Concerns over fraud, misuse of NDIS funding (Individual advocacy)

Submission 319

Submission to the Senate Inquiry (community affairs)

National Disability Insurance Scheme Amendment (Securing the NDIS for

Future Generations) Bill 2026

I write this submission as a parent and community member deeply concerned about the sustainability, integrity and future viability of the National Disability Insurance Scheme (NDIS). While the NDIS is essential for Australians with profound and genuine disability, widespread misuse, weak oversight and lack of accountability are placing enormous strain on the system. If these issues are not addressed, those with the highest and most complex needs will continue to lose support while public confidence in the scheme deteriorates.

The NDIS must return to its original purpose: supporting Australians with permanent and significant disability who genuinely require lifelong functional supports.

Fraud, Misuse and Lack of Oversight

There is widespread community concern regarding misuse of funding, exchanging funds for cash instead of support, false invoices, price gouging therapies, inflated supports, poor provider accountability and exploitation of loopholes within the system. Many supports currently funded under the NDIS resemble ordinary parenting responsibilities; lifestyle supports or household assistance unrelated to substantial functional impairment.

The current system lacks sufficient preventative safeguards and real-time oversight mechanisms.

Recommended Anti-Fraud Measures

The Government should implement stronger fraud prevention and compliance measures, including:

• Mandatory GPS tracking and electronic verification for support workers, cleaners, gardeners and lawn maintenance providers to ensure services are delivered.

• Real-time attendance logging for support work, cleaners and lawn maintenance.

• Random audits of providers and participants receiving high-value plans. Especially for those in prison, juvenile detention centers and on complex stream needs

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• Greater data sharing between government agencies to identify inconsistencies in informal supports, living arrangements, and financial circumstances.

• Cross-referencing with: o Centrelink o Medicare o State housing providers o Service NSW and equivalent agencies o Births, Deaths and Marriages records o Rental agreements and deed titles o Utility bills and household composition records o Schools (emergency contacts) o Gp records (emergency contacts, next of kin) o Child protective services records or concerns

These measures would help identify situations where:

• participants have undisclosed informal supports,

• couples are living together while claiming otherwise,

• parents are receiving extensive funded supports despite having substantial informal capacity,

• or supports are being used for non-disability-related purposes. The Government must also investigate excessive provider charging, duplicate supports and inflated service delivery practices.

Consumables and Everyday Household Items

There must be stricter limits around consumables and low-value sensory items that have limited evidence of long-term functional benefits.

The NDIS is increasingly funding everyday items, lifestyle products and commercially marketed “sensory” products that many families would ordinarily purchase themselves without government assistance.

Examples include:

• crash mats,
• mellow mats,
• muscle mats,

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• nook couches,
• sensory toys,
• sensory blankets,
• sensory swings,
• sensory tents
• weighted blankets,
• weighted toys,
• weighted animals,
• digital calendars,
• jetproof clothing,
• compression clothing,
• pens and stationery,
• spinning cushions,
• spinning chairs,
• vibrating cushions,
• wobble cushions,
• iPads and tablets,
• chewable necklaces,
• fidget kits,
• sleep support night lights,
• dream pods,
• white noise machines.
• High risk items swing sets, monkey bars Many of these products are marketed aggressively to parents despite limited independent evidence supporting significant functional outcomes.

The NDIS should fund evidence-based disability supports rather than ordinary household purchases, commercially promoted sensory products or items that overlap with parental responsibility.

Non-Evidence-Based Therapies

There must also be greater scrutiny regarding therapies that lack strong evidence of functional improvement.

Significant amounts of NDIS funding are being directed toward therapies with questionable evidence bases, including:

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• music therapy,

• art therapy,

• hydrotherapy and physiotherapy used for swimming lessons especially for children,

• Positive Behaviour Support Plans (PBSP) often fail in practice. Because they are often excessively long and generated by software, educators and burned-out caregivers struggle to read, implement, or get trained on them. Consequently, schools prefer to concise plans that align directly with their own mandatory policies and procedures.

• The Problem with Plan Length & Format

• Overwhelming length: PBSPs can exceed 50 pages, making them highly impractical for quick, daily use.

• Generic generation: Relying on computer software to generate strategies often results in standardised text rather than practical, individualised support.

