Submission 1418

Carolyn Fitzgibbon Trellis Mental Health

26/05/2026

Submission to Senate Community Affairs Legislation Committee Inquiry National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Table of Contents:

• Submission to Senate Community Affairs Legislation Committee Inquiry ……………………………………………………. 1
• National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 ………. 1
• Table of Contents: ………………………………………………………………………………………………………………………………… 1
• Impact of the proposed NDIS legislation on gender equality, safety and the rights of women and girls ………….. 5
  • Supporting women’s meaningful participation and needs ……………………………………………………………………… 6
  • Reducing sexual and gender-based violence ………………………………………………………………………………………. 11
  • Supporting resilience, crisis, law and justice responses for women and girls ………………………………………….. 13
  • Leadership and accountability…………………………………………………………………………………………………………… 14
  • Care and Support Workforce…………………………………………………………………………………………………………….. 15
• Closing the Gap Outcomes potentially impacted by NDIS Reform …………………………………………………………….. 17
  • Closing the Gap Outcomes ……………………………………………………………………………………………………………….. 18
  • Everyone enjoys long and healthy lives ……………………………………………………………………………………………… 18
  • Children are born healthy and strong ………………………………………………………………………………………………… 19
  • Children thrive in their early years and access culturally appropriate early childhood education ……………… 19
  • Students achieve their full learning potential ……………………………………………………………………………………… 20
  • Strong economic participation and development ……………………………………………………………………………….. 21
  • Housing security ……………………………………………………………………………………………………………………………… 21
  • Adults and young people are not overrepresented in the criminal justice system …………………………………… 22
  • Children are not overrepresented in the child protection system …………………………………………………………. 23
  • Families and households are safe ……………………………………………………………………………………………………… 23
  • Social and emotional wellbeing …………………………………………………………………………………………………………. 24
  • People maintain a distinctive cultural, spiritual, physical and economic relationship with their land and waters ……………………………………………………………………………………………………………………………………………. 24
  • Cultures and languages are strong, supported and flourishing ……………………………………………………………… 25
• Impact on CALD Participants and Families ……………………………………………………………………………………………… 25

Submission 1418

Safety Concerns Regarding the Proposed Assessment Model

26

Recommendations

26

General Recommendations

26

Human Rights, Safety and Safeguarding

27

Choice and Control

28

Assessment Processes

29

Women and Gender-Based Violence

29

Aboriginal and Torres Strait Islander Peoples

30

CALD Communities

30

Foundational Supports and Mainstream Services

31

Workforce Recommendations

31

Transition and Implementation

32

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Submission 1418

Dear Community Affairs Legislation Committee RE: NDIS Bill

RE: NDIS Bill

I am writing in my capacity as an Occupational Therapist in private practice whose work includes the NDIS. I work with people with psychosocial, neurodevelopmental, neurological and intellectual disabilities, many of whom experience multiple and complex disabilities.

I request that the proposed reforms do not pass in their current form.

The proposed legislation has the potential to exclude significantly more people from accessing and remaining on the NDIS than the currently estimated 160,000 participants expected to leave the scheme. The reforms introduce multiple changes to eligibility criteria and reassessment processes, yet there remains very limited information about how these criteria will be interpreted and applied in practice. In particular, there is substantial concern regarding the proposed requirement that people must have undertaken all appropriate treatments to reduce impairment. Many people with disabilities may be unable to meet this requirement due to cost, access barriers, medical risk, trauma, personal choice and cultural considerations. At present, there is no information and therefore insufficient clarity regarding what treatments would be considered mandatory for reducing impairments in autism, intellectual disability, psychosocial disability, neurological conditions, Deafness, blindness and other lifelong disabilities.

The legislation also appears inconsistent with several existing government commitments, policies and recommendations, including recommendations of the Disability Royal Commission, the National Plan to End Violence Against Women and Children, the Women, Peace and Security Agenda, and commitments relating to Closing the Gap. These frameworks emphasise human rights, supported decision-making, trauma-informed practice, bodily autonomy, self-determination, cultural safety and prevention of violence, abuse, neglect and exploitation. Several aspects of the proposed reforms appear to move away from these principles toward more restrictive, standardised and administratively driven systems.

“Changes may increase expectations of informal supports. The option includes a more vigorous consideration of what informal supports are reasonable for delegates to consider. This is likely to have direct flow on impacts to family members and kin (particularly of younger people) and may impact on the role of informal support under Australia’s Disability Strategy.1 Given most carers are female, these impacts may be disproportionately experienced by women.1”

“However, implementation will need to carefully consider and mitigate the risk of disproportionate impacts on First Nations or Culturally and Linguistically Diverse participants, individuals who need support with decisions or who have low literacy or numeracy skills. “

          *(SECURING THE NDIS FOR FUTURE GENERATIONS)* BILL 2026 EXPLANATORY MEMORANDUM

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Submission 1418

This submission will focus specifically on the impacts of the proposed legislation on women with disability and on Aboriginal and Torres Strait Islander peoples in relation to Closing the Gap outcomes. I acknowledge that these reforms will also significantly impact many men with disability and that other submissions will address the broader implications across the disability community.

There has been recognition that foundational supports will be expanded; however, with the exception of the “Thriving Kids” initiative, very little detail has been provided regarding what these supports will involve, how they will operate, or whether they will adequately meet the needs of people exiting the NDIS. Block-funded and commissioned services may provide broad population-level supports, but they often lack the flexibility and specialised expertise required to meet complex individual needs. This is particularly concerning for people who currently rely on smaller specialist allied health providers and sole practitioners with disability-specific expertise.

There is also no clear transition plan for the allied health workforce that currently operates within the NDIS ecosystem, nor has any financial compensation or workforce retraining package been announced. In many other sectors, significant government reform processes are accompanied by transition funding, retraininig pathways and economic adjustment supports. No equivalent supports have been identified for the disability workforce despite the likelihood of substantial service disruption. These reforms risk increasing business closures, workforce attrition and unemployment, including for women with disability and women working within the allied health and disability sectors.

