Submission 4274 — Name Withheld — NDIS Future Generations Bill

Submission to the Senate Community Affairs Legislation

Committee

National Disability Insurance Scheme Amendment (Securing the NDIS for

Future Generations) Bill 2026

To: Community Affairs Legislation Committee

Email: community.affairs.sen@aph.gov.au CC: policy@otaus.com.au

Subject: Submission: NDIS Future Generations Bill 2026

Submitted by: [Your Name]

Date: May 2026

Capacity: Occupational Therapist (private practice) and parent/primary carer of three children with disability

Introduction

I am an Occupational Therapist with over two decades of clinical experience, currently working in private practice with children and adults with complex disability and high support needs. I hold additional training in complex case management and work extensively with people with neurodiversity, complex seating needs, and co occurring conditions. I am also the sole parent and primary carer of five children, three of whom have disabilities and receive NDIS funding. I manage my own health needs alongside these responsibilities. I have no informal support network.

I write this submission from both of those positions simultaneously — as a clinician with deep professional knowledge of how disability, function, and support intersect, and as a parent who lives the consequences of policy decisions every single day.

I am strongly opposed to this Bill in its current form. The proposed changes are not a measured reform of a system with known problems. They are a fiscally driven restructure that will reduce access, cut essential supports, redefine disability to suit a budget target, and place people with disability — including children — at serious and foreseeable risk of harm. I understand that reform is necessary to address fraud and misappropriation of funds within the scheme. But reform driven by a political imperative to reduce costs through a biased narrative is not genuine reform. It is systemic neglect. And as I will set out in this submission, the proposed changes, taken together, increase the likelihood of death for some of the most vulnerable people in this country.

I support the Occupational Therapy Australia No OTs, No NDIS campaign and endorse OTA’s recommendations to the Committee.

1. Ministerial Powers to Impose Broad Funding Reductions

Without Individual Review

One of my most serious concerns about this Bill is the expansion of Ministerial power to reduce or cap whole categories of supports at a system level, without individual assessment, clinical review, or transparent and accountable process.

The Bill proposes a 10 per cent reduction to capacity building daily activity supports and a 50 per cent reduction to social, civic and community participation supports, to take effect from 1 October 2026. These are not minor adjustments. They are blanket cuts applied across an entire participant population, regardless of individual need, risk profile, or functional consequence. They are also financially driven cuts to definitions of disability and functional capacity — definitions that have been redefined by the Minister to suit a budget target rather than to reflect the lived reality of disability.

This is not reform. This is rationing by ministerial decree.

The ethical problem is fundamental. A person’s NDIS supports are not a discretionary budget line. They are the mechanism by which a person with significant and permanent disability is able to live, function, and participate in society. Cutting those supports by percentage targets set at a Ministerial level — without any requirement to assess what those cuts mean for an individual — is a profound breach of the duty of care this system owes to its participants.

To make this concrete: for many participants, community participation and daily living supports are used for toileting, showering, feeding, transport, and access to medical appointments. These are not optional activities. They are the basic requirements of human existence and health maintenance. A blanket 50 per cent cut to community participation funding means that a person with disability may be forced to choose between having their personal care needs met, eating, or attending a medical appointment. That is not a hypothetical scenario. That is the direct, foreseeable, and predictable consequence of the proposed cuts as they apply to people with high support needs.

I also draw the Committee’s attention to the NDIS’s existing record on decision making timeframes, because this context is directly relevant to the proposed

expansion of Ministerial powers and the extension of review windows. The NDIS has a self-imposed 21-day timeframe for urgent decisions. In my own experience as a parent, I waited 31 days — ten days beyond that self-imposed limit — for an urgent decision regarding approval for supports for one of my children. During those 31 days, without the approved supports in place, my child declined day by day. They stopped eating. They stopped drinking. They lost the ability to dress themselves. They were unable to attend school. They were at severe risk of hospitalisation, of long-term health consequences, and of death.

The Bill proposes extending decision timeframes to 90 days. The NDIS has historically exceeded even its current timeframes. If a 31-day wait without supports brought my child to the point of medical crisis, a 90-day wait — or longer, given the system’s track record — would produce catastrophic results. This is not speculation. It is a projection based on direct, lived, documented experience.

