanent congenital impairment, held to fall outside the scheme because clinicians are continuing to treat them.

Subsection 25A(2) is the most concerning provision. It expressly states that treatment may be appropriate treatment even where the person cannot access it for reasons of finance or geography. This puts regional and remote participants, low-income participants, and participants in thin treatment markets in an impossible position: ineligible because of treatment they cannot reach. For people under guardianship orders, the test creates a further risk. A guardian motivated to secure scheme access for a family member may direct that the person undergo invasive treatments against their own wishes, simply to demonstrate that all appropriate treatment has been undertaken. That is a coercion risk built into the eligibility test itself.

Item 94 makes the test apply to all access decisions made after commencement, whether or not the person is already a participant. Existing participants are exposed, including myself, who has already been subject and victim to this arbitrary test before.

Recommendations

R E C O M M E N D A T I O N Schedule 1, Part 8 should be opposed in full. The proposed tightening of permanence reintroduces the very subjective uncertainty the NDIS was designed to remove for those with certain disabilities.

R E C O M M E N D A T I O N In the alternative, subsection 25A(2) should be repealed. A test that deems treatment appropriate regardless of whether the person can access it cannot stand. Geography, finance, and personal circumstances must be material to whether a treatment is appropriate.

R E C O M M E N D A T I O N In the alternative, the application provision at item 94 should be amended so the new test does not apply to access decisions affecting existing participants.

R E C O M M E N D A T I O N

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The Bill should provide an express exception for impairments that are congenital, progressive, episodic, or otherwise inherently requiring ongoing treatment.

R E C O M M E N D A T I O N The Bill should provide an express protection of the participant’s right to refuse treatment, drawn from the Australian Charter of Healthcare Rights and Articles 12, 17 and 25 of the Convention on the Rights of Persons with Disabilities, including where the participant is subject to a guardianship order.

S E C T I O N 3 Ministerial power to reduce categories of supports

Provisions

Schedule 1, Part 4, item 34 inserts new section 34A of the Act. Paragraph 34A(1)(a) authorises the Minister to determine, by legislative instrument, a percentage lower than 100 per cent by which the funding component amount for a specified group of supports is reduced. Subsection 34A(3) requires the Minister to have regard to the safety of participants. Subsection 34A(5) provides that the determination has effect even if the funding for a particular reasonable and necessary support, or for all supports in the plan taken together, is less than the cost of those supports.

Concern

Section 34A places at the discretion of a single Minister the power to reduce entire categories of support across the Scheme. The only stated constraint is the financial sustainability purpose in subsection 34A(1) and the obligation to have regard to participant safety in subsection 34A(3). Have regard to requires the Minister to turn their mind to safety. It does not prevent a determination that compromises it. Subsection 34A(5) confirms in terms that the determination operates even where it leaves a participant with less funding than the cost of their reasonable and necessary supports.

Legislation must be drafted for governments of every political persuasion, not for the Minister of the day. The current government may exercise this power with care. A future Minister may not. There are no requirements in section 34A for transparency of process,

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peer-reviewed costing evidence, consultation with disability representative organisations, or independent actuarial review. There is also no scrutiny from the Parliament or disallowance provision. The Minister is a publicly elected parliamentarian. They will not in every case have qualifications in economics, allied health, or the disability sector. Vesting unilateral category-reduction power in that office is incompatible with the scheme’s ‘original intent’ and status as an independent insurance-based, individually assessed program.

The protection in paragraph 34A(1)(b), which limits each determination to plans coming into effect on or after the determination commences, is a real but partial safeguard. It is undermined by the operation of section 50A (plan renewal). A renewed plan comes into effect at renewal, which exposes it to any section 34A determination in force at that time, and the safeguard’s temporal protection therefore erodes as renewal cycles work through the cohort. Subitems 58(3) and 58(4) of Schedule 1 permit the Minister, by legislative instrument, to substitute an earlier end date for existing old framework plans with reassessment dates falling after 1 October 2027. The Minister may therefore accelerate the renewal of these plans, and so accelerate their exposure to any section 34A determination then in force. The cumulative effect is that section 34A reaches every old framework plan over time, through the renewal mechanism, without participants having a say into whether the determination will negatively affect their quality of life or safety.

Participants will rightfully live in fear that their plans can be reduced, or whole categories of support removed, without the Minister being required to provide independent actuarial or evidentiary justification, and without the substantive scrutiny that Parliament would apply to primary legislation. Disallowance under the Legislation Act 2003 is a thin safeguard for a power of this magnitude.

Recommendations

R E C O M M E N D A T I O N Section 34A should be opposed. The power to reduce whole categories of support across hundreds of thousands of plans should not sit with a single Minister.

