NDIA Accountability Project

Concerns regarding the impact of NDIS Amendment Bill on Aboriginal and Torres Strait Islander people with disability

‹ PrevPage 1 of 11 · Source p. 1Next ›
Submission 1734

Indigenous Allied Health Australia

Submission

Senate Standing Committees on Community Affairs – Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

June 2026

Contact:

  • Paul Gibson,
  • Chief Operating Officer
  • (02) 6285 1010 |

Submission 1734

Acknowledgement

Indigenous Allied health Australia (IAHA) acknowledges the Traditional Custodians of the lands and waters throughout Australia. We pay respect to Elders past and present. We recognise Aboriginal and Torres Strait Islander peoples’ continuing connection to Country and Island Home. We acknowledge that sovereignty was never ceded.

About IAHA

IAHA welcomes the opportunity to contribute to the Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 (NDIS Amendment Bill).

IAHA is a national not-for-profit, community controlled and member-based Aboriginal and Torres Strait Islander allied health organisation with approximately 2,300 members across Australia. IAHA members play an integral role in reforming and transforming systems, and improving health and wellbeing outcomes, working with and for Aboriginal and Torres Strait Islander people, including those living with disability.

IAHA was established in 2009 by the Aboriginal and Torres Strait Islander Strait Islander workforce as an act of self-determination with a vision of supporting and empowering the current and future workforce. A founding motivation was to reduce isolation experienced by Aboriginal and Torres Strait Islander allied health workforce and to provide a culturally safe community of connection that reduces the burden of racism – both interpersonal and systemic – while also embedding culturally responsive ways of working within allied health practice.

This remains an essential goal in ensuring that the NDIS can respond to the needs of Aboriginal and Torres Strait Islander people with disability, their families, and the broader community.

Introduction

IAHA acknowledges the need for reform and to ensure the sustainability of the NDIS, however we are concerned about several elements of this Bill and an accompanying lack of detail. There are legitimate concerns that proposed reforms to the NDIS will have a disproportionate, negative impact on Aboriginal and Torres Strait Islander people with disability, their families and communities, who already underserviced under current NDIS arrangements, further entrenching inequity.

IAHA notes that the timeframe for public consultation on the NDIS Amendment Bill is incredibly short. In our view, this is not consistent with best practice and is not an accessible process for Aboriginal and Torres Strait Islander people with disability, or the communities and organisations that support them. Further, the consultation period included National Reconciliation Week and National Sorry Day. In this context, IAHA provides this submission to the Committee, relating to the high-level principles of concern with respect to the NDIS Amendment Bill.

IAHA’s recommendations regarding this important work are consistent with and reaffirm existing Australian Government commitments including with respect to the following:

  • United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP)
  • Convention on the Right of Persons with Disability (CRPD)
  • Disability Sector Strengthening Plan
  • NDIS First Nations Strategy 2025 - 2030

Submission 1734

  • National Agreement on Closing the Gap (the National Agreement)
  • National Aboriginal and Torres Strait Islander Health Plan 2021 - 2031 (the Health Plan)
  • National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021 - 2031 (the Workforce Plan)
  • Australian Human Rights Commission – The National Anti-Racism Framework

We also note the outcomes of two significant reviews of the NDIS:

  • The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Disability Royal Commission), and
  • Independent Review into the National Disability Insurance Scheme (NDIS Review).

We encourage the Committee to consider the above commitments and reviews to ensure the needs of Aboriginal and Torres Strait Islander people and allied health workforce are appropriately addressed through the Committee’s consideration of the NDIS Amendment Bill. As such, we recommend that the Bill not proceed in its current form, but instead that its impacts be more fully understood through genuine co-design with Aboriginal and Torres Strait Islander people and communities, health and wellbeing peaks, allied health peak bodies, and community-controlled sector representatives, before any further steps are taken. Our other recommendations in this submission set out the minimum changes we see as required to address the most acute risks identified.

