Submission 3200 — Choosing Harmony — NDIS Future Generations Bill

Submitted by: Caroline Smith

Principal Practitioner – Choosing Harmony

NDIS Registered Provider

Registration Groups: 0110, 0115, 0116, 0118, 0128, 0130

Executive Summary

As a Behaviour Support Practitioner, Functional Capacity Assessor, Early Childhood

Practitioner, Assistance Animal Trainer, and NDIS Provider working directly with participants across metropolitan, regional, and remote Australia, I am deeply concerned about the recent NDIS reforms and the manner in which they are being implemented.

While I acknowledge the need to ensure scheme sustainability and prevent misuse of public funds, the current reforms create significant ambiguity, inconsistency, and uncertainty for participants, families, providers, and planners alike.

The most concerning aspect is not necessarily the intent of the reforms, but the absence of clear operational guidance regarding implementation. This ambiguity has already resulted in delayed decision-making, increased administrative burden, inconsistent funding outcomes, and heightened distress for participants with disability and their families.

The reforms risk shifting the NDIS away from its original intent as a participant-centred scheme and toward a compliance-driven model where access to essential supports depends heavily on interpretation rather than need.

1. Ambiguity Creates Inequity The fundamental issue with the current reforms is that they introduce broad concepts without providing adequate operational definitions.

Examples include:

• “Everyday living expenses”
• “Reasonable and necessary supports”
• “Value for money”
• “Substitution of informal supports”
• “Evidence requirements”
• “Alternative mainstream supports”

These concepts appear reasonable on the surface but lack sufficient detail regarding how they are to be consistently applied.

As a result:

• Different delegates make different decisions.
• Similar participants receive vastly different outcomes.
• Families cannot predict what evidence will be required.
• Providers cannot accurately advise participants.
• Participants are forced into repeated reassessments and reviews. The practical consequence is a postcode lottery whereby funding outcomes depend less on disability-related need and more on individual interpretation.

This directly undermines procedural fairness.

2. Increased Administrative Burden on Participants Many participants already experience significant impairments affecting:

• Executive functioning
• Communication
• Literacy
• Cognitive processing
• Mental health
• Emotional regulation The reforms assume a level of administrative capacity that many participants simply do not possess.

Participants are increasingly required to:

• Justify supports repeatedly
• Obtain additional reports
• Navigate changing guidance documents
• Understand evolving operational policies
• Challenge decisions through reviews For many families, obtaining reports costs thousands of dollars.

Families are now routinely funding:

• Functional Capacity Assessments
• Occupational Therapy Reports
• Behaviour Support Assessments
• Specialist Medical Reports
• Educational Reports before they can even establish eligibility for supports.

The reforms therefore create barriers that disproportionately affect the very people the scheme was designed to assist.

3. Lack of Clarity Around Replacement Supports One of the most significant concerns emerging from the reforms is the suggestion that participants should access supports through:

• Health systems
• Education systems
• Housing systems
• Child protection systems
• Aged care systems
• Community organisations However, many of these systems are already overwhelmed.

In practice:

Participants are frequently told:

“This support should be provided elsewhere.”

Yet when families approach the alternative service, they are told:

“This support is not available here.”

This creates a support vacuum.

Participants become trapped between systems while essential interventions remain unfunded.

The reforms do not adequately address how these service gaps will be resolved.

4. Impact on Rural and Regional Australia The reforms fail to adequately account for workforce shortages in rural and regional communities.

Many participants already experience:

• Limited provider availability
• Long waitlists
• Significant travel requirements
• Reduced access to specialist services When funding becomes more restricted, participants in regional areas are disproportionately affected because they often have fewer alternative options.

In some communities:

• There are no Behaviour Support Practitioners.
• There are no specialist Occupational Therapists.
• There are no Autism Assessors.
• There are no Assistance Animal Providers. Funding reductions or restrictions therefore have a much greater functional impact than they might in metropolitan settings.

5. Concerns Regarding Evidence Thresholds The reforms appear to place increasing emphasis on clinical evidence.

While evidence-based practice is essential, there is growing concern regarding the standard of evidence now being expected.

Many disabilities:

• Fluctuate
• Present differently across environments
• Cannot be fully captured through diagnostic labels Functional impact often differs significantly from diagnostic severity.

A participant may:

• Hold a diagnosis considered “mild”

• Yet require substantial daily support Conversely:

• A participant may possess extensive medical documentation

• Yet demonstrate higher levels of independence The focus should remain on functional impact rather than the quantity of reports produced.

