Complex needs participants face safety risks due to standardised support ratios (Provider advocacy) | External submission

Submission 444

Submission to the Senate Community Affairs Legislation Committee

Inquiry into the National Disability Insurance Scheme Amendment

(Securing the NDIS for Future Generations) Bill 2026

Submitted by Minimbah Disability Support Services Ltd

Submission Date: 27 May 2026

Submitted by:

Chief Executive Officer

Minimbah Disability Support Services Ltd

10 Vincentia Street

Marsfield NSW 2122

Introduction

Minimbah Disability Support Services is a not-for-profit disability provider which has been delivering support services, “making the best life with our people”, since 1983. Minimbah’s services include centre-based day programs, community participation supports and support coordination services for people with intellectual disability, complex and high support needs.

Minimbah supports reforms that strengthen the long-term sustainability, integrity and consistency of the National Disability Insurance Scheme (NDIS). We acknowledge the importance of reducing fraud, improving accountability and ensuring the Scheme remains viable for future generations. Minimbah believes that reforms must also ensure the sustainability of long established, trusted, registered service providers.

This submission focuses primarily on the operational and participant impacts of proposed funding, planning and support model reforms contained within the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026. We note however, that they do not align with the recommendations of the 2023 NDIS Review, and in particular the establishment of an independent pricing review body.

Submission 444

Provisions addressed in this submission

This submission addresses the operational and participant impacts arising from proposed reforms relating to:

support determinations and funding flexibility
revised “reasonable and necessary” support provisions
value for money considerations in planning decisions
ministerial powers to alter support funding through legislative instrument
reassessment and plan variation processes
standardisation of funding assumptions and support ratios
implementation of future rules and legislative instruments
and the interaction between funding decisions and safeguarding obligations under the NDIS Quality and Safeguards framework.

Executive Summary

Minimbah is concerned that aspects of the proposed reforms may create consequences for participants with complex support needs, their families and frontline disability providers.

Key concerns include:

The Bill places strong emphasis on funding controls and sustainability measures, while many broader structural issues identified in the 2023 NDIS Review remain unresolved.
Funding compression does not proportionately reduce provider operating obligations or safeguarding responsibilities.
Standardised support ratio assumptions will create safety risks for participants with complex needs.
Reduced social and community participation funding will increase social isolation, economic pressure and family burnout, and demand for higher cost supports such as Supported Independent Living (SIL).
Community participation programs provide important preventative and safeguarding functions, not merely recreational activities.
Proposed ministerial powers to reduce funding create concerns regarding transparency, accountability and independent oversight.
Significant aspects of the reform framework remain subject to future rules, legislative instruments and operational policy development.
Proposed reassessment restrictions will delay participants from accessing additional supports when their circumstances or safety needs change.
The increasing tension between reduced funding assumptions, assessed participant support needs and the safeguarding obligations imposed on providers through the NDIS Quality and Safeguards Commission and related regulatory frameworks will accelerate risk.
The reforms risk shifting operational and safeguarding risk from government systems onto participants, families and providers.
Reform implementation should include phased transition, operational impact assessment and genuine co-design with participants, families and providers.

Submission 444

Support determinations, funding assumptions and participant safety

Relevant reforms: Schedule 1, Part 4 - Support determinations; Schedule 1, Part 6 - Reasonable and necessary supports.

Minimbah is concerned about proposed mechanisms within the Bill that may allow support ratios or funding assumptions to become increasingly standardised across cohorts of participants through support determinations, revised reasonable and necessary support provisions and increased emphasis on value for money considerations.

The NDIS was established as an individualised support scheme intended to respond to the specific needs and circumstances of each participant. Minimbah is concerned that aspects of the proposed reforms risk shifting the Scheme toward increasingly standardised funding assumptions that may not adequately account for complexity, fluctuating support needs or safeguarding requirements.