R E C O M M E N D A T I O N In the alternative, subsection 34A(3) should be strengthened from “have regard to” to “must not adversely affect” participant safety, with safety expressly defined to include risk of injury, deterioration of impairment, loss of housing, loss of community

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connection, effect on wellbeing and quality of life, and exposure to violence, abuse and neglect. The Minister should further be required, before making any determination, to publish independent analysis demonstrating that identified less restrictive financial sustainability measures (including provider fraud enforcement, pricing reform, eligibility integrity and plan management oversight) have been implemented, have operated over a full annual reporting cycle, and have been independently assessed as insufficient to achieve the sustainability outcome. Every section 34A determination should be subject to a sunset of no longer than twelve months, requiring fresh justification, fresh consultation and fresh Parliamentary scrutiny for any continuation.

R E C O M M E N D A T I O N In the alternative, section 34A should require the Minister, before making any determination, to commission and publish independent actuarial analysis, conduct formal consultation with disability representative organisations, and obtain the concurrence of the Scheme Actuary. The determination should be disallowable.

R E C O M M E N D A T I O N Subsection 34A(5) should be repealed. Legislation should not authorise determinations the explicit effect of which is to fund a participant’s plan below the cost of their reasonable and necessary supports.

S E C T I O N 4 Ministerial power to set maximum prices

Provisions

Schedule 3, Part 1, item 4 of the Bill inserts new section 45C of the Act. Subsection 45C(1) authorises the Minister, by legislative instrument, to determine the maximum amount, or the method for determining the maximum amount, for an NDIS support or class of supports. Subsection 45C(2) limits the determination to supports funded under plans managed by a registered plan management provider or the Agency. Subsection 45C(3) prohibits Agency payment in excess of the maximum. Subsection 45C(6) makes any amount paid in excess of the maximum a debt due to the Agency under section 182.

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Concern

Centralising the pricing function in the office of the Minister removes the limited independence currently provided through the NDIA Pricing Arrangements process. The Minister is not required by section 45C to have regard to industry-standard pay rates, the Fair Work Commission’s Social, Community, Home Care and Disability Services Industry Award, the cost of delivery in thin regional and remote markets, or peer-reviewed cost data. The pricing power is, in form, unilateral.

Pricing affects who is willing and able to provide services. Suppressed prices in thin markets produce withdrawn providers, and withdrawn providers produce participants who cannot get the support their plan funds. The Central Coast, where I live, is already a thin market for accessible transport, allied health, and after-hours support. A unilateral pricing determination set without regard to regional cost differentials will close off services I currently rely on.

I note that subsection 45C(2) limits the determination to plan-managed and agency- managed funding. Self-managed participants will not be directly bound by a section 45C maximum, but the practical effect of suppressed prices is that the providers self- managers depend on will exit the market. The exemption is narrower in effect than it appears. In addition, these provisions are not subject to sunsetting, which means that they will likely remain in force indefinitely without parliamentary review as to their impact.

Recommendations

R E C O M M E N D A T I O N Section 45C should require the Minister, before making any determination, to obtain and publish independent cost-of-delivery analysis, including separate analysis for regional, rural and remote markets, and analysis of relevant industry awards including the SCHADS Award.

R E C O M M E N D A T I O N Section 45C should require formal consultation with disability representative organisations, provider peak bodies, and the relevant unions, with a published response to consultation.

R E C O M M E N D A T I O N

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Pricing should be set or reviewed by an independent body at arm’s length from the Minister, by analogy with the Independent Health and Aged Care Pricing Authority. If the policy intent is to align NDIS pricing with Medicare and aged care, the appropriate mechanism is a single independent authority across the three schemes, not a unilateral Ministerial power.

R E C O M M E N D A T I O N A determination under section 45C should be a disallowable legislative instrument.

S E C T I O N 5 Caps on groups of supports

Provisions

Schedule 1, Part 6, item 68 inserts new subsections 33(2EA) and 33(2EB) of the Act. Subsection 33(2EA) authorises determinations specifying, for a support or class of supports, a maximum amount of funding, a maximum intensity of provision, or a maximum worker-to-participant ratio, in relation to participants generally or a class of participants. Subsection 33(2EB) requires the method for working out funding component amounts to give effect to those maximums. Note 1 to subsection 33(2EA) confirms the maximums apply regardless of whether the funding component amount meets the cost of the supports in the group.