I am also aware that new eligibility criteria and a new functional capacity assessment framework are proposed. The government has not clearly articulated how functional impairment will be assessed or how categories such as “low”, “medium” and “high” functioning may be defined or applied. The government has also not released detailed modelling explaining how it expects to reduce participant numbers by approximately 160,000 people, or how projected participant growth will be reduced by 300,000 people compared with previous forecasts.

Based on the proposed legislative changes and the limited information currently available, there is a significant risk that many people with disability may no longer qualify for the NDIS or may lose access following reassessment processes. This may include people with:

• Intellectual disability
• Psychosocial disability
• Autism
• Sensory disabilities, including Deaf and blind people
• Down syndrome

Submission 1418

• Neurological and physical disabilities, including conditions such as Ehlers-Danlos syndrome (EDS), Postural Orthostatic Tachycardia Syndrome (POTS), multiple sclerosis and motor neurone disease

The cumulative impact of these reforms has the potential to significantly reduce access to disability supports for many Australians with lifelong and substantial disability, while simultaneously weakening safeguards, reducing participant choice and increasing pressure on already under-resourced mainstream systems.

The changes to eligibility criteria that exclude geographical location and being unable to afford treatments risk disproportionately impacting women, First nations, CALD and other disadvantaged groups.

Impact of the proposed NDIS legislation on gender equality, safety and the rights of women and girls

“The Australian Government is a committed global champion of the Women, Peace and Security (WPS) agenda. We take seriously our UNSCR 1325 commitment to the advancement of WPS, ensuring that Australia continues to promote gender equality, protect the human rights of women and girls, and secure their full, equal and meaningful participation in peace and security processes.”

Australia’s actions to implement these commitments across government are guided by our second National Action Plan (NAP) on WPS 2021–2031, a whole-of-government strategy developed in consultation with a host of civil society organisations. Building on the work of our first NAP 2012-18 on WPS,

Australia’s second NAP 2021–2031 on WPS will deliver on four outcomes:

• supporting women’s meaningful participation and needs in peace processes
• reducing sexual and gender-based violence
• supporting resilience, crisis, and security, law and justice efforts to meet the needs and rights of all women and girls
• demonstrating leadership and accountability for WPS Progress reports will track the Australian Government contributions to the WPS agenda. The first progress report reflects the Government’s efforts in the first two years (2021–2023) of action to achieve these goals.

Second Australian National Action Plan on Women, Peace and Security 2021–2031

Australia has committed under the United Nations Security Council Resolution 1325 (UNSCR 1325) and the National Action Plan on Women, Peace and Security 2021–2031 to promote gender equality, reduce sexual and gender-based violence, support the rights and safety of women and girls, and demonstrate leadership and accountability in these areas.

The proposed NDIS legislation raises serious concerns regarding whether these commitments are being upheld for women and girls with disability. Women and girls with disability experience significantly higher rates of violence, coercion, abuse, housing insecurity, institutionalisation and barriers to justice. Legislation that reduces safety, autonomy, access to supports or independent living may disproportionately impact women and girls with disability. This submission will address the impact of the legislation on the four WPS outcomes of supporting women’s meaningful participation and needs in peace processes, reducing sexual and gender-based violence,

Submission 1418

supporting resilience, crisis, and security, law and justice efforts to meet the needs and rights of all women and girls, and demonstrating leadership and accountability for WPS.

Supporting women’s meaningful participation and needs

The proposed legislation risks reducing the ability of women with disability to participate fully and meaningfully in the community, employment, education, parenting and decision-making.

Schedule 1 – Item 66 (Repeal of section 31):

Removing participant-directed and individualised planning reduces the ability of women with disability to exercise choice and control over supports required for participation, parenting, employment and independent living.

For example one Autistic woman may be requesting disability supports to access her local book club whilst another Autistic Woman may be asking for access to OT to assist with reducing overwhelm in daily routines. Under the new legislation the funding can be assigned per impairment category (autism) rather than their individual goals or needs. People with disabilities fought for choice and control over their funding because they know what they need and I request that the government not remove this from the NDIS.

Another example includes women with disability who may choose to engage female support workers for intimate personal care such as showering due to safety, trauma or cultural reasons. Under the proposed legislative changes, participants may have reduced flexibility and may instead be required to access registered provider arrangements where they have limited or no control over the gender of support workers providing intimate care. Choice of providers may decrease due to increased block funding and blended payment approaches.

In my professional experience, I have worked with many women with psychosocial disabilities who have experienced sexual violence perpetrated by men and who would not feel safe receiving intimate personal care from a male support worker. Reducing participant choice and control in these circumstances may retraumatise participants, reduce service engagement and create significant safety risks.

This is not a small proportion for women with disability either with 33% of women with disability having experienced sexual violence since age 15 by gender.

“People with disability may also experience a lack of control over their personal safety. In Public hearing 20, ‘Preventing and responding to violence, abuse, neglect and exploitation in disability services (two case studies)’, we heard evidence residents had little or no control over their personal care and who provided it. Following sexual misconduct by a Life Without Barriers worker towards Natalie, a resident in a group home, her mother requested that Natalie’s personal care be performed only by a female. The trauma already suffered by Natalie and her mother was exacerbated by Life Without Barriers’ failure to comply with its assurances that it would put this in place”

          Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability report

Submission 1418

Violence against people with disabilities factsheet

Schedule 4 – New Framework Planning:

Standardised budgeting and capped funding approaches may fail to account for the complex and gendered realities experienced by women with disability, including caring responsibilities, domestic violence recovery, trauma, parenting responsibilities and fluctuating support needs.

Participants may lose choice regarding reasonable and necessary supports that meet their specific needs.

• Choice regarding where to live may be reduced if funding does not adequately reflect support needs.

• Choice regarding who to live with may also be reduced due to funding restrictions.

• Choice regarding assistive technology may be reduced despite assistive technology often reducing long- term support costs and increasing independence.

• Choice of providers may decrease due to increased block funding and blended payment approaches.

• Choice to obtain further assessments or challenge inaccurate assessments appears reduced.

• Access to capacity building interventions with allied health may be capped and not suit individual needs.