Many participants accessing Minimbah’s services require highly individualised supports due to:

intellectual disability
behaviours of concern
absconding risks
communication barriers
high intensity complex support needs. While group-based supports are appropriate and beneficial for many participants, there are also participants for whom reduced staffing ratios would create significant risks to personal safety, community safety and safeguarding outcomes.

Participants with absconding risks or complex behavioural presentations cannot always be safely supported within compressed staffing assumptions without increasing safeguarding risk.

One participant currently supported by Minimbah has clinically assessed needs requiring 1:1 support, clearly documented within a Behaviour Support Plan and associated clinical assessments. The participant has a history of absconding, no road safety awareness and is at significant risk of serious injury if unsupervised in the community.

Due to aggressive behaviours toward others, the participant is unable to safely attend a centre based environment and instead receives individualised community-based supports. These supports are delivered through structured activities, including bushwalking and outdoor community access, which align with the participant’s interests, reduce behavioural escalation and support quality of life outcomes.

The participant recently received a new NDIS plan in which previously funded 1:1 supports were substantially reduced and replaced with a predominantly 1:2 funding model.

Minimbah does not consider it possible to safely deliver supports to this participant within a 1:2 staffing arrangement without creating unacceptable safeguarding risks to the participant, our staff, and the broader community.

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In practical terms, this means the participant’s options are now limited to:

receiving fewer days of support while maintaining a safe 1:1 ratio, or
continuing to receive support at safe staffing levels until available funding is exhausted.

The likely consequence is that the participant will spend increasing periods unsupported or within their Supported Independent Living environment or family support structure. This will likely place additional pressure on both informal and funded support systems and increasing the risk of social isolation, behavioural escalation and crisis-driven responses. For working families, the need to provide additional unpaid care could further create economic pressures if time out of the workforce becomes required.

Minimbah is concerned this example reflects the practical impact of broader policy shifts within the Bill toward standardised support assumptions, reduced funding intensity and increased emphasis on value for money considerations.

While this example reflects one participant experience, Minimbah is observing similar themes emerging across multiple planning discussions and plan reviews involving participants with complex support needs.

Support needs are also dynamic and can fluctuate throughout the day depending on environmental factors, transport requirements, behavioural triggers and participant wellbeing. These operational realities are difficult to safely capture through standardised or compressed funding assumptions.

Minimbah recommends that any implementation of support ratio guidance, intensity limits or funding caps retain flexibility for participants with demonstrated high support needs or significant behavioural and safeguarding risks.

Value for money considerations and service sustainability

Relevant reforms: Schedule 1, Part 6 - Reasonable and necessary supports, including principles relating to scheme sustainability and value for money considerations

The proposed reforms place strong emphasis on value for money and scheme sustainability. While Minimbah supports responsible stewardship of public funding, reductions in funded support hours or staffing ratios do not create equivalent reductions in provider operating costs.

Providers continue to carry substantial obligations including:

safeguarding requirements
behaviour support obligations
work health and safety responsibilities
supervision and leadership requirements
transport logistics
workforce compliance
training
audit and regulatory compliance costs. The reforms also risk creating workforce expectations and safeguarding obligations that are increasingly disconnected from the funding assumptions underpinning service 4

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delivery. Providers are expected to maintain high safeguarding standards, reduce restrictive practices, strengthen reporting obligations and deliver increasingly complex supports while simultaneously operating within compressed funding environments.

For centre-based programs in particular, viability relies on maintaining a sustainable balance between participant complexity, staffing requirements and funding levels. The effectiveness of the NDIS depends upon the continued viability of a diverse provider market capable of supporting participants with varying levels of complexity.

The Explanatory Memorandum shows circumstances where funding for supports may be set below the actual cost of delivering those supports. Minimbah is concerned that this approach may create significant pressure on providers delivering high complexity supports, particularly where safeguarding obligations and workforce requirements cannot be proportionately reduced.

