Impacts of Bill on people with disability, carers, workers and communities in remote areas (Individual advocacy)

Submission 378 - Supplementary Submission

National Regional, Rural,

Remote and Very Remote

Community Legal Network

https://clcs.org.au/4rs-network/

Committee Secretary

Community Affairs Legislation Committee

Senate Standing Committees on Community Affairs

Parliament House

Canberra ACT 2600

E: community.affairs.sen@aph.gov.au

17 July 2026

Dear Chair and Committee Members,

Further Submission

regarding National Disability Insurance Scheme Amendment

(Securing the NDIS for Future Generations) Bill 2026

1. This submission follows on from the first submission by the National Regional, Rural, Remote and Very Remote Community Legal Network (‘4Rs Network’) dated 1 June 2026 published by the Committee as submission no. 378.

2. As noted in the earlier submission, the 4Rs Network consists of about 95 community- based legal assistance services, networks and peaks most of which provide legal and related assistance in or to 4Rs areas. This includes participating Aboriginal Community Controlled Organisations (‘ACCOs’) and non-Indigenous organisations. The Network is growing, currently involving over 200 individuals.

3. This submission mainly focuses on the situation since the tabling of the Committee’s Interim Report and urges express and rigorous protections for people with disabilities in 4Rs areas, including and especially First Nations people who make up an increasing proportion of the population in communities with distance from metro areas.

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 378 - Supplementary Submission

Endorsement of the positions of PWDA, WWDA, DANA, FPDN and other disability peaks

4. The 4Rs Network endorses the positions of People with Disability Australia; Women With

Disabilities Australia; the Disability Advocacy Network Australia, the First Peoples

Disability Network and other disability peaks and organisations which are calling, at the very minimum, for no cuts to the NDIS before alternative supports are in place.

5. As the effectiveness of the NDIS varies with location, and is especially challenging in many 4Rs areas, any reductions without proper alternatives are likely to disproportionately impact people many people with disability in 4Rs areas. Treatment of human rights, safety, wellbeing and inclusion of people with disability in 4Rs areas

6. The Committee tabled an Interim Report on 23 June 20261 noting that at the time of writing that 1042 submissions had been published by the Committee.2 Elsewhere in the Report it was indicated that the inquiry had received over 4,000 submissions.

7. By 9 July 2026 the Committee had published 2156 of the submissions received.

8. An AI assisted review of those 2156 submissions produced over 100 pages of quotes from submissions about adverse impacts of the Bill for people with disability, carers, workers and communities in 4Rs areas.

• Quotes from a fraction of submissions which raised concerns in addition to the 4Rs Network submission, are at Attachment 1.

9. The volume of submissions raising concerns about impacts of the Bill in 4Rs areas requires full, transparent, attention by the Committee.

10. The Committee’s Interim Report summarised some issues but did not reflect in depth consideration of seriousness of the issues raised relating to the humanitarian, safety, wellbeing and human rights effects which are likely to result for many people with disability in regional, rural, remote and very remote areas. The potential for this to radiate out to adverse impacts on carers, workers, workforce and communities have not been adequately considered.

11. The nature and seriousness of these concerns and the frequency with which they were raised with the Committee must be matched by the Committee properly assessing these aspects of the Bill. This includes properly testing and assessing Departmental and Government evidence, projections, explanations and assurance regarding impacts on people with disability in 4Rs areas.

1 Community Affairs Legislation Committee, ’National Disability Insurance Scheme Amendment (Securing the

NDIS for Future Generations) Bill 2026’, Australian Parliament House (Interim Report, June 2026)

2 p. 33

Submission 378 - Supplementary Submission

12. All members of the Committee and all members of Parliament are likely highly aware of the circumstances and challenges affecting people with disabilities in many in regional, rural, remote and very remote areas.

• Parliament does not have a licence to treat people with disability, carers, support workers and communities in 4Rs areas, inequitably or harshly, in ways which harm them or impinge on their human rights.

• There is no licence to use people’s place or residence or location against them to deny them their safety, wellbeing and inclusion.

13. Many Senators and Members have deep concerns about the needs and rights of people with disability in 4Rs areas. This Bill lacks care, safety nets, and concrete assurances to the point that it calls those concerns to account.

14. The Committee has not adequately evaluated the human rights compatibility statement accompanying the Explanatory Memorandum. This statement, and the Bill have been assessed as falling short of human rights requirements by the Parliamentary Joint

Committee on Human Rights.3 The Human Rights Committee Report raises concerns

about adverse geographic impacts of provisions in the Bill which have not been properly examined by the current Committee The Human Rights Committee Report expressed that the Bill could adversely discriminate against people with disability based on their place of residence in non-urban areas. The current Committee did not engage with ‘place of residence’ in the Interim Report despite this being crucial to considering the human rights impacts.

15. The Preamble to the Convention on the Rights of Persons with Disabilities para (p) expresses concern about forms of discrimination, stating as follows:

“(p) Concerned about the difficult conditions faced by persons with disabilities who are subject to multiple or aggravated forms of discrimination on the basis of race, colour, sex, language, religion, political or other opinion, national, ethnic, indigenous or social origin, property, birth, age or other status,”

16. While the CRPD does not elaborate on ‘other status’ the CRPD Committee recognises ‘other status’ includes ‘place of residence’ or similar (e.g.: CRPD General Comment No. 8, Art 27: Work and Employment - para 4 and CRPD General Comment No. 5 (2017) Art 19: Right to independent living - para 9 refers to ‘right to choose one’s residence’, para 10 to ‘freedom to choose residence and domicile’; paras 16(a), 24, 39, 46, 47 and 72 refer to place of residence.