Schedule 1 – Proposed section 34A:

Broad funding reduction powers may disproportionately impact women who rely on supports to safely parent children, escape violence, access employment or maintain community participation.

In my professional experience, I have worked with many women with psychosocial disabilities, intellectual disabilities and Autism who have experienced coercive control over their finances, significantly limiting their ability to independently access supports and services. Reductions to social and community participation funding, transport supports and other capped funding areas may disproportionately impact women in these circumstances, particularly where their individual safety risks and social circumstances are not adequately recognised within standardised budgeting models.

I am not suggesting that the NDIS is responsible for addressing domestic violence itself. Rather, the NDIS plays an important role in funding the disability-related supports that enable women with disability to safely access community services, maintain social connection, attend appointments and participate in recovery and support

Submission 1418

Pathways. Broad funding reductions or capped approaches that do not account for individual circumstances risk increasing isolation, dependence and vulnerability for women experiencing coercive control and violence.

The rates that women with disabilities experience intimate partner violence is high with figures in the diagrams below:

Violence Against People With Disabilities Factsheet

Violence Against People With Disabilities Factsheet

Violence Against People With Disabilities Factsheet

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Schedule 1 – Proposed subsections 34(1G)-(1J)

Parenting and family responsibility:

These provisions risk shifting unsustainable caring expectations onto women and mothers with disability and may increase family stress, carer burnout and child protection involvement.

These changes disproportionately impact women with 67.7% of primary carers being women. The bill does not describe an age limit to carer and family responsibility with elderly women carers therefore included in expectations to care for their adult children with disabilities. There is a dignity factor that is missing here too. Adult women (and men) with a physical disability may have a strong preference for someone other than a parent to be washing their bodies and this needs to be respected rather than the government seeing this as a lifelong parental responsibility.

Submission 1418

“Due to the gendered nature of caring, women are more likely to be impacted by changes to the supports available or provided to the people they care for. 67.7 per cent of primary carers were women in 2022.1 Changes are likely to increase informal caring responsibilities, which may impact levels of social and economic participation for female carers. Opportunities to increase gender equality will be considered as part of the design and evaluation of future market reforms to delivering social and community participation and capacity building activities.”

(SECURING THE NDIS FOR FUTURE GENERATIONS) BILL 2026 EXPLANATORY MEMORANDUM

Women carers who have increased caring responsibilities may be less able to participate in the workforce. In the April 2026 employment figures there was a notable increase in women’s unemployment figures. While there are likely to be many factors this also coincided with NDIS funding cuts to plans which may have already increased caring responsibilities as well as decreased support worker and other NDIS provider employment.

      https://www.actu.org.au/media-release/jobless-rise-should-pause-any-more-interest-rate-rises/

Recommendation: Statistical analysis on the rise of women’s unemployment as the NDIS reduces funding and spending with specific data collected on unemployment due to caring responsibilities and NDIS jobs.

Schedule 1 – Proposed section 25B (Alternative supports): Women may be excluded from NDIS supports based on assumptions that mainstream or informal supports exist, despite many women experiencing poverty, social isolation, family violence or inadequate service access. 78% of females with severe or profound disability receive a government pension or allowance as their main source of income, yet many will be expected to access medicare service with gap fees to meet their own needs or their children’s needs. Thriving kids proposals include an expectation of a significant component of allied health interventions to be accessed through medicare with significant gap fees being prohibitive. This will result in unmet need for women and their children. People with psychosocial disabilities may also be told similar information. If the government is serious about meeting needs of women outside of the NDIS then they need to increase the number of medicare sessions and the fee for Medicare rebates to decrease the size of the gap fee for Better Access, Chronic disease, Eating Disorder and Neurological Assessment and Intervention items.

Submission 1418

“The main source of income varies by sex, age and severity of disability . Of those aged 15 and over who have\n • females with disability (23% or 411,000) are less likely than males with disability (25% or 430,000) to\n receive wages or salary as their main source of income\n • females with severe or profound disability (78% or 394,000) are more likely than males with severe or\n profound disability (73% or 306,000) to receive a government pension or allowance as their main\n source of income”

https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/income-and- finance/income

Reducing sexual and gender-based violence

Women with disability experience significantly higher rates of domestic violence, coercive control, sexual violence and exploitation. Reductions in support access, independent living supports and safeguarding mechanisms may increase exposure to violence.

Expanded reassessment and suspension powers may place women with psychosocial, cognitive, neurological disability, trauma histories or communication barriers at increased risk of losing critical supports during periods of crisis or instability.

In my professional experience, I have worked with many women with disabilities who have been unable to answer phones, open emails or letters due to their disabilities and also associated low energy, mental illness and executive functioning challenges.

Schedule 2 – Fraud and Integrity powers:

Expanded compliance and investigative powers may create fear and disengagement for victim-survivors of violence, particularly women with psychosocial disability, cognitive disability or trauma histories. People are already fearful of making mistakes.

Schedule 3 – Automation and algorithmic decision-making:

Automated decision-making processes may fail to identify safeguarding concerns, domestic violence risks or gender-based vulnerabilities that require nuanced human assessment. Algorithms and automated systems are also known to carry significant risks of reinforcing existing systemic discrimination and bias against women and girls.

Schedule 3 – Automation and algorithmic decision-making: Automated decision-making processes may fail to identify safeguarding concerns, domestic violence risks and gender-based vulnerabilities that require nuanced human assessment and professional judgment. In my professional opinion, some existing assessment tools already appear to disadvantage women. For example, I believe the Life Skills Profile, which is currently used in assessments for people with psychosocial disability, may contain gender bias that contributes to the lower rates of women with psychosocial disability accessing the NDIS. Women often present differently to men in relation to psychosocial disability, trauma responses and masking which may not be adequately captured by standardised assessment tools.

Submission 1418

Similarly, autistic women and girls are frequently diagnosed later than males, and their support needs are often underestimated due to differences in presentation, social masking and longstanding gender bias within diagnostic frameworks. Conditions such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID, which disproportionately affect women, are also frequently minimised or poorly understood within healthcare and disability systems, resulting in disability impacts being underestimated.

