Submission to the Senate Community Affairs Legislation Committee

Re: Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026. Submitted by: Date: 31.05.2026 Publication: I consent to this submission being published, anonymously. -

To whom it may concern,

As an Occupational Therapist of 22+ years, who also has a close family member who sustained a catastrophic, life changing disability - I have both lived experience in how impactful disability is, and professional experience working with people affected by disability to support them regain independence, function, safety, autonomy, and dignity with their daily occupations.

I am opposed to many of the changes proposed in the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026, and I wish to outline my concerns specific to the Bill, and some recommendations for consideration by members of the Senate of Australia.

For people with disabilities, their families and support people, this Bill and proposed NDIS Legislative changes convey disregard for the individual with disability, and their participation, independence, safety, dignity, and well-being.

Area of Concern 1: Bill proposal - Tightening the Definition of “Permanent” Disability

Tightening this definition does not take into consideration that many people with lifelong disabilities still require ongoing intervention, can fluctuate over time, or may also worsen with age. There is also the risk that if ongoing treatment or therapy is deemed as evidence that a condition is not “permanent”, people may be trapped in a cycle of continually attempting to prove “disability”, despite experiencing life-long impairment.

I am concerned about the requirement for participants to have exhausted all “appropriate treatment” before impairments are considered permanent. Many people with lifelong disability continue to engage in therapy or medical intervention to maintain function, reduce decline or improve quality of life. Ongoing treatment should not prevent access to disability supports. I am also concerned that participants who cannot afford private treatment may be disproportionately disadvantaged.

I would suggest that the Senate considers:

• Clarification on the definition of “appropriate treatment.”
• Ensure ongoing therapy or rehabilitation does not prevent recognition of permanent disability.
• Recognise that many lifelong disabilities require ongoing treatment to:
  • maintain function,
  • reduce decline,

• Ensure participants are not disadvantaged due to:
  • financial barriers,
  • geographic location,
  • inability to access specialist treatment,
  • or medication side effects.
• Ensure treatment expectations remain realistic, evidence-based and accessible.

Area of Concern 2: Bill Proposal - Supports Must Arise “Directly” From Impairment

As per the explanatory memorandum for the Bill, “directly from impairment” refers to “the direct and immediate source, cause or origin” of the support need.

However, this is a narrow understanding of disability and related support needs. In reality, disability support needs often arise through the interaction between impairment and environment, rather than impairment alone. For example, participants may require support because inaccessible housing, sensory environments or community barriers prevent safe participation. I am concerned the proposed wording may narrow the interpretation of disability-related need and reduce recognition of the real-world context in which disability occurs.

Area of concern 3: Bill proposal - Changes to “Value for Money”

The Bill strengthens the NDIA’s ability to consider lower cost „comparable supports“ when deciding value for money. Alarmingly, the Bill appears to neglected/ omitted that the comparable support achieves the same functional outcome. I am concerned that the strengthened value for money provisions may increasingly prioritise lower cost supports, even where they do not provide equivalent safety, independence or long-term sustainability. In occupational therapy practice, cheaper alternatives are not always truly comparable and may lead to increased carer burden, reduced participation and higher long-term costs if supports fail.

Safety of participants will be compromised when “comparable supports” are prioritised over supports that meet the functional needs of the individual in relation to their disability. Examples of potential for compromised safety include NDIA decisions that result in complex wheelchairs being replaced with basic alternatives; reduced therapy intensity, lower staffing atio, completing only partial home modifications, reducing community participation, and delaying or funding inappropriate Assistive Technology.

It is highly important that: a) The definition of “comparable supports” must provide: - equivalent safety, - functional benefit, - sustainability, - and participation outcomes. b) That “comparable supports” requires consideration of: - long-term costs, - prevention, - carer burden,

• safeguarding risks,
• and sustainability, and is not just upfront expenditure. c) This Bill ensures participants are not forced to accept supports that are:
• unsafe,
• ineffective,
• inappropriate,
• or unsustainable. d) Ensures value for money considerations include:
• quality of life,
• dignity,
• independence,
• and long-term participation outcomes.