Minimbah also notes that elements of the proposed policy direction appear to already be influencing planning and funding decisions prior to the passage of the legislation. In Minimbah’s experience, recent planning outcomes appear increasingly influenced by value for money considerations and standardised support assumptions.

In practice, this has coincided with participants receiving reduced funding for supports that providers and allied health professionals consider necessary, through functional capacity and clinical assessments, to safely meet existing support needs. This is creating uncertainty for participants, families and providers, particularly where planning decisions appear increasingly influenced by broader cost containment objectives ahead of full parliamentary consideration of the proposed reforms.

There is concern that significant funding compression will:

reduce service availability
reduce provider willingness to support high-complexity participants
increase workforce instability
reduce market diversity
narrow genuine participant choice and control. The practical effect of the reforms will be to transfer operational and safeguarding risk from the Scheme to participants, families and providers, who will experience increased risk.

Minimbah recommends that implementation of funding reforms include meaningful consultation with frontline providers and transitional modelling to better understand operational impacts on participant safety and service sustainability.

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Alignment Between Funding Decisions and Safeguarding Obligations

Relevant reforms: Schedule 1, Part 4 - Support determinations; Schedule 1, Part 6 - Reasonable and necessary supports and value for money considerations

Minimbah is concerned about the increasing disconnect between funding assumptions under the proposed reforms and the safeguarding, compliance and duty of care obligations imposed on registered providers through the NDIS Quality and Safeguards Commission and broader regulatory frameworks.

Registered providers remain subject to extensive obligations relating to:

participant safeguarding
behaviour support implementation
incident prevention and reporting
restrictive practice reduction
work health and safety
supervision requirements
delivery of safe and competent supports. In practice, registered providers may face significant regulatory consequences where supports are delivered in a manner that fails to adequately mitigate foreseeable risks to participants and workers or the community.

However, there is increasing tension where planning decisions and funding determinations appear to assume lower staffing ratios or reduced support intensity than providers and clinicians, through functional capacity assessment, consider necessary to safely manage identified risks. This creates circumstances where providers may effectively be required to choose between:

delivering supports in a manner they do not consider safe or consistent with their individual support plans, or
reducing or withdrawing services because available funding is insufficient to safely meet safeguarding obligations.

Minimbah is concerned that reforms focused heavily on value for money and funding compression will increase these tensions unless funding decisions are appropriately aligned with safeguarding and regulatory expectations.

Minimbah recommends that implementation of funding reforms include formal consideration of:

Quality and Safeguards Commission obligations
Support plan requirements including high complex care needs and behaviour support
Provider duty of care obligations to maintain participant and worker safety
operational risk management and WHS requirements. Funding assumptions should remain consistent with the level of staffing and supervision required to safely deliver supports in accordance with existing regulatory expectations.

Submission 444

Reasonable and Necessary Supports and Social & Community

Participation

Relevant reforms: Schedule 1, Part 6 - Reasonable and necessary supports, including provisions relating to value for money, informal supports and support funding limits.

Minimbah is particularly concerned about the predictable impacts arising from proposed support determinations, revised reasonable and necessary support provisions and increased emphasis on value for money assessments as they relate to social and community participation supports.

For many people with intellectual disability and complex support needs, structured day programs and community participation supports provide far more than recreational activities. These services:

maintain routine and behavioural stability
support social connection and inclusion
build community to reduce social isolation
provide protective oversight and safeguarding
support communication and skill development
supports family and informal caring arrangements. In practice, these supports frequently operate as preventative supports that reduce the likelihood of crisis escalation and more restrictive or costly interventions.

Minimbah is concerned that preventative supports and community participation outcomes are at risk of being undervalued within increasingly standardised and cost-focused funding approaches. While the benefits of these supports may be less immediately measurable than direct care activities, they play a critical role in maintaining long-term participant stability, community inclusion and safeguarding outcomes.