Developing automated decision-making systems or algorithms within the context of these existing structural and diagnostic biases creates a significant risk of further entrenching discrimination against women and girls with disability. Without strong human oversight, transparency and gender-sensitive safeguards, automation may amplify existing inequities and reduce access to appropriate supports.

“Artificial intelligence (AI) is transforming our world – but when it reflects exiting biases, it can reinforce discrimination against women and girls. From hiring decisions to healthcare diagnoses, AI systems can amplify gender inequalities when trained on biased data.”

United Nations Women

Assessment processes When functional capacity assessment and support needs assessment are completed by workers who are not allied health professionals they have reduced communication and other skills to notice red flags of abuse including coercive control. I reiterate the point here made above regarding women with disabilities being under recognised and under rated.

Funding to live in the place of choice

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Submission 1418

Women with disabilities face higher rates of violence in group homes and need to have the choice of where they live rather than being denied choice through funding mechanisms. This was emphasised in the Disability Royal Commission Final report. The NDIS reform funding cuts could lead to women needing to live in congregate care and other institutions with increased rates of violence.

“b. reform of NDIS participant funding models, including Supported Independent Living, Specialist Disability Accommodation and Individualised Living Options to provide greater flexibility. In particular, this flexibility should ensure that administrative and pricing mechanisms do not favour group home living over other models of inclusive housing.

c. development of clear and supportive transition pathways that provide access to advice, advocacy and support for people with disability to understand and explore their housing options, make decisions about transitioning to the housing of their choice, and receive support for that transition.

This should include:

• an individualised assessment of a person’s housing needs and preferences, with the option for this to be regularly updated
• an update of a person’s NDIS plan to include specific support, including capacity building to support the decision to transition to more independent living
• where a person is interested in changing housing, the development of an individual transition plan that identifies current available and emerging alternative housing options, beyond the offerings of their current provider
• access to independent advocacy and an independent support coordinator to provide support for and facilitate the transition.”

Disability Royal Commission Final Report – Volume 3: Nature and extent of violence, abuse, neglect and exploitation

Supporting resilience, crisis, law and justice responses for women and girls

Australia’s National Action Plan commits to ensuring systems respond to the needs and rights of all women and girls. The proposed legislation risks undermining this commitment for women and girls with disability.

Schedule 1 – Items 88–94 (Permanence and treatment): The proposed permanence test risks undermining bodily autonomy and informed consent by creating pressure for participants to undertake treatments or medical interventions in order to maintain access to disability supports. There are also broader concerns regarding gender inequity in healthcare, including that many medical treatments and medications have historically been less thoroughly tested on women, and that women’s pain, side effects and adverse reactions are more likely to be minimised or dismissed within healthcare systems.

Women and girls with disability have historically experienced disproportionately high rates of medical coercion, forced treatment and loss of bodily autonomy. Will Women on the NDSI for a psychosocial disability from chronic depression need to have ECT before they can access the NDIS? How can they realistically access this treatment? This Bil has a Too Bad So Sad feel about it rather than a recognition of the barriers to health care that so many people with disabilities face.

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Submission 1418

The legislation should therefore explicitly protect the right of participants to refuse treatment without losing access to the NDIS.

The proposed provisions also fail to adequately recognise the impact of personal circumstances on a person’s ability to access treatment. Experiences of domestic and family violence, coercive control, caring responsibilities, poverty, housing instability and social disadvantage may significantly limit a person’s capacity to attend appointments, afford treatment, travel to specialists or safely engage with healthcare systems. Women are later to be diagnosed with many disabilities and therefore have a delay in being able to access treatments.

Despite this, proposed section 25A(2) specifically states that treatment may still be considered “appropriate treatment” regardless of whether a person’s individual circumstances restrict access to that treatment. This creates a serious risk that women experiencing violence, financial abuse or severe disadvantage may be unfairly penalised for circumstances outside their control.

“In general, people with disability, especially those with severe or profound disability, are more likely than people without disability to receive their income mainly from a government pension, benefit or allowance and less likely to receive most income from salary or wages. Of people aged 15 and over who have a source of income”:

• government pension or allowance is the main source of income for 56% (or 2.0 million) with disability, and 76% (or 702,000) with severe or profound disability, compared with 13% (or 1.9 million) without disability https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/income-and- finance/income

Schedule 1 – Proposed section 17B (Sustainability principles): Positioning financial sustainability as a dominant interpretive principle risks deprioritising the safety and human rights of women and girls with disability. This overrides participant rights and reasonable and necessary supports.

• The economic modelling underpinning the proposed cuts and reforms has not been transparently released.

Leadership and accountability

Australia’s National Action Plan emphasises leadership, accountability and consultation with affected communities. The development and implementation of this legislation raises concerns regarding whether women with disability have been meaningfully included in decision-making.

• There has been insufficient transparency regarding the long-term impacts of the legislation on women and girls with disability. As previously noted the government has acknowledged that it will have an inverse impact on women.
• There has been inadequate publication of gender impact analysis, violence risk analysis and safeguarding impact assessments.
• Women with disability, particularly women with psychosocial disability, intellectual disability, autism and neurological disabilities, do not appear to have been meaningfully included in many aspects of the legislative

Submission 1418

design process. A two-week consultation period for this NDIS bill disproportionally impacts women with young children and who are carers of disabled participant and women with disabilities.

The lack of clarity regarding future rules, participant classes, assessment tools and budgeting methodologies reduces accountability and prevents informed consultation.

There are multiple parts of this legislation that are not applying the principle of empowerment including:

• Reduction and removal of review processes and appeal rights.
• Reduction and removal of complaint pathways.
• Schedule 1 – Reassessment and suspension powers: Expanded suspension powers may disproportionately impact participants with communication barriers, psychosocial disability and fluctuating capacity.
• Schedule 2 – Fraud and Integrity powers: Expanded compliance and investigative powers risk creating fear, surveillance and disproportionate enforcement impacts for disabled people.
• Removal of choice and control across multiple parts of the legislation.
• The proposed early intervention pathway may reduce long-term empowerment due to its short-term and potentially restrictive structure.
• The legislation does not sufficiently establish pathways to support people living in inappropriate or unsafe accommodation to transition into more suitable housing.