Area of Concern 4: Bill proposal - “Effective and Beneficial” Evidence Hierarchy

I am concerned that the proposed hierarchy of evidence may reduce the weighting given to participant-specific clinical reasoning and lived experience. Many participants have highly individualised support needs that do not fit neatly into published research evidence. This may disproportionately disadvantage people with rare conditions, psychosocial disability or complex presentations.

I urge the Senate to ensure that the evidence hierarchy maintains a strong weighting for participant-specific evidence, clinical reasoning, lived experience, and functional assessment. Decisions pertaining to “effective and beneficial” must recognise that not all disability supports have extensive published research evidence. It is important to recognisesupports aimed at maintaining function, reducing decline, improving quality of life, or preventing escalation, are valuable outcomes. Prioritising published research evidence over other factors will disadvantage many, such as participants with rare conditions, highly individualised support needs, fluctuating conditions, or psychosocial disability. Real work occupational performance, individual variability, and complexity of the individual need to be valued factors in addition to having published research evidence as support for recommendations.

Area of concern 5: Bill Proposal - Change to Whole of Person Assessment

I am concerned that the proposed wording may move the Scheme away from whole-of- person assessment. In clinical practice, support needs often arise from the interaction between multiple impairments, environmental barriers and participation demands.

The changes to the whole of person assessment are concerning because people are not simply a diagnosis or a single impairment. Many participants have multiple impairments, c comorbidities, environmental barriers, psychosocial factors, fatigue, sensory issues, trauma histories, and personal circumstances that interact to create functional support needs. It is important to ensure that the legislation preserves whole-of-person assessment.

Area of Concern 6: Bill Proposal - Controlling Scheme and Plan Inflation

I am concerned that extending reassessment decision timeframes from 21 days to 90 days may leave participants without appropriate supports during periods of crisis, deterioration or carer breakdown. Delays in reassessment timeframes will risk creating a reactive system rather than a preventative one. It is important to retain shorter reassessment decision timeframes, particularly where safety or crisis issues are present.

Also important is:

• The creation of clear, urgent reassessment pathways for: safeguarding concerns, hospital discharge, carer breakdown, housing instability, behavioural escalation, and significant functional deterioration.
• Ensuring gradual, cumulative and fluctuating changes can still trigger reassessment.
• Ensuring evidence requirements remain realistic and accessible.
• Ensuring reassessment systems remain responsive to real-world risk, not just administrative thresholds.

Area of Concern 7: Bill Proposal - Funding Cuts, Funding Caps & Ministerial Powers

The Bill appears to provide broad ministerial powers to reduce funding through support determinations, apply percentage reductions to supports, and set funding limits or caps for: groups of participants, types of supports, or classes of supports.

I am concerned that proposed powers allowing percentage-based funding reductions andunding caps for groups of participants may significantly reduce individualised planning within the NDIS. In clinical practice, participants with the same diagnosis often have vastly different functional needs, environmental barriers and support requirements. Funding decisions based on broad cohorts or capped support categories risk oversimplifying disability and may result in participants receiving supports below what is required to maintain safety, participation and independence.

Recommendations for consideration include:

• Ensure any ministerial funding powers include:
  • transparency,
  • review mechanisms,
  • clinical oversight,
  • and meaningful consultation.
• Avoid blanket percentage-based funding reductions that ignore:
  • individual need,
  • safety,
  • risk,
  • sustainability,
  • and environmental context.
• Avoid benchmarked or capped funding approaches that assume participants with similar diagnoses have similar support needs.
• Ensure funding decisions continue to prioritise:

• Individualised functional assessment,
• Occupational participation,
• Safeguarding,
• And long-term sustainability.
• Ensure preventative, therapy and participation supports remain recognised as critical components of disability support.