Submission 1757

Senate Community Affairs Legislation Committee Inquiry 28 May 2026

Inquiry into the National Disability Insurance Scheme Amendment

(Securing the NDIS for Future Generations) Bill 2026

Submission by Jemma Brady

Occupational Therapist Be Your Best Occupational Therapy

I am writing as an Occupational Therapist working directly with Australians living with significant disability and complex support needs regarding the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

I support the need for reform to improve the long-term sustainability of the NDIS and acknowledge that tighter safeguards around expenditure and consistency are necessary. However, I am deeply concerned that several proposed amendments risk creating serious unintended consequences for people with disability, their families, and the broader health and social care systems.

In particular, many of the practical mechanisms that will ultimately determine participant access, asessment outcomes and funding appear intended to be implemented later through rules, tools, algorithms and ministerial determinations that have not yet been fully disclosed, tested or independently scrutinised. Parliament is therefore being asked to legislate broad powers without full visibility regarding how these reforms will operate in practice.

Additionally, reductions in disability supports do not eliminate need. In many cases, they simply shift costs from the NDIS onto hospitals, aged care, mental health services, housing systems, child protection systems, emergency services and unpaid carers, potentially increasing long-term social and economic costs elsewhere.

I am also concerned that the proposed reforms appear to assume the availability of alternative or foundational supports that remain inconsistent, underdeveloped or inaccessible in many parts of Australia. Narrowing Scheme access before these systems are fully operational risks leaving participants without meaningful support.

My primary concerns are outlined below.

Functional Capacity and Assessment Design

The proposed definition of functional capacity removes consideration of environmental and personal circumstances, assistive technology, and supports. In practice, this does not reflect how disability and functioning operate in real life.

A person’s functional capacity cannot be accurately assessed in isolation from their environment. For example, assessing whether someone can safely drive by testing them only on a closed acetrack, while ignoring traffic, weather, pedestrians, fatigue and real-world road conditions, would not provide a realistic picture of their functioning. Likewise, assessing a wheelchair user’s mobility without considering stairs, ramps, lifts, transport supports and modifications would not provide a realistic picture of their functioning.

Submission 1757

Similarly, many people with invisible, fluctuating, neurological, psychosocial or cognitive disabilities may appear capable during a short assessment in a quiet, structured environment, yet remain unable to function safely, consistently or sustainably in daily life without supports.

Functional capacity assessment is a clinical process requiring professional reasoning, contextual analysis and understanding of how disability impacts daily life across environments and over time. It cannot safely be reduced to a standardised checklist or automated scoring system.

Many disabilities are not static. Participants may fluctuate significantly from day to day or mask difficulties during short assessments. Systems that rely heavily on snapshot assessments risk systematically underestimating support needs.

I am deeply concerned that the Bill may allow decisions about people’s supports to increasingly be shaped by rules, tools and frameworks rather than high-quality assessments conducted by appropriately qualified professionals.

Good assessments matter because they identify not only what a person can physically do once in an ideal environment, but whether they can safely, consistently and sustainably function in the real world.

Use of Automation, Algorithms and Standardised Tools

The Bill allows greater use of automation, algorithms and standardised tools in decision-making.

While administrative efficiencies may be appropriate in some areas, I am highly concerned about the increasing use of “tick-box” or automated systems for complex disability assessment and funding decisions.

Two people with the same diagnosis may have profoundly different functional capacity, support needs, risks and outcomes depending on their environment, cognition, fatigue, housing, trauma history, supports, coping strategies and cumulative impairments. Human clinical judgement is essential.

Recent media coverage regarding the assessment tool used within the Aged Care system highlights the significant risks of overly standardised assessment systems that fail to adequately capture complexity, fluctuating needs and real-world functioning.

There is significant concern that similar approaches within the NDIS may underestimate participant needs, reduce procedural fairness, and contribute to increasingly standardised or partially automated “robo-planning” approaches that reduce professional discretion and fail to adequately capture complex, fluctuating or contextual disability support needs.

Participants and families should not be subjected to automated or algorithmic decisions without meaningful professional oversight, transparency, and review pathways.

Introduction of Undefined Assessment Models

The Bill proposes major changes to scheme eligibility and participant reassessment while the assessment methodology itself remains undefined.