What happened to my child during those 31 days was governmental neglect. The system knew a child needed supports. It had set its own standard for when that decision should be made. It failed to meet that standard. And a child’s health and safety deteriorated as a result. Enshrining longer decision timeframes in legislation, in a system that already routinely exceeds its own windows, is a policy choice to expose vulnerable people to foreseeable harm.

Furthermore, the Bill gives the Minister power to reduce or cap supports without individual review, without clinical input, and without meaningful accountability. It also creates a broader mechanism that could be used to reduce other support categories in future — including therapy supports — at ministerial discretion. The concentration of this level of power over the lives of people with disability in a single ministerial role, exercisable without transparent process or individual review, is deeply concerning and must be constrained.

I call on the Committee to recommend the removal or substantial constraint of these Ministerial powers, to require that all decisions affecting participant supports be grounded in individual need, clinically informed assessment, and transparent, reviewable process, and to reject any extension of decision timeframes that would increase the period during which people with disability are left without essential supports.

2. The I-CAN Assessment Tool: Validity, Access, and What

It Cannot See

The Bill proposes replacing diagnosis-based access with a standardised assessment framework, with the I-CAN tool identified as the instrument to be used. I have significant concerns about the validity of this approach, the conditions under which it will be administered, and the fundamental gaps in what it is designed to capture.

The tool is not validated for NDIS administration The I-CAN assessment tool is standardised for administration by health professionals. It has not been validated for use by NDIS workers who do not have a health professional background. Administering a clinical assessment instrument outside the conditions under which it was validated undermines the reliability and meaningfulness of its results. A score produced by an unqualified administrator, in a non-clinical context, using a tool designed for a different purpose and a different workforce, is not a valid basis for funding decisions that will determine whether a person with disability can eat, leave their home, or receive personal care.

The tool cannot reach many of the people who need it most I ask the Committee to consider: what is the access pathway for people with disability who have no functional communication? For those who are unable to engage due to trauma or psychosocial disability? For those whose level of insight or cognitive capacity means they cannot accurately self-report their support needs? A standardised assessment administered to a person who cannot meaningfully participate in it will produce a result that reflects not their actual need but the limitation of the tool. Those participants — often the most vulnerable, those with the highest and most complex support needs — will be systematically underserved by a process designed around the assumption that the person being assessed can engage with it.

The tool does not capture what occupational therapy assessment captures Occupational therapists assess a person’s capacity within their context — including intrinsic and extrinsic strengths and difficulties, environmental considerations, meaningful activities, the role of informal supports, and the quality and safety of the person’s participation in daily life. This includes the nuances of “managing” — the difference between a person who can technically perform a task and a person who can perform it safely, consistently, and without significant physical or psychological cost. It includes the complexity of masking — a person who presents as highly functional in a structured, one-off assessment environment, but who is bedridden for days afterwards from post-exertional fatigue. It includes the psychosocial safety of

the person within the assessment process, and their vulnerability to abuse, exploitation, or harm.

These dimensions have been excluded from the proposed assessment framework. In their place is a basic, standardised tool that applies broad assumptions about disability to individual people. This creates a systematic bias toward a funding model, at the expense of capturing the actual, relevant, individual needs of the person being assessed. A person with a physical disability may present as able to enter their home, without the assessor perceiving access issues within the broader community. A person who masks throughout their assessment may appear to have significantly lower support needs than they do — and then spend the following days unable to function due to the exertion of performing that mask.

This is not a minor technical flaw in the assessment design. This is discrimination. It is a system that will, by design, undercount the needs of people whose disability is not visible, not static, not easily quantified, and not captured by a one-size tool — and those are precisely the people the NDIS was designed to support.

The algorithm cannot get plans right without clinical conversation In my experience of plan reviews — both as a clinician and as a parent — every single review has required a conversation to get the supports right. Every time, the initial algorithmic allocation has not produced supports that are appropriate, reasonable, or necessary for the individual’s particular needs. Needs change with growth, with situational changes, with different life stages and support contexts. A plan generated by an algorithm, without clinical input and genuine conversation, is a plan that starts wrong and stays wrong until someone intervenes. The Bill’s direction of travel — toward more automation, less professional oversight, and more standardisation — will produce more plans that are wrong, and fewer opportunities to correct them.