17. The Committee on Economic Social and Cultural Rights similarly recognises (General Comment 20 (2019)) that ‘other status’ includes:

3 Parliamentary Joint Committee on Human Rights, ‘Human rights scrutiny - Report 7 of 2026’, Australian Parliament House (Report, 12 June 2026)

Submission 378 - Supplementary Submission

“Place of residence

34. The exercise of Covenant rights should not be conditional on, or determined by, a person’s current or former place of residence; e.g. whether an individual lives or is registered in an urban or a rural area, in a formal or an informal settlement, is internally displaced or leads a nomadic lifestyle. Disparities between localities and regions should be eliminated in practice by ensuring, for example, that there is even distribution in the availability and quality of primary, secondary and palliative health-care facilities.”

35. Non-discrimination based on where people are located in Australia should be reflected in all parliamentary processes, including Committees, all Government policies, all advice to Government, all portfolio actions, policies and programs. Similarly, to ensure special measures for safety-nets, inclusion, and human rights in regions and local areas, where required.

36. The expectations and treatment of the current Bill should reflect this and not validate the unacceptable. For example the Committee’s Interim Report Recommendation 2 which proposes that the Government amend the Explanatory Memorandum to include further clarification about matters including:

• …
• “how the impact of reforms on thin markets, including in regional, rural and remote areas will be monitored to ensure any unintended consequences are minimised;”

Proposes a reactive approach. In the light of the volume of submissions referred to earlier, this is a proposal to observe harm happening. The language could be interpreted as meaning that all harms could be treated as consequences which were anticipated, setting the scene for no harms which need to be minimised. Further, what ‘minimising’ ‘unintended consequences’ means is unclear as there are no parameters or criteria, and no proposal that this be made enforceable.

Conclusion and recommendations

20. The safety, health, wellbeing, inclusion and human rights of people with disability in regional, rural, remote and very remote areas are vastly unprotected by the directions proposed in the Interim Report.

21. The extent and seriousness of the impacts on adults and children with disability, on carers, on the availability and continuity of supports in regional, rural, remote and very remote areas raised in submissions are not reflected in the Committee’s Interim Report.

22. The adverse effects on disability sector workers, their families and communities in regional, rural, remote and very remote areas also require full consideration and effective response.

23. All jurisdictions, including the ACT surrounded by regional, rural and remote areas of NSW, stand to be adversely affected by reduced responsiveness to people with

Submission 378 - Supplementary Submission

disability, careers and workers in 4Rs. House of Representative electorates which include 4Rs areas stand to be adversely affected and metropolitan electorates may experience flow on effects, through increased rates of hospitalisation and out of home care required by people with disability from 4Rs areas.

24. Insuficient human rights, legal protections and care for people with disability, carers, workers and communities in 4Rs areas are brought into view by the proposals t. The standards to safeguard the human rights of people with disability are not in place, the system is not working to treat people with disability in 4Rs areas as rights-holders.

25. All federal elected representatives should work from the position that they have responsibilities to every person, wherever in Australia, including in 4Rs areas.

26. Provisions in the Bill, which have disproportionate adverse effects according to where people live – should not be supported or contemplated.

27. Where people live, in metropolitan, regional, rural, remote and very remote areas must be front of mind as an aspect of evaluating all aspects of the Bill.

28. No reduction in access to the NDIS should proceed unless and until alternative supports are available to each person, where they are located, according to their needs.

Final recommendation

29. The Committee should consider how the NDIS Act, other relevant legislation, parliamentary committee processes, parliamentary process, government policy and practices can be strengthened to better safeguard and respond to the human rights and needs of people with disability wherever located including in regional, rural, remote and very remote areas.

Attachment 1: Examples in submissions to the NDIS

Future Generations Bill inquiry

The following are some examples of concerns relating to impacts on people with disability, carers, support workers and communities in 4Rs areas in submissions to the Senate

Community Affairs Legislation Committee inquiry into the National Disability Insurance Scheme

Amendment (Securing the NDIS for Future Generations) Bill 2026.

The submissions are arranged by submission number.

The quotes contain the footnote numbering in the original, footnotes are reproduced with numbering added. 82 Justice and Equity Centre Submission no 82.1 Supplementary Submission 1 June 2026

p. 18:

Submission 378 - Supplementary Submission

“The Bill requires decision-makers to disregard whether treatment is unaffordable or geographically inaccessible.234 Although the Explanatory Memorandum emphasises the need to ensure all ‘people with disability have access to mainstream services’,245 this ignores the lived experience of many people with disability, particularly those facing disadvantage or living in regional and remote areas, who often encounter barriers in accessing health services.256 These reforms are likely to have a disproportionate and adverse impact on certain communities including Aboriginal and Torres Strait Islander participants residing in the Northern Territory who commonly face significant structural barriers to engaging with mainstream health services, especially in remote communities where interpreters and culturally safe supports are limited.267

By requiring people to exhaust treatment options that may exist only in theory before an impairment can be considered ‘permanent,’ the proposed test risks excluding people with lifelong disabilities on the basis of hypothetical future treatments options, regardless of their practical accessibility. As the Explanatory Memorandum itself recognises, many impairments require ongoing treatment to maintain functional capacity, and this should not be a barrier to NDIS access.278

160 NT Disability Advocacy Consortium

Disability Advocacy Service Inc., Integrated Disability Action Inc. and Darwin Community Legal

Service (NT Disability Advocacy Consortium), Submission No. 160, 29 May 2026

p. 2 “However, in its current form, the Bill will cause serious and predictable harm to NDIS participants in the Northern Territory, and to Aboriginal and Torres Strait Islander participants in particular. Several provisions assume a metropolitan service market, a literate and digitally connected participant, and mainstream services that simply do not exist in the NT. The Bill also assumes safeguards and replacement systems that, across large parts of the Northern Territory, are theoretical rather than operational in practice.

