Submission 285 — Occupational Therapy Australia (285

NDIS Amendment (Securing the

NDIS for Future Generations)

Bill – OTA Supplementary

Submission – July 2026

Introduction

About Occupational Therapy Australia

OTA is the peak membership body       representing  occupational therapists nationally. We empower and

elevate over 34,000 exceptional professionals who in turn work in partnership with individuals and

communities to enable meaningful participation in the activit                ies of life.   We’re the single, unifying

connection point for    occupational therapists     in the nation, leading the profession through education,

support, and advocacy, so every         occupational therapist      is informed,   inspired and fulfilled in their

profession.

As one of Australia’s largest allied health workforces, occupational therapists provide essential supports across primary care, aged care, disability, mental health, veteran care and more.

About Occupational Therapy

Occupational therapy is a person -centred health profession concerned with promoting health and wellbeing through participation in occupations. Occupational therapists achieve this by working with participants to enhance their ability to engage in the occup ations they want, need, or are expected to do;

or by   modifying  the occupation or the environment to better support their occupational

engagement. Occupational therapists provide services across the lifespan and have a valuable role in

supporting participan     ts affected by developmental disorders; physical, intellectual,              chronic  and/or

progressive disability; and mental health issues.

Occupational therapists are highly skilled in assessing the degree to which a person’s disability affects their level of function in daily tasks. Given their expertise and area of practice, many occupational therapists deliver services funded by the NDIS. Services focus on promoting independence in activities of daily living and enablement of social and economic participation. These services may include functional

capacity assessment and intervention; disability       -related chronic disease management; prescript       ion and

implementation of assistive technology and/or environmental modifications; mental health interventions;

positive behaviour support;    driving assessments (when specifically trained to do so); and targeted, goal               -

focussed rehabilitation.

NDIS Amendment Bill 2026   – OTA Supplementary Submission    – July 2026                                                             2

Recommendations

1. OTA recommends inserting an additional line requiring that NDIS rules specify that assessors hold relevant health qualifications.

2. OTA recommends amending subsection 45C(17) to require the Minister seek and publish written advice from an independent body – such as IHACPA - or input from allied health peaks, before making a

pricing determination.

3. OTA recommends inserting “must have regard to any existing regulatory obligations of the provider under a Commonwealth or state law” into the Bill’s compliance enforcement provision.

Report

Occupational Therapy Australia (OTA) welcomes the opportunity to provide additional feedback on the (‘the Bill’) to the Senate Community Affairs Legislation Committee. We acknowledge the Committee Secretariat for its work supporting this inquiry, including reviewing a substantial volume of responses within a short consultation period.

OTA maintains   our serious concerns with the Bill         , which  remains  insufficiently safeguarded and      overly

centralised. It introduces changes that would restrict participant access and place considerable pressure on the occupational therapy workforce.

The 13 recommendations outlined in    our original submission     call for amendments that protect participant

access and choice, ensure occupational therapists and allied health professionals play a central role in assessment and reform design, constrain broad ministerial powers over funding and pricing, and reduce reg ulatory burden on allied health practitioners. We continue to advocate for those 13 recommendations.

Interim Report

OTA has  closely  followed  the  Bill’s progression through Parliament and the        Senate Community Affairs

Legislation Committee. Since our original submission,     OTA has analysed the Bill further,  engaged with MPs,

ministers and senators, read published submissions,        observed hearings,   and reviewed the  Committee’s

interim report.  We welcome   recent  minor amendments to the Bill that       strengthen   safeguards and

protections for participants .

Alongside over 4,000 submissions, including many from occupational therapists at the frontline of service delivery, we have advocated strongly for changes to the Bill. Even within the limited time available, the weight of that evidence was clear and consistent - the Bill poses serious risks to participant safety,

independence, and human rights.       OTA has yet to see   the Inquiry meaningfully address this feedback.     A

Bill that fundamentally reshapes access, funding, and oversight across the NDIS deserved a stronger

response   , reflecting   the scale and significance of concerns raised.         OTA cannot support a       Bill  that

NDIS Amendment Bill 2026   – OTA Supplementary Submission    – July 2026                                                             3

continues to prioritise budget savings and growth reduction targets at the expense of participant wellbeing and access to supports .

