Submission 1854

Submission to the Senate Community Affairs Legislation Committee

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

28 May 2026

I am writing this submission as both a professional and advocate working within the disability sector on the NSW Central Coast. Through my work as an occupational therapist with Coast Rehab, I support client’s living with complex neurological and degenerative disabilities including spinal cord injury (SCI), motor neurone disease (MND), acquired brain injury (ABI), multiple sclerosis (MS), cerebral palsy (CP), and other progressive conditions.

I strongly support the concerns and recommendations raised by Occupational Therapy Australia and the “No OT, No NDIS” campaign.

My concerns relate specifically to proposed reductions to capacity building and community participation supports, the increased use of automated or standardised assessment processes, restrictions on reassessment flexibility, and the broader powers within the Bill that may enable future reductions to therapy and allied health supports. In practice, these proposed changes place some of the most vulnerable people in our community at significant risk.

Community participation funding is not optional for many neurological participants. These supports enable people to safely access their community, maintain social connection, preserve routine, reduce isolation, and participate in meaningful life roles. People with disabilities already have significant barriers to participate in community activities without the added reduction in supports. Community participation is linked directly to mental health, physical wellbeing, carer sustainability which in turn effects function and support needs. Without these supports, many participants will become increasingly isolated, vulnerable, and dependent on acute health services.

The proposed restrictions on reassessment are particularly concerning for participants with degenerative or fluctuating conditions. Neurological conditions do not remain static. Functional deterioration can occur rapidly and unexpectedly. Delays in reassessment can create serious safety risks. For example, if a participant’s ability to transfer safely deteriorates we need to be able to assess for support and equipment needs in a timely manner, not wait for funding periods and a set timeframe for reassessment, whilst in the meantime the client or carer have been injured, creating more costs to both NDIS and the hospital system. Participants with complex needs are not predictable enough have such limitations.

Delayed reassessment and inadequate funding directly contribute to hospitalisation. A participant developed a mild pressure injury while awaiting plan reassessment after funding

Submission 1854

exhaustion. Without timely OT intervention and home support implementation, the injury significantly deteriorated, resulting in hospital admission with a higher-grade pressure injury. The participant remains in hospital due to insufficient funding and supports available to safely manage the condition at home. Earlier intervention would likely have prevented both the hospital admission and the increased long-term healthcare costs. Unfortunately, this type of scenario is not uncommon, even with the current systems in place, therefore it will happen to even more people with the proposed changes.

Similarly, we have supported participants with spinal cord injuries who were not allocated adequate funding to manage essential self-catheterisation needs. This is not a luxury support. It is a fundamental daily requirement for dignity, health, infection prevention, and basic human functioning. Situations like this demonstrate the danger of systems that rely too heavily on standardised frameworks or “tick-box” approaches that fail to account for real-world clinical needs.

I am deeply concerned about the Bill enabling increased reliance on automation, algorithms, and standardised assessment tools in funding and eligibility decisions. Human judgement and appropriately qualified allied health assessment are essential when working with complex neurological disability. Functional capacity cannot be accurately understood through standardised scoring systems alone. Clinical reasoning, environmental context, progression of disease, psychosocial impacts, carer capacity, and safety risks must all be considered together.

There are also significant workforce and sustainability concerns associated with the proposed reforms. The disability sector is already experiencing considerable strain following the 2024– 25 NDIS pricing and travel changes. Allied health providers delivering community-based neurological services are now performing the same travel and service demands while only receiving half the travel funding previously available. This has placed substantial financial pressure on providers, particularly small and medium multidisciplinary practices servicing regional and community-based participants. Without sustainable pricing and funding structures, the sector risks: - increased clinician burnout; - difficulty retaining experienced occupational therapists and neurological clinicians; - reduced multidisciplinary collaboration; - increased participant waitlists; - reduced access to specialised neurological services; - closure of smaller community-based providers; and - consolidation of services into larger corporate models with reduced flexibility and continuity of care. These reforms may ultimately reduce access to the very skilled workforce required to keep participants safe, independent, and living within the community. Occupational therapy and allied health supports are not simply costs within the system. They are preventative, functional, and enabling supports that reduce hospital admissions, prevent injury, support carers, maintain independence, and improve long-term outcomes.

Submission 1854

I urge Parliament to carefully consider the real-world consequences of these proposed reforms and adopt the recommendations put forward by Occupational Therapy Australia, including: - ensuring functional assessments are conducted by appropriately qualified allied health professionals; - prohibiting fully automated funding or eligibility decisions; - retaining flexible reassessment pathways; - reversing reductions to capacity building and community participation supports; - protecting therapy supports from broad future funding reductions; and - ensuring pricing reforms support a sustainable allied health workforce. The future sustainability of the NDIS cannot come at the cost of participant safety, dignity, independence, and access to essential therapy supports.

Thank you for the opportunity to provide this submission.

Yours sincerely

Occupational Therapist