When these assumptions fail in the NT, the burden of scheme sustainability shifts onto the people least able to carry it. When NDIS supports are reduced, delayed or removed, participants often have nowhere else to go; there is no alternative support system. Rather than transitioning into another functioning support system, they frequently fall through the gaps entirely, increasing the risk of homelessness, hospitalisation, justice and child protection system contact, institutionalisation, suicide, and preventable harm.”

pp. 5-6

“How NDIS participants are impacted

4 NDIS Bill, accompanying legislative note to proposed subsection 25A(2). 5 Explanatory Memorandum 63 6 See for example, Firew Tekle Bobo et al, ‘Disparities in access to health and support services for people with disability in Australia: a scoping review of the structural social determinants’ (2026) 26 BMC Health Services Research 72

7 Disability Advocacy Service, Integrated Disability Action and Darwin Community Legal Service, Joint

Submission to the NDIS Amendment (Securing the NDIS for Future Generations) Bill 2026 (29 May 2026) 11 8 Explanatory Memorandum 62

Submission 378 - Supplementary Submission

Across the NT, thin and failing service markets are the norm. Many communities face ongoing shortages of qualified, culturally safe and reliable providers. Workforce shortages, provider withdrawal, inconsistent service quality and exploitative practices mean participants often have little genuine choice.

In many remote communities, “choice and control” does not mean choosing between multiple providers. Participants often accept whichever provider is available, regardless of quality, cultural safety or suitability, or go without support entirely. Changing providers can place existing services at risk. For many Territorians with disability – particularly Aboriginal participants in remote communities – the issue is not simply whether services exist, but whether safe, ethical and reliable supports are available. The language of “choice and control” does not always reflect conditions on the ground.

The systems expected to sit outside the NDIS are also underdeveloped. In many parts of the NT there are limited or no locally available psychosocial supports, behavioural supports, disability-specific community programs or early intervention pathways. The NDIS often functions as the primary support system because there is little else available to absorb unmet need.

Workforce shortages further limit access. Allied health professionals, behaviour support practitioners and specialist disability accommodation remain chronically scarce. Public system waitlists for paediatric developmental assessments in Alice Springs and Darwin are months long and can exceed a year, depending on the discipline.

Language and communication barriers are also significant. Many participants speak English as an additional language, with Tiwi, Yolgŋu Matha, Warlpiri, Arrernte, Pitjantjatjara, Kriol and many other languages spoken across the Territory. Interpreters are limited and written English literacy varies considerably. These barriers are compounded by unreliable internet and phone connectivity in remote areas, with Closing the Gap Target 17 (digital inclusion) remaining off track.

Together, these factors create a real risk that participants – particularly Aboriginal participants in remote communities – fall between disability systems and broader mainstream services, without either system meeting need.”

p. 6 “How the proposed amendments will make these problems worse

The 2025 Productivity Commission Annual Data Compilation Report identified the NT as

the worst-performing jurisdiction against the National Agreement on Closing the Gap, with progress worsening across eight targets.⁷ Despite this, the Bill introduces reforms built around assumptions that more closely reflect metropolitan service environments:

• Available specialist services
• Stable housing
• Digital access
• Consistent phone coverage
• Accessible transport
• Available interpreters
• Workforce availability
• Continuity of clinical care. These assumptions frequently do not reflect the reality of disability service delivery in the NT.

Submission 378 - Supplementary Submission

If ongoing participation in the Scheme depends on a participant being contactable by phone or email, navigating an online portal, providing documentary evidence within strict timeframes, attending assessments, accessing “appropriate treatment”, or obtaining support from mainstream services, many NT participants will face significant barriers.

When these assumptions fail, the consequences are serious. Participants may lose access to the Scheme and essential supports in circumstances where no alternative system exists to respond. This creates foreseeable risks of harm, including abuse, neglect and avoidable adverse outcomes.

The sequencing of reform is a major concern. The Bill tightens access to NDIS supports and increases reliance on mainstream and foundational services before those systems are adequately established in the Northern Territory. Participants should not lose disability supports on the assumption that alternative systems will respond where those systems remain underdeveloped, inaccessible, or absent altogether.”

275 Disability Advocacy Network Australia

DANA Submission 275 29 May 2026

pp. 20-21

“Permanence and appropriate treatment The Bill tightens permanence by requiring ‘all appropriate treatment’ to have been undertaken, and by considering whether other treatment could materially improve, reverse or alleviate the impact of the impairment. The NDIS Review supported legislative clarification following the Davis decision, but it did not recommend a purely theoretical treatment test. It said any legislative change should ensure that “treatment for people with disability outside the NDIS likely to be affected by the change is available and affordable” (NDIS Review Supporting Analysis, p. 248). It also said the process should include “extensive engagement with people with disability and representative organisations, as well as administrative law experts” (p. 248). The Bill does not clearly require treatment to be practically available before it is relied on. This creates a risk that people are excluded because treatment exists in theory, even where it is unavailable, unaffordable, delayed, unsafe, clinically unsuitable, culturally unsafe or practically inaccessible. This concern is amplified for individuals in remote communities, where access is further constrained by limited transport options, including cost and availability. The Bill should be amended to require appropriate treatment to be actually available, affordable, timely, clinically appropriate and safe before it can be relied on to refuse access and that; The Bill should be amended to remove the provisions relating to ‘all appropriate treatment’.

