Submission 2202 — Name Withheld — NDIS Future Generations Bill

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202 Submission to the Senate Community Affairs Legislation Committee Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

I am an AHPRA-registered Occupational Therapist working with NDIS participants, including people with neurodevelopmental, psychosocial and cognitive disabilities. My work includes functional capacity assessment, assistive technology recommendations and capacity building supports. I am making this submission because I am concerned that the proposed Bill may have significant unintended consequences for participants whose functional impairments are complex, contextual and not always immediately visible. I recognise the importance of maintaining a sustainable NDIS. A sustainable Scheme is essential for current and future participants. However, sustainability should not be achieved by weakening individualised planning, narrowing access, reducing preventative supports, or creating administrative processes that participants with disability cannot realistically navigate. A genuinely sustainable Scheme must also prevent deterioration, reduce crisis presentations, support families, preserve participant independence and reduce pressure on health, mental health, housing, education and child protection systems. My concerns are based on my direct clinical experience as an occupational therapist. Many participants I work with can appear superficially capable during brief interactions, while still experiencing substantial functional impairment in daily life. This is particularly common for participants with autism, intellectual disability, psychosocial disability, acquired brain injury, and other neurodevelopmental or invisible conditions. These participants may have significant impairment with executive functioning, emotional regulation, sensory processing, communication, safety awareness, self-management and daily routines. These functional impacts are often only visible through detailed assessment, observation, collateral information and consideration of how the person manages in their actual home and community environment. For this reason, I am concerned that several aspects of the Bill may move the NDIS away from individualised, functional and real-world assessment, and toward a more standardised, medicalised and compliance-driven model.

1. Individualised planning must remain central to the NDIS I am concerned about any reform that weakens the central role of individualised planning. In occupational therapy practice, individualised planning is not simply a preference or administrative ideal. It is clinically necessary. Participants with neurodevelopmental, psychosocial and invisible disabilities often have support needs that are highly contextual. Their functional capacity may change depending on their environment, routine, sensory demands, fatigue, emotional regulation, communication demands, informal supports, prompting, structure and access to assistive technology. A planning system that moves away from individualised assessment risks producing plans that may appear administratively consistent, but do not reflect the person’s actual daily life. The NDIS was designed to provide reasonable and necessary supports based on the person’s individual circumstances, goals and functional needs. If the legislative foundation for participant- directed and individualised planning is weakened, there is a risk that professional evidence,

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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202

participant lived experience and real-world functional needs will carry less weight than standardised categories or budget assumptions. This would disproportionately affect participants whose needs are less visible, particularly where their support needs relate to daily routines, self-management, communication, emotional regulation, community access or safety. I ask the Committee to ensure that the legislation retains strong and explicit protections for individualised, participant-directed planning.

2. Functional capacity must be assessed in real-world context Functional capacity cannot be accurately understood by looking at isolated task performance alone. In occupational therapy practice, function is assessed in context. A participant’s capacity is shaped by their environment, routines, sensory load, executive functioning demands, communication needs, fatigue, regulation, informal support, prompting, co-regulation and access to assistive technology. These are not peripheral details. They are often the central factors that determine whether a person can safely and reliably complete everyday activities. Assessing a person’s function without support can be clinically useful where it helps identify the support they require. However, functional capacity should not be determined by an isolated snapshot that removes the environmental adjustments, assistive technology, prompting, routines and support systems that shape daily functioning. The relevant question is not only what a person can do once without support. It is what they can do safely, reliably and repeatedly in their real environment. For neurodivergent participants, capacity is often variable rather than fixed. A participant may complete a task once in a structured setting but be unable to repeat it consistently across a week without regulation support, environmental modification or prompting. A participant may be able to describe what they need to do, but still be unable to initiate, sequence, complete or sustain the task in everyday life. A participant may appear calm and articulate in a short appointment but experience shutdown, burnout, sensory overload or emotional dysregulation when demands accumulate. This is particularly concerning for participants with executive functioning impairment. Many participants require support to plan, organise, initiate, transition between tasks, manage time, regulate emotions, respond to correspondence, attend appointments, maintain routines and complete daily activities. These impairments are not always obvious in short interactions, but they have a major impact on independence, safety and participation. If assessment processes focus too narrowly on what a participant can do in a brief, unsupported or unfamiliar assessment context, they may overestimate functional capacity and underestimate the supports required for daily life. This is especially problematic where a participant’s needs relate to consistency, safety, reliability, regulation, fatigue, prompting, sequencing or the ability to sustain routines over time. I ask the Committee to ensure that functional capacity is assessed in real-world conditions, with proper consideration of environmental barriers, assistive technology, informal supports, executive functioning, sensory needs, fluctuating disability, cumulative impairments and the person’s actual day-to-day functioning.