• School incompatibility: Schools are bound by strict internal procedures and rely on Individual Behaviour Support Plans (IBSPs) that are just 2 to 3 pages long

• The Burden on Caregivers

• Unreliable data collection: The primary benefit of the plans is often data collection, which ultimately falls on parents.

• Caregiver burnout: This heavy data burden is especially unreliable when parents are already dealing with caregiver burnout.

• Lack of training: Schools, allied health and support networks frequently do not receive the necessary training to implement the complex strategies outlined in lengthy PBSPs.

• and activity-based interventions with unclear measurable outcomes.

• recreational therapy models or programs,

• expensive school holiday programs, bike riding, fishing, surfing, camping instead of building capacity. Many of these children are already capable of these skills. Cheaper options would be a support worker.

Funding should prioritise therapies and interventions that demonstrate measurable improvements in:

• communication,
• functional independence,
• emotional regulation,
• mobility,
• education participation,

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• and long-term capacity building. The current system often rewards providers for ongoing engagement rather than meaningful participant outcomes.

Behavioural Practitioner Concerns

Concerns exist regarding overreliance on reward charts, token economies, and incentive based strategies for everyday self-care tasks and ordinary household expectations. In some cases, children may become conditioned to expect rewards for basic daily activities such as dressing, hygiene, eating, school attendance, or following routine instructions, which can undermine intrinsic motivation, resilience, independence, and age-appropriate expectations over time. This adds an extra financial burden and becomes unaffordable.

These approaches may also set some children up for repeated failure where behavioural targets are unrealistic, inconsistently applied, or developmentally inappropriate, potentially increasing frustration, oppositional behaviours, family conflict, and reliance on ongoing paid supports.

Behaviour supports funded through the NDIS should be evidence-based, outcome focused, developmentally appropriate, and regularly reviewed to ensure they promote genuine functional capacity, emotional regulation, and long-term independence rather than creating dependency on external rewards or escalating support needs.

Parents and carers should be provided with practical, sustainable strategies that can realistically be maintained in ordinary home environments without excessive reliance on therapists, complex behavioural systems, or continual paid intervention.

Children’s Plans and Parental Responsibility

The NDIS was never intended to replace ordinary parenting responsibilities. There has been significant expansion of support for children that go far beyond reasonable and necessary disability support. Support worker funding and short-term respite, cleaners and lawn maintenance in child plans.

Lawn Maintenance and Cleaning

Lawn maintenance and household cleaning should be removed from all children’s plans. Parents are ordinarily responsible for maintaining the household environment unless there

Submission 319

are extraordinary circumstances involving profound disability or significant carer impairment independently evidenced.

These supports are being overused and are difficult to monitor appropriately.

Excessive Use of Support Workers for Children

There must be stricter limits around support worker funding for children, particularly children under 10 years old.

The current system often funds:

• before-school care,
• after-school care,
• school drop-offs and pick-ups,
• weekend babysitting,
• overnight care,
• respite
• and household assistance for parents rather than direct disability support for the child.

Support workers should not replace ordinary parenting.

Support worker funding should be prioritised for:

• children with profound disability or ONLY attend SSP (schools for specific purpose disability schools) excluding support units and mainstream schools.

• children unable to safely attend school due to disabilities,

• children forced into homeschooling because of significant functional impairment,

• and situations where there is clear evidence of substantial behavioural or psychosocial complexity.

Children capable of attending school full-time or part-time generally have significantly fewer barriers than children who are completely excluded from education due to disability.

It is inappropriate for taxpayers to fund extensive support worker hours for children attending school while support workers simultaneously undertake household tasks, grocery shopping or parenting responsibilities unrelated to disability.

Submission 319

Short-Term Respite (STR) and Respite Reform

Eligibility for short-term respite/accommodation and respite must be tightened considerably.

Too many respite supports are functioning as:

• tourism,
• recreational holidays,
• concerts,
• activities,
• events,
• informal babysitting,
• or social weekends away unrelated to genuine disability support needs. Children attending school regularly and functioning adequately in educational environments should face a higher threshold before receiving substantial respite funding.

Greater evidence should be required before approving STR, including:

• documented behavioural incidents from all environments,
• Partial school attendance (less than 3 hours) school suspensions, explosions
• If a child can attend school, then no approval,
• evidence of exclusion from educational settings,
• learning support plans with substantial accommodations incorporated,
• reports from treating clinicians,
• evidence of failed community supports,
• evidence that mainstream social activities have been attempted and exhausted. Autism Diagnoses Cost-of-Living Pressures and extra school funding

There is increasing public concern that rising cost-of-living pressures are contributing to over-diagnosis or diagnostic inflation, particularly relating to autism spectrum disorder.

