Submission 4241 — Ms Kate Dean — NDIS Future Generations Bill

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

Submission Regarding Proposed NDIS Reforms and Their Impact on People with

Complex Disabilities and Their Families – Personal and Professional perspectives.

Executive Summary: This submission presents both personal and professional perspectives regarding proposed reforms to the National Disability Insurance Scheme (NDIS) and the potential impacts on Australians living with complex disabilities, their families, carers, and service providers.

As the mother of an adult son with severe psychosocial disability and a clinician working within the disability sector, I have witnessed firsthand the consequences of inadequate support systems and the benefits that appropriate disability supports can provide. My son’s 25-year history of severe mental illness has included repeated psychiatric admissions, homelessness, involvement with police and the justice system, and prolonged difficulties maintaining housing, employment, and independent living. Despite extensive engagement with health and mental health services, he frequently fell through gaps between disability, health, housing, community and justice systems. The supports now available through the NDIS represent the first genuine opportunity to provide coordinated assistance that may reduce future crises, hospitalisations, and reliance on emergency services.

From a professional perspective, I have also worked with participants living with permanent and complex disabilities whose funding for essential therapies, supports, and consumables has been reduced despite clear evidence of ongoing need. In several cases, funding reductions have been followed by increased health complications, functional decline, greater care requirements, and substantially higher long-term costs.

While I recognise the need to ensure the financial sustainability of the NDIS and safeguard public funds, I am concerned that broad reductions in support may simply shift costs to other government systems, including health, mental health, housing, aged care, welfare, and justice services. Such reforms risk creating significant gaps in care for some of Australia’s most vulnerable citizens while increasing long-term expenditure and placing additional burdens on families and carers.

I respectfully urge policymakers to carefully examine the long-term social, economic, and human consequences of proposed reforms and to ensure that people with permanent and substantial disabilities continue to receive the supports necessary to live safely, participate in their communities, and maintain their health, wellbeing, and independence.

Thank you for your time and consideration of these issues. Yours sincerely, Kate Dean MClExPhys (Rehabilitation)

Accredited Exercise Scientist (AES)

Accredited Clinical Exercise Physiologist (AEP)

Mother, Grandmother and Great-Grandmother.

1

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

31/05/2026

Submission Regarding Proposed NDIS Reforms and Their Impact on People with

Complex Disabilities and Their Families – Personal and Professional perspectives.

I am writing to express my concerns regarding proposed changes to the National Disability Insurance Scheme (NDIS) and the potential impacts these reforms may have on people with complex disabilities, their families, carers, and the broader community.

This submission reflects both my personal experiences as the mother and carer of a person living with severe psychosocial disability, and my professional experience working with people who rely on disability supports to maintain their health, safety, and quality of life.

As both a small business owner and professional clinician working in the disability sector and the mother of adult children living with disabilities, I have a direct understanding of both the operational and human impact of these systems. I also bring lived experience spanning decades, including the institutionalisation of my brother following an acquired brain injury in the 1970’s and the lifelong consequences this had on him and our family. Those institutions were abhorrent, and provided appalling treatment of people with disabilities, but there were extremely limited services otherwise available at that time. I saw this personally on the many weekend visits to see my brother.

There is growing concern within the disability community that current reform directions may result in reduced access to essential supports, increased administrative and reassessment burdens, greater reliance on unpaid carers, and heightened pressure on already strained state based health, mental health, and community services. Of particular concern is the potential for fragmented service delivery models that increase complexity for participants and families without delivering clear efficiency gains.

Personal Experience: My Son’s Circumstances

My son has a long history of severe mental illness and psychosocial disability spanning more than 25 years. His diagnoses include:

• Schizoaffective Disorder (Mixed Type)
• Antisocial Personality Disorder
• Major Depressive Disorder
• Attention Deficit Hyperactivity Disorder (Combined Type)
• Post-Traumatic Stress Disorder (PTSD) Throughout his adult life, he has experienced repeated episodes of psychosis, mood instability, impaired judgement, hallucinations, delusions, disorganised thinking, and significant functional impairment.

