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

Submission 2115

To the Senate Committee,

Re: Submission regarding proposed changes to the National Disability Insurance Scheme (NDIS) via the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026. My name is Nicole, I am an Occupational Therapist who has been supporting people with disabilities in our community since 2014. I have seen first hand the incredibly positive impact of the NDIS since its inception and implementation. I am writing to express significant concern regarding the proposed reforms and legislative changes to the NDIS. I work closely with people with disability and see the complexity of functional impairment, environmental impacts, support needs, and the realities faced by participants and families every day. These proposed changes risk moving the Scheme further away from individualised, evidence-based disability support and toward a rigid, impersonal system that does not reflect real-world disability impacts.

National Disability Insurance Scheme Amendment Bill 2026

Submission 2115

assessments and make determinations regarding disability support needs. Understanding the interaction between person, environment, career/occupation underpins occupational therapy practice disability assessments. This something unqualified assessors do simplistic tools Removing properly qualified processes places participants at significant risks.

Recommendations:

• Continue utilise qualified OTs other allied health medical professionals expertise experience provide comprehensive accurate assessments participant. Ensure there method review / appeal decisions relating NDIS plans Agency does get right reasonable mechanism such as s100 process ART. The proposed redefinition functional capacity alarming asking disregard participants’ experiences manage impairments caused disabilities reducing thoroughness of creates dangerous situation where unqualified individuals may making determination about function without ever meeting observing speaking meaningfully them supports instead rely heavily self-reports are not always inaccurate opportunity identify inaccuracies through observation clinical reasoning These reforms appear move away International Classification Functioning (ICF) understanding within broader context activity participation environment The changes redefine what a can do isolation environmental factors influence day-to-day functioning is reflective real life must be considered in context There also concern broad powers granted future rules classifications have released Different thresholds assessment methods inflexible systems fail meet real disability support Variable capacities different environments situations critical reality many people with cannot simply ignored.

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

Submission 2115

Recommendations:

• Ensure that functional capacity assessments consider environmental context, assistive technology needs informal supports efforts limitations social regulation fatigue sustainability function over time.
• Utilise qualified assessors including OTs other allied health medical professionals with expertise experience provide comprehensive accurate assessments participant.
• Recognize fluctuates invisible disabilities masking presentations impact effectiveness one-off telehealth assessment.
• It is vital safety sustainable participation real-world functioning when assessing capacity.

The proposed changes permanence appropriate treatment requirements also deeply problematic idea treatments financially geographically inaccessible could be considered “appropriate” exclude from scheme if they haven’t undergone them dangerous ignores genuine barriers such as financial limitations workforce shortages transport access culturally safe care trauma histories lack specialist services these extremely common particularly rural regional areas low-income participants which accounts many NDIS participants unable work disability reforms appear manifestly unfair toward those simply cannot access demands of them there clarity around constitutes reasonable treatment nor who will making decisions about what can reasonably excluded necessary services and puts large cohort Australians profound risk risks becoming exclusionary classist ## Recommendations: - Clarify definition “appropriate” entail ensuring participants aren’t excluded or disadvantaged due to financial geographic location inability specialists medication side effects.

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

Submission 2115

• Recognition that disability may be permanent but there remains a role for ongoing therapy or rehabilitation activities to maximise function. This does not imply disappearance; rather it often means necessary therapies/treatments maintain function reduce decline or enhance participation/quality-of-life.

Ensure treatment expectations stay realistic/evidence-based accessible. The proposed changes in Reasonable Necessary criteria also concern us greatly: Introduction lower-cost comparable support without maintaining “same outcome” requirement risks undermining individualised provision Cheaper doesn’t necessarily meet needs If selected based on cost over outcome participant’s safety/independence/wellbeing will suffer.The hierarchy prioritising peer-reviewed evidence above participant experience clinical reasoning is concerning especially complex behaviours/support ratios/specialist assistive tech where research base lacks Lived experiences matter No two participants have identical needs Risk planners reject supports despite strong specific evidence because not meeting narrow research criteria Conversely research alone isn’t enough to ensure appropriateness of any given support The person must remain at centre of scheme Individualised needs and evidence are essential achieving good outcomes Removing flexibility/person-centred decision-making inevitably leads inappropriate supports/participant deterioration greater long-term costs Recommendations: Ensure “comparable” provide equivalent safety, functional benefit sustainability & participatory outcomes. Participants should never forced unsafe ineffective inappropriate unsustainable value money considerations include quality life dignity independence&long term particpation outomes.