Funding frozen against inflation means real cuts every year Funding that does not adjust from year to year in line with economic inflation becomes, in practice, a smaller package every year. As provider prices rise with cost pressures, participants cannot access the same volume of services for the same nominal funding amount. This is a form of hidden annual cut that compounds over time and particularly affects participants with high support needs who are already stretching their plans to their limits.

3. Ministerial Redefinition of Disability and Functional

Capacity: Ableism by Legislation

The Bill allows the Minister to redefine what constitutes a disability, and what constitutes functional capacity, for the purposes of NDIS eligibility. This is not a technical or administrative power. It is the power to determine, by ministerial decree, whose disability is considered real, significant, or permanent enough to warrant support.

The Minister does not have the experience of living with each disability as it presents in daily life. The Minister does not know what it is like to be the parent of a child who cannot be understood by anyone when he is trying to communicate, who runs onto a road without warning because he believes he can run fast enough that cars cannot hit him, and who cannot participate in ordinary community activities with his peers without close 1:1 support for his and others’ safety. The Minister does not know what it is like to be the parent of a daughter who does not eat without direct assistance and supervision. The Minister does not know what it is like to be the client who is autistic, has POTS and ME/CFS, lives alone, is at extreme risk of falls, and is bedridden for up to a week following exertion — including exertion from attending therapy appointments. Or the client who is autistic, lives with a housemate who works long hours, and is at risk of aspiration when eating and requires supervision for every meal.

On what basis would the Minister determine that Autism is not a significant disability — when the lived reality of autism, as described above, is that it prevents participation in ordinary daily life, creates serious and ongoing safety risks, and requires constant, skilled, funded support? The redefinition of disability and functional capacity by a Minister whose primary accountability is to a budget target — not to the lived experience of disability — is ableist. It undermines the dignity and experience of people with disability. And it creates a framework in which the definition of who deserves support can shift with the political priorities of the government of the day, without any requirement for clinical evidence, lived experience input, or independent oversight.

Who determines that a disability is permanent or significant? Under this Bill, the Minister does. That is not acceptable.

4. Evidence Thresholds, Equipment Decisions, and the

Overriding of Clinical Judgment

Evidence thresholds that disadvantage people with disability Funding decisions are increasingly being based on requirements for published clinical evidence of intervention effectiveness. There is limited research on occupational therapy interventions and recommendations — not because OT is ineffective, but because research funding and infrastructure in allied health has historically been inadequate, and because the complexity and individuality of disability does not lend itself easily to the randomised controlled trial designs that dominate evidence hierarchies. The consequence is that supports which are clinically indicated, functionally necessary, and clearly appropriate for an individual may not be approved because the supporting evidence base does not meet the required threshold. A person’s safety is then at risk — not because those supports are inappropriate, but because the research has not been done.

Equipment and assistive technology decisions made without therapist consultation I am also concerned about the pattern — already present in the system, and likely to be entrenched by this Bill’s direction — of planners overriding therapist equipment recommendations in favour of lower-cost alternatives, without consulting the recommending therapist. A specific piece of assistive technology is recommended for clinical reasons: it fits the person’s body, their environment, their functional profile, and their safety needs. A planner identifies a similar item at lower cost and approves that instead. The similar item may be entirely unsuitable — a mobile shower commode, for example, that cannot fit over the toilet in the participant’s bathroom. The result is not a cost saving. It is an inappropriate piece of equipment, an unsafe support arrangement, and a person whose needs are unmet. These decisions must require therapist consultation before substitution.

5. Clinical Case Example: The Inadequacy of Blanket

Approaches to Complex Households

In my clinical practice, I support families where the complexity of the household cannot be separated from the complexity of the individual participant’s needs. I wish to draw the Committee’s attention to one such situation, presented in de-identified terms.

I work with a child who requires 2:1 support due to high-risk behaviours and a significant risk of injury to others. This child’s parent provides care and supervision for five other household members, all of whom also have disabilities. The 2:1 support model is not a luxury — it is the minimum configuration required to maintain safety and enable the child to complete daily routines, while the parent simultaneously attends to the needs of the rest of the household. Critically, the second support person must be someone other than a family member, because the complexity and dynamics of the household make a family-only support model clinically unsafe.