The interim report defers questions about the Bill’s most controversial provisions to future rules, the

Technical Advisory Group, and Explanatory Memorandum clarifications.  While the Committee

acknowledged widespread community concern, it has not recommend ed any amendments to the Bill itself

before it passes.   This suggest  s a preference for legislative momentum over legislative rigour            .

The inquiry  also operated under compressed timeframe      s, with submissions open for just 11 days       , and the

reporting deadline extended twice. OTA welcomes this extension         as an  opportunity for the Committee to

receive additional feedback and genuinely address these concerns in its final report. OTA also requests

the opportunity to engage directly with the Committee during      these additional hearings.   This time must be

used  to hear  further witnesses and evidence,     and address  feedback from   people with disability,    their

families, advocates    , service providers,  and organisations.

Recommendations

The interim report  acknowledged widespread concerns       for participant safety, independence and human

rights. These outcomes rely on a stable, well -supported occupational therapy workforce and viable

provider base to deliver them.     If the Bill proceeds   , OTA recommends   incorporating  three amendments  that

mitigate the workforce and provider pressures most likely to compromise participant outcomes if left unaddressed. Without action, these negative impacts will compound, and will ultimately impact the participants the Scheme is intended to support.

The changes proposed    in this Bill  will further limit access to qualified OTs       , who deliver supports at the heart

of the frontline of the NDIS, every day, across every state and territory. They face mounting workforce

pressures   - our members tell us they can no longer sustain NDIS work under the current conditions.         More

than 7000 participants lost access to essential       occupational therapy   supports in 2025 because    providers

simply can’t afford to stay.

The reforms in this Bill   also point to a broader pattern of regulatory complexity      affecting  small businesses

across the disability sector.    For a sector already operating on tight margins,       the Bill threatens the viability

of sole -practitioner and  smaller providers    , risking  reduc ed service supply at a time when demand remains

high. OTA’s NDIS Provider Survey, conducted last year, found 39% of OT s do not expect to remain profitable under current pricing rules, and 55% made no profit in 2024 -25.

Providers in rural, regional, and remote areas are already at breaking point, bearing a disproportionate burden compared to their metro counterparts. They are often the first to feel the impact of NDIS reforms,

and the participants  they work with  are often the first to lose services.   The same  survey found 92% of OTs

expected to reduce travel and outreach, and 63% would reduce service provision in regional and remote areas , due to continued price freezes.

A qualified allied health workforce is crucial to better outcomes and cost savings               in the NDIS   , including

through the assessment process          . Occupational   therapists are best placed to identify       participant  needs

and appropriate supports,   preventing  long -term and downstream reliance on the broader health system.

NDIS Amendment Bill 2026   – OTA Supplementary Submission    – July 2026                                                             4

However, pricing, registration, and uncertainty around assessments and reforms are driving instability and

attrition among occupational therapists         . The government  must address    the factors destabilising the

workforce the Scheme  depends on   - you cannot build a sustainable NDIS on an unsustainable workforce               .

We have presented three recommendations below, which      respond to  these pressure  s and would stabilise

the Scheme - qualified assessors protect the clinical basis of the scheme; pricing transparency addresses the affordability pressures driving provider exit; and streamlined registration eases the regulatory burden weighing hardest on small and rural providers.

A. Qualified assessors Occupational therapists have long conducted functional capacity assessments as an established, evidence -based clinical practice. The Bill gives the NDIA power to set the rules, criteria and classifications used to assess functional capacity, without requiring that assessors hold relevant clinical qualifications.

