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

This submission outlines some of my concerns regarding this proposed Bill. Those concerns are based on my experience as an Occupational Therapist (OT) working within the NDIS model \nan awareness of how the proposed changes will impact the people I work wit\nh.

Support Needs Assessment tool and process

The proposed new tool is the ICAN to be used by NDIA staff and administered via technology - phone or zoom call(I anticipate). The assessmennt wilnotbe face-to-faceand notadministeredbyatrainedalliedhealthprofessional.I am concernedthe resultswillno provideanaccuratepictureoftheperson’sneeds.Thereis no observationa person doing taskintheir environment.Theres no considerationfor any individual compensationsor strategiesperson requires todo thtask.For example-a persong with psychosocial disorder tells you they shower independently.Somem participantsI meet consider independentshoweringisto showerwhenthey feel comfortable showering anda canb once every4-5 days.Sittingwith them, yousmell body smells,youcan see unkempt state their room.This inadequatemeethygiene standards.The reasons do noshower daily can many varied are unique lifexperiences.Theywill tell a perso overphone these uniquefeatures They may struggle motivation complete basic hygiene.Theymayexperience specific challenges such hearing voices from shower rose believingpeople watching in shawr this safe place.Only when supporting structur experience safethey risk personal hygieneskin infectionsbody odour easy manage social settings. The participant describes as being independentshowering what people know wellconsiderbasic hygiene standards.Thenuances willpick up phon conversation person doesknowwell.Occupational Therapists trained and equipped functional assessments to consid the personenvironment interplay features undertake task.Wilnotcaptured ICAN process.results not accurate representation needed.reduced clinical discretion focus objective narrow assessment flexible represent individu needs.I understandparticipant will not be able draft of assessmen results before submitted.would question if enables participant confident information about realistic picture theirneeds.New Framework planningunderstands participant receive total budget someflexible non-flexible.increased responsibility on participant plan funds spent for allied health support work.

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

Submission 1695

I question whether some of the participants I work with will have the capacity to make those decisions without support.

This would seem to me to be designed by people who do not understand the needs of people living with a disability. There will be risks that participants don’t get the support they need. For example: A participant with an intellectual disability might spend all their allied health budget on speech services as they enjoy working with the speech pathologist but dislike doing muscle stretches under physiotherapy so allocate more funds towards speech therapy leaving limited or no funding available in physical therapy sessions if these are neglected there may result at worst case surgery being necessary due contracture management leading long-term loss function which could otherwise been prevented through regular physiotherapy sessions Some participants won’t possess sufficient decision-making ability requiring assistance risk missing out important therapies such as physiotherapy.

What defines permanence of disability?

The reasons why someone does follow up every option treatment vary:

• Limits spatial access rural participants face;
• Cost travel accommodation when needing transport;
• Availability and accessibility specialist services. I wonder how determines person exhausted all possible treatments? Is this medical framework? in my experience parents already talk burden guilt for failing exhaust options (family needs v individual needs cost days off work, time away from other family members.) for adult participants frustration trying service providing nothing benefit again They make decisions manage best what have left life routines question makes choice about whether scheme like NDIS benefits them or exclusion is significant change to lives.

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

Submission 1695

It appears there is an assumption that parents need to take on ALL the load for ALL the care of their child regardless of the level of disability. Most parents already compromise on so many levels to provide informal support. I question this blanket assumption and again ask that individual circumstances need to be considered.- Some children will progress and retain skills. Some children have regression of skills(Childhood dementia, autism disorder).

• Most parents anticipate the need for supervision and personal care will decrease over time. For some parents with children who have very complex needs, this does not happen. In some cases, the need for care increases.

•    It is vastly different to toilet and bathe a 4-year-old to doing those same tasks for a 14-year-old.

What is considered effective and beneficial? itappearsthechangesbillwillbeapplyinggeneralisedguidelinesbasedonpublished peer review literature,evidence practice models. For somparticipantsthereareno‘cohort’studiesorevidencemodelsbecausethey areuniqueintheirrangeofimpairmentsandcircumstances.Again,the proposed changes suggest participants followthispathbecausethisis what we know.Example: ihavebeenaskedtoprovidesupportfora7yearoldlearnerdriverwholiveswithbrittle bonedisorder.Icannotfindanyevidencefromresearchastowhatistedefinitelygoingto workforthelearner driver.Myproposedplanistothatwewillneedtotrialarangeoptions.There manyindividualsyoucannotpredictwhat istowork.Therisknowledgewisdomlived experience that valuable consider but often you neet try range options.In cannot rely on blanket generalisations of study sort reflect my participant’sneeds because am unsure they yet.Decision time framework being extended from3 weeks t0 months Forparticipatess living with fluctuating degenerative conditions may die while waiting decision over month.Should person suddenly start decline, likely end up local hospital wait safe discharge which requires equipment extra supports care needs. I do have concerns the proposed changes will result in ‘blank and generalized plans where not based holistic assessment qualified to do so.iagreethenDIS is a valuablescheme does need be overhaulbutthe proposedchangeslikelyresultparticipantsworkbeingleftvulnerableandrisk. Occupational Therapist, northern NSW E:27/05/2026