Concern

Setting caps for classes of participants and classes of supports does not reflect the reality of disability. The class of physical impairment in which spina bifida sits, and which is comparable to spinal cord injury, contains enormous variation. Within spina bifida alone, two people of similar age can have radically different functional needs depending on the level of the spinal lesion, the extent of damage at birth, the presence of hydrocephalus, the presence of tethered cord, and other congenital and acquired comorbidities. Some people with spina bifida walk and drive. Others have never walked and rely on full assistance to transfer from a bed. The same is true of many other impairment groups. The Scheme was designed as a world-first individualised support model. Capped class-based funding reverses that design and the scheme’s original intent. This also means that the

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Minister can, without evidentiary basis, set different caps for different demographic or diagnostic groups without regard to individual assessment.

The policy difficulty is real. Reference packages and typical support ranges can assist with internal consistency and actuarial planning, and we know these have been working operationally for quite some time in regards to planning guidelines. The objection here is not to indicative ranges. The objection is to determinations that operate as binding caps, made without transparency, without published methodology, based on political priorities and without an effective route to exceed them where the clinical evidence supports a higher amount, or if the compounding effect of multiple impairments result in significant and severe functional impairment.

Recommendations

R E C O M M E N D A T I O N Subsection 33(2EA) should require transparent publication of the method for determining each maximum, the supporting evidence, and the typical support packages on which each maximum is based.

R E C O M M E N D A T I O N Subsection 33(2EA) should provide an express right for a participant to seek individual funding above any maximum, in circumstances of demonstrated clinical need, supported by medical and allied health evidence, with the CEO’s decision to refuse a higher amount being a reviewable decision under section 99.

R E C O M M E N D A T I O N Determinations under subsection 33(2EA) should be disallowable legislative instruments and should be reviewed at least every two years against actuarial and outcome data.

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S E C T I O N 6 Limiting reassessments

Provisions

Schedule 1, Part 2, items 18 to 21 repeal and substitute section 48 and insert new section 48A of the Act. The new section 48 requires a participant request for reassessment to satisfy the conditions in section 48A. Subsection 48A(1) requires a significant change to those ongoing support needs of the participant that arise from an impairment, resulting from either an alteration in functional capacity or an alteration in personal or environmental circumstances. Subsection 48A(2) further requires that the alteration in functional capacity be significant and ongoing and produce a substantial reduction in the participant’s ability to perform daily activities. Item 19 also extends the agency’s response time from 21 days to 90 days. Schedule 1, Part 5 inserts section 50A providing for automatic plan renewal. Subsection 50A(4) provides that no statement of participant supports is required at renewal, and that the renewal does not involve any reviewable decision.

Concern

There is a real sustainability question behind the volume of reassessments now required for the number of participants on the scheme, I accept that. The Government should not assume, however, that the volume of unscheduled reassessment currently before the agency reflects opportunism. In my case, I had not had a face-to-face full planning meeting since 2019. My plan was rolled over year after year through COVID, for six years. In 2025, I told the agency that I would need a check-in with a local area coordinator at the next rollover because my equipment was aging and my wheelchair was failing. Instead, the agency again rolled the plan over. I was then required to lodge a request for reassessment due to Change of Circumstances. After an 8 month process and two technical advisory branch reviews, I received a five-year plan with inclusion of most of the equipment I had not had updated since joining the scheme. On the actuarial data, the plan looks like a $60,000 increase. The reality is that it captured six years of deferred equipment replacement, offset by reductions in therapy funding and was actually a net reduction of other core supports. This is an example of how unscheduled reassessment data fails to capture what is actually happening at the participant level.

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What the data records as an unscheduled reassessment is, for many participants, the agency catching up on a review it should have conducted years earlier. Section 48A as drafted will close that door. The significant change and substantial reduction in daily activities tests do not capture the participant who has had no face-to-face review in five years, the participant whose equipment has aged out, or the participant whose progressive condition has deteriorated within the bounds of what was clinically anticipated.

The interaction with section 50A makes this worse. Subsection 50A(4) removes the statement of participant supports and the reviewable decision point from renewal. Together, sections 48, 49 and 50A remove the ordinary reassessment point from automatic plan renewal. Together, sections 48 and 50A reduce participant-initiated review to a narrow window contingent on satisfying a tight functional test and proving a substantial deterioration or change of condition. This is likely to have the effect of many participants’ needs being neglected over time.

Recommendations

R E C O M M E N D A T I O N Section 48A should be amended to include a deemed-eligibility category for participants who have not had a face-to-face plan review for a period exceeding three years.

R E C O M M E N D A T I O N Section 48A should include an express carve-out for participants with progressive conditions, including motor neurone disease, Friedreich’s ataxia, amyotrophic lateral sclerosis, and other neurodegenerative conditions, who should be entitled to seek reassessment without satisfying the significant change test.