…

“Alternative supports and other systems The Bill allows access to be affected where another system, scheme or support is considered responsible for meeting the person’s needs. DANA is concerned that people may be refused access, or have access revoked, because another system is theoretically responsible, even where that system is not actually providing timely, adequate or safe support. This risk is particularly acute for people living thin market and or remote and very remote communities, where alternative systems - such as health, mental health, aged care, or community services - may be

Submission 378 - Supplementary Submission

limited, under-resourced, or entirely unavailable. Even where services exist in policy, they may not be accessible in practice due to distance, workforce shortages, transport barriers, or cultural inappropriateness.

The Bill should be amended to ensure access is not refused or revoked unless alternative supports are actually available, adequate and in place, with no gap in support”

p. 23: “Shorter claiming timeframes

The Bill reduces the timeframe for making claims.

This may create risk for people who self-manage, rely on others to claim, or face crisis, hospitalisation, family violence, homelessness, digital exclusion or limited support. A shorter claiming period may also affect people in thin markets or complex support arrangements where invoices, evidence or provider records are delayed.

These risks are heightened in remote and very remote areas, where administrative processes often take longer due to limited-service availability, workforce shortages, unreliable telecommunications, and delays in receiving documentation or processing claims. Shorter timeframes may not account for these practical constraints, increasing the likelihood that participants in these areas are unable to submit claims in time.

The Bill should be amended to include broad exceptional circumstances (e.g., remoteness) and hardship pathways for late claims, including disability-related, safety related and system related barriers.”

pp. 23-24

“Suspension and revocation where participants are not contactable The Bill includes stronger powers where participants cannot be contacted. This may create serious risk for people experiencing homelessness, family violence, psychosocial disability, cognitive disability, hospitalisation, coercion, unstable support arrangements or limited access to phones, email or mail. These risks are compounded for people living in remote and very remote areas, where access to reliable telecommunications, postal services, and safe or consistent points of contact may be limited or intermittent.

Being “not contactable” should not be treated as disengagement without first testing whether the person is unsafe, unsupported or facing practical barriers to communication

The Bill should be amended to require accessible contact attempts, advocacy referral, supported decision-making and safeguarding checks before suspension or revocation occurs.”

331 Women With Disabilities Australia

WWDA Submission No 331, 1 June 2026

pp. 15 & 18

Submission 378 - Supplementary Submission

“2. Support cuts will shift costs and safety risks onto women *** Key Message #12: Supply delays should not erase approved supports. A participant may have approved capital funding for home modifications, a hoist or essential equipment, but cannot use the funding before the plan ends because assessments, installation, quotes or suppliers are delayed. This does not mean the support is unnecessary. It means the system has not delivered it in time. Use-it-or-lose-it settings risk removing approved supports because of delays outside the participant’s control. This risk will be greater for women in regional and remote areas, women managing violence or unstable housing, and women balancing disability support with caring responsibilities.”

386 National Rural Women’s Coalition

NRWC Submission No 386, May 2026

p. 3 “NRWC notes that people with disabilities are overrepresented in regional areas and roughly one quarter of Aboriginal and Torres Strait Islander people live with a disability. The proportion of the total population who are First Nations increases with remoteness from (2.2% in Major cities, to 30% in Remote and very remote areas) (Australian Institute of Health and Welfare, 2024). These factors mean that real-life access to both mainstream and NDIS funded services must be a critical consideration in redesigning the NDIS.

We support WWDA’s recommendation that the Bill does not proceed in the absence of a comprehensive, public gender impact analysis, and gender-responsive reforms co designed with women, girls and gender-diverse people with disability. This analysis must also include women living rural, regional and remote communities, who already experience daily challenges with lack of access to appropriate health and social services including primary and specialist medical care, childcare and reproductive health care.”

pp. 3-4

“1. Assumed availability of mainstream support

NRWC is concerned that proposed section 25A assumes services exist, which across much of regional, rural and remote Australia, is simply not the case. Appropriate treatment cannot be assumed where a person cannot practically access it because of cost, distance, workforce shortages, safety, culture or local service gaps. For example, areas classified as MM5-7 (small rural towns, remote and very remote communities) have a lower-than-average number of doctors per 100,000 people and MM6 has the lowest rate (40% per cent below the national rate) (Royal Australian College of General Practitioners, 2025). About half a million Australians live in GP deserts and receive 40% fewer GP services than the national average (The Conversation 2025). National Rural Health Alliance data shows disparity of access to other health professionals including pharmacists, dentists and medical specialists. These figures highlight the nature of

Submission 378 - Supplementary Submission

accessing health services in many parts of rural Australia, which must be considered when making changes to the NDIS to avoid significant negative impacts for rural regional and remote NDIS participants. Some of the barriers to access to mainstream services faced by rural, regional and remote women include:

• Lack of local specialists, allied health providers or diagnostic services;
• Long waitlists for visiting services
• Long travel distances that add significant cost and stress”

367 National Rural Health Alliance

National Rural Health Alliance, Submission No. 367, 29 May 2026

p. 2 “The rural equity test for the Bill is simple: no person with a disability living in Australia should lose fundamental access to support because the legislation assumes the existence of a functioning service market that is not available in their community.