Current implementation risks creating a system where participants with greater financial resources can obtain stronger evidence and therefore secure better outcomes.

6. Impact on Early Intervention The reforms create uncertainty around early intervention funding.

As a practitioner working with children, I regularly observe that:

Early intervention is often the most cost-effective support the scheme can provide.

When early supports are delayed or reduced:

• Behaviours escalate.
• Family stress increases.
• School exclusion becomes more likely.
• Mental health deteriorates.
• Long-term support costs increase. The reforms risk creating a false economy whereby short-term savings generate substantially higher costs in future years.

7. Impact on Behaviour Support The NDIS has invested heavily in reducing restrictive practices and improving participant quality of life through Positive Behaviour Support.

However, current reforms create uncertainty regarding:

• Behaviour support funding
• Capacity building interventions

• Family training
• Skill development supports Without clarity, there is a real risk that preventative supports will be reduced while crisis responses increase.

This would be contrary to the objectives of the NDIS Quality and Safeguards Framework.

Preventative support is significantly less expensive than responding to crises, hospital admissions, police involvement, placement breakdowns, or restrictive practices.

8. Assistance Animals and Emerging Supports The reforms provide limited clarity regarding emerging evidence-based supports such as assistance animals.

Across my practice I have observed significant functional improvements for participants using task-trained assistance animals, including:

• Improved community access
• Reduced reliance on support workers
• Enhanced emotional regulation
• Improved safety monitoring
• Increased independence However, inconsistent interpretation across planners and delegates creates substantial uncertainty regarding access to these supports.

Clear national guidance is required.

9. Mental Health Impact of Reform Uncertainty Perhaps the most overlooked consequence of the reforms is the psychological impact on participants and families.

Many participants already experience:

• Anxiety
• Depression
• Trauma
• Autism

• Cognitive disability The ongoing uncertainty surrounding support eligibility creates:

• Chronic stress

• Financial insecurity

• Fear of losing essential supports

• Family burnout

• Reduced trust in the scheme Families frequently report feeling that they must constantly prove the existence of their disability.

This is not a sustainable model.

10. Recommendations Recommendation 1

Develop detailed national implementation guidelines before introducing significant policy changes.

Recommendation 2

Create publicly available decision-making frameworks to ensure consistency across delegates and planners.

Recommendation 3

Require publication of operational definitions for all key reform terminology.

Recommendation 4

Establish independent monitoring of decision consistency across regions.

Recommendation 5

Recognise functional impact as the primary determinant of support need rather than volume of evidence submitted.

Recommendation 6

Protect funding for early intervention and preventative supports.

Recommendation 7

Undertake rural and regional impact assessments before implementing funding restrictions.

Recommendation 8

Provide explicit guidance regarding assistance animals and other emerging evidence based supports.

Recommendation 9

Develop transition arrangements that prevent participants from losing supports while policy interpretation remains unresolved.

Recommendation 10

Establish meaningful consultation processes with participants, families, allied health practitioners, and disability providers before future reforms are implemented.

Conclusion

The sustainability of the NDIS is important and reforms are necessary to ensure the scheme remains viable for future generations. However, reforms must be implemented in a manner that promotes certainty, transparency, and equity.

At present, the greatest risk is not the reform itself but the ambiguity surrounding its application.

Without clear implementation guidance, participants, families, providers, and decision makers are left navigating uncertainty, resulting in inconsistent outcomes and unnecessary distress.

The NDIS was established to empower Australians with disability to live ordinary lives and pursue meaningful goals. Any reform must preserve this foundational principle.

The Senate should carefully examine not only the legislative intent of these changes but also the practical consequences of implementation ambiguity and the significant risks this creates for some of Australia’s most vulnerable citizens.

Submitted by:

Caroline Smith

Principal Practitioner

Choosing Harmony

NDIS Registered Provider

CPCA Level 4 Member

PACT Level 2 Practitioner

Behaviour Support Practitioner and Functional Capacity Assessor

Wishing you good mental health

Caroline Smith

Certified, Accredited PACT (Paediatric Autism Communication Therapy) Level 1 and 2

Practitioner: Registration Number: 23090402

Certified Autism Spectrum Disorder Clinical Specialist (ASDCS)

Certified Clinical Trauma Professional Level 2 (CCTP-II)

Certification Number: 125718

Mobile: 0400 392 646