R E C O M M E N D A T I O N Section 48A should include an express carve-out for assistive technology and home modification needs that have arisen from the natural ageing of existing equipment or modifications.

R E C O M M E N D A T I O N

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Subsection 50A(4) should be amended to provide a reviewable decision at renewal, at least in relation to any alteration determined under subsection 50A(3).

R E C O M M E N D A T I O N The extension of the response time from 21 to 90 days in item 19 should be reconsidered. A 90-day response window for a participant whose equipment is failing, or whose condition is deteriorating, is too long. A tiered response time, indexed to the urgency of the request, would better balance the competing considerations.

S E C T I O N 7 Fraud measures and provider registration

Provisions

Schedule 2, Part 1, items 1 to 7 of the Bill amend the definition of NDIS provider and insert new section 10C of the Act. Schedule 2, Part 2 introduces an expanded civil penalty and regulatory regime, including new NDIA inspector and investigator roles (section 73ZSK). Schedule 2, Part 6 expands the regulation of registered plan management providers. Schedule 2 also contains expanded information gathering powers in Part 3 and record retention obligations in Part 4.

Concern

Action against provider fraud and against the small number of providers responsible for serious harm is welcome. The Bill’s overall design, however, equates provider registration with quality and safety. The evidence does not support that equation. The most serious abuse and neglect cases under the Scheme, including the death of Ann Marie Smith, occurred in services delivered by registered providers in registered group home settings. The majority of banning orders issued by the NDIS Commission have been against registered providers. By contrast, smaller independent providers and individual workers who maintain long-term relationships with participants have not been the locus of serious systemic abuse.

I rely on a small team of independent workers. A former paramedic. A single mother. A former professional who left another career to do this work. They know my medical history, my routines and my home. They take me to my volunteer commitments, to family

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events, and to my work activities. My occupational therapist let her registration lapse in 2025 because the audit and compliance costs were prohibitive for an individual practitioner. My psychologist of eight years is not registered, and the wait time of registered allied health therapists in my region now exceeds 12 months. The Bills redefinition of ‘NDIS Provider’ in section 10C is indeed broad enough to capture individual workers and sole traders. Mandatory registration, or de facto registration through the redefinition of NDIS provider in new section 10C and the expanded compliance regime in Schedule 2, will push these workers out of my plan. It will produce thinner markets in regional areas, including the Central Coast, where individual practitioners and small providers are already the only providers available.

On the fraud architecture more generally, basic integrity measures have been incomplete for a decade. Self-managers were not required to upload invoices until 2026. Up until 6 months ago claims under $500 could still be processed without an invoice. These are baseline measures that should have been in place from scheme commencement. They have been in place for less than a year. The Government cannot, on a single year of data under a partial compliance regime, sustain the claim that the scheme is structurally unsustainable on participant conduct grounds. The integrity measures should be allowed to operate over a full reporting cycle before category cuts and participant exits suggested by the Minister are imposed in a drastic manner. Payment integrity flagged claims that are subsequently found to be valid are not to be included in the reported data as they artificially inflate the level of fraudulent claims.

I note that the Bill does not mandate the use of a particular digital identity system but the Minister has alluded to the introduction of a digital payment system. However, the expanded information gathering and compliance regime in Schedule 2 creates the architecture within which digital identity verification requirements could be imposed by subsequent rules or operational policy. To the extent any subsequent rules or operational policy require digital identity verification of participants, that requirement should remain voluntary and should preserve alternative verification pathways, consistent with the Privacy Act 1988 and the Trusted Digital Identity framework.

Recommendations

R E C O M M E N D A T I O N The Bill should not have the effect of mandating registration for individual support workers, sole-trader allied health practitioners, and small providers. The redefinition of NDIS provider in new section 10C, together with any rules made for subparagraph

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10C(1)(b)(ii) and subsection 10C(2), and the broader compliance framework, should be drafted so that small and independent providers remain able to work with self- managing and plan-managed participants without being pushed into a registration framework designed for large providers.

R E C O M M E N D A T I O N The Government should commission and publish an independent review of the relationship between registration status and substantiated harm to participants, drawing on NDIS Commission data, before further provider registration requirements are imposed.

R E C O M M E N D A T I O N Existing baseline integrity measures, including mandatory invoice requirements, should be permitted to operate over a full annual reporting cycle before the category cuts in section 34A and the caps in subsection 33(2EA) are made available to the Minister.

R E C O M M E N D A T I O N Any expansion of digital identity verification for participants under Schedule 2 should be voluntary, with documented alternative verification pathways, and should comply with the Privacy Act 1988 and the Australian Government Digital Identity System Framework.