I am highly concerned about legislation being passed before Parliament, participants, clinicians and the disability community have visibility regarding how people will actually be assessed. Assessment frameworks fundamentally determine who receives support and who does not. Such significant reform should not proceed without transparency, consultation, piloting, and evidence that the proposed model is valid, fair and safe.

“All Appropriate Treatment” Requirements

The proposed permanence provisions create a concerning expectation that all treatment pathways must be exhausted before a person may qualify for support.

Submission 1757

This fails to recognise that people may reasonably decline treatment due to:

• significant risks or side effects,
• previous adverse experiences,
• trauma,
• limited likelihood of benefit,
• cultural or personal beliefs,
• financial barriers,
• or lack of access.

No Australian should effectively be forced into medical treatment in order to access disability support.

The proposal also risks creating inequity whereby people who cannot afford specialists, repeated interventions, interstate travel or expensive treatments may fail eligibility requirements despite having substantial lifelong disability.

Funding Decision-Making and Evidence Standards

While value for money considerations are important, the proposed framework risks prioritising “cheaper” supports rather than supports that actually achieve equivalent outcomes.

The legislation also elevates published evidence over lived experience and individual outcomes. In disability practice, particularly assistive technology and complex disability support, the evidence base often lags behind real-world innovation and participant need.

Many highly effective supports used successfully by participants may have limited formal published evidence simply because disability research funding is limited and technology evolves rapidly.

Restrictions on Reassessment and Review

The Bill limits unscheduled plan reassessments to “exceptional circumstances”.

In practice, participant needs can change rapidly due to:

• deterioration in health,
• carer illness or death,
• domestic violence,
• housing instability,
• mental health decline,
• burnout,
• or breakdown of informal supports.

Restricting reassessment pathways risks leaving participants unsafe for prolonged periods while waiting for review, creating further burden on the already-at-crisis health system.

The reforms appear partly based on an assumption that participants frequently seek reassessment to increase funding unnecessarily.

In practice, many reassessments occur because plans are initially underfunded and do not adequately meet participant needs. In my clinical experience, reassessment requests are often a symptom of inadequate initial planning rather than overuse of the Scheme.

This is reflected in the high proportion of Administrative Review Tribunal matters that resolve in favour of participants or through revised NDIA decisions prior to hearing. If plans were more appropriately funded in the first instance, there would likely be substantial reductions in repeated assessments and reporting, legal costs, administrative burden, review requests and crisis-driven escalations.

Submission 1757

In degenerative conditions such as Motor Neurone Disease and Multiple Sclerosis, rapid and substantial functional decline is an expected part of the disease trajectory. In my clinical experience, participants already face major barriers obtaining urgent reassessment and support adjustments due to administrative delays and inconsistent understanding of complex disability needs. Legislative changes that further restrict flexibility and responsiveness within the Scheme risk leaving participants without essential supports during periods of rapid deterioration, with potentially catastrophic consequences including hospitalisation and death.

Suspension of Participants for Lack of Contact

I am also highly concerned about provisions allowing participants to potentially have plans suspended where the NDIA is unable to contact them.

People with disability are often the very people most likely to miss calls, emails, paperwork or deadlines because of the impacts of disability itself. Fatigue, executive functioning impairments, psychosocial disability, cognitive overload, hospitalisation, homelessness, communication barriers, trauma and crisis situations may all affect a person’s ability to consistently engage with complex administrative systems.

In my professional experience, many participants already report receiving a single missed phone call from an unknown number before being advised that the NDIA has proceeded to make significant decisions, including finalising plans or progressing administrative actions, on the basis that the participant or nominee was “unable to be contacted”. For many participants, these decisions are life-changing and may occur without meaningful engagement or opportunity to respond.

Expanding powers to suspend supports or limit access based on unsuccessful contact attempts creates substantial procedural fairness and safeguarding concerns, particularly for participants whose disabilities directly impair communication, organisation, responsiveness or capacity to navigate administrative systems. Suspension of supports in these circumstances risks catastrophic outcomes including hospitalisation, homelessness, safeguarding risks, carer breakdown and institutionalisation.

Capacity Building and Participation Supports

I am deeply concerned about proposed reductions to capacity building and participation supports.