2

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

His disability has resulted in numerous psychiatric admissions, periods of homelessness, involvement with police and the justice system, and prolonged difficulty maintaining housing, employment, and independent living. During periods of mental health deterioration, repeated failures in communication, information sharing, and coordination between hospitals, community mental health teams, housing services, and other support providers such as hospital based social workers have contributed to serious escalation in his psychosocial disability. These systemic gaps have often resulted in worsening symptoms, avoidable crises, repeated hospital presentations, homelessness, and increased reliance on emergency and justice services. Mental health services across Queensland and New South Wales have repeatedly advised our family that the level of support he requires exceeds available resources. On many occasions he was denied admission due to bed shortages, or considered to be “at baseline” despite clear deterioration in his condition and often discharged prematurely.

As a result, he has frequently fallen through the gaps between mental health, disability, housing, and justice systems. The supports currently funded through the NDIS provide a vital opportunity to break this cycle. For the first time in 25 years, there is potential for coordinated, ongoing support that addresses the functional impacts of his disabilities before they escalate into crisis. These supports are not a luxury or an optional service; they are an essential safeguard against further deterioration. Without adequate support, his history demonstrates a clear pattern of worsening mental health, repeated hospitalisation, homelessness, and involvement with emergency and justice services. Maintaining appropriate NDIS supports is therefore not only critical to his wellbeing and safety but is also likely to reduce future demand on significantly more costly acute and crisis-based government services. There are parents, care givers, family and loved ones of participants across Australia who are now experiencing risks and fears of losing these much-needed supports.

My son has received treatment at multiple facilities since 2004, including:

• Bloomfield Hospital (NSW)
• Cumberland Hospital (NSW)
• Ipswich Hospital (QLD)
• Lismore Base Hospital (NSW)
• Logan Hospital (QLD)
• Mater Hospital (NSW)
• Orange Health Service (NSW)
• Princess Alexandra Hospital (QLD) Several admissions have exceeded three months in duration.

Independent assessments using the Life Skills Profile (LSP-16) and the World Health Organization Disability Assessment Schedule (WHODAS) have identified severe to extreme functional impairment across most domains.

3

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

Periods of relative stability outcomes were only achieved through intensive family support. My adult daughter and I have provided substantial assistance with housing, finances, transport, healthcare access, employment preparation, study support, daily living tasks, and crisis intervention. We are no longer able to provide support appropriate to his needs.

Carer Circumstances

I now work more than 50 hours per week in my own allied health company, and my daughter also works full time, she has 4 children of her own and we each have our own health concerns. The level of support required by my son exceeds what can reasonably be provided by family members.

My greatest concern is that without adequate disability supports, my son will experience repeated cycles of deterioration, hospitalisation, homelessness, social isolation, and interaction with the justice system.

I would like him to live independently with appropriate formal supports in close proximity to us so that our family relationship can be maintained while ensuring his safety, wellbeing and quality of life.

Concerns About NDIS Reforms

My family is deeply concerned that participants such as my son and many of my clients (2 of whom I note herein), who live with severe psychosocial and/or physical disability may again fall through service gaps if supports are reduced or participants are removed from the NDIS.

Many individuals living with complex disability already experience significant uncertainty and fear regarding ongoing access to essential supports the proposed cuts are creating increased stress and extreme fear.

While I acknowledge the importance of ensuring the sustainability of the NDIS and preventing misuse of public funds, I am concerned that broad funding reductions may unintentionally affect participants with legitimate and substantial support needs. There is a significant risk that the proposed reforms will create the appearance of savings within the NDIS while increasing expenditure elsewhere across government such as with Thriving Kids.

For many participants with complex disabilities, supports funded through the NDIS prevent hospital admissions, homelessness, family breakdown, interactions with police, and entry into more intensive and costly service systems. Reducing these supports may simply transfer costs to health, housing, welfare, aged care, and justice systems, ultimately resulting in higher

4

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

long-term expenditure and poorer outcomes for participants and their families. The recent changes to Aged Care has caused considerable distress, reduced access to services and increased financial burden to be placed on our elderly who desperately need supports they were previously able to access.

For people with severe psychosocial and physical disability, reductions in support can have profound consequences including:

• Increased psychiatric admissions
• Increased medical care needs
• Increased homelessness
• Increased interactions with police and justice systems
• Increased pressure on emergency departments and services
• Loss of housing stability
• Reduced community participation
• Greater carer burden and family breakdown These outcomes are not only harmful for participants and families but often result in significantly higher costs to government systems over time. This is precisely what has occurred in my son’s circumstances over the past 25 years. Repeated gaps in support have contributed to cycles of mental health deterioration, repeated hospital admissions, homelessness, social isolation, involvement with police and the justice system, and prolonged reliance on crisis-based services.