S E C T I O N 8 Social and community participation

Provisions

The reduction of social and community supports operates through the combined effect of the supports determination power in section 34A, the maximum funding and intensity caps in subsection 33(2EA), the redrawing of the reasonable and necessary support test in Schedule 1, Part 6, item 70 (new paragraph 34(1)(g), allowing the CEO to refuse funding for a support more appropriately funded by another scheme or existing government service system), and the scheme principles inserted by item 65 (new section 17B), which

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directs the CEO to have regard to the financial sustainability of the scheme and the desirability of community responses.

Concern

Social and community participation funding is not, for many participants, an optional category. It is the funding that allows us to leave the house and many participants are wholly dependent on it. The mainstream community programs the Government has signalled as a replacement are unlikely to exist in my electorate at the level of frequency, accessibility, or transport that would substitute for an individualised support hour. They will, in many cases, function as segregated programs that route participants into disability-only activities, in conflict with Article 19 of the Convention on the Rights of Persons with Disabilities.

The arithmetic of social and community supports within plans and in particular regional Australia, is not well understood to decision-makers and the Minister, so I would like to discuss it further. A social and community budget is calculated on a basic per hour weekday rate without penalty rates or kilometre costings, the allocation of social supports in the plan is therefore in deficit before it is even utilised.

I live in one of the longest local government areas in Australia, approximately 100 kilometres from end to end. Activity-based transport is charged at approximately $1.00 per kilometre for a standard vehicle and $2.79 per kilometre for a wheelchair-accessible vehicle. A return trip to the nearest major shopping centre costs around $70 in kilometres alone. After-hours, weekend and public holiday penalty rates exceed $100 per hour. In my current plan, activity-based transport already accounts for approximately one-third of my weekly community supports budget. A single public holiday outing can consume the equivalent of two weeks of allocated community support. I already ration my participation, as do many other participants, to account for the shortfall due to penalty rates and activity-based transport costs.

On the Central Coast, public transport outside the rail line is sparse. Warnervale station, the closest station to me, is not accessible. The accessible alternative is a thirty-minute round trip. There are no accessible footpaths between my home and a bus stop. Support worker hours and accessible vehicle hire are the only mechanisms by which I can reach paid work, volunteer commitments, medical appointments and community participation.

I have to be direct: a reduction of social and community supports of the magnitude flagged in the public discussion of section 34A would be catastrophic to my quality of

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life. It will produce isolation and I will be effectively, housebound. It will produce isolation most sharply in regional and outer-suburban communities, where mainstream alternatives are not available and where transport costs already consume a disproportionate share of allocated supports.

The 15 per cent cost growth in this support category that has been publicly cited as justification for cuts is not the result of participant demand. It is the result of an award rate adjustment by the Fair Work Commission under the Social, Community, Home Care and Disability Services Industry Award. If the Government considers that award rate unsustainable, it should make that argument to the Fair Work Commission. Participants should not bear the cost of an award decision by losing the support hours their plans depend on.

Recommendations

R E C O M M E N D A T I O N Section 34A should not be used to reduce funding for social and community participation supports.

R E C O M M E N D A T I O N Subsection 33(2EA) caps for social and community participation supports should be set with an explicit regional, rural and remote loading, accounting for activity-based transport costs, accessible vehicle costs, and after-hours penalty rates, based on postcode not the Modified Monash Model which considers some regional centres as metropolitan.

R E C O M M E N D A T I O N New paragraph 34(1)(g) should be amended so that the existence of a mainstream service does not provide a basis for refusing NDIS funding unless that service is, in fact, accessible to the individual participant, available at the frequency and time required, and capable of providing equivalent individualised support.

R E C O M M E N D A T I O N The Government should fund mainstream community programs as a complement to individualised supports, not as a substitute. Segregated disability-only programs

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must not be presented as a discharge of obligations under Article 19 of the Convention on the Rights of Persons with Disabilities.

S E C T I O N 9 Psychosocial disability and psychology supports

Concern

I raise this issue separately because policy and operational reductions of psychology and psychosocial disability supports are already occurring under the existing framework, in advance of the reforms in this Bill, and the Bill’s combined effect through sections 17B, 34A, 33(2EA) and 34(1)(g) will accelerate that trajectory.

For the past eight years I have been funded for psychology sessions in my NDIS Plan. I received a new five-year plan in December 2025 which provides for some sessions in year one, reducing to none across years two to five. Psychology for people with disability is not equivalent to acute mental health care under the Better Access initiative. It is a disability support that addresses the lifelong psychological impact of living with disability: higher rates of depression, disrupted careers, strain on relationships, grief alongside chronic and congenital conditions, and the cumulative effect of navigating systems that are often hostile.