Decreasing funding according to “classes’ of supports can entrench the idea of some peoples disability not being as important as others. The Minister can decide to cut or cap funding for all people with intellectual disabilities or all people with FASD. The methodology has not been clear on this, and protections need to be in place so it is not the people with disabilities who are least able to speak up and advocate for themselves. The rationale for this has not been provided.

The proposed legislation risks increasing poverty, dependence, unsafe living arrangements, institutionalisation and exposure to violence for women and girls with disability. These impacts appear inconsistent with Australia’s commitments under the National Action Plan on Women, Peace and Security 2021–2031 and broader commitments to gender equality, bodily autonomy, safety and human rights and the disability royal commission recommendations, the Closing the Gap recommendations and Labour election promises.

A comprehensive gender impact assessment, violence prevention assessment and disability safeguarding assessment should occur.

Care and Support Workforce

Women make up approximately 68 per cent of the care and support workforce. A reduction of $38 billion in NDIS spending over four years is therefore likely to have a disproportionate and significant impact on women’s

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employment and economic security. This has been noted in the Understanding memorandum for the bill (refer to text box)

Many women working within the care and support workforce also have their own caring responsibilities, disabilities and/or medical conditions. These factors may make it substantially harder, and in some cases impossible, for workers to easily transition into alternative forms of employment. The scale and speed of the proposed reductions may also result in a very large number of workers seeking alternative employment simultaneously, potentially increasing unemployment and financial insecurity within the sector.

The care and support workforce has also created important employment opportunities for women from culturally and linguistically diverse (CALD) backgrounds, including roles providing culturally safe and language- specific supports to people within their own communities. Similarly, Deaf people have been able to gain meaningful employment supporting other Deaf NDIS participants. Reductions in NDIS funding may disproportionately impact these workers and communities, while also reducing access to culturally appropriate and language-accessible supports for participants. There are also concerns regarding the impact on women with disability who work within the NDIS workforce. Many women with disability rely on the flexibility of NDIS-related employment to manage fatigue, fluctuating health conditions, disability-related needs and caring responsibilities. Some are only able to work very short shifts, work intermittently, provide telehealth services or work flexible weekend hours around childcare and health needs. This level of flexibility is often not readily available in other industries and may be extremely difficult to replace.

Many sole trader allied health professionals operate small businesses within the NDIS not primarily because of higher income, but because the flexibility allows them to remain in the workforce while managing disability, health conditions, parenting responsibilities or caring roles. Significant reductions to the NDIS workforce may therefore disproportionately force women with disability and carers out of employment altogether.

There are also serious concerns regarding the absence of transition funding, business support or retraining assistance for the disability workforce and small businesses affected by these reforms. In many other industries, major government-led structural changes that result in large-scale workforce disruption are accompanied by financial transition packages, retrainin pathways or targeted employment supports. No comparable transition support appears to have been offered to the NDIS workforce despite the significant scale of the proposed reductions.

Many small businesses operating within the NDIS sector are already reporting financial instability, service reductions and risks of closure. This includes sole trader allied health professionals and small multidisciplinary practices that have developed highly specialised disability expertise over many years. Allied health professionals are a highly valuable workforce whose skills are transferable across health systems, education, rehabilitation, mental health and community services. However, sudden large-scale workforce disruption risks creating substantial unemployment and workforce loss before other sectors are able to absorb these workers.

Approximately 25,000 out of Australia’s 35,000 Occupational Therapists are estimated to work within the NDIS sector. Significant reductions in NDIS funding and participant supports may therefore place a substantial proportion of the Occupational Therapy workforce at risk of unemployment, underemployment or business closure. This may also create long-term workforce shortages and loss of disability expertise that would be extremely difficult to rebuild in the future.

Submission 1418

“Reforms that reduce the demand for NDIS services in the market will disproportionately affect women who make up approximately 68 per cent of the care and support workforce. The magnitude of impact on providers is dependent on which supports are reduced and the percentage those supports represent of provider revenue and the extent to which the current demand for effected NDIA supports is currently met through market supply. All things being equal, providers with smaller revenue streams will be more significantly impacted by reductions in supply.

Tightening the definition of reasonable and necessary supports will also reduce NDIS funding and demand for services across all support categories.

Collectively, if reforms result in increased stress on provider viability, then governments may need to prevent market failure and ensure essential services continue.”

              (SECURING THE NDIS FOR FUTURE GENERATIONS) BILL 2026 EXPLANATORY
                                                 MEMORANDUM

                                                                                      https://fpdn.org.au/

“Changes also have the potential to affect certain Closing the Gap outcomes.“

“However, implementation will need to carefully consider and mitigate the risk of disproportionate impacts on First Nations or Culturally and Linguistically Diverse participants, individuals who need support with decisions or who have low literacy or numeracy skills.” (SECURING THE NDIS FOR FUTURE GENERATIONS) BILL 2026 EXPLANATORY MEMORANDUM

Submission 1418

The NDIS reform is acknowledged to have the potential to affect a number of Closing the Gap outcomes. The Australian Government has made a commitment to Closing the Gap, and I do not believe legislation should proceed where there is a significant risk of worsening these outcomes for First Nations people with disability.

In the absence of adequate published analysis regarding these impacts, I am drawing on my own clinical experience working with First Nations NDIS participants, as well as volunteer work completed in Queensland Aboriginal communities. I strongly encourage direct consultation with First Nations participants, families, Elders and Aboriginal Community Controlled Organisations. I do not wish to speak on behalf of First Nations people. I am a concerned ally and given the short consultation timeframe, I feel an urgent need to raise these concerns.

There are multiple aspects of this legislation that do not reflect the principle of genuine collaboration, including:

• the absence of meaningful reduction in power imbalances between participants and government decision-makers
• limited consultation timeframes
• lack of transparency regarding assessment processes and operational guidelines
• insufficient evidence that First Nations communities have been appropriately consulted regarding culturally safe implementation. The next section analyses the Closing the Gap Outcomes that may potentially by impacted by NDIS reform.