This Bill’s framing of child support needs as “parental responsibility” — and its proposals to restrict what is considered reasonable and necessary — directly threatens this family’s safety. A child with significantly delayed development across physical, verbal, behavioural, and learning domains does not have needs that fall within the ordinary scope of parental responsibility, regardless of how that term is defined. The developmental gap between this child’s needs and the typical demands of parenting is substantial and clinically documented.

If the 2:1 support funding is removed or reduced under the proposed cuts, the outcomes are foreseeable: the child is at serious risk of injury or of causing injury to others; the parent’s capacity to support the other household members collapses; and the entire family system fails. This is not a theoretical risk. It is a foreseeable risk of serious physical harm and, in some scenarios, death.

6. My Family: The Personal Consequences of These

Reforms

I have three children with NDIS funding. Their diagnoses and support needs differ substantially, despite all three holding an Autism Level 2 classification.

My youngest child is eight years old, autistic with co-occurring ADHD. He cannot be understood by most people when he communicates. He runs onto roads without warning, because he believes he can run fast enough that cars cannot hit him. In the community, he requires 1:1 support. Without that support, I cannot take my children out as a family. The funded support worker is not supplementary to our family life — it is what makes community life possible for us at all.

My ten-year-old is autistic with ADHD, Childhood Apraxia of Speech, global dyspraxia, and a sleep disorder. The interaction between these conditions shapes every part of their day — their capacity to communicate, to move safely, to regulate,

to sleep, and to learn. Their support needs cannot be understood by looking at any one diagnosis in isolation.

My twelve-year-old is autistic with ADHD, anxiety, and ARFID, with the ARFID being a direct feature of their autistic profile. They do not eat without direct assistance and supervision. This is not a behavioural choice or a parenting problem. It is a clinical reality that requires ongoing, skilled, funded support.

All three of my children share an Autism Level 2 classification. On paper, they look similar. In practice, the frequency, intensity, and type of support each child requires is substantially different. A blanket reduction to a support category — without individual review — will cut support from children whose needs, risks, and circumstances are far from average.

There is a further dimension I ask the Committee to consider. One child’s behavioural dysregulation directly triggers another child’s anxiety response. My children do not exist as separate NDIS participants who happen to share an address. They are a sibling group whose needs interact. Support for one child is inextricable from the stability of the others. A funding model that assesses each participant in isolation will always underestimate total support need in a household like mine.

I am one person. I have no partner, no family support, no informal network. I manage my own health alongside the daily demands of caring for three children with complex disabilities. The funded supports my children receive are what make my care sustainable — what allow me to remain employed, maintain my own health, and continue being present for my children. If those supports are cut, my children face safety risks, my family faces social isolation, my children lose developmental opportunities, and I face a deterioration in my own capacity that would ultimately place my children at greater risk than any cost saving could justify.

7. Children’s Access, Thriving Kids, and the Risk of Gaps My youngest child sits precisely at the boundary of the proposed Thriving Kids cohort. Autism is a lifelong neurological condition. Early intervention has value, but it does not resolve the underlying disability. The nature and expression of support needs changes over time; the need for support does not.

Channelling children with autism and developmental delay away from the NDIS and toward a time-limited early intervention model, before the alternative infrastructure is adequately built and demonstrated to be effective, is premature and dangerous. The

risk of a child losing NDIS access before an adequate alternative is in place is real and foreseeable — particularly serious for children with complex and co-occurring needs whose profiles exceed what a light-touch early intervention model is designed to serve.

I am also concerned about equity. Families with greater financial, social, and educational resources will be better placed to navigate a new pathway and access private supports. Sole-carer families, families managing multiple members with disability, and families in regional and remote areas will not have that buffer. The Bill does not adequately address this inequity.

8. Restrictions on Reassessment and Review: A Direct

Risk to Life

The Bill limits unscheduled plan reassessments to “exceptional circumstances.” This provision, combined with what I know of the NDIS’s existing failure to meet its own decision timeframes, represents one of the most dangerous elements of this legislation.

I have already described in Section 1 what happened when my child waited 31 days for an urgent decision — ten days beyond the NDIS’s self-imposed 21-day limit. During that time, my child stopped eating, stopped drinking, lost basic self-care capacity, and could not attend school. They were at risk of hospitalisation and death. The system already fails its own standards. The Bill proposes to enshrine slower timeframes in legislation and to restrict the circumstances under which a reassessment can be sought.