Families experiencing financial hardship may perceive substantial financial incentives associated with diagnoses due to access to:

• centrelink payments,
• carer payments,

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• carer allowance,
• cheaper utility rates
• PBS medications
• subsidised government housing,
• free vehicle registration,
• companion card
• NDIS supports,
• respite, support workers used as babysitters, cleaners, lawn maintenance
• free therapies
• free programs, camps, fishing trips, charter boats recreational
• SDA and SIL pathways,
• school funding
• access to support units
• access to assisted school travel program
• and additional government concessions. This creates pressure on already overwhelmed assessment and support systems.

Consequently:

• children with profound autism and severe functional impairment may receive reduced supports,

• waitlists increase,

• funding becomes diluted,

• and public trust in the NDIS declines. The Government must ensure diagnoses alone are insufficient for large funding packages. Functional impairment must remain in primary consideration.

Substantial supporting evidence should be required before significant supports are approved, including:

• school reports,
• behavioural incident records, (support workers, doctors or allied health)
• suspension histories, explosions,
• evidence of failed mainstream supports,
• documented participation barriers,
• clinician reports,

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• multidisciplinary team diagnosis for access especially for children,
• and evidence that reasonable community and family support have been exhausted. School staff frequently require parents to obtain a medical or clinical diagnosis for their child to unlock the targeted funding necessary to provide essential in-class support, teacher aides, or specialised resources.

Without a formal diagnosis, schools won’t receive extra funding. Unfortunately, this practice can be highly deceptive; instead of directly aiding the specific child, schools may legally pool this money or redirect it toward general school upgrades, equipment, and broader classroom support.

Here is a clearer breakdown of this dynamic:

• Why schools want the diagnosis: Educational funding models (such as the NCCD in Australia) allocate money based on specific diagnostic categories, incentivizing schools to push for labels like Autism over ADHD to trigger government funding. In systems like the Nationwide Consistent Collection of Data (NCCD) in Australia, schools often face strict government criteria. While education departments officially state that schools should adjust for functional need rather than just a label, the reality is that clinical diagnoses—especially for conditions like Autism Spectrum Disorder (ASD)—hold significantly more weight when schools are trying to prove eligibility for higher tiers of financial assistance

• The funding reality: Schools are often not required to spend a designated funding dollar strictly on the child who generated it. Instead, the money frequently goes into a central, pooled resource used for general teacher’s aides, specialized equipment, or broader infrastructure.

• Parent experience: Many parents are unaware that formal medical diagnoses are entirely unnecessary for a student to receive learning support. State and national educational departments (such as the NSW Department of Education) confirm that students can receive necessary educational adjustments and support plans without a formal diagnosis.

Tribunal and Legal Costs

There are also concerns regarding escalating legal and tribunal costs associated with NDIS disputes.

Substantial public funds are being spent on:

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• lawyers,
• barristers,
• external experts,
• prolonged litigation,
• and repeated assessments. Greater efficiency is needed within tribunal processes.

Consideration should be given to:

• automatic access to complete medical and clinical records early in proceedings,
• mandatory evidence disclosure timelines,
• reducing duplication of expert assessments,
• and stronger early resolution pathways. The current system is placing enormous emotional and financial pressure on participants while simultaneously increasing costs to taxpayers.

Means Testing and Sustainability

Consideration should also be given to introducing some form of means testing for certain lower level supports and discretionary services.

The NDIS was designed as an insurance scheme for substantial disability-related needs, not as a universal lifestyle support system.

Means testing could help preserve sustainability while ensuring those with the greatest disability-related needs remain prioritised.

Support Worker Registration and Qualifications

There must be mandatory national registration, qualification standards, and background screening requirements for all support workers (working with children’s credentials).

Current inconsistencies across the workforce create risks relating to:

• participant safety,
• exploitation,
• poor-quality care,
• fraud,

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• and inappropriate service delivery. Minimum standards should include:

• mandatory training,

• worker screening,

• ongoing professional development,

• clear codes of conduct,

• and stronger penalties for fraud or misconduct.