The mainstream Medicare-funded acute mental health system was not designed to absorb this load and cannot do so. Better Access offers ten sessions per year and is not structured around the formulation issues that disability-specific psychology addresses. The cost to my own health system contact is illustrative. Before the NDIS, I averaged two to three inpatient psychiatric admissions per year. In the six years since I have had adequate disability-specific psychology funding, I have had no inpatient admissions. The economic argument and the human argument both point in the same direction.

I am also concerned about the implications for the autistic community. As a child whose autism went unrecognised, who experienced sensory food aversion and restriction (ARFID), I spent six months at age ten on a feeding tube at Westmead Children’s Hospital, and a decade in and out of inpatient psychiatric care for eating issues from age sixteen. The cost to the health system was extraordinary. Most of it was preventable through earlier and better disability-specific support. New paragraph 34(1)(g) of the Act, which

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permits the CEO to refuse funding on the basis that another scheme would more appropriately provide the support, will, on its plain reading, be used to push psychosocial disability supports back to Medicare. Medicare is not capable of absorbing them at the frequency required, nor capable of handling complex medical co-morbidity, capacity building and ensuring maintenance of functional capacity.

Recommendations

R E C O M M E N D A T I O N The Committee should request from the Government an explicit statement of how psychosocial disability supports and disability-specific psychology funding will be protected under the Bill, with particular reference to the operation of new paragraph 34(1)(g).

R E C O M M E N D A T I O N New paragraph 34(1)(g) should be amended so the existence of mainstream Medicare-funded mental health services does not provide a basis for refusing NDIS funding for psychosocial disability supports unless those mainstream services can, in fact, deliver equivalent disability-specific clinical care at the frequency required.

R E C O M M E N D A T I O N Section 17B should include an express principle that the Scheme is to fund supports for psychosocial disability in recognition of the lifelong impact of disability on mental health, and that such supports are not equivalent to mainstream mental health care.

S E C T I O N 1 0 Consultation and co-design

Concern

The disability peak bodies, including the two on whose boards I sit, were not given the opportunity for meaningful consultation on the changes in this Bill before announcement. The same was true of the Thriving Kids changes announced in 2025. The NDIS participant reference group I served on between 2018 and 2020, and the consultations I have participated in since, have made clear that the scheme has moved further away from meaningful co-design year on year, not closer to it.

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The Convention on the Rights of Persons with Disabilities, ratified by Australia in 2008, requires at Article 4(3) that States Parties closely consult with and actively involve persons with disabilities in the development and implementation of legislation and policies to implement the Convention. The development of this Bill does not meet that standard. Tokenistic consultation after design decisions have been finalised is not co- design. The disability community knows the difference.

I want to be candid with the Committee about where I sit. I have both fundraised for and voted Labor because I trusted that this Government would protect this scheme. I have watched a two-year public narrative develop, about fraud, about rorts, about unsustainability, that does not match the evidence and that has in significant part been perpetuated by the Government itself. The fraud rate, properly measured against comparable government programs, is lower. Prosecutions to date have been against providers, not participants. The scheme is an economic engine. My own plan supports the work of ten people. None of this is being said clearly by those responsible for the scheme.

What is being proposed is not the reform the scheme requires. It is a budget repair exercise being conducted on the bodies of disabled people. The absence of co-design means even the parts of this package that might have been salvageable are being lost, and the trust that the Disability community has built with successive governments in good faith participation in scheme reform over many years is being eroded.

Recommendations

R E C O M M E N D A T I O N The Committee should recommend that further progress of this Bill be deferred until a structured co-design process, compliant with Article 4(3) of the Convention on the Rights of Persons with Disabilities, has been completed with disability representative organisations and an appropriately resourced participant reference panel.

R E C O M M E N D A T I O N The Committee should recommend that any future amendments to the NDIS Act be accompanied by a statement of compatibility with Article 4(3) of the Convention, in addition to the statement of compatibility required by the Human Rights (Parliamentary Scrutiny) Act 2011.

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C O N C L U S I O N Concluding remarks

I have spent nine years inside the consultation, planning, review and appeal processes of this scheme. I am not a person who is afraid of change. I understand the financial pressures on the scheme. I do not accept the fraud narrative as it has been deployed publicly and the ‘social contract’ of this scheme has been undermined not by participants but also by the government itself fuelling a media narrative to justify these rushed reforms. The Disability community and peak bodies have not been provided independent evidence of widespread fraud and abuse over and above the rate in comparable government schemes. I do accept that there are operational, integrity and structural reforms that the scheme requires. The disability community has the solutions and is willing to do the work with the government to ensure fraud measures are implemented without impacting participants rights and safety. But we have not been asked.