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

Submission 2115

Changes to what may be considered a parental responsibility and the increased reliance and pressure on informal supports is also deeply worrying. Families are already providing substantial care. Expecting parents or family members to continue filling increasing gaps in formal support is unrealistic and harmful.The intensity,frequency,and complexityofcarerequiredformanychildrenandadultswithdisabilityisfundamentallydifferentfromordinary caregivingresponsibilities. Manyparticipantsrequiresupportwellbeyondwhatisepectedinordinaryparentingorfamilycare.Delayedskillacquisition.extensiveprompting.behaviouralsupports.personalcaresupervision.and safetymonitoringcancontinuefarbeyontypicaldevelopmentallstages.Parentsandcarerscannotrealisticallyprovideintensive.support24hoursperdayindefinitely.Thesereformsfailtoadequatelyrecognizetherealityandriskplacingenormousstrainon families.particularlywomen.whilenegativelyimpactingtheircapacitytomaintaintheirown personalandsel-care.engagementinemaningfulactivities,andalternatepaidemployment. Recommendations:

• Recognisethedifferencebetweenordinaryparentingtasks,and disability-related car-intensitycomplexity. Ensureconsiderationofcargiverburden.sustainability.sleep disruption.emotionalexhaustion.behavioural-complexity,andworkforceparticipation impacts.

• Ensurebehavioursupporthemotionalco-regulationhigh-intensity supervisionneedsappropriatlyrecognizedas-disabilityrelated-support demands.*

• Ensuredecision-makingconsidersthecumulativeimpactofcarendments impactonsiblingsandfamilywellbeing.long-term sustainability ofinformalc carearrangements* TheproposedpowersrelatingtominimumfundingamountssUPPORT ratios.or capped levels off supportareanothersignificantconcern.Thesemeasuresignoretherealitythattwoindividuals withsimilardiagnosissonpapermayhavevastlydifferentsupportneedsinpractice.Som participantslegitimatelyrequire 2:1or3:supportsdue to behavioural risks.complextmedical needs.or safety concerns.Cappingsupportswithout individualisedassessmentplaces participantssupporworkers.and thebroadercommunityatriskoharm.

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

Submission 2115

The proposed powers allowing the Minister to reduce or remove funding for entire groups or classes of support represent a substantial legislative overreach. This includes concerns regarding community participation supports: Their enabling meaningfull participation in communit life nd suppor people wth disabilti engage n societ ythe same way os others.

Th suggestion tht fundng f these suports could be reduced r removed, wih t power fo Minster decd this cld b reducd upo % is deeply alarming. Community participatns sre essntal dly lfe suspts They enble partncrs ts shop fr food dtt apptmnts accss hltchrc, maint snfety nd ptpctpn i socit . Many pnrtcipnts rqur both tn comunity at home. Their need dt mkn gtsst ss, svpvsion prsnl cr, ds nt dprr on loctn What you llk ly end u see ng that pticipants will qhr higher levls Asssitw Dyl Lif fnidg plce Scl Ecnm Cmmty Ptciptn fnidg It sl an incrbl shrt-sghted propsd chgn th won’t sav sigfn cant mnths o the Schme but wil negtvtl mpact a lg coh rt of participants isolting them fm their cmmties. The trsnsfr pf prcng authty to thr Mnr rather than n indpdent bd also rs cs rngtrng transprncy and cntbility Notably rcmdtions rgrdng pricing rform hv not bn pblicly relsed dsplt reqsts. Recommendations:

• Ensure any ministerial funding powers include transparency review mechanisms clinical oversight md meaningful consultation. Avoid blanket percentage-based funding reductions that ignore individual needs safety risk sustainability d environmental context. Avo benchmarkd or cped fundng approaches tssum pts wth simil diagnses hve sml support nds. Ensure fndng decisons contnue tp pritse indivldulised funcnl ssessmnt ocptnal pnctpn sgfgrndng nd lng-trm sustntbilty. Ens preventative therapy pd ptcpntion suspts remn recogzcd as crtical cmpnts df disablt supprt.