I have made suggestions regarding additional tracking so that the harm of the proposed NDIS reform is tracked if it proceeds.

Closing the Gap Outcomes

Everyone enjoys long and healthy lives

Target: Close the Gap in life expectancy within a generation, by 2031. Being able to live a long and healthy life requires access to disability support, assistance with attending medical appointments, medication management, transport, meal preparation, and support to engage with health services safely and consistently. Some participants who lose access to the NDIS may also lose support to:

• organise prescriptions and packed medications
• attend dialysis or specialist appointments
• manage chronic health conditions
• access mental health support
• maintain nutrition and personal care.

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For some First Nations participants, particularly those with psychosocial, neurological, intellectual or neurodevelopmental disability, the loss of support may result in rapid deterioration in both physical and mental health. Reduced access to disability support also has the potential to contribute to increased suicide risk and avoidable hospitalisation.

Participants living in remote and regional communities may be disproportionately impacted due to existing shortages of accessible health services and transport.

Suggested tracking:

First Nations people with disability should be tracked as a distinct subgroup within Closing the Gap reporting.

Children are born healthy and strong

Target: By 2031, increase the proportion of Aboriginal and Torres Strait Islander babies with a healthy birthweight to 91 per cent.

Women with disability often require disability support in order to manage the determinants of healthy pregnancy outcomes, including:

• attending antenatal appointments
• taking medications consistently
• grocery shopping and meal preparation
• managing fatigue and daily living tasks
• caring for other children, including children with disability.

If women lose disability supports due to stricter eligibility requirements or reduced budgets, this may negatively affect maternal health, stress levels, nutrition and access to healthcare.

Women with psychosocial disability, intellectual disability or cognitive impairments may face particular barriers in proving they have completed all “reasonable treatment” requirements, especially where there is trauma, homelessness, domestic violence, service disengagement or limited continuity of care.

Suggested tracking:

First Nations women with disability should be tracked as a specific subgroup within Closing the Gap reporting.

Children thrive in their early years and access culturally appropriate early childhood education

Targets: By 2025, increase enrolment in Year Before Fulltime Schooling to 95 per cent.
By 2031, increase the proportion of children developmentally on track in all five AEDC domains to 55 per cent.

Submission 1418

Children with disability already experience significant barriers to participating in education and early intervention services. The proposed foundational supports model represents a substantial reduction in funding and intensity compared to current NDIS supports for many children.

There are serious concerns that:

• children may lose access to intensive early intervention

• therapy frequency will decrease

• families will experience long waitlists

• services will become more generic and less individualised

• culturally safe and relationship-based supports will be replaced by short-term or fly-in-fly-out models.

• In many communities, allied health professionals embedded within the community have developed long-

term trust and cultural understanding. Replacing these services with rotating NGO or contracted

providers risks reducing continuity of care and cultural safety.

The proposed “Thriving Kids” framework is also concerning because it moves away from evidence-based therapy models without sufficient published evidence demonstrating equivalent outcomes for children with complex disability.

Currently, fewer than 34% of First Nations children are developmentally on track across all five AEDC domains. Reducing disability support during early childhood may worsen this disparity.

Suggested tracking:

• First Nations children with disability

• children whose parents have disability

• developmental outcomes for children accessing foundational supports versus current NDIS supports.

Students achieve their full learning potential

Children and young people with disability often require support workers, therapy, assistive technology and capacity-building supports in order to attend school consistently and participate safely.

Reduced NDIS supports may result in:

• decreased school attendance

• school refusal

• behavioural escalation due to unmet sensory or communication needs

• reduced access to tertiary education

• increased suspension or exclusion

• increased caregiver burnout affecting educational participation.

Submission 1418

Students in remote communities may be disproportionately impacted due to limited alternative supports.

Suggested tracking:

• First Nations children with disability
• children whose parents have disability
• developmental outcomes for children accessing foundational supports versus current NDIS supports.

Strong economic participation and development

Target: By 2031, increase the proportion of Aboriginal and Torres Strait Islander people aged 25-64 who are employed to 62 per cent.

Many First Nations people with disability rely on NDIS supports to participate in employment, volunteering, parenting and community life.

Reduced supports may lead to:

• loss of employment capacity
• reduced access to transport
• increased poverty
• reduced ability to engage in training or education
• increased reliance on unpaid carers
• increased housing instability.

There is also concern that tighter price controls and reduced participant-directed funding may reduce opportunities for Aboriginal-owned disability support services and independent support workers operating within communities. The budget for social and community participation is being reduced by 50% so the First Nations people who are employed to do this work will either be unemployed or have their work rapidly cut in half.

Suggested tracking:

• First Nations people with disability

Submission 1418

within discrete Aboriginal and Torres Strait Islander communities receive essential services that meet or exceed the relevant jurisdictional standard in or near to a town receive essential services that meet or exceed the same standard as applies generally within the town (including if the household might be classified for other purposes as a part of a discrete settlement such as a “town camp” or “town based reserve”).

NDIS supports often play a critical role in helping people maintain housing through assistance with daily living, imotional regulation, transport, budgeting, cleaning and attending appointments.

Loss of supports may contribute to:

• homelessness
• overcrowding
• inability to sustain tenancies
• increased hospitalisation or incarceration.

This is particularly concerning given the existing overrepresentation of Aboriginal and Torres Strait Islander people experiencing housing insecurity.

Suggested tracking:

• First Nations people with disability

Adults and young people are not overrepresented in the criminal justice system

Target By 2031, reduce the rate of Aboriginal and Torres Strait Islander young people (10-17 years) in detention by at least 30 per cent. By 2031, reduce the rate of Aboriginal and Torres Strait Islander adults held in incarceration by at least 15 per cent.

Many people with psychosocial, intellectual, cognitive and neurodevelopmental disabilities rely on disability supports to maintain safety and stability within the community.

Reducing access to supports may increase:

• contact with police

• behavioural crises

• homelessness

• substance misuse

• incarceration risk.