SDA and SIL Concerns

There are also growing concerns regarding Supported Independent Living (SIL) and Specialist Disability Accommodation (SDA), including:

• inappropriate placements,
• inflated provider profits,
• conflicts of interest,
• and participants being encouraged into highly funded housing arrangements unnecessarily.

Independent oversight and stricter evidence requirements are needed before approving SIL and SDA pathways.

Hospital Social Admissions and Mental Health System Failures

Hospitals are increasingly being used for social admissions rather than genuine medical crises due to lack of community mental health support and housing instability.

The solution is not simply increasing NDIS spending. There must be:

• stronger community mental health services,
• people with genuine needs placed on waitlists
• no beds available for immediate mental health crisis resulting in suicides
• earlier intervention,
• accessible public psychiatric care,
• affordable housing,
• and crisis prevention supports outside hospitals.

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Without broader mental health investment, vulnerable individuals risk worsening isolation, homelessness, and preventable deaths.

Accessing NDIS

The NDIS should not operate as a first-line service system. Applicants should be required to demonstrate genuine engagement with and exhaustion of reasonable mainstream and clinical supports before access or significant reassessment funding increases are approved.

Access to relevant medical and clinical records should be mandatory where necessary to verify diagnosis, treatment history, functional impairment, evidence of permanency, and whether alternative mainstream interventions remain appropriate or available.

Reassessments for eligibility

Reassessments should include review of historical outcomes from previously funded supports to determine whether interventions delivered measurable functional improvement, reduced risk, increased independence, or represented poor value for money.

Psychosocial Disability

For psychosocial disability claims, evidence should include longitudinal clinical records, documented treatment engagement, medication history where relevant, hospital or community mental health involvement, and evidence that impairments persist despite appropriate treatment and psychosocial interventions.

Caps and Tier system on Therapies and Support Worker Hours

Consideration should be given to introducing clearer caps, benchmarks, and tiered funding limits for therapies and support services, particularly for school-aged children who can attend educational settings for substantial periods of time.

The NDIS was not intended to replace ordinary parenting responsibilities, school support, or mainstream childhood activities. In some cases, therapy intensity and support worker utilisation appear disproportionate to demonstrated functional impairment or measurable outcomes, resulting in escalating long-term costs without clear evidence of improved independence or capacity-building.

Submission 319

Greater consistency and accountability could be achieved through tiered support frameworks linked to verified functional impairment, school attendance capacity, clinical complexity, risk, and demonstrated outcomes from previous funding periods.

For children who can attend school, consideration should be given to limiting excessive support worker hours outside educational settings unless there is clear evidence of substantial functional impairment, safety risk, or exceptional care needs beyond ordinary parental responsibility.

Funding decisions should also consider whether supports are promoting long-term independence and community participation, rather than unintentionally fostering overreliance on paid support from an early age.

Therapy funding should be subject to periodic outcome review, with continued high intensity therapy requiring evidence of measurable functional gains, skill development, reduced support needs, or clinically justified maintenance objectives.

Concerns

Concerns have also been raised about perverse incentives emerging within parts of the disability support system, where crisis escalation may unintentionally influence access decisions or funding outcomes.

In some cases, families reportedly present to hospitals, threaten relinquishment of care, self-report to child protection authorities, or emphasise system breakdown to demonstrate crisis severity and secure access to higher levels of NDIS funding or emergency supports.

While many families are experiencing genuine hardship and inadequate mainstream support, the current system structure may unintentionally reward crisis escalation rather than early intervention, sustainable supports, parental capacity-building, and accountability across mainstream service systems.

These risks create inequity between participants and may place additional pressure on hospitals, child protection systems, emergency departments, and the NDIS. Greater safeguards, independent functional assessment, cross-agency coordination, and evidence-based review mechanisms may help ensure funding decisions are based on verified functional impairment and genuine support needs rather than system escalation dynamics.

Submission 319

Protecting the Future of the NDIS

The NDIS must remain sustainable for future generations. Fraud, over-servicing, weak evidence standards and blurred boundaries between disability supports and parenting responsibilities are threatening the long-term viability of the scheme.

The Government must:

• strengthen compliance,
• enforce parental responsibility,
• tighten eligibility criteria,
• improve auditing and oversight,
• and ensure funding is directed toward Australians with genuine and substantial disability-related functional impairment.

Failure to act risks undermining both the financial sustainability of the scheme and community confidence in one of Australia’s most important social programs.

Yours faithfully,