IAHA’s submission sits within a broader landscape of Aboriginal and Torres Strait Islander expert evidence being brought to this Inquiry. We encourage the Committee to consider our submissions together, as a body of Aboriginal and Torres Strait Islander expert evidence speaking collectively to the impact of the NDIS Amendment Bill on Aboriginal and Torres Strait Islander peoples with disability, and to the scale of reform required before it can be considered consistent with Australia’s obligations under the National Agreement on Closing the Gap, the United Nations Declaration on the Rights of Indigenous Peoples, and the Convention on the Rights of Persons with Disability. IAHA notes the leadership of the First Peoples Disability Network (FPDN) in the disability sector. IAHA has endorsed FPDN’s submission to the Committee on the NDIS Amendment Bill.

Discussion

Timeframe

We understand the importance and urgency of ensuring long-term sustainability of the NDIS. We also support a fiscally responsible approach. We remain very concerned, however, that the timeframes for community consultation on the NDIS Amendment Bill are too short to support a fulsome public discussion and to ensure a rights-based and culturally safe approach for Aboriginal and Torres Strait Islander allied people and the allied health workforce.

The Australian Government Guide to Policy Impact Analysis provides that consultation should occur for a minimum of 30 days where possible.

Recommendation

Extend the timeframe for consultation on the NDIS Amendment Bill.

Submission 1734

Human Rights and Cultural Safety

In our view, human rights and cultural safety are inextricable intertwined. For Aboriginal and Torres Strait Islander people, culture is healing and health promoting, and Aboriginal and Torres Strait Islander people with disability require culturally safe and holistic supports and services to achieve and maintain optimal health and wellbeing. This was acknowledged by the Disability Royal Commission and is consistent with understandings under a social model of disability. Incorporating the cultural determinants of health, acknowledges that stronger connections to culture and community, and Country/Island Home, builds resilience, self-esteem and stronger individual and collective identities.

Aboriginal and Torres Strait Islander people with disability experience intersectional disadvantage, occurring in the context of colonisation, dispossession, racism and intergenerational trauma and complex, and intersecting support needs that are not adequately met by most institutional frameworks or policies. Aboriginal and Torres Strait Islander people experience chronic disease at substantially higher rates than the broader Australian population, and chronic disease frequently co-occurs with disability in ways that complicate both NDIS eligibility determinations and ongoing plan adequacy.

The NDIS Reforms Impact Analysis (Impact Analysis) attached to the Explanatory Memorandum to the NDIS Amendment Bill acknowledges that “First Nations Australians are more likely to experience chronic disease due to the cumulative impacts of historical, social and systemic inequalities” — yet several of the NDIS Amendment Bill’s provisions are likely to disadvantage Aboriginal and Torres Strait Islander people with disability. Indeed, the Impact Analysis further acknowledged that the changes to the NDIS have the “potential to affect certain Closing the Gap outcomes”, yet the Bill does not appear to contain any mechanisms to monitor, report on, or mitigate this risk.

Cultural safety must be understood as a system-level obligation, embedded through funding models, commissioning, regulatory settings, workforce development and accountability mechanisms. The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) and the Convention on the Rights of People with Disability (CRPD) clearly provide that respect for culture is central to respecting the human rights of Aboriginal and Torres Strait Islander people with disability.

Relevantly, Priority 9 of the Aboriginal and Torres Strait Islander Health Plan 2021-2031 demands access to person-centred and family-centred care. Further, Objective 9.7 provides:

    Improve access to responsive health care for people with disability
     
     Innovative, culturally safe disability service models must be supported at the local level to increase access to disability services. All health services, including ACCHS, must be equipped to provide appropriate care for people with disability. This includes ensuring appropriate physical access, equipment, facilities and staff training. There must also be a rights-based and strengths-based approach to respond to the unique and intersectional experiences of Aboriginal and Torres Strait Islander people with a disability.

Further, due to the ongoing impacts and far-reaching effects of colonisation, as well as increasing experiences of racism, the development of a strong relationship with health and disability care providers can often take a very long time to develop for Aboriginal and Torres Strait Islander people

Submission 1734

and communities. Frequently, this requires the assistance of, if not direct provision of services by, the Aboriginal and Torres Strait Islander workforce. The NDIS Amendment Bill does not provide any flexibility to ensure that systems of care that are effective remain in place. Nor does the NDIS Amendment Bill anticipate impacts on the much-needed Aboriginal and Torres Strait Islander workforce.