For young people with disability, reduced early intervention and family supports may increase disengagement from school and contact with youth justice systems.

Submission 1418

Suggested tracking:

• First Nations people with disability

Children are not overrepresented in the child protection system

Target: By 2031, reduce the rate of over-representation of Aboriginal and Torres Strait Islander children in out-of- home care by 45 per cent.

Parents with disability may require practical disability supports in order to safely care for children.

This can include:

• support with routines

• transport

• meal preparation

• emotional regulation

• attending appointments

• home organisation.

Removing or reducing these supports may increase child protection involvement despite the underlying issue being lack of support rather than lack of parental capacity.

Suggested tracking:

• First Nations children with disability
• First Nations children whose parent/s have a disability

Families and households are safe

Target: By 2031, the rate of all forms of family violence and abuse against Aboriginal and Torres Strait Islander women and children is reduced at least by 50%, as progress towards zero.

Capping participant budgets or using standardised funding models may fail to account for:

• domestic violence

• cultural obligations

• language barriers

• geographic isolation

• trauma histories

• family complexity.

Submission 1418

This may result in unsafe living situations where participants are forced to rely on unsafe family members or remain in violent environments because they cannot access sufficient support.

Women with disability, particularly women with psychosocial or intellectual disability, may be disproportionately impacted.

Suggested tracking:

• First Nations people with disability

Social and emotional wellbeing

Target:

Significant and sustained reduction in suicide of Aboriginal and Torres Strait Islander people towards zero.

The reforms may significantly affect social and emotional wellbeing for First Nations participants.

Many participants rely on disability supports to:

• maintain community connection
• engage in cultural activities
• manage distress
• attend appointments
• prevent isolation
• access trauma-informed supports.

The uncertainty surrounding reassessment, treatment requirements and funding reductions may also increase distress and suicidality. The need for documentation to access the NDSI and maintain eligibility will have an increased burden on first nations people with more people not meeting this criteria due to the removal of geographical and low finances as considerations.

An Aboriginal woman with psychosocial disability may avoid hospitals due to trauma associated with foster care, homelessness or previous institutional experiences. She may miss appointments due to memory impairment, emotional dysregulation, executive functioning difficulties or lack of transport. Under stricter treatment exhaustion requirements, she may be unable to prove she has completed all recommended treatments and therefore lose access to the NDIS despite having substantial functional impairment.

Suggested tracking:

• First Nations people with disability

People maintain a distinctive cultural, spiritual, physical and economic relationship with their land and waters

Submission 1418

Cultures and languages are strong, supported and flourishing

Target

15a:

By 2030, a 15 per cent increase in Australia’s landmass subject to Aboriginal and Torres Strait Islander peoples’ legal rights or interests.

15b:

By 2030, a 15 per cent increase in areas covered by Aboriginal and Torres Strait Islander people’s legal rights or interests in the sea.

By 2031, there is a sustained increase in number and strength of Aboriginal and Torres Strait Islander languages being spoken.

The cuts to social participation will reduce the access to land and waters and to elders who teach culture and languages by 50%

Participant-directed funding currently allows many First Nations participants to choose support workers who:

• understand their community
• speak their language
• understand kinship structures
• provide culturally safe support.

More centralised or standardised service systems may reduce participant choice and increase reliance on large NGOs without long-term community relationships.

This risks reducing cultural safety and trust in disability services.

Suggested tracking:

• First Nations people with disability

           Impact on CALD Participants and Families
  

“However, implementation will need to carefully consider and mitigate the risk of disproportionate impacts on First Nations or Culturally and Linguistically Diverse participants, individuals who need support with decisions or who have low literacy or numeracy skills. “

(SECURING THE NDIS FOR FUTURE GENERATIONS) BILL 2026 EXPLANATORY MEMORANDUM

The proposed reforms may also disproportionately impact culturally and linguistically diverse (CALD) participants and families.

Participant choice and control currently allow many CALD participants to employ support workers who:

• speak their language

Submission 1418

• understand their culture and religion
• provide culturally appropriate meals and personal care
• support communication with family members and services
• understand trauma and migration experiences.

More centralised or standardised service delivery models may shift supports toward large NGOs or agency-based staffing models where participants have significantly less control over who provides their care.

This may reduce:

• cultural safety
• communication access
• trust in services
• participant autonomy
• engagement with supports.

For women from CALD communities, disability support work has also provided flexible and meaningful employment opportunities that align with caring responsibilities and language skills. Reductions in participant-directed funding and increased market centralisation may reduce employment opportunities for CALD women within the disability sector.

This has the potential to negatively affect both economic participation and culturally appropriate care for participants.

Safety Concerns Regarding the Proposed Assessment Model

There are multiple aspects of this legislation that raise significant safety concerns, including:

• needs assessments potentially being completed by unknown assessors
• lack of clarity regarding assessor qualifications and experience
• budgets being determined through standardised assessments without adequate review processes
• excessive pressure on participants to communicate all needs effectively during a single assessment
• cultural, trauma-related and language needs potentially not being recognised within standardised funding

modes

• the failure to assess the whole person, including all disabilities and environmental factors
• participants potentially being forced into unsafe living arrangements due to funding limitations.

The assessment process must recognise that disability does not exist separately from environment, trauma, culture, language, poverty and safety.

Recommendations

General Recommendations

• Do not pass the legislation in its current form.

Submission 1418

• Delay implementation until the government releases full operational details regarding eligibility criteria,

  reassessment processes, assessment tools, participant classifications and funding methodologies.
  

• Undertake comprehensive and genuine consultation with people with disability, women with disability,

   Aboriginal and Torres Strait Islander organisations, CALD communities, allied health professionals and
  
    disability organisations.
  

• Extend consultation periods to allow meaningful participation by carers, women with disability, sole

   traders and people with complex disability.
  

• Publish transparent economic modelling explaining:

  o how participant numbers will be reduced

  o how funding reductions were calculated

  o projected impacts on disability outcomes, healthcare systems, Close the Gap outcomes, women’s

      outcomes, housing, child protection and employment.
  