I ask the Committee to amend the Bill in line with the recommendations set out above, or in the alternative to defer the Bill until the design work has been done with the people it will affect. We are asking that the changes made to our lives be made with us not to us.

The effect of a delay is temporary. The effect of getting these changes wrong is not and could be serious, consequential and long lasting. The Bill, as drafted, vests unilateral powers in the Minister, authorises automation of evaluative decisions about participants, removes review rights at the point of plan renewal, and introduces a permanence test that imports access to treatment as a precondition of eligibility. It does this on a compressed parliamentary timetable, in the absence of co-design with the very people it affects.

I note I have only touched on a few provisions in this Bill, and I have concerns about a number of the other provisions listed however these are not my subject matter area and are best left to those with more in depth knowledge of the operation of those systems such as Plan Management, Supported Independent Living and impact on Early Intervention and Children. I ask the Committee listen to those with expertise in those areas for their considered analysis on the impact of those changes on participants and providers.

I thank the Committee for its consideration of this submission and would welcome the opportunity to provide further evidence in person. If further evidence or input is required, I will be unavailable by phone due to my participation as a grant funded delegate to attend

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the United Nations Conference of State Parties (COSP19) this year, so I ask that any requests be made via email at , however I can make myself available remotely if required for further input.

Kind regards,

S C H E D U L E Consolidated recommendations

Summary of Recommendations:

• Opposition recommendations (Recommendations 5-6, 10, 13, 30) – calling for entire provisions to be opposed.

• Amendment recommendations (Recommendations 1–4, 7–12, 14–29, 31-36) – proposing specific textual changes to add additional safeguards for participants.

• Process recommendations (Recommendations 37–38) — calling for co-design and Article 4(3) compliance consistent with Australia’s treaty obligations.

The following list consolidates all recommendations made in this submission, in the order they appear.

1. Subsection 59B(4) should be amended to exclude evaluative administrative action from automation. The exercise of discretion, the formation of evaluative judgement, and the formation of states of mind about a participant should remain with a human decision-maker.

2. Every action taken under subsection 59B(5) should be a reviewable decision under section 99 of the Act, regardless of whether the underlying provision would otherwise be reviewable. The current carve-out at the note to subsection 59B(1) for action that does not involve an administrative decision being made should be removed.

3. Commencement of Schedule 3, Part 2 should be deferred until the Agency has demonstrated, through published audited data over a full annual planning cycle, that existing automated systems are operating correctly under human oversight.

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4. Standard operating procedure instruments under section 59D should be made by disallowable legislative instrument, subject to consultation with disability representative organisations, and tabled with the explanatory statement identifying the categories of evaluative action to be automated.

5. Schedule 1, Part 8 (tightening permanence) should be opposed in full. The proposed test reintroduces the subjective uncertainty the NDIS was designed to remove.

6. In the alternative, subsection 25A(2) should be repealed. A test that deems treatment appropriate regardless of whether the person can access it cannot stand.

7. In the alternative, the application provision at item 94 should be amended so the new test does not apply to access decisions affecting existing participants.

8. The Bill should provide an express exception for impairments that are congenital, progressive, episodic, or otherwise inherently requiring ongoing treatment.

9. The Bill should provide an express protection of the participant’s right to refuse treatment, drawn from the Australian Charter of Healthcare Rights and Articles 12, 17 and 25 of the Convention on the Rights of Persons with Disabilities, including where the participant is subject to a guardianship order.

10. Section 34A should be opposed. The power to reduce whole categories of support across hundreds of thousands of plans should not sit with a single Minister.

11. In the alternative, subsection 34A(3) should be strengthened from “have regard to” to “must not adversely affect” participant safety, with safety expressly defined to include risk of injury, deterioration of impairment, loss of housing, loss of community connection, effect on wellbeing and quality of life, and exposure to violence, abuse and neglect. Before making any determination, the Minister should publish independent analysis demonstrating that less restrictive sustainability measures have been implemented over a full annual reporting cycle and assessed as insufficient. Determinations should be subject to a twelve-month sunset

12. In the alternative, section 34A should require the Minister, before making any determination, to commission and publish independent actuarial analysis, conduct formal consultation with disability representative organisations, and obtain the concurrence of the Scheme Actuary. The determination should be disallowable.

13. Subsection 34A(5) should be repealed. Legislation should not authorise determinations the explicit effect of which is to fund a participant’s plan below the cost of their reasonable and necessary supports.