IAHA is concerned, therefore that the NDIS Amendment Bill does not ensure cultural safety for Aboriginal and Torres Strait Islander people and communities. In the absence of an explicit focus on guaranteeing the needs of Aboriginal and Torres Strait Islander people with disability are met, it is likely that there will be an increased and ongoing detrimental impact on Aboriginal and Torres Strait Islander participants. Such an outcome would be inconsistent with international obligations as well as the National Agreement on Closing the Gap.

In our view, the risk of the reforms reducing Aboriginal and Torres Strait Islander people’s access to culturally safe disability supports is disproportionately high. We also understand that detailed analysis of the impact of the NDIS Amendment Bill on Aboriginal and Torres Strait Islander people has not occurred.

Recommendations

  • To ensure safety and wellbeing, and to demonstrate a commitment to the rights of Aboriginal and Torres Strait Islander people with disability, implement safeguards to ensure there is not a reduction in current NDIS supports for Aboriginal and Torres Strait Islander participants until at least equivalent supports are in place.

  • Conduct an impact analysis of the NDIS Amendment Bill on Aboriginal and Torres Strait Islander people with disability, led and informed by Aboriginal and Torres Strait Islander expertise to ensure a holistic.

The Aboriginal and Torres Strait Islander Allied Health Workforce

The Aboriginal and Torres Strait Islander allied health workforce is central to a functional NDIS and to ensuring Aboriginal and Torres Strait Islander people with disabilities receive the care and support they need for optimal health and wellbeing.

The allied health workforce provides a broad range of services and supports to Aboriginal and Torres Strait Islander people with disability, including under the NDIS. The allied health workforce can conduct functional assessments to inform eligibility determinations, prepare the evidence that supports plan development and review, delivers the capacity building supports — therapies, reablement, skill development — that give participants genuine agency over their own lives. Allied health assistants can coordinate care, liaise with family and carers and support the person with their therapy program. For some communities and families, the Aboriginal and Torres Strait Islander allied health workforce may be the primary, most continues, or only culturally safe health-related service. In such instances, the quality and continuity of those relationships have immeasurable impacts on participant outcomes.

Aboriginal and Torres Strait Islander community-controlled organisations and the allied health workforce routinely provide unfunded cultural safety and support functions, such as relationship- building with families, wrap-around support across health, disability, and aged care, cultural navigation

Submission 1734

for participants engaging with complex systems, and not billing for report-writing, so that participants can use the funding for additional much needed supports. This commitment to supporting Aboriginal and Torres Strait Islander people with disability improves the health, social and emotional wellbeing of Aboriginal and Torres Strait Islander people. Without it, many Aboriginal and Torres Strait Islander people would not receive the supports they require for optimal quality of life. In the absence of proper investment in the allied health workforce, this is likely to result in deterioration of condition and increasing unmet need for Aboriginal and Torres Strait Islander people and communities.

Recommendation

That the Committee consider the impact of the NDIS Amendment Bill on the Aboriginal and Torres Strait Islander allied health workforce and recommends direct action to grow and support the Aboriginal and Torres Strait Islander disability workforce.

Regulation of the NDIS workforce

We note the amendments NDIS provide registration provisions. In our view, all NDIS providers must also be required to provide culturally safe services. A culturally safe environment requires thorough ongoing and lifelong education and development for the workforce in cultural safety, engagement of Aboriginal and Torres Strait Islander staff, where possible, and systems and processes developed to effectively support cultural safety in service provision. Cultural safety training for all levels of staff across the sector, with a commitment to lifelong learning through continuing professional development in cultural safety, will support the development of a culturally safe organisation and service delivery, as well as a culturally safe workplace and sector.

