NDIA Accountability Project

Occupational therapist raises concerns about impact on clients with degenerative conditions and complex needs

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

Submission 2005

Dear Committee Members, I am writing as a practising occupational therapist to express my serious concerns about the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

Who I Am

I am an occupational therapist working directly with NDIS participants, including children, adults with degenerative conditions, and individuals with complex and high support needs. I work daily with participants and their families to assess functional capacity, support safety, and enable meaningful participation in everyday life. So

If you’re doing My concerns relate to the parts of the Bill that would:

  • Reduce capacity building daily activity supports
  • Reduce social, civic and community participation supports
  • Restrict plan reassessments to “exceptional circumstances” Raise eligibility thresholds in ways that narrow access to the Scheme Occupational therapy assessments are not administrative processes — they are clinical investigations that explore an individual’s real-world functional capacity, safety risks, and ability to live a meaningful life. This Bill risks replacing that professional judgement with standardised tools and ministerial rules that cannot capture the complexity of individual need.

Of particular concern is the Bill’s failure to account for a participant’s lack of insight into their own functional abilities and limitations. Many of the people I support are unable to accurately self-report what they can and cannot do safely. Without a qualified professional conducting a thorough assessment, funding decisions will be based on inaccurate information, resulting in supports that do not reflect the person’s actual needs — and in many cases, placing them at serious risk of harm or death.

I am also deeply concerned about the impact on families and carers. The burden carried by families supporting individuals with high and complex needs is already at crisis point. Many carers I work with are experiencing severe mental health deterioration as a direct result of inadequate support. This Bill does not acknowledge the extraordinary nature of this caring role and risks further harm to entire family units.

For clients with degenerative conditions, the restriction of unscheduled reassessments is particularly dangerous. Their needs will inevitably increase over time. Limiting access to review means their plans will become misaligned with their functional status, leaving them without the support required to remain safe.

I am also concerned about the broad ministerial powers introduced by the Bill, which could be used to further restrict supports — including therapy — in the future, without transparent or individualised decision-making processes.

A Real-World Example

I support a single mother raising four children, including twins with autism spectrum disorder and intellectual disability. One twin regularly absconds from the home; the other has attempted to set fire to the home. Due to their diagnoses, neither child understands their actions or the consequences. The family cannot leave the home to access the

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

Submission 2005

The mother is unable to shower or use the toilet whilst her children are home without placing them at serious risk. The two siblings without disability are now medicated for severe anxiety as a direct result of the stress and lack of support in the household.

This is not ordinary parental responsibility. Under the proposed changes, this family’s situation may be classified as a parenting matter rather than a disability support need. That classification would be catastrophically wrong and would leave this family in a genuinely dangerous situation.

The broader picture

NDIS supports have allowed many of my clients to build their capacity, enter employment, and participate in their communities. Cuts to capacity building and participation supports will reverse this progress — increasing long-term costs to government through increased unemployment, increased reliance on crisis services, and avoidable hospitalisations.

I also wish to raise that occupational therapists have not received a pay increase since the NDIS began, despite significant increases in the cost of living. Sustainable pricing reform is essential to maintain a qualified allied health workforce capable of delivering the assessments and supports the Scheme depends upon.

What I am asking Parliament to do

I urge Parliament to:

  • Remove or substantially constrain the proposed reductions to capacity building and community participation supports Retain accessible pathways for plan reassessment and review that reflect the reality of fluctuating and degenerative conditions
  • Ensure that all eligibility and funding decisions are based on assessments conducted by appropriately qualified allied health professionals, including occupational therapists
  • Prohibit fully automated or algorithmic decision-making without qualified human oversight
  • Reject any provisions that classify complex disability support needs as ordinary parental responsibility
  • Address sustainable pricing for the allied health workforce I encourage the Committee to adopt Occupational Therapy Australia’s recommendations and to recognise the critical role that occupational therapists play in ensuring the NDI$ delivers safe, individualised, and clinically appropriate outcomes.

Thank you for the opportunity to contribute to this inquiry. Yours sincerely,

Occupational Therapist.