The Bill proposes major changes to access, functional capacity assessment, support determinations, plan renewals, unscheduled reassessments, permanence criteria, plan, suspension, and support budgets. In metropolitan areas, some changes may be mitigated by provider density, advocacy capacity, transport, and market alternatives. In rural, regional, and remote Australia, these mitigations are often absent. This results in a disproportionate increase in the risk profile the associated with implementing these legislative changes in rural Australia.

The proposed changes raise concerns about fairness, safety, and equity in how people with disability access and sustain supports. Alliance members have expressed concerns that several provisions would shift significant decision-making power to a Minister or Agency without adequate safeguards, transparency, or accountability. This creates a risk that funding decisions such as setting caps, redefining “reasonable and necessary” supports, or imposing broad determinations could override individual needs, inequity amongst the Australian public for political gain and undermine the principle that supports should be tailored to enable participation, independence, and long-term wellbeing. These issues would be exacerbated for people with a disability who live in rural Australia.

A further concern is that the proposals place undue weight on narrow or inaccessible forms of evidence and service availability, which risks entrenching inequity. Requiring participants to exhaust all “appropriate” treatments, or privileging peer-reviewed research over lived experience and other forms of evidence, does not reflect the realities of disability support. This is particularly relevant in rural, remote, or underserved areas where services may be unavailable, unaffordable, or unsupported by a strong research base. Similarly, reliance on alternative support systems assumes these are equivalent and accessible, which is often not the case, particularly in thin markets where service options are limited or non-existent.

The risk is not theoretical: reform without funded alternatives creates a service cliff.”

Submission 378 - Supplementary Submission

376 Carers NSW

Carers NSW, Submission No. 376, 1 June 2026

“3. Treatment requirements considered ‘Appropriate’ regardless of Circumstances Part 8 of the Bill required participants to undertake all ‘appropriate’ treatment before supports may be considered eligible, while excluding personal and financial circumstances from this assessment. In practice. These risks disadvantaging participants in rural, regional and remote areas where specialist services are limited, unavailable or require significant travel. It also risks further disadvantaging people who already experience significant financial stress as a result of their disability or caring roles and may not be able to afford public or private health services. Where participants cannot access recommended treatment due to geographic, financial or systemic barriers, carers often absorb the resulting gaps in support. This may increase caring responsibilities for unpaid carers who are already disproportionately affected by service shortages in regional communities.

Recommendation 4. Amend Part 3 to require consideration of the actual availability and accessibility of treatment services, including geographic access and financial capacity. Participants should not lose access to funded supports where recommended treatment is unavailable, inaccessible or delayed due to systemic service gaps.”

379 Carers Australia

Carers Australia, Submission No. 379 June 2026

pp. 15-16

“Registration of NDIS providers: Market failure and thin markets

Provider availability challenges remain most acute in thin markets, particularly in regional, rural, and remote areas. While strengthening provider registration and clarifying the definition of NDIS providers may improve regulatory oversight, these changes will not address underlying supply constraints, including workforce shortages, high service delivery costs, and low market density.

Where provider availability is limited or services withdrawn, carers and participants continue to bear the consequences. Even where supports are funded, they may remain practically inaccessible, requiring carers to fill gaps through increased direct care, coordination of services, and personal cost. In these circumstances, carers often become the primary source of care continuity.

The 2024 NDIS Review highlighted that provider withdrawal and lack of viable supply persist in thin markets - funding does not equal access in regional and remote areas, and carers and participants absorb risk when markets fail.339 The Review confirmed that these pressures are not incidental as the market-based mechanisms alone have been insufficient to overcome workforce shortages, high travel costs and low service density. This reflects a structural limitation of market-based approaches, where regulatory improvements alone cannot resolve service shortages.

9 NDIS Review (2024), Improving access to supports in remote and First Nations communities. Canberra:

Australian Government

Submission 378 - Supplementary Submission

Reforms to provider registration should be accompanied by targeted strategies to address market failure, including strengthening oversight while ensuring sufficient provider availability. Without this balance, there is a continued risk that gaps in service provision will result in increased reliance on carers, 34 reinforcing existing inequities and undermining both participant outcomes and system sustainability”

380 Mental Health Australia

MHA, Submission No. 380, 29 May 2026

p. 15 “Proposed section 25A(2) states “Treatment may be appropriate treatment… regardless of whether the person’s individual circumstances restrict the person from accessing the treatment.” A note outlines that this includes the person’s financial circumstances and geographical location. This proposed section unfairly discriminates against people with low personal income. People with psychosocial disability often have lower income – and therefore lower access to treatment and support – compared to people with other disabilities.xxix10 In addition there are significant barriers to accessing mental health treatment in rural and remote Australia, xxx 11and Aboriginal and Torres Strait Islander people and people from culturally and linguistically diverse populations also face particular challenges in accessing culturally safe services.xxxi12 People should not be denied access to psychosocial supports because they cannot afford or do not have access to safe mental health treatment.”