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

Submission 2115

The proposed reforms fail to adequately recognise the importance of whole-of-person assessment. The Administrative Review Tribunal has previously reinforced the importance of considering the whole person and the real-world impact of disability. People cannot be compartmentalised into isolated impairments without considering how those impairments interact. For example, where a participant requires bariatric equipment due to intersecting disabilities and health conditions, these factors cannot simply be excluded from consideration because they do not fit neatly into a narrow definition. Disability is complex, interconnected, and individual.

Recommendations:*

• Ensure the legislation recognises the interaction between impairment, environment, participation barriers, and support needs. Avoid overly narrow interpretations that separate disability from real-world context.* Maintain alignment with the social model of disability and occupational participation principles. Ensure supports that prevent crisis, safeguard risk,social isolation, or unsafe living arrangements remain recognised as disability-related supports. The proposed processes for requesting additional supports during a plan period are concerning.A90-day decision timeframe is far too long for participants experiencing rapid deterioration,housing instability, behavioural escalation, or support breakdown.Delays of weeks or months may place participants at significant risk of harm.The requirement for “significant change”may also unfairly disadvantage participants experiencing gradual decline, fluctuatingconditions,or accumulating risk factors.There appears to be no clear urgent review pathway.Temporary changes suchas informal carers becoming unavailable dueto illness orespite needssstill have veryreal impacts onparticipantsandcannotsimplybedismissed.

Recommendations:* Retain shorter reassessment decision timeframes,presumably where safety orcrisisis present.* Createclearurgentreassessmentpathwaysforsafeguardingconcerns,hospitaldischarge,carerbreakdown,housinginstability,behaviouralescalation,andsignificanfunctionaldeterioration.* Ensuringradualcumulativeandfluctuatingschangescan stilltrigger reassestment.

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

Submission 2115

• Ensure evidence requirements remain realistic and accessible.
• Ensure reassessment systems remain responsive to real-world risk, not just administrative thresholds. There are also substantial concerns regarding proposed pricing and quality changes, including panel arrangements for SIL and plan management providers, which may disproportionately harm small businesses and reduce participant choice and control.The proposed registration and enrolment systems must also become affordable and accessible particularly for smaller providers and sole practitioners who play critical roles within the disability sector.Finally, foundational supports remain unclear and underdeveloped yet participants are already being removed or excluded from the Scheme without those replacement supports being in place.This is putting people at risk of severe harmwith some reporting suicidal isolation due tothe proposed changesand fear aroundtheproposedchanges.These reforms collectively increase reliance on unpaid informal supportsreduce individualised careweaken safeguardsforparticipantsfamiliesandrisk excluding vulnerable peoplenecessary essentialsupports.Theyalso risking undermining early interventionandeffectivesupport deliverywhich will likely increaselong-term costsnegative outcomesTheNDIS wasdesignedtosupportpeople withdisabilitytolive safemeaningfulparticipatory livesTheseproposed changesshow awayfromindividualisedevidence-based disabilitysupporntowardrigidsystemsthat failto reflect complexityofreal human functioning The short consultationandsubmission timeframe surrounding these reformshasnegatively impactedpeoplewith disabilitiestheir familiesand providerseffortsto understandandrepondohighly complex legislative changesthisis not been a collaborativeco-designedor transparent processat all Itisnot faultparticipantsthe government couldaccurately forecast thenumber

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2115

vulnerable and marginalised group in the way that these reforms would. Removing funding from this group does not reduce the need for support. It instead leaves people with no where to turn.

We can all acknowledge that changes are needed in the NDIS space to protect those participants who need it most. The proposed changes are not an ethical solution to the\Schemes fundamental issues. Reform around inefficient internal processes, inability of the
dis to meet any of their own timeframes for review and decisions, and review of the high spend relating to legal fees disputing reasonable and necessary participant supports would be a much more effective, effective approach to these reforms.