Importantly, many of the state-based supports that once existed have been reduced, are chronically underfunded, or no longer exist in a form capable of meeting the needs of people with complex psychosocial and/or physical disabilities. As a result, there are limited alternative pathways for individuals whose support needs exceed the capacity of mainstream health and community services.

I am therefore deeply concerned that proposed reductions to NDIS supports will not eliminate these support needs but instead leave vulnerable people without access to the services necessary to maintain stability and independence. For individuals such as my son, the likely consequence is not reduced demand for government services, but increased demand on emergency departments, acute mental health units, homelessness services, welfare systems, and the justice system. The result would be a serious and profound gap in care, placing some of the most vulnerable members of our community at significantly greater risk of harm while increasing long-term costs to taxpayers and government agencies.

5

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

Professional Observations

In my professional capacity I have worked with individuals who have highly complex disabilities and who have experienced reductions in funding despite permanent and ongoing support needs.

One example is an individual living with:

• Spastic Tetraplegic Cerebral Palsy
• Branchio-Oculo-Facial Syndrome
• Mood Disorder with Psychosis
• Hypertension
• Seizure Risk
• Recurrent Shoulder Dislocations
• Severe mobility limitations requiring specialised wheelchair support
• Scoliosis o For individuals living with tetraplegia, scoliosis accompanied by thoracic compression represents a significant and potentially life-threatening complication. The combination of severe motor impairment, reduced postural control, muscle weakness, and progressive spinal deformity can substantially compromise respiratory function and overall health.

Despite lifelong and permanent support requirements, funding for essential supports including therapies and even consumables such as continence aides has been reduced on multiple occasions, resulting in repeated appeals and additional administrative and legal costs.

I have also worked with an individual diagnosed with Friedreich’s Ataxia who experienced significant improvements through ongoing therapy. Following reductions in therapy funding, serious psychological and functional decline occurred, and care requirements increased substantially before his untimely death in April 2026. The last 6 months of his life care costs included 24 hours 7 days per week 2:1 supports, Physiotherapy, Occupational Therapy and Exercise Physiology multiple weekly visits with a multitude of assistive technology and aides such as hoist, bed, shower table, wheelchair etc. Short term funding cuts resulted in longer term exponential increase to care costs and his untimely death.

These examples raise concerns about whether short-term funding reductions may ultimately contribute to greater long-term expenditure across disability, health, aged care, and community services.

6

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

Systemic Concerns

I am concerned about:

• The emotional and psychological impact of funding uncertainty on participants and carers.

• Cost shifting between the NDIS, health, welfare, housing, and justice systems.

• The increasing administrative burden placed on families who must also repeatedly gather evidence to justify ongoing supports.

• Carer burnout and carer health impacts along with relative resultant cost implications to the Medicare system.

• The growing cost of reviews, appeals, tribunal proceedings, and legal processes.

• Public narratives that portray participants and providers negatively without recognising the realities faced by people living with severe and permanent disabilities.

The overwhelming majority of participants and families are simply attempting to secure the supports necessary to live safe and meaningful lives.

Requests for Consideration

I respectfully ask that policymakers:

1. Carefully examine the impact of proposed reforms on people with severe and complex disabilities.

2. Ensure participants with permanent and substantial impairments are protected from inappropriate reductions in support.

3. Consider the long-term fiscal consequences of reducing supports that prevent hospitalisation, homelessness, and justice involvement.

4. Strengthen safeguards against misuse without reducing access for those with genuine need.

5. Improve coordination between disability, health, housing, and mental health systems.

6. Ensure reforms are informed by the lived experiences of participants, families, carers, clinicians, and disability professionals.

7

Beaudesert QLD 4285

Phone: 0432 468 100 Email: admin@oahhub.com.au www.oahhub.com.au

ABN: 613 5388 0470

Conclusion

The NDIS has transformed the lives of many Australians with disability. However, for people with complex needs, support reductions can have devastating consequences not only for participants but also for families, carers, and other government systems.

I respectfully ask that careful consideration be given to the long-term social, economic, and human impacts of any reforms that may reduce access to essential disability supports.

Thank you for your time and consideration of these issues. Yours sincerely, Kate Dean MClExPhys (Rehabilitation)

Accredited Exercise Scientist (AES)

Accredited Clinical Exercise Physiologist (AEP)

Mother, Grandmother and Great-Grandmother.

8