These supports are not “extras”. They are often the very supports that allow people to:

• maintain independence,
• participate in the community,
• access healthcare,
• sustain relationships,
• remain safely housed,
• maintain mental health,
• reduce carer burden,
• and avoid crisis escalation.

Reducing these supports may create short-term budget savings while significantly increasing long-term costs through hospitalisation, carer burnout, family breakdown, mental health deterioration and increased reliance on health and social services.

Participants access the community for a wide variety of essential reasons, including medical appointments, shopping, therapy, education, social participation and maintaining wellbeing. Broad reductions without consideration of individual needs are highly inappropriate.

Submission 1757

Parenting and Family Responsibility

I am also concerned regarding proposed changes relating to parental responsibility and informal care expectations.

The Bill appears to narrow recognition of disability-related parenting supports while increasing reliance on informal family care. This risks shifting unsustainable caring burdens onto families and may increase family breakdown, child protection involvement, safeguarding concerns and withdrawal from workforce participation by carers.

Increasing reliance on informal family care may also have substantial economic consequences through reduced workforce participation, carer burnout, financial hardship and long-term impacts on family wellbeing.

The role of disability-related parenting supports is not to replace parenting, but to enable safe and sustainable parenting where disability creates additional barriers.

Ministerial Powers and Broad Funding Reductions

I am highly concerned about the expansion of ministerial powers to impose broad or class-wide funding reductions across support categories.

Funding decisions should remain based on individual need and clinically-informed assessment, not broad fiscal measures that fail to consider the realities of daily living with disability.

For example, broad reductions to community access funding fail to recognise that support needs do not disappear simply because a participant remains at home. Without corresponding increases in in-home supports, participants with complex disabilities may be left at significant risk of harm, crisis presentation and avoidable hospitalisation.

The proposed powers risk shifting costs onto families, unpaid carers, hospitals and crisis systems.

Recommendations

• ensure functional capacity and support needs assessments are conducted by appropriately qualified allied health professionals, including occupational therapists;
• prohibit fully automated eligibility or funding decisions and require human oversight of any assessment tools or algorithms;
• remove or substantially constrain ministerial powers to impose broad or class-wide funding reductions;
• ensure all decisions remain based on individual need, clinically informed assessment, and transparent, non-automated processes;
• retain practical pathways for reassessment and review;
• reverse proposed reductions to capacity building and participation supports;
• limit broad ministerial powers that reduce transparency or individualised decision-making;

Conclusion

I strongly support ensuring the sustainability of the NDIS for future generations. However, reforms of this scale should not proceed without genuine consultation, transparency, detailed assessment modelling, and robust safeguards.

I strongly believe that meaningful and sustainable reform is achievable. However, reforms of this scale should be developed collaboratively with the disability community, allied health peak bodies, participant advocacy organisations and people with lived experience.

I would also encourage Parliament to consider how other insurance-based schemes operate. Effective insurance systems recognise that timely investment in early intervention, rehabilitation, environmental supports and gradual capacity building often reduces long-term costs and dependency.

Submission 1757

In disability practice, meaningful functional improvement is frequently slow, incremental and achieved over extended periods of time. For many participants, therapy and capacity building supports do not produce sudden or dramatic changes within short plan periods, but instead contribute to gradual gains in safety, independence, caregiver sustainability and reduced long- term support needs. These gains are often evidenced through consistent functional reporting over many years.

The current direction of the Scheme appears increasingly focused on short-term or easily measurable improvements within relatively short timeframes. This risks undervaluing the long-term benefits of sustained therapeutic intervention, environmental supports and preventative approaches that may ultimately reduce future support costs and improve participant outcomes.

The risk of getting these reforms wrong is profound. These changes have the potential to significantly impact safety, dignity, participation, family stability, and quality of life for Australians living with disability.

I respectfully urge Parliament to substantially reconsider and amend the Bill prior to implementation.

Sustainable reform is both necessary and achievable, but sustainability cannot be achieved by reducing individualised decision-making, limiting procedural fairness, and shifting risk onto disabled people, families and crisis systems.

Sustainable reform should not be developed in opposition to the disability sector, but in partnership with the people and professionals who understand the real-world impacts of these declarations.

Jemma Brady Occupational Therapist B.Occ.Thy (2003) Be Your Best Occupational Therapy This submission reflects my personal professional views based on my clinical experience and does not represent the formal position of any organisation.

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