420 Indigenous Australians Lived Experience Centre

IALEC, Submission No. 420, 1 June 2026

p. 3 “Service Access and System Design

As previously outlined, Aboriginal and Torres Strait Islander NDIS participants are less likely to receive care than the non-Indigenous population. However, this issue is not addressed in the Bill. Aboriginal and Torres Strait Islander people, particularly those living in rural and remote locations, face significant barriers to accessing appropriate care. These barriers can range from lack of culturally safe services to outright absence of services in that area. It is for this reason that the suggested definition of appropriate treatment in the Bill raises concerns. By legislating that “treatment may be appropriate treatment for a person’s impairment or impairments regardless of whether the person’s individual circumstances restrict the person from accessing the treatment,” Aboriginal and Torres Strait Islander NDIS participants may be forced to choose between accessing unsafe services or going without the support they sorely need.

10 Australian Institute of Health and Welfare (2024) People with disability in Australia

11 Productivity Commission (2020) Inquiry Report: Mental Health and Suicide Prevention Agreement Review

12 Slewa-Younan S, Blignault I, Chimoriya R, Agho K, Li B, Jorm AF, Salvador-Carulla L, Bagheri N, Renzaho AM

(2025) The State of Multicultural Mental Health in Australia Research Report; Gayaa Dhuwi (Proud Spirit)

Australia (ND) Equitable access to culturally safe mental health care

Submission 378 - Supplementary Submission

For similar reasons, the suggested definition of a permanent disability as having accessed all available treatment has the potential to negatively affect Aboriginal and Torres Strait Islander people. There must be considerations given to the economic feasibility of accessing treatment, the availability of treatments within an individual’s place of living, and the cultural safety and appropriateness of treatment methods.”

P. 7 “Conclusion

IALEC supports reform that improves the accessibility, safety, equity and sustainability of the NDIS. However, reform must not come at the expense of Aboriginal and Torres Strait Islander people with disability, psychosocial disability, mental health challenges, suicide-related lived experience, or social and emotional wellbeing needs.

In its current form, the Bill does not adequately reflect First Nations lived experience, cultural safety, social and emotional wellbeing, or the realities of service access across urban, regional, rural and remote Communities. Without amendment, the Bill risks compounding existing inequities and causing avoidable harm.

…”

448 First Peoples Disability Network

FPDN, Submission No 448, May 2026

This submission is endorsed by Bullinah Aboriginal Health Service located in and around Ballina, Indigenous Allied Health Australia, Lowitja Institute and SNAICC.

p. 2:

“Existing Structural Inequity Within the Scheme

Aboriginal and Torres Strait Islander People experience disability at significantly higher rates than non-Indigenous Australians, yet Aboriginal Community Controlled Organisations remain substantially underrepresented within the disability service system. In many communities, significant numbers of participants are already unable to fully access the supports contained within their plans.

The NDIS already does not work equitably for many Aboriginal and Torres Strait Islander participants. These reforms risk widening existing gaps rather than fixing them.

Many aspects of the Bill assume access to:

• specialist healthcare
• stable telecommunications
• permanent and locally established health services
• transport
• internet access
• culturally safe services
• consistent engagement with administrative systems Those assumptions do not reflect the reality for many people across remote communities, regional towns or urban communities already navigating poverty, housing instability, thin markets and inaccessible, unsafe systems.

Submission 378 - Supplementary Submission

The increasing emphasis on integrity, fraud and sustainability within the reform narrative contributes to more punitive, restrictive and surveillance-based approaches that disproportionately impact people already facing systemic disadvantage.

Cumulative Impact of the Proposed Reforms

A central concern with the Bill is the cumulative impact of the reforms.

No single amendment fully captures the level of risk created by the Bill, although some are highly concerning in their own right. The significant concern is the way these measures interact with each other within a Scheme that already underserves many Aboriginal and Torres Strait Islander people with disability.

….”

p. 3 (bold added to recommendation 4) “Recommendations

Key recommendations include:

1. Delay implementation of restrictive eligibility, reassessment and funding measures until foundational and community-based supports recommended by the NDIS Review are operational and independently assessed as culturally safe and accessible.

2. Ensure all reassessment tools, functional capacity assessments and automated decision-making systems are independently culturally validated by First Nations-led researchers before implementation.

3. Maintain accessible and effective review and appeal rights for all participants, including access to culturally safe advocacy and legal assistance.

4. Remove provisions that allow treatment requirements to apply where treatment is inaccessible due to poverty, geography, racism, workforce shortages or systemic barriers.

5. Ensure participants are not denied meaningful access to supports because funding does not reflect the real cost of accessing services, particularly in regional and remote communities.

6. Ensure participants are not suspended, exited or disadvantaged due to communication barriers, housing instability, digital exclusion, cultural obligations or inability to maintain ongoing engagement with government systems.

7. Establish and fund permanent First Nations disability governance mechanisms, including the First Nations Disability Forum recommended by the Disability Royal Commission.