3. Permanence should not become a treatment-compliance test I am concerned that proposed changes to the definition of permanence may create unreasonable barriers for participants with lifelong, neurodevelopmental, psychosocial or invisible disabilities. For many participants, intervention may improve functioning in specific areas, but it does not remove the underlying disability or eliminate the need for ongoing support. A person with autism may develop

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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202

improved routines, emotional regulation strategies or communication supports, while still requiring long-term disability-related assistance. A person with psychosocial disability may benefit from treatment, while still having enduring functional impairment. A person with intellectual disability, acquired brain injury or complex developmental disability may improve with capacity building, but still require support across daily living, community access, safety and self-management. Permanence should not require a participant to prove they have exhausted every possible treatment pathway before their disability is recognised. This is especially concerning where treatment is unavailable, unaffordable, geographically inaccessible, clinically unsuitable, poorly tolerated, previously unsuccessful, or not consistent with the person’s informed consent. In practice, many participants already face barriers obtaining specialist evidence. Some cannot afford repeated specialist appointments. Some live in areas where appropriate specialists are unavailable. Some have historical diagnoses but no longer have access to old records. Some rely on general practitioners or allied health professionals because specialist services are inaccessible. Some experience fatigue, anxiety, trauma, communication barriers or executive functioning impairment that makes repeated assessment processes extremely difficult to navigate. There is also a risk that capacity building supports may be misunderstood as treatment that must be completed before a person is accepted as having permanent disability. This would be inappropriate. Capacity building is often required because the person has a permanent or enduring disability. It should not be used as a reason to delay or deny access to disability support. I ask the Committee to ensure that permanence requirements do not become a treatment- compliance test. Participants should only be expected to consider interventions that are evidence- based, clinically appropriate, reasonably available, financially accessible and consistent with free and informed consent.

4. Occupational therapy, assistive technology and capacity building are preventative supports I am concerned that the Bill may contribute to a reduction in access to therapy, assistive technology, capacity building and community participation supports, particularly if planning becomes more standardised or funding reductions can be applied broadly to categories of support. In my experience, occupational therapy and capacity building supports are often preventative. They assist participants to develop routines, increase independence, improve safety, reduce reliance on informal carers, access the community, build daily living skills, manage sensory and emotional regulation needs, and reduce crisis escalation. Assistive technology can also be essential for independence and safety. For participants with neurodevelopmental, cognitive, psychosocial or invisible disabilities, assistive technology may support memory, organisation, communication, prompting, regulation, personal safety, meal preparation, medication routines, transport use, community access and participation. These supports should not be viewed as optional extras. They often reduce longer-term reliance on more intensive supports. They can prevent functional deterioration, reduce carer burnout, support family stability and reduce pressure on health, mental health, housing and crisis systems. For example, a participant who receives appropriate OT input may be better able to establish routines for meals, hygiene, household tasks, appointments and community access. A participant who receives suitable assistive technology may require less direct prompting or supervision. A participant who receives capacity building support may develop safer routines and reduce the likelihood of crisis-driven intervention. If these supports are reduced, the apparent short-term saving may be outweighed by increased downstream costs. These costs may appear in hospital presentations, mental health crises, housing

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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202

instability, family breakdown, increased informal carer burden, reduced participation and greater long-term support needs. I ask the Committee to ensure that the legislation protects access to occupational therapy, assistive technology, capacity building and community participation supports where these supports are reasonable, necessary and linked to the participant’s functional needs and goals.

5. Broad funding reductions should not override individual need I am concerned about any mechanism that would allow broad percentage-based reductions to categories of supports without individual reassessment of participant need. Participants do not use supports in the abstract. Supports are connected to daily routines, safety, participation, family sustainability, carer burden, communication, regulation, skill development and community access. A reduction that appears modest at a policy level may have significant consequences for an individual participant. For some participants, a reduction in support worker hours may mean they no longer have reliable assistance to attend appointments, shop for food, participate in the community or maintain routines. For others, a reduction in therapy may mean loss of capacity building at a critical point. For participants with psychosocial or neurodevelopmental disability, reduced community participation support may increase isolation, dysregulation, functional decline and mental health risk. The concern is not only the amount of funding. The concern is whether the person’s actual functional needs are assessed before supports are reduced. A category-level reduction risks treating participants as budget units rather than individuals with distinct circumstances, risks and support requirements. I ask the Committee to ensure that funding decisions remain based on individual functional need, evidence and reasonable and necessary criteria, rather than broad category-level reductions.

