NDIA Accountability Project

Occupational therapist concerns regarding participant safety and access to supports

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

Submission 1962

SUBMISSION: NDIS FUTURE GENERATIONS BILL 2026

As an Occupational therapist I wish to raise concerns about the NDIS Future Generations Bill 2026.

The following raise concerns for both me and the NDIS participants that I support:

  • Redefining Functional Capacity: assessment of what a person can do without assistance from others, without assistive technology and excluding environmental and personal circumstances raises concerns that participants may appear ‘functional’ in isolated settings while remaining unsafe or unable to participate in meaningful activity. I work with participants with brain injury who might be assessed in the morning and appear to be more independent than they would be if assessed in the afternoon when they have cognitive and physical fatigue, are at increased risk of injury due to poor decision making or physical weakness. Another example is of a client who can independently mobilise within their home due to home modifications having been completed and making it accessible but require support in the community due to inaccessible environments. Participants I work with function safely only because of the extensive supports and adaptations already in place.

  • Tightening the Definition of “Permanent” Disability: As an Occupational Therapist I regularly work with participants who have lifelong permanent disability who continue to require interventions. I am concerned about the requirement for participants to have exhausted all ‘appropriate treatment’ before impairment is considered permanent. Ongoing engagement in therapy and medical interventions is required by people with lifelong disability to maintain function, reduce decline or improve quality of life. Ongoing treatment should not prevent access to disability supports.

  • Supports Must Arise “Directly” from Impairment: In my experience in practise the need for disability supports often arises through the interaction between impairment and environment rather than impairment alone. For example, a client with cognitive impairment due to a brain injury often requires support when out in the community to find their way, monitor appropriateness of interactions, whereas at home their need for this support may be less due to being in a familiar environment. I have concern that this wording contracts the interpretation of disability-related need and reduced recognition of the real world context in which disability occurs.

  • Changes to “Value for Money”: Whilst I acknowledge a need to make the scheme sustainable, I am concerned that this provision may prioritise lower cost supports, when these are not able to provide the same safety, independence or provide long term sustainability. As an Occupational Therapist I regularly find that cheaper alternatives are not always truly comparable and lead to increased safety risk. Eg: a cheap shower commode without appropriate postural support for a client who requires increased manual handling by carers to maintain their safety in the equipment.

  • “Effective and Beneficial” Evidence Hierarchy: In an ideal world we would have research evidence for every detail of what we do as therapists. This is not the case in reality.Whilst research evidence is used when required and available as an Occupational Therapist, I find it essential to give equal weighting to participant specific clinical reasoning and lived experience as many participants have individualised support needs that may not fit into the research evidence.

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

Submission 1962

  • Increased reliance on informal support and parents: In my clinical experience informal supports provided by family, spouses always result in care giver burden and burnout. It is not reasonable that a family member has to have their own quality of life affected by the need to provide specific disability support for their family member. The majority of participants I work with have family members already providing significant levels of support which is unsustainable and any increase in the expectation will likely result in the need for increased formal support due to burnout and adverse health effects for the family member providing the informal support.

  • Change to Whole of Person Assessment: I am concerned about the Scheme moving away from whole of person assessment. In my experience support needs arise from the interaction between multiple impairments, environment barriers and participation requirements. As an Occupational Therapist I have significant experience in assessments and know that thorough assessment of the person, their environment and participation contexts are vital to ensure that participants have appropriate levels of support to function safely.

  • Controlling the Scheme and Plan Inflation: I have concern that the planned extension of reassessment decision timeframes from 21 to 90 days may result in participants without appropriate and adequate supports during times of crisis; if they have a period of deterioration or due to carer burnout and inability to provide informal supports.

  • Funding Cuts, Funding Caps and Ministerial Powers: I have grave concerns around the proposed funding reductions and funding caps participants or groups of participants. Removal of funding and support does not remove a person’s need for support. Removal of community/social support will impact participant’s ability to go out into the community to do their shopping; attend appointments; complete essential community based tasks. This funding support is not just about leisure and cutting this funding sends a message that people with a disability are not to be seen out in the community. The use of generalised assessment for disability groups will not allow for individual and differing functional needs of people with the same diagnosis or impairment. For example I work with participants with cognitive impairment – functional ability can range from being mostly independently with daily tasks and support occasionally to someone who is completely dependent and requires 24 hour support. Participants often have multiple impairments and differing combinations results in vastly differing support needs between individuals. There is concern that funding reductions will result in insufficient support to maintain safety, participation and independence. Provision of supports I have been able to provide participants has resulted in mobility independence within their homes and community (via driving and vehicle modifications); safety for the participant and their support workers; increased participation in daily life and activities.

I want Parliament to change the proposed bill to ensure that participants have thorough individualised assessment to capture their functional needs; no blanket reductions to participants funding or access to occupational therapy, capacity building or community participation supports.