8. Ensure all reforms are independently assessed against Closing the Gap Priority Reforms, human rights obligations and cumulative impacts on Aboriginal and Torres Strait Islander people with disability.”

p. 8:

Submission 378 - Supplementary Submission

“Concerns Regarding “Appropriate Treatment” Requirements

The proposed amendments relating to permanence and “appropriate treatment” are particularly concerning. The Bill provides that treatment may still be considered “appropriate treatment” even where a person’s circumstances prevent them from accessing it, including due to financial barriers or geographic location. This creates the risk of structurally impossible eligibility requirements. Many Aboriginal and Torres Strait Islander people with disability already experience:

• poverty
• healthcare workforce shortages
• specialist waitlists
• lack of local services
• inaccessible transport
• limited culturally safe healthcare
• chronic illness
• multiple diagnoses
• high out-of-pocket medical costs. A framework that effectively requires people to access unavailable or unaffordable treatment before they can qualify for support embeds systemic discrimination within the eligibility framework itself. There cannot be a fair or equitable disability support system where people are excluded because they cannot afford treatment or because services do not exist where they live. Additionally, People should not lose access to disability supports because they refuse, cannot tolerate or do not consent to particular treatment pathways”

508 State and Territory Disability Ministers

State and Territory Disability Ministers, Submission No 508, June 2026

p. 6 Reforms to the NDIS must not lose sight of the people the NDIS was set up to serve

The NDIS was designed as a national early intervention insurance scheme for Australians in the event of significant disability, providing eligible people with individualised, tailored supports, certainty of funding based on need, and genuine choice and control over how their needs were met.

The Australian government has said it is working to restore the NDIS to its original intent. The changes in this Bill risk undermining the original intent of the Scheme.

The Bill’s proposed new definition of ‘functional capacity’ and the requirement for support needs to be directly related to eligible impairments (Schedule 1, parts 1 and 3 of the NDIS Bill) risk narrowing the basis on which support needs are assessed by giving less weight to the social, environmental, socioeconomic, geographical and personal circumstances that shape a person’s functioning in practice.

While the scheme’s sustainability is an important objective, reforms must not prioritise expenditure reduction over participant safety, wellbeing, and life outcomes.

Submission 378 - Supplementary Submission

No. Recommendation

6 Any NDIS rules or legislative instruments made having regard to financial sustainability should be accompanied by an impact assessment on participants, families and carers, including impacts on safety, economic participation, regional and remote, home and living, and demand on mainstream and state-funded systems.”…

p. 7: “Greater safeguards are needed in relation to proposed unilateral Ministerial changes to, and caps on, participant budgets. The proposed changes would allow the Minister, via a determination, to make broad changes to participant budgets, including by reducing funding for categories of supports (proposed section 34A) and setting caps, limits or ratios for supports (proposed subsections 33(2EA) and 33(2EB)). This is a significant power with limited safeguards, and there is insufficient clarity about how these changes would operate in practice, including whether they would apply across the scheme or whether some participants would be exempt.

If budget settings are changed too broadly, or quickly, additional pressures may be placed on families and carers and destabilise provider markets. This could have a disproportionate impact in regional areas and thin markets, and lead to service gaps. For example, a participant in Supported Independent Living (SIL) who relies on social and community participation to attend a day program may face reduced effective support if broad funding changes are applied without regard to their existing living arrangements and specialised provider needs. This may then have implications for provider sustainability.”

585 Mental Health Carers NSW

MHCA, Submission No. 585, June 2026

p. 7 “For psychosocial disability, support needs may arise through a multi-step causal chain. A psychosocial impairment may affect social capacity, executive functioning, emotional regulation, trust, motivation, safety and the ability to engage with services. These impacts may then affect housing, community participation, appointments, routine, relationships and crisis risk. Members have warned that narrower reasonable and necessary rules may disadvantage people with multiple disabilities or overlapping support needs. When a support is refused because it does not fit neatly within an eligible impairment category, families are often left to fill the gap.

Likewise, this gap does not affect everyone equally. People with access to legal advice and detailed reports may be better able to establish the required connection. Families and consumers without that support, including those in regional and remote areas, are more likely to miss out. MHCA anticipates that the amendment may lead to further disputes about causation, particularly following the line of case law leading up to CEO of the NDIA v Eastham [2026] FCA 147. Families and carers already take on a significant degree of administrative burden leading up to and during the course of NDIS access. This will be a burden made more complex when interacting with legal systems.

Submission 378 - Supplementary Submission

Recommendation 4. Amend the proposed change to s 34(1)(aa) so supports can be funded where the eligible impairment is a substantial or material source of the support need, including where there is a multi-step causal chain between impairment and support need”

600 Intellectual Disability Rights Service

IDRS, Submission No. 600, 1 June 2026

P. 5 “III. Changes to eligibility requirements for an impairment to be ‘permanent’ could greatly limit access to the NDIS

The Bill introduces several provisions that would prevent people accessing the NDIS if there are treatments that could improve or reduce the effect of their impairment. It may also require that a person try all appropriate treatment before accessing the scheme. The requirement to try “all appropriate treatment” could have unfair or unpredictable impacts.

IDRS is concerned as people with disability should not be denied support because treatment is theoretically available. A treatment may be clinically available in Australia but practically inaccessible because of cost, waitlists, cultural unsafety or lack of specialists available.

Significantly, these provisions would reverse the Federal Court’s decision of the NDIA v Davis [2022]FCA 1002 where the Court found where a possible treatment for a person’s impairment existed but the person could not realistically access the treatment for reasons such as being unable to afford it or their geographic location, this would not bar them from accessing the scheme.

IDRS recommends that The Bill should be amended so that treatment is only relevant where it is realistically available”

631 Multicultural Disability Advocacy Australia

MDAA Submission 631, May 2026

p. 12 “Failure to Consider Individual Circumstances and Access Barriers MDAA is extremely concerned about provisions indicating that the NDIA may not consider whether a person’s individual circumstances restrict their ability to access treatment, including financial and geographic barriers.”

p. 15 “Recommendation 3 Ensure that individual circumstances, including financial hardship, geographic isolation, trauma, family violence, housing instability, language barriers, digital exclusion and barriers to accessing treatment, remain relevant considerations in NDIA decision-making. The NDIA should also be required to consider the practical accessibility of mainstream and alternative services before determining that supports are available outside the NDIS.”

