Submission 457
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: AB - Occupational Therapist
Introduction
I am an Occupational Therapist