National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1190
Senate Community Affairs Legislation Committee Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submissions close: 29 May 2026
Impacts of the NDIS Amendment (Securing the NDIS) Bill 2026 on Children with Complex Needs in Regional NSW: A Submission from a Paediatric OT Sole Practitioner
OTA Australia member | Over 20 years clinical experience Submission Date: 29 May 2026
- About This Submission
I am a registered paediatric occupational therapist with more than 20 years of clinical experience and I deliver a mobile therapy service across , working with children in their homes, schools, preschools and community settings.
My caseload comprises children aged 2–12 with autism, developmental delay, ADHD, sensory processing disorders, global developmental delay, learning disabilities, Ehlers-Danlos Syndromes, chromosomal and genetic conditions, ODD, anxiety, trauma histories, and neurological conditions. These children require support for fundamental daily tasks: dressing, eating, emotional regulation, and classroom participation.
I support the goal of NDIS sustainability. This submission identifies specific risks in the Bill’s provisions that, in my clinical view, have not been adequately considered for children with complex needs and their families.
- The Children Affected
Children with autism and developmental delay make up close to half of all NDIS participants nationally and constitute my entire caseload. Policy language such as ‘low to moderate support needs’ and ‘functional capacity’ can obscure what support actually involves for these children day to day.
The children I work with require NDIS funding to manage basic daily tasks: dressing, eating, carrying a school bag, regulating behaviour in a classroom. Many attend mainstream schools because consistent, individualised therapy has built their capacity over time. If that therapy is interrupted, functional gains erode.
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1190
Many families in my practice include parents with their own disabilities or mental health challenges, multiple children with disability, and involvement with child protection or out-of-home care. These families cannot reliably navigate new intake systems or attend group programs at a community hub. They require a practitioner who attends their environment, knows the child and family, and adapts to their circumstances. A group-delivery model cannot replicate this.
- The Permanence Test: Regional Access Implications
The Bill requires that an impairment be considered permanent only if the person has tried every appropriate treatment available in Australia, and explicitly states that financial and geographic circumstances may not be treated as grounds for not having done so. This creates a significant practical concern for the children in my caseload.
Many conditions in my caseload—autism, chromosomal conditions, neurological conditions—do not resolve with treatment. The clinical question is how well supported the child is to function, not whether the condition will persist. However, as written, the permanence test may allow access to be challenged at reassessment for families unable to access every clinically recommended treatment due to cost, geographic distance, or the practical demands of caring for multiple children with disability.
Specialist programs and intensive intervention models available in metropolitan centres are not consistently accessible to families in the Hunter region, for financial and logistical reasons. The provision as written creates a structural disadvantage for regional families that is not acknowledged in the Bill.
- The Thriving Kids Transition: What the Timeline Means in Practice
The government has announced that from 1 January 2028, children aged 8 and under with low to moderate support needs will be directed to Thriving Kids rather than the NDIS. The first services are expected from October 2026. In the Hunter region, Newcastle and Lake Macquarie were included in the 2025 DCJ consultation sites, which places this area in scope for early commissioning.
The shift toward community-embedded, family-centred early intervention delivery is broadly consistent with the evidence base. However, the transition as planned carries implementation risks that are not yet resolved.
The Thriving Kids model is designed for children with low to moderate support needs. Many of my currently NDIS-funded clients have complex needs that are not the result of diagnostic over-identification. Some will continue to qualify under new criteria; others will fall between systems—needs too significant for time-limited group programs, but no longer meeting the permanence threshold for the NDIS.
The practical risks I see in the current transition plan are these:
The Thriving Kids model relies on group delivery, supported playgroups, parenting programs and community hubs. Many families I work with— including those with parental disability, out-of-home care involvement, or
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1190
acute financial stress—cannot reliably attend group programs. The children with the highest needs do not always benefit most from universal delivery models. The commissioning preference for not-for-profit organisations raises an unresolved question: whether a sufficiently resourced NFP with local OT capacity can be operational in the Newcastle and Lake Macquarie area by October 2026. If not, the exceptional circumstances pathway and allied health fee-for-service panel must be available and functional. The transition timeline is tight. Established therapeutic relationships with complex families take months to years to develop. Moving a child to a new provider, model, and intake process carries clinical risk. No individual-level transition protocol has been published. The allied health fee-for-service panel for private practitioners is described as expected to launch in the second half of 2026. That is not a firm date, and it is very close to the October 2026 service commencement. If the panel is delayed, or if the commissioning of Targeted Supports in this area does not proceed as planned, children will fall through.
- The Capacity Building Budget Reductions
The announced 10 percent reduction to capacity building daily activity allocations and 50 percent reduction to social, civic and community participation budgets from 1 October 2026 will affect my current clients before the Thriving Kids transition even begins.