Submission 378 - Supplementary Submission

725 Young Labor Left NSW

YLLNSW Submission No 725

p. 3 “Recommendation 2: Remove Schedule 1 Part 1 Defining functional capacity

The Bill introduces a strict definition of “functional capacity” which would be assessed by a standardised test that is yet to be seen.

Young Labor Left NSW does not believe that a standardised assessment is suitable for determining who should and should not access disability support under the NDIS. The nature of disability is complex, nuanced, and fluctuating, and people with disabilities often have more than one condition. Determination of eligibility should not be done by a standardised tool.

In particular, Young Labor Left NSW is concerned with the inclusion of Section 9B(1)(b) where “functional capacity” excludes “as far as possible, the impact of the person’s environmental and personal circumstances” .

A definition of functional capacity that excludes environmental and personal circumstances is highly detrimental and unrealistic. Two individuals who have the same condition may have vastly different needs depending on socio-economic class, housing, access to transport, family conditions, culture, and geography. A definition of functional capacity that excludes such conditions will be highly detrimental as determining access to supports should not be based on an unrealistic scenario.

If the Bill is to proceed with the functional capacity assessments, Young Labor Left NSW recommends that s9B(1)(b) under Schedule 1 Clause 4 be omitted such that a functional capacity assessment accurately reflects the nature of the user’s impairment.”

800 Illawarra Disability Alliance

IDA, Submission No. 800, 1 June 2026

“3. Restriction of Unscheduled Plan Reassessments Part 2 of Schedule 1 specifies the circumstances in which a participant can request a plan reassessment. IDA’s members identified this as one of the highest-risk provisions in the Bill for participant safety and for flow-on costs to the health and hospital systems.

• Unscheduled plan reassessments currently function as an early intervention mechanism. They allow providers and participants to request additional funding when needs escalate for example following a health event, a breakdown in informal supports, or deterioration in behaviour. This prevents crisis presentations to hospitals.

• When this mechanism is restricted, providers face an impossible position: continuing to deliver support with inadequate funding (unsustainable), reducing the level of care (unsafe), or taking a participant to hospital. As stated directly in the IDA consultation by one of the CEO’s who participated: “What you’ll find is that services… can’t provide a service that’s safe anymore… The only option you have is to take that person to a hospital setting.”

Submission 378 - Supplementary Submission

• This is not a hypothetical risk. In the Illawarra Shoalhaven Local Health District, 125 hospital beds were occupied by patients awaiting NDIS or aged care discharge as of October 2025, already described as the worst bed block situation in the country. Restricting plan reassessments will add to this number at a cost of $2,000–$3,000 per hospital bed per day with concomitant impacts on the participants’ health and wellbeing, elective surgery waitlists and other flow on effects.

• The Bill also expands the NDIA’s ability to suspend plans in certain circumstances (Part 7). Combined with restriction of reassessments, participants with escalating needs may find themselves with inadequate plans they cannot change. This creates huge safety and legal risks for providers who are legally required to deliver safe, appropriate support.

Recommendation 3: The Bill should be amended to preserve the ability of registered (i.e. quality, trusted) providers, on behalf of participants, to request an unscheduled plan reassessment when there is a documented, material change in the participant’s support needs that creates a risk to the safety of the participant or others. Restriction of unscheduled reassessments should not apply to participants in SIL or other 24-hour care settings without an alternative funded escalation pathway being specified in the legislation.”

1731 Law Council of Australia

Law Council of Australia, Submission No. 1731, July 2026

pp. 4-5

18. Proposed section 25A would define “appropriate treatment” as a treatment that is evidence-based; can reliably be expected to materially improve, reverse or alleviate the impact of the impairment or impairments; and is regularly undertaken in Australia.

However, proposed subsection 25A(2) provides that (emphasis added):

Treatment may be appropriate treatment for a person’s impairment or impairments regardless of whether the person’s individual circumstances restrict the person from accessing the treatment.13

Note: a person’s individual circumstances include the person’s financial

circumstances and geographical location.

19. Legal practitioners have expressed concern that the new test for assessing permanence of impairments will impose barriers for NDIS participants, as it appears to assume different options are accessible and affordable.

14 Rather, applying objective standards to individual circumstances may mean that people with disability otherwise eligible for the NDIS, but who are unable to access “appropriate treatment” due to financial, geographical or other barriers, are denied access to supports they need. For example, an individual may live in a regional or remote area, and “appropriate” treatment may only be available in their capital city. They may not be able to afford to travel and/or take time off work to access such

Submission 378 - Supplementary Submission

treatment. This could have a disproportionate impact on First Nations people, individuals from disadvantaged economic backgrounds, new residents who have limited understanding of services or how to access them, and others living in regional or remote areas. Practitioners are therefore concerned that the proposed amendment will have discriminatory effects in practice, which warrants detailed analysis of impacts of the proposed measure and potential mitigations prior to inclusion of this provision. The Law Council recommends that proposed 25A(2) be withdrawn, as it is likely to result in unfairness.”

p. 15 “Recommendations …

“the definition of “appropriate treatment” in proposed section 25A be reconsidered as it may discriminate against applicants who may not be able to access the relevant treatment due to financial, geographical or other barriers;”