Without access to appropriate community participation supports, there is significant risk of:

increased social isolation
heightened vulnerability to abuse, neglect and exploitation
family and carer burnout
family and carer economic pressures
deterioration in participant wellbeing
increased safety risks
increased behavioural escalation
reduced functional capacity over time. There is also concern that reducing access to lower-intensity preventative supports will increase demand for higher-cost systems and supports, including:
Supported Independent Living (SIL)
emergency respite responses
inappropriate hospitalisation
risk of restrictive practices. 7

Submission 444

Minimbah is concerned that significant reforms are being implemented before alternative community, health and safeguarding systems are adequately prepared to absorb the downstream impacts of reduced supports. For participants with complex disability, poorly sequenced reforms risk increasing pressure on families, SIL providers, hospitals, and crisis responses.

Participants with significant disability and their families should not bear disproportionate risk arising from rapid system-wide cost containment measures.

Minimbah encourages the Committee to recognise the protective and preventative value of structured community participation supports when considering reforms to funding models and “reasonable and necessary” support determinations.

Ministerial Powers, Legislative Instruments and Governance

Relevant reforms: Schedule 1, Part 4 - Support determinations; Schedule 3, Part 1 - Decision making on pricing

Minimbah is concerned about proposed provisions within the Bill that allow the Minister to reduce funding for groups of supports through legislative instrument.

While Minimbah acknowledges the role of government in ensuring the NDIS operates effectively, efficiently and sustainably, there is concern that the proposed framework concentrates significant discretion within the office of the Minister with limited operational transparency and a lack of external scrutiny.

The NDIS was established as an independent statutory scheme intended to support individualised, evidence-based and participant-centred decision making. The proposed reforms risk shifting the balance away from independent needs-based assessment toward broader fiscal and administrative decision making.

Of particular concern is the potential for funding reductions to occur across categories of supports without sufficient visibility regarding:

operational impacts
participant safeguarding risks
workforce implications
or impacts on other government systems including health and housing. Minimbah is concerned that broad funding reductions applied through legislative instruments will materially negatively affect participant outcomes and provider sustainability while remaining outside ordinary merits review processes.

Further concern arises that significant aspects of the reform framework remain subject to future rules, legislative instruments and operational policy development that are not yet fully developed or tested within frontline service environments.

Submission 444

Minimbah notes that previous reform discussions emphasised:

focus on permanent and lifelong disabilities
co-design
participant choice and control
transparency in decision making
reducing opaque administrative practices within the Scheme. We note that recent statements by the Minister identify that NDIA systems are not providing the required levels of control, and that a common theme of submissions to the NDIS Integrity Review identify dysfunctional systems for the management of the NDIS as a key cause of the lack of cost control within the NDIS. The proposed reforms appear to place greater emphasis on standardised funding controls, administrative consistency and fiscal management within the Scheme rather than ensuring the systems supporting the scheme are fit for purpose.

Minimbah believes the role of government should be to ensure the NDIS operates effectively, sustainably and with integrity, while maintaining appropriate safeguards, transparency and accountability in decision making.

Minimbah recommends that decisions relating to broad funding adjustments, pricing methodologies and support determinations be informed and overseen by an independent body or pricing authority, being consistent with Recommendation 17 of the NDIS Review 2023, rather than resting solely with the Minister of the day.

Given the scale and significance of these decisions for participants, families, providers and the broader disability support system, there should be appropriate separation between government policy objectives and independent assessment of reasonable funding levels, operational impacts and safeguarding considerations.

Minimbah notes that comparable approaches exist within other nationally regulated care systems, including aged care, where pricing and funding advice is informed through independent mechanisms.

An independent approach would assist in:

improving transparency and stakeholder confidence
improving confidence in the independence and transparency of funding decisions
strengthening accountability
ensuring operational and safeguarding impacts are properly considered
supporting longer-term stability across the disability sector. At a minimum, any support determinations or broad funding reductions should require:
independent impact assessment
public consultation
publication of supporting evidence and modelling
clear review and accountability mechanisms. 9

Submission 444

Reassessment Restrictions and Responsiveness to Risk

Relevant reforms: Schedule 1, Part 2 - Limit unscheduled plan reassessments; Schedule 1, Part 5 - Plan renewal.