Cultural Safety Training

Cultural safety training is increasingly required for health professionals under the Australian Health Practitioner Regulation Agency (Ahpra), through the leadership of self-regulating professional associations, and within service and contract requirements and standards. Training should be of a suitable high quality, for example requiring evidence of contribution to the professional behaviours identified by Ahpra and evidence such as that outlined in the Lowitja Institute’s discussion paper on Cultural Safety in Australia.3 By way of example, IAHA’s Cultural Responsiveness Training is highly regarded as a quality and comprehensive training package.

Enabling Cultural Safety at Scale

Cultural safety cannot be delivered at scale without governments explicitly enabling it. For those providers with the capability to invest in staff development in cultural safety, there is a leadership role to ensure that this is understood to be a requirement for safe and effective care which requires consideration of the levers and enablers to influence practice and priorities. Regulatory and compliance, accreditation, and funding and commissioning all provide opportunities to influence behaviours and to promote cultural safety. Alongside this, targeted supports for smaller providers, sole traders, rural, and remote and Aboriginal and Torres Strait Islander providers may be necessary to facilitate access. For example, the Rural Workforce Agency scholarship model and locum assistance programs support workforce engagement in professional development alongside business continuity – which could more explicitly support the disability workforce – as could targeted cultural safety grant opportunities or development funds.

3 Lowitja Institute (2024) Cultural Safety in Australia.

Submission 1734

We draw the Committee’s attention to the application of Priority Reform Two of the National Agreement on Closing the Gap: building the community controlled sector. The provider registration provisions must be carefully designed to ensure that Aboriginal and Torres Strait Islander community controlled organisations and allied health providers are supported to achieve registration, and to minimise provider withdrawal from the NDIS market.

To support the Aboriginal and Torres Strait Islander allied health workforce and associated businesses and organisations, we recommend consideration of mechanisms to support the community controlled sector with the costs of registration and support for any associated barriers. This could include:

  • Targeted Aboriginal and Torres Strait Islander business grants to provide support for business start-up. Grants should minimise out-of-pocket expenses and ensure that funds are sufficient to fund governance and establishment costs, as well as any infrastructure required including clinical information systems.

  • Incentives for current Aboriginal and Torres Strait Islander allied health services and businesses providing primary health and aged care to expand services to the NDIS. Grants and/or waivers should support the upfront costs for NDIS registration, compliance and other governance requirements.

  • Consistent with the recent Productivity Commission Interim Report: Delivering quality care more efficiently, consideration of additional cost-reduction and streamlining of systems and registration requirements across the care and support economy is required, in addition to targeted support for the onboarding of new Aboriginal and Torres Strait Islander providers. 4

  • Financial support for clinical supervision, professional development allowances and leadership training is greatly needed to support the Aboriginal and Torres Strait Islander allied health workforce to operate within a small business / disability services context. Innovative and multi-faceted programs of support must be considered to ensure the market is ready to effectively meet the needs of Aboriginal and Torres Strait Islander people, including supporting the workforce to step outside of systems and structures which may have the capacity provide more supervision and development support, such as the public sector.

  • Promoting the role and viability of the Aboriginal and Torres Strait Islander allied health assistants, including capacity to assist with conducting NDIS assessments, coordination of services, liaison with family and community, supporting the participant with completion of their health program to maintain the highest attainable health and wellbeing, and ensuring early attention is provided by the relevant health and medical professionals when there is a change in the health of the person with disability.

Recommendation

That the registration provisions in the NDIS Amendment Bill require providers to undertake cultural safety training and demonstrate steps taken to provide culturally safe and responsive services.

Submission 1734

Cultural Validation – assessments, tools and automated decisions

NDIS tools, assessment processes and automated decision-making systems must be informed and validated for cultural safety by Aboriginal and Torres Strait Islander people with disability.

IAHA is concerned by the intended introduction of automated decision-making. All Automated decision systems are trained on existing data, which may be more likely to reproduce those patterns, at scale. This can include being based on a system that is not necessarily culturally safe, contains racial biases, or does not consider the importance of cultural safety for Aboriginal and Torres Strait Islander people with disability.