Removing this     role  from qualified allied health professionals risks turning assessment into an

administrative exercise rather than a clinical one, reducing the quality, consistency and fairness of

outcomes for participants      , as well as reducing the cost effectiveness     of the Scheme   .

NDIS p articipants rely on robust, effective, and clinically -informed functional capacity assessments, and occupational therapists are indispensable to delivering them. Yet when their clinical expertise and skills

are not  recognised   or fully utilised, this creates a disincentive to working in the NDIS. Und          ermining that

expertise not only weakens the Scheme’s most consequential functions, it also puts participants who depend on it at risk.

This change  would align with Recommendation 9 (6.63) of the     recent  Integrity report by the   Joint Standing

Committee on the NDIS, which recommended that the NDIS Act 2013 be amended to specify that

assessments “  can only be completed by clinicians who are registered with relevant professional bodies              ”.

Recommendation 1: OTA recommends inserting an additional line requiring that NDIS rules specify that assessors hold relevant health qualifications.

B. Pricing transparency The NDIA’s pricing methodology has systematically undervalued occupational therapy pricing for eight consecutive years. The Bill transfers pricing authority from the NDIA to the Minister without requiring

independent advice     , removing a key opportunity to correct this.     Robust  ministerial decision making must

be supported by a range of evidence that is      diverse and independently sourced        . Accordingly,  OTA calls for

additional safeguards   and stronger transparency    in this decision -making  process.

OTA acknowledges the recent amendment requiring the NDIA to provide a summary of advice to the Minister to support a pricing determination, and the tabling of that advice in Parliament. This is welcome,

but insufficient on its own.    Pricing decisions must draw on an independent body beyond the NDIA              - such

as the Independent Health and Aged Care Pricing Authority (IHACPA)          - or structured input  from allied health

peak bodies, such as OTA          . Without this independent check, small and sole          -practitioner providers     in

particular bear the cost of pricing decisions they had no opportunity to influence.

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Small and sole -practitioner providers already operate on thin margins and have limited capacity to absorb

unexplained pricing changes     or freezes  , as other business costs go up        . Opaque decision  -making makes

it difficult for these providers to plan, invest or forecast . The government should ensure that reforms intended to strengthen the scheme do not come at the expense of a sustainable, viable small business sector.

Recommendation 2 : OTA recommends amending subsection 45C(17) to require the Minister seek and

publish written advice from an independent body     – such as IHACPA    - or input from allied health peaks,

before making a pricing determination.

C. Registration alignment Occupational therapists already meet rigorous registration obligations through Ahpra and the National Registration and Accreditation Scheme. The Bill’s expanded compliance and enforcement powers take no

account o  f this obligation     , creating a risk of duplicative regulatory burden.        Any new NDIS registration

approach must recognise this existing oversight and avoid unnecessary duplication .

Many rural and regional providers operate as sole practitioners with limited administrative support. Duplicative regulatory burden is felt most acutely by these providers, who are often the primary source of support in those communities . In thin rural markets, this added burden increases the risk of providers scaling back or exiting service delivery altogether .

Recommendation 3 : OTA recommends inserting “must have regard to any existing regulatory obligations of the provider under a Commonwealth or state law” into the Bill’s compliance enforcement provision.

Conclusion

OTA thanks the Committee for the opportunity to provide this additional feedback and for extending the inquiry timeframe to allow further consideration.

The three amendments outlined above offer a practical path to strengthen the Bill’s safeguards, protect the occupational therapy workforce and support the viability of small and rural providers, without delaying the Bill’s passage.

OTA requests the opportunity to engage directly with the Committee directly during additional hearings and remains available to provide further evidence or clarification as the inquiry progresses.

We can be reached at   policy@otaus.com.au     .

NDIS Amendment Bill 2026   – OTA Supplementary Submission    – July 2026                                                             6

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NDIS Amendment Bill 2026   – OTA Supplementary Submission    – July 2026                                                             7