6. Reassessment, suspension and compliance processes must recognise disability-related barriers I am concerned that reassessment, suspension and compliance processes may unintentionally penalise participants for the functional impacts of their disability. Some participants I work with have impairment with initiation, planning, organisation, communication, emotional regulation, correspondence management and system navigation. These barriers can directly affect their ability to respond to phone calls, emails, letters, forms, review requests, evidence deadlines and administrative instructions. For these participants, missed contact should not automatically be interpreted as disengagement or non-compliance. It may reflect executive functioning impairment, burnout, psychosocial deterioration, cognitive impairment, communication barriers, trauma, homelessness, family stress, sensory overwhelm or lack of informal support. A system that suspends or reduces supports because a participant has not responded may increase risk rather than resolve it. Loss of support can lead to deterioration, carer breakdown, missed appointments, reduced daily living capacity, mental health decline, housing instability and increased crisis involvement. Compliance processes should be accessible, proportionate and trauma-informed. Participants should have access to advocacy, support coordination or other assistance to understand and respond to requests. The NDIA should be required to make genuine accessible communication attempts before any adverse action is taken. This should include consideration of the person’s disability, communication preferences, support network and known barriers. Page 4 of 6

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202

I ask the Committee to ensure that reassessment, suspension and compliance provisions include strong safeguards, accessible communication requirements, advocacy pathways and human review before supports are suspended or reduced.

7. Automation must not replace professional judgement and human review I am concerned about expanded automation and algorithmic decision-making within the NDIS, particularly where decisions relate to eligibility, planning, funding or support allocation. Automated systems may be useful for low-risk administrative functions. However, they should not replace professional judgement, participant lived experience, clinical reasoning or individualised assessment. Disability is often complex, contextual and fluctuating, particularly for participants with neurodevelopmental, psychosocial, cognitive and invisible disabilities. A standardised or automated system may not properly recognise executive functioning, sensory processing, communication barriers, fatigue, emotional regulation, environmental demands, informal support breakdown or cumulative functional impact. It may also make it harder for participants and clinicians to understand why a decision has been made. I ask the Committee to ensure that automated systems are not used to make or materially determine eligibility, planning or funding decisions without transparent reasons, human oversight, appeal rights and independent review.

8. The Bill may disproportionately affect participants with invisible and neurodevelopmental disabilities Across the proposed reforms, I am particularly concerned about the cumulative impact on participants whose disabilities are not immediately visible. This includes participants with autism, intellectual disability, psychosocial disability, acquired brain injury, trauma-related disability, neurological conditions, fatigue-related conditions and complex developmental profiles. These participants may already experience barriers being understood within short assessments or highly administrative processes. A system that places greater weight on standardised assessments, treatment history, administrative compliance, automation or broad funding categories risks under-recognising people whose support needs require nuanced, contextual and functionally informed assessment. I ask the Committee to ensure that the legislation explicitly protects participants with invisible, fluctuating, neurodevelopmental, psychosocial and cognitive disabilities from being disadvantaged by standardised, medicalised or administratively rigid processes.

Conclusion I support the goal of a sustainable NDIS. However, sustainability should not be measured only by reduced Scheme expenditure. A sustainable NDIS must also preserve independence, safety, dignity, participation, family stability and access to reasonable and necessary supports. From my perspective as an occupational therapist, the Bill should not proceed in its current form without stronger safeguards. I am concerned that the proposed reforms may weaken individualised planning, narrow access for people with invisible and neurodevelopmental disabilities, reduce the practical value of functional evidence, increase reliance on standardised or automated decision- making, and create compliance processes that some participants cannot realistically navigate because of the functional impacts of their disability.

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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 2202

I respectfully ask the Committee to recommend amendments that:

1. Retain strong legislative protections for individualised, participant-directed planning.
2. Require functional capacity to be assessed in real-world context, including environmental factors, assistive technology, executive functioning, fluctuating disability and support systems.
3. Ensure permanence requirements do not become treatment-compliance tests.
4. Protect access to occupational therapy, assistive technology, capacity building and community participation supports where these supports are reasonable and necessary.
5. Prevent broad funding reductions from overriding individual assessment of functional need.
6. Ensure reassessment, suspension and compliance processes include accessible communication, safeguarding review, advocacy access and human oversight.
7. Prohibit automated systems from making or materially determining eligibility, planning or funding decisions without transparent reasons, human review and appeal rights.
8. Explicitly protect participants with invisible, neurodevelopmental, psychosocial, cognitive and fluctuating disabilities from being disadvantaged by standardised or overly medicalised assessment models.

The NDIS should remain a Scheme that recognises the real-life functional impact of disability. For many participants, particularly those with neurodevelopmental and invisible disabilities, support needs are not always obvious at first glance. They are seen in the daily work of planning, initiating, regulating, communicating, maintaining routines, staying safe, participating in the community and sustaining independence over time. I urge the Committee to recommend changes that preserve the individualised, functional and participant-centred foundations of the NDIS while pursuing sustainability in a way that does not shift costs and risks onto participants, families, unpaid carers, providers and crisis systems.

Kind regards, (B Occ Thy) | Occupational Therapist (AHPRA: ) 29 May 2026

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