Similarly, assessment tools are designed and deployed under ‘norms’ and worldviews not aligned with Aboriginal and Torres Strait Islander people’s lives, needs and aspirations, limiting their application and effectiveness. Without appropriate workforce and public education, including with respect to allied health services, and their diverse roles, effectiveness and impact, people will continue to be underserviced. This is concerning within a broader context of financial sustainability and the very public intent to contain NDIS expenditure, with the re-design and application of these tools, potentially further constraining access to the holistic, multidisciplinary care that participants should expect.

Assessment tools and processes must also be informed by and a validated for cultural safety. By way of example, the following are two validated tools for Aboriginal and Torres Strait Islander people, developed by the University of Western Australia:

  • Kimberley Indigenous Cognitive Assessment (KICA) – a cognitive screening tool validated for Aboriginal and Torres Strait Islander people
  • Good Spirit Good Life (GSGL) assessment framework, validated for older Aboriginal Australians, aged 45 years and over.

Any automation must also be governed by a transparent legal framework and provide assurances that safety mechanisms are in place, noting trust and prior experiences. This includes with respect to ‘Robodebt’ and the findings of the Royal Commission into the Robodebt Scheme warrant consideration.

Recommendation

Ensure all assessment processes, tools and automated decision-making systems are independently culturally validated by Aboriginal and Torres Strait Islander people.

A further aspect of concern is Indigenous Data Sovereignty. The National Agreement on Closing the Gap’s Priority Reform Four establishes that Aboriginal and Torres Strait Islander people have a right to access, and control over, data about themselves and their communities. The automated decision-making framework in the NDIS Amendment Bill will presume to involve the largescale collection, analysis, and algorithmic processing of data about Aboriginal and Torres Strait Islander participants. There is no clear reference to Indigenous Data Sovereignty principles, or any requirement that data governance arrangements be developed in partnership with Aboriginal and Torres Strait Islander people, and without any mechanism for Aboriginal and Torres Strait Islander communities or peak bodies to access the data being used to make decisions about Aboriginal and Torres Strait Islander people.

Submission 1734

Recommendation

Consider the application of the National Agreement on Closing the Gap and include provision for Indigenous Data Sovereignty and governance arrangements in the NDIS Amendment Bill.

Plan suspension and revocation

The NDIS Amendment Bill allows for the suspension or revocation of a participant’s plan if contact is not made within 90 days. We are concerned that this approach is not consistent with the human rights of Aboriginal and Torres Strait Islander people with disability, and does not sufficiently consider:

  • the right to practise culture and tradition, including, but not limited to sorry business and ceremony
  • long-term hospitalisation and acute illness, including social and emotional wellbeing issues, physical and psychosocial periods of illness and incapacity, including illness of family and carers, who may support communication with the NDIS
  • geographic and communication barriers, such as unreliable telecommunications, seasonal disruptions, mobile and transient communities
  • the inappropriately high levels of incarceration of Aboriginal and Torres Strait Islander people with disability.

There should therefore be a high threshold and appropriate governance for decision making with respect to the revocation of plans, culturally safe approaches to communication with Aboriginal and Torres Strait Islander participants and their families including ownership and onus on the system (including staff practices and behaviours and resourcing trusted partners involved in coordination), and low barrier to recommencement/re-entry following suspension.

Recommendation

That reforms to the NDIS include built-in mechanisms to require consideration of, and flexibility for, Aboriginal and Torres Strait Islander people with disability.

Requirements to undertake “appropriate treatments”

IAHA is deeply concerned about the new requirement to require a person to undertake all “appropriate treatment” to be eligible for the NDIS. We are concerned that there are numerous reasons for why a person may not be able to meet this requirement, these include, but are not limited to:

  • cultural and personal belief systems
  • access to services, including culturally safe and responsive services
  • workforce shortages, particularly the Aboriginal and Torres Strait Islander allied health workforce
  • high cost of medical or other treatments
  • transport and related considerations.

