Submission 2114

Submission to the Senate regarding the proposed NDIS Bill

28th May 2026

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

To the Senate Committee,

I write this submission in my capacity as an Occupational Therapist working with Australians living with complex disabilities across community settings. Through my clinical role, I regularly support participants and families experiencing significant functional impairment, vulnerability, psychosocial stress, behavioural complexity, environmental barriers, and carer burnout.

I acknowledge the importance of ensuring the long-term sustainability of the NDIS. However, I hold significant concerns that several proposed amendments within the Bill risk unintentionally disadvantaging vulnerable Australians living with disability and may create increased long-term human, social, and economic costs.

In my clinical experience, disability cannot be understood outside of the real-world context in which people live. Functional capacity is not determined solely by what a person can demonstrate during isolated assessment tasks. Many participants function only because extensive supports, routines, environmental modifications, behavioural co-regulation, assistive technology, and informal care arrangements are already in place.

I am particularly concerned by the proposed redefinition of functional capacity, which appears inconsistent with the World Health Organisation International Classification of Functioning, Disability and Health (ICF). Occupational Therapy practice is grounded in the understanding that function occurs through the interaction between body functions and structures, activities, participation, environmental supports, and personal circumstances. Removing these factors from consideration risks creating an artificial and inaccurate picture of disability.

This may disproportionately disadvantage individuals with:

• Autism spectrum disorder;
• Intellectual disability;
• Psychosocial disability;
• Acquired brain injury;

Submission 2114

• Degenerative neurological conditions;
• Executive dysfunction; and
• Fluctuating or invisible disabilities.

I am also deeply concerned regarding increased reliance on standardised assessments and the potential for these assessments to be conducted by individuals without appropriate tertiary qualifications, regulated clinical training, or professional scope of practice in functional assessment. Functional capacity assessment requires advanced clinical reasoning and cannot be reduced to checklist-style observations completed outside the context of a participant’s daily life and support environment.

Further concern exists regarding proposed changes to permanence and “appropriate treatment” requirements. Many lifelong disabilities require ongoing therapy, rehabilitation, behavioural intervention, psychology, medication, or allied health support to maintain function, reduce decline, or preserve safety and participation. Ongoing treatment should not be interpreted as evidence that a disability is temporary.

I am particularly concerned that the Bill appears to allow treatments to be considered “appropriate” even where they are not realistically accessible due to:

• Financial disadvantage;
• Rural and regional workforce shortages;
• Long waitlists;
• Geographic isolation; or
• Lack of specialist availability.

This risks creating inequitable access pathways where participants may be denied support based on theoretical treatment availability rather than realistic accessibility.

Additionally, I hold concerns regarding increased reliance on informal supports and the reframing of highly complex disability-related care as “ordinary parenting” or family responsibility. In practice, many families are already providing unsustainable levels of supervision, behavioural support, emotional co-regulation, manual handling, overnight care, and safety monitoring far beyond what would ordinarily be expected.

Reducing formal supports does not reduce disability-related need. Instead, it risks transferring burden onto families already operating beyond sustainable capacity, increasing the likelihood of:

• Carer burnout;
• Mental health deterioration;
• Hospitalisation;
• Housing instability;
• Safeguarding concerns; and
• Crisis-driven intervention.

As a clinician, I am concerned the proposed amendments risk shifting the Scheme away from person-centred and whole-of-person assessment principles toward increasingly narrow, standardised, and administratively driven decision-making frameworks that fail to adequately recognise the complexity of disability and lived experience.

I respectfully urge the Senate Committee to reconsider amendments that:

• Narrow the interpretation of functional capacity;

Submission 2114

• Reduce recognition of environmental and contextual factors;
• Overemphasise standardised assessment processes;
• Restrict recognition of permanence;
• Increase reliance on informal supports; The NDIS was established to support participation, safety, dignity, inclusion, and independence for Australians living with disability. It is critical that future reforms preserve these principles and remain grounded in evidence-based, person-centred, and clinically informed practice.

Thank you for the opportunity to provide this submission.

Kind regards,

Katerina Cook

3 of 3

A: Unit 19/91 Poinciana Ave, Tewantin QLD 4565 E: admin@heroeshealth.com.au