Under the proposed changes, my child would not have been eligible for reassessment in that situation. Their disability had not changed. The deterioration they experienced was a direct consequence of unmet support need — not a “significant” or “long-term” change in their underlying condition as the Bill’s threshold requires. The Bill treats a child’s acute functional decline as insufficiently changed to warrant review, because the diagnosis remains the same. That is a clinically dangerous distinction.

This problem extends far beyond my child’s situation. It will apply to every NDIS participant with a degenerative, neurological, fluctuating, or episodically complex condition. These participants’ needs do not change in neat, permanent, diagnosable steps. They change in response to environment, unmet need, seasonal patterns, developmental transitions, and co-occurring health events. The “exceptional

circumstances“ threshold will systematically exclude the people most likely to require urgent reassessment — those whose conditions are dynamic rather than static, and for whom a delay in support approval is not an inconvenience but a medical crisis.

Every plan review I have experienced — both as a clinician and as a parent — has required genuine clinical conversation to get the supports right. Every time, the initial algorithmic allocation has been insufficient or inappropriate. Restricting access to review removes the mechanism through which these errors can be corrected.

I urge the Committee to reject the proposed restrictions on reassessment and review, to retain accessible and responsive pathways for plan review that reflect the real-world variability of disability, and to introduce enforceable decision timeframes with genuine accountability mechanisms — not aspirational targets the system has already demonstrated it cannot meet.

9. Proving Permanent Disability: The Traumatising Burden

of Annual Evidence Requirements

I wish to raise a concern that receives insufficient attention in policy discussions: the cumulative psychological harm caused by requiring people with permanent, degenerative, or lifelong disability to repeatedly prove the existence and severity of their disability to access and retain support.

In my clinical practice, I support a client who has lived with rheumatoid arthritis for over 40 years. Her body carries the physical evidence of that disease in ways that are visible, significant, and permanent. She is required to supply photographic evidence of her disability to the NDIS annually. This process is deeply traumatising. She must photograph and present her body — deformed by decades of a progressive, neurodegenerative disease — as proof that she still has the condition she has had for 40 years and will have for the rest of her life. There is no cure for rheumatoid arthritis. There is no cure for autism. There is no cure for an intellectual disability or a neurological condition. These are not temporary states that might resolve between reviews.

Requiring people with permanent disability to repeatedly prove that their disability continues to exist is discriminatory. It is ableist. It does not reflect the lived reality of disability. It causes harm — psychological harm to the person required to perform their disability for administrative purposes, and practical harm in the form of the energy, capacity, and support required to navigate that process. For people already managing the daily demands of significant disability, that burden is not trivial.

The Bill does not adequately address this. If anything, its direction — toward more standardised assessment, more frequent review, more administrative gatekeeping — risks entrenching and expanding this burden. I call on the Committee to recommend that the Bill include explicit protections against requiring people with permanent, lifelong, or degenerative conditions to repeatedly re-prove the existence of their disability.

10. Choice, Control, and Access to Providers The proposed changes to self-management, registered provider requirements, and the removal of access to smaller, family-based or community-based providers threaten the fundamental principle of choice and control on which the NDIS was built.

For many participants — particularly those in rural and regional areas, those from culturally and linguistically diverse communities, those with complex trauma histories, and those whose support needs are highly specific — smaller, unregistered, or community-based providers are not a second-best option. They are the option. They are the providers with the cultural knowledge, the relational continuity, the flexibility, and the community embeddedness that make support actually work for that person.

Restricting participant access to registered providers only, or to a closed panel of approved providers, reduces choice, increases wait times, and drives out the providers best placed to serve participants with complex or highly individual needs. Choice and control are not bureaucratic niceties. They are the mechanism through which the NDIS produces better outcomes than block-funded, provider-directed service models. Eroding them does not make the scheme more sustainable. It makes it less effective.

11. The Role of Occupational Therapists in the NDIS The NDIS cannot function effectively without occupational therapists. OTs are central to access, assessment, planning, assistive technology prescription, home modification, capacity building, and functional goal-setting. We are frequently the professionals with the most detailed and longitudinal understanding of a participant’s functional profile, their environment, their risks, and their strengths.