Minimbah is concerned that proposed tightening of unscheduled reassessment provisions may reduce the ability to respond quickly where funding reductions create Participant safety or service delivery risks.

Participants with complex support needs often experience changing circumstances relating to:

increasing complexity as disability-related health and clinical needs progress
behavioural escalation
ageing of participants
ageing carers
changes in SIL arrangements
mental health deterioration
breakdown of informal supports. Minimbah acknowledges the need to reduce inappropriate reassessment requests and unnecessary plan inflation. However, there is concern that more restrictive reassessment thresholds may unintentionally delay timely responses where participant safety or support sustainability is deteriorating.

This is particularly concerning in circumstances where participants may already have experienced reduced funding intensity under revised planning approaches.

We are concerned that the change to the NDIA CEO response time for a request for reassessment per Item 19 – Subsection (48)3 from 21days to 90 days is unreasonable and submit that 30 days is a more reasonable timeframe given the potential impacts longer delays in response may have on the wellbeing of a Participant.

Implementation, Transitional Safeguards and Co-Design

Relevant reforms: Schedule 1 - Access and planning measures; Schedule 5 - Transitional rules.

Minimbah acknowledges the significant pressures facing the NDIS and supports ongoing reform to strengthen the Scheme.

However, reforms of this scale should be implemented carefully and in genuine consultation with:

people with disability
families and carers
frontline providers delivering complex supports. The operational realities of supporting people with intellectual disability and high support needs are often difficult to fully capture through high-level policy modelling.

Minimbah is concerned that the sequencing and pace of reform may not allow sufficient time for participants, families, providers and interconnected service systems to safely adapt to substantial changes in funding approaches and support delivery assumptions.

Submission 444

Minimbah recommends that implementation of major funding and planning reforms include:

phased implementation
Inclusive co-design
operational impact assessments
transitional planning and safeguards
ongoing review mechanisms to monitor participant safety and service sustainability outcomes.

Summary of Recommendations

Minimbah recommends that the Committee consider:

that, consistent with Ministerial statements that the NDIS was intended to provide support for people with permanent and lifelong disabilities, and that they should not be required to continually reprove their disabilities, a classification of Participants with permanent, lifelong disabilities and complex high intensity support needs be created to provide a mechanism for the application of separate rules and determinations for the funding of their NDIS Plans.
ensuring the requirements for funding determinations align with existing safeguarding, duty of care and Quality and Safeguards Commission obligations
recognising the importance of social inclusion and the preventative and stabilising value of Social Civic and Community Participation (SCCP) supports
implementing transitional safeguards and phased reform implementation
undertaking inclusive co-design with participants, families and frontline providers
requiring operational impact assessments before significant funding changes are introduced
maintaining responsive reassessment mechanisms where participant risk increases
establishing an independent body or pricing authority to oversee, pricing, broad funding adjustments and support determinations per the recommendations of Section 17 of the NDIS Review 2023.

Conclusion

Minimbah supports the long-term sustainability and integrity of the NDIS and acknowledges the need for reform.

However, sustainability should not be pursued in a way that undermines participant safety, social inclusion, safeguarding outcomes or the long-term stability of disability support services.

Community participation supports are not discretionary lifestyle supports for many participants with complex disability. They are preventative, stabilising and safeguarding supports that help sustain participants safely within families and communities while reducing pressure on more restrictive and higher-cost systems.

We encourage the Committee to ensure that reforms remain flexible enough to recognise the complexity of participants with high support needs and the important preventative role that

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community participation supports play in sustaining both participants and families within their communities.

Minimbah thanks the Committee for the opportunity to provide this submission.