For the children I work with, capacity building is the mechanism by which they develop the functional skills that enable mainstream school attendance, family participation, and self-care. A 10 percent reduction in therapy hours, for a child already receiving minimum viable support, may be the difference between maintaining and losing school participation.
The 50 percent reduction to social and community participation funding is not clinically defensible for this population. For children with autism or sensory processing difficulties, community participation is not discretionary—it is the applied practice environment in which therapy skills generalise to real-world settings. The evidence base supporting community participation as a developmental necessity is well established.
The children most likely to lose community participation funding are those least able to access mainstream community activities without support. The reduction does not decrease demand; it transfers unmet need to families and schools.
- Implications for Mobile Sole Trader Practices
These business realities directly affect service availability for families.
As a sole trader, I have lower overhead than larger providers but no financial buffer when income is disrupted. The combination of reduced client budgets, the travel rate
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1190
reduction to half the therapy rate with a cap on claimable travel time, and increased compliance obligations raises a genuine question about the viability of mobile delivery at current rates.
Mobile delivery is clinically necessary, not a scheduling preference. Assessment and therapy in the child’s home, school, and daycare is how I evaluate actual functional performance and deliver intervention that transfers to daily life. The travel rate reduction does not reflect this clinical rationale.
If mobile sole trader practices become financially unviable, families do not gain access to clinic-based alternatives. In most cases, no local clinic-based alternatives with capacity exist. The outcome is extended wait times or no service at all.
I am currently preparing an EOI to DCJ for the Thriving Kids program as a potential NFP subcontractor and under the exceptional circumstances pathway. I raise this to illustrate a structural issue: the Thriving Kids commissioning model depends on experienced local practitioners. If the policy environment makes it unviable for those practitioners to continue operating in the interim, commissioned programs will have reduced local capacity, not more.
- Algorithmic Budget Allocation and Planning Quality
The Bill introduces framework planning and algorithmic tools for support needs assessment and budget allocation. A specific concern arises for children with complex, layered presentations.
A child with autism, sensory processing disorder, and a trauma history presents differently across settings. The assessments I complete to support NDIS applications (including BOT-2, Movement ABC, WRAVMA, Beery VMI, SPM, and HWST) require significant professional time and direct cost to families, typically drawn from existing plan funds.
Planning consistency and the application of clinical evidence in NDIA decision- making are already documented problems. Layering algorithmic budget allocation on an already inconsistent process is more likely to produce systematic underfunding than greater accuracy, with reduced capacity for correction—particularly if therapy hours have already been reduced.
- Recommendations
I am asking the committee to consider the following:
Amend the permanence test to expressly require that geographic and financial accessibility of treatment be taken into account. A family in the Hunter region that cannot access a therapeutic program available only in Sydney should not be assessed as though they refused treatment. The Bill as written will disadvantage regional families in ways that are not acknowledged. Require that the Thriving Kids Targeted Supports service in each commissioning area be demonstrably operational and at genuine capacity before NDIS access criteria change for that area. The 1 January 2028 date
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1190
should not be a fixed national cliff edge applied regardless of whether local services are ready to receive the children being redirected. Develop and publish a transition protocol for children currently receiving NDIS-funded therapy who will move into the Thriving Kids system. Children with complex needs and families in difficult circumstances need more than an administrative transfer. They need a clinically managed handover. Reconsider the 50 percent reduction to social and community participation budgets for children. For this population, community participation is a clinical intervention, not a discretionary activity. The evidence supports it as a determinant of long-term outcomes. Confirm a firm launch date and eligibility framework for the allied health fee- for-service panel, and ensure it is operational before October 2026. Sole practitioners with established local relationships and clinical experience working with complex paediatric presentations should not be excluded from the Thriving Kids system by default. Require an independent review of the impact of the travel rate reductions on mobile service delivery in regional and rural areas, with particular attention to paediatric allied health services where in-home and in-school delivery is clinically necessary rather than a scheduling preference.
Conclusion
Over 20 years of practice in this region, I have observed the consequences when children miss early intervention, when families fall between systems, and when practitioners leave the sector because the economics no longer support continued practice. The outcomes are specific and measurable: a child who loses mainstream school placement, a family in crisis with no clinical support.
Not all aspects of the Bill are problematic, and the sustainability case for NDIS reform is understood. However, the provisions most likely to reduce access for children with complex needs—the permanence test, the Thriving Kids transition timeline, the capacity building and community participation budget reductions, and the effective exclusion of experienced sole practitioners from the new system—have not been adequately analysed at the level of individual implementation impact.
I am asking the committee to examine the implementation sequencing of these provisions and ensure that children currently sustained by early intervention are not placed at risk in the transition to a redesigned delivery model.