Human Rights, Safety and Safeguarding

Conduct a comprehensive:

• gender impact assessment

• disability safeguarding assessment

• violence prevention assessment

• Closing the Gap impact assessment

• CALD impact assessment

• workforce impact assessment

     prior to implementation of any reforms.
  

Ensure all reforms are consistent with:

• the Disability Royal Commission recommendations

• the National Plan to End Violence Against Women and Children

• the National Action Plan on Women, Peace and Security 2021–2031

• Closing the Gap commitments

• Australia’s obligations under the Convention on the Rights of Persons with Disabilities (CRPD).

Maintain strong legislative protections for:

• bodily autonomy

Submission 1418

• informed consent

• supported decision-making

• participant choice and control

• cultural safety

• trauma-informed practice.

Explicitly protect the right of participants to refuse medical treatment without losing access to the NDIS.

Ensure all reassessment, suspension and compliance processes include:

• trauma-informed safeguards
• human review processes
• accessible communication methods
• protections for participants experiencing domestic violence, homelessness or psychosocial crisis.

Choice and Control Retain the principles currently contained in section 31 of the NDIS Act regarding:

• individualised planning including consideration of personal and environmental circumstances

• participant-directed supports

• choice and control

• community participation

• flexibility.

Prevent funding models from assigning supports solely according to diagnostic “classes” or impairment categories.

Ensure participants retain the right to:

• choose their support workers

• choose culturally appropriate and gender-appropriate supports

• choose where and with whom they live

• access independent allied health assessments

• challenge inaccurate assessments and funding decisions.

Ensure funding models recognise individual circumstances including:

• domestic violence

• parenting responsibilities

• trauma histories

• fluctuating disability

Submission 1418

• cultural obligations

• communication needs

• cognitive and executive functioning

• rural and remote living.

Assessment Processes

Ensure all functional capacity and support needs assessments are completed by appropriately qualified professionals with disability-specific expertise.

Require assessors to have:

• disability training

• cultural safety training

• trauma-informed practice training

• understanding of psychosocial disability, autism, intellectual disability and neurological disability.

Ensure assessment processes consider:

• the whole person

• multiple disabilities and comorbidities

• environmental barriers

• social determinants of health

• fluctuating capacity

• masking and gendered presentations of disability.

-Prohibit fully automated decision-making for eligibility, budgeting or reassessment decisions.

• Require transparent publication and independent review of all assessment tools and algorithms prior to implementation.
• Ensure participants can access independent review and appeal processes without unreasonable barriers.

Women and Gender-Based Violence

Ensure NDIS budgeting processes explicitly account for:

• domestic violence risk

• coercive control

• parenting responsibilities

• trauma recovery

• fluctuating support needs.

Protect funding for supports that enable women with disability to:

Submission 1418

• safely parent children

• escape violence

• maintain housing

• participate in the community

• attend healthcare and legal appointments.

Ensure women with disability can continue to request female support workers for intimate personal care where required for safety, trauma or cultural reasons.

Undertake further consultation with women with psychosocial disability, autistic women, women with intellectual disability and women with chronic illness regarding assessment bias and access barriers.

Review existing psychosocial disability assessment tools for gender bias and cultural bias.

Aboriginal and Torres Strait Islander Peoples

Undertake direct consultation with Aboriginal Community Controlled Organisations and First Nations disability organisations before implementing reforms.

Ensure all NDSI assessment and planning processes are culturally safe and recognise:

• trauma

• racism

• housing instability

• remote service access barriers

• kinship structures

• language diversity.

Ensure First Nations participants retain the ability to choose support workers and providers connected to their communities and cultures.

Prevent replacement of community-embedded allied health services

Collect and publicly report disability outcome data for Aboriginal and Torres Strait Islander people across Closing the Gap targets.

Provide additional tracking on closing the gap outcomes specific to disability. Report on the impact of NDIS reforms on these outcomes.

Ensure no participant loses access to disability supports without appropriate alternative services already in place and independently evaluated.

CALD Communities

30 | P a g e

Submission 1418

Protect participant choice to engage support workers who:

• speak their language

• understand their culture or religion

• provide culturally safe support.

Ensure reforms do not unintentionally reduce employment opportunities for:

• CALD women

• community-based disability workers.

• Provide all assessment, review and compliance processes in accessible languages and formats.

• Ensure interpreters and culturally appropriate communication supports are funded and available.

Foundational Supports and Mainstream Services

do not remove NDIS supports until foundational supports are fully established, independently evaluated and adequately funded.

Publish detailed operational information regarding foundational supports before legislative changes commence. Ensure foundational supports are:

• evidence-based

• accessible

• culturally safe

• neuroaffirming

• available in regional and remote communities.

Increase Medicare rebates and session limits for:

• Better Access

• Chronic Disease Management

• Eating Disorder treatment

• neurological and developmental allied health services.

• Reduce gap fees and improve affordability of allied health services outside the NDIS.

Workforce Recommendations

- Develop a comprehensive workforce transition strategy for the disability and allied health sectors.
- Provide:
     o  transition funding

     o business support

     o retraining pathways

Submission 1418

Workforce Retention Strategies

for providers and workers impacted by reforms.

• Recognise the importance of flexible employment arrangements within the NDIS workforce for:

  • women with disability
  • carers
  • parents
  • people with chronic illness.

• Undertake workforce modelling regarding the impact of reforms on:

  • Occupational Therapists
  • speech pathologists
  • physiotherapists
  • psychologists
  • support workers
  • rural and remote services.

• Include Occupational Therapists and other allied health professionals in future policy and psychosocial early intervention design processes.

• Ensure reforms do not create long-term loss of disability expertise from the Australian workforce.

Transition and Implementation

• Ensure no participant exits the NDIS without: - a transition plan - confirmed replacement supports - continuity of care - safeguarding review where relevant.

• Phase reforms gradually to prevent large-scale workforce disruption and service collapse.

• Establish independent monitoring of: - participant outcomes - violence risks - homelessness - hospitalisation - incarceration - child protection involvement - voluntary assisted dying rates in disability

Submission 1418