The proposed Bill undermines the role of OTs in multiple ways: by allowing automated and algorithmic tools to substitute for professional assessment; by administering assessment tools outside the conditions of their validation; by cutting the funding lines through which OT services are delivered; by expanding Ministerial power to reduce support categories — including therapy supports — without clinical input; by enabling equipment and support decisions to be made without therapist consultation; and by reducing the plan management and support coordination infrastructure through which participants access OT services.

A system that removes or marginalises OT involvement will produce less safe plans, poorer outcomes, and more expensive downstream consequences. The short-term savings from cutting allied health access will be vastly outweighed by the long-term costs of preventable deterioration, hospitalisation, and family breakdown.

I echo OTA’s recommendation that functional capacity and support needs assessments be conducted by appropriately qualified allied health professionals, including occupational therapists; that fully automated eligibility and funding decisions be prohibited; that equipment and support recommendations not be overridden without therapist consultation; and that pricing and integrity reforms support a sustainable, clinically governed allied health workforce.

Conclusion and Recommendations

I urge the Committee to recommend that this Bill not proceed in its current form. Specifically, I ask the Committee to:

1. Remove or substantially constrain Ministerial powers to impose broad, category-wide funding reductions without individual review, clinical input, or transparent and accountable process.

2. Reject the proposed extension of decision timeframes, and instead introduce enforceable, accountable timeframes for urgent decisions with genuine consequences for breach.

3. Ensure functional capacity assessments are conducted only by appropriately qualified health professionals; prohibit administration of validated clinical tools by workers without relevant health qualifications; and require that co-occurring conditions, household context, masking, post-exertional fatigue, and psychosocial safety be explicitly assessed.

4. Prohibit fully automated eligibility or funding decisions and require human professional oversight at every stage.

5. Reverse the proposed 50 per cent reduction to social, civic and community participation supports and the 10 per cent reduction to capacity building daily activity supports.

6. Ensure the Bill does not narrow access to the Scheme, particularly for children and people with complex, co-occurring, fluctuating, degenerative, or progressively worsening conditions.

7. Reject the Ministerial redefinition of disability and functional capacity as a budget instrument, and require that any such definitions be developed through genuine co-design with people with disability, their families, and the allied health professionals who support them.

8. Reject the framing of children’s disability support needs as ordinary parental responsibility, and explicitly protect safety-critical support configurations from blanket categorical cuts.

9. Retain accessible, responsive pathways for plan reassessment and review that reflect the real-world variability of disability, including for participants whose conditions fluctuate, deteriorate episodically, or change in response to unmet need.

10.Prohibit requirements for people with permanent, lifelong, or degenerative conditions to repeatedly re-prove the existence or severity of their disability.

11.Require therapist consultation before any substitution of clinically recommended equipment or assistive technology.

12.Protect participant choice and control, including access to self-management and unregistered or community-based providers where these best meet individual need.

13.Ensure plan management and support coordination reforms do not reduce access for participants with complex needs or multi-member disability households.

14.Recognise the essential role of occupational therapists in the NDIS and ensure reforms support, rather than undermine, a sustainable and clinically governed allied health workforce.

The NDIS was built on a promise: that Australians with significant and permanent disability would receive the reasonable and necessary supports they need to live a good life. What I have described in this submission — a child declining to the point of near-hospitalisation during a 31-day wait; a family unable to leave their home without funded 1:1 support; a child who cannot safely eat or communicate without assistance being told those needs may be parental responsibility; a woman required to

photograph her arthritic body annually to prove she still has a disease she has lived with for 40 years; a person bedridden for days after attending a therapy appointment that was supposed to help them — this is not the failure of a sustainable system being responsibly reformed. This is the failure of a system being dismantled in the name of a budget target. And if this Bill passes in its current form, the consequences will include preventable deterioration, preventable hospitalisation, and preventable death.

I ask the Committee to hold the Government to its promise.

I support the Occupational Therapy Australia No OTs, No NDIS campaign and endorse OTA’s recommendations to this Committee.

Submitted by: [Your Name], Occupational Therapist and parent/primary carer

Contact: [Your email address]

Date: May 2026