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14. Section 45C should require the Minister, before making any determination, to obtain and publish independent cost-of-delivery analysis, including separate analysis for regional, rural and remote markets, and analysis of relevant industry awards including the SCHADS Award.

15. Section 45C should require formal consultation with disability representative organisations, provider peak bodies, and the relevant unions, with a published response to consultation.

16. Pricing should be set or reviewed by an independent body at arm’s length from the Minister, by analogy with the Independent Health and Aged Care Pricing Authority. If the policy intent is to align NDIS pricing with Medicare and aged care, the appropriate mechanism is a single independent authority across the three schemes, not a unilateral Ministerial power.

17. A determination under section 45C should be a disallowable legislative instrument.

18. Subsection 33(2EA) should require transparent publication of the method for determining each maximum, the supporting evidence, and the typical support packages on which each maximum is based.

19. Subsection 33(2EA) should provide an express right for a participant to seek individual funding above any maximum, supported by medical and allied health evidence, with the CEO’s decision to refuse a higher amount being a reviewable decision under section 99.

20. Determinations under subsection 33(2EA) should be disallowable legislative instruments and should be reviewed at least every two years against actuarial and outcome data.

21. Section 48A should be amended to include a deemed-eligibility category for participants who have not had a face-to-face plan review for a period exceeding three years.

22. Section 48A should include an express carve-out for participants with progressive conditions, including motor neurone disease, Friedreich ataxia, amyotrophic lateral sclerosis, and other neurodegenerative conditions, who should be entitled to seek reassessment without satisfying the significant change test.

23. Section 48A should include an express carve-out for assistive technology and home modification needs that have arisen from the natural ageing of existing equipment or modifications.

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24. Subsection 50A(4) should be amended to provide a reviewable decision at renewal, at least in relation to any alteration determined under subsection 50A(3).

25. The extension of the response time from 21 to 90 days in item 19 should be reconsidered. A tiered response time, indexed to the urgency of the request, would better balance the competing considerations.

26. The Bill should not have the effect of mandating registration for individual support workers, sole-trader allied health practitioners, and small providers. The redefinition of NDIS provider in new section 10C, and the rules made under subsection 10C(2), should be drafted so that small and independent providers remain able to work with self-managing and plan-managed participants without the compliance burden of registration designed for large providers.

27. The Government should commission and publish an independent review of the relationship between registration status and substantiated harm to participants, drawing on NDIS Commission data, before further provider registration requirements are imposed.

28. Existing baseline integrity measures, including mandatory invoice requirements should be permitted to operate over a full annual reporting cycle before the category cuts in section 34A and the caps in subsection 33(2EA) are made available to the Minister.

29. Any expansion of digital identity verification for participants under Schedule 2 should be voluntary, with documented alternative verification pathways, and should comply with the Privacy Act 1988 and the Australian Government Digital Identity System Framework.

30. Section 34A should not be used to reduce funding for social and community participation supports.

31. Subsection 33(2EA) caps for social and community participation supports should be set with an explicit regional, rural and remote loading, accounting for activity- based transport costs, accessible vehicle costs, and after-hours penalty rates, based on postcode not Modified Monash Model.

32. New paragraph 34(1)(g) should be amended so that the existence of a mainstream service does not provide a basis for refusing NDIS funding unless that service is accessible to the individual participant, available at the frequency and time required, and capable of providing equivalent individualised support.

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33. The Government should fund mainstream community programs as a complement to individualised supports, not as a substitute. Segregated disability-only programs must not be presented as a discharge of obligations under Article 19 of the Convention on the Rights of Persons with Disabilities.

34. The Committee should request from the Government an explicit statement of how psychosocial disability supports and disability-specific psychology funding will be protected under the Bill, with particular reference to the operation of new paragraph 34(1)(g).

35. New paragraph 34(1)(g) should be amended so the existence of mainstream Medicare-funded mental health services does not provide a basis for refusing NDIS funding for psychosocial disability supports unless those mainstream services can deliver equivalent disability-specific clinical care at the frequency required.

36. Section 17B should include an express principle that the Scheme is to fund supports for psychosocial disability in recognition of the lifelong impact of disability on mental health, and that such supports are not equivalent to mainstream mental health care.

37. Further progress of this Bill should be deferred until a structured co-design process, compliant with Article 4(3) of the Convention on the Rights of Persons with Disabilities, has been completed with disability representative organisations and an appropriately resourced participant reference panel.

38. Any future amendments to the NDIS Act should be accompanied by a statement of compatibility with Article 4(3) of the Convention, in addition to the statement of compatibility required by the Human Rights (Parliamentary Scrutiny) Act 2011.

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