Submission 1734

We are concerned that this requirement creates a system that is structurally inaccessible to those with the greatest need, and only accessible by those with the financial means and support systems required to enable access. This is inconsistent with Australia’s obligations under the CRPD and UNDRIP. It is also inconsistent with the National Agreement on Closing the Gap.

Recommendations

  • Ensure that eligibility provisions do not embed structural and systemic inequity
  • Ensure that eligibility requirements are consistent with commitments to the National Agreement on Closing the Gap and human rights.

Decision-making and cultural safety

IAHA is concerned by the broad volume of decisions and powers provided in the NDIS Amendment Bill that are not subject to parliamentary scrutiny. While we recognise this can be necessary, powers that can reduce or impact human rights and further systemic inequity are a grave concern.

Further, given the significance of cultural safety to ensure Aboriginal and Torres Strait Islander people with disability can fairly and equitably access the NDIS, there needs to be a mechanism to ensure the needs of Aboriginal and Torres Strait Islander people are considered and appropriately consulted in the development of delegated legislation and decision-making parameters.

Recommendation

Establish a legislative mechanism with Aboriginal and Torres Strait Islander leadership to ensure delegated legislation and other decision-making parameters are culturally safe.

Informal Supports

In many Aboriginal and Torres Strait Islander communities, caring responsibilities are distributed across extended kinship networks. Grandparents, aunties and uncles, older siblings, and community members may all contribute to the care of a person with disability, as a natural expression of cultural care, commitment and responsibility. This network is a strength, as recognised by the seminal work by First Peoples Disability Network and Professor Scott Avery in Culture is Inclusion: a narrative of Aboriginal and Torres Strait Islander people with disability. It is also a network that is already stretched by simultaneously supporting multiple family members with chronic illness, disability, aged care needs, and the social and emotional wellbeing impacts of intergenerational trauma arising because of colonisation and systemic racism. We are concerned that intentional and structured over-reliance on informal supports can have a disproportionate impact on Aboriginal and Torres Strait Islander people and communities, if not appropriately supported and valued

Recommendations

Rules and policies relating to informal supports must be subject to:

  • Co-design with Aboriginal and Torres Strait Islander people, communities as well as health and wellbeing peak organisations.

Submission 1734

  • A mandatory review cycle, with public reporting of outcomes disaggregated by participant Indigenous status and remoteness category.

Reduction in Social, Civic and Community Participation

The proposed reduction in Social, Civic and Community Participation (SCCP) Support risk having a significant impact on Aboriginal and Torres Strait Islander people with disability, in the absence of established alternatives. The SCCP provides valuable and necessary supports, particularly to those who may be isolated. The SCCP can support the social connection that is required for Aboriginal and Torres Strait Islander social and emotional wellbeing.

We are concerned that reductions to SCCPs risks increasing social and cultural isolation and disengagement, reducing quality of life for participants. In some communities there may be very few alternatives. For instance, in very remote, remote communities or smaller regions, there is often only one service provider. Sometimes there is no service provider at all, and services visit the region on a cyclic basis. There may be no market with which to negotiate, and no other participants to attend group sessions with. There may also be limited available culturally safe services under the new Inclusive Communities Fund.

Recommendation

Ensure that the SCCP is not reduced until there are culturally safe alternative supports in place to ensure Aboriginal and Torres Strait Islander people do not experience increasing isolation, disengagement and inequity.

Final remarks

The NDIS Amendment Bill is complex and requires more time to consider. While it is a legislative framework and therefore limited in its capacity to holistically cover off all issues in depth, its contents and policy intent are significant guides to interpretation and application, requiring detailed consideration about the direct and indirect effects of its passage.

Consideration must be given to the impacts on vulnerable and disadvantaged cohorts and the allied health workforce that provides the critical supports required for a functioning NDIS. We are particularly concerned that the NDIS Amendment Bill could result in further reducing access to services for Aboriginal and Torres Strait Islander people with disability, resulting in increasing inequity and unmet need.

IAHA would be pleased to provide additional information to the Committee and would welcome the opportunity to discuss the needs of Aboriginal and Torres Strait Islander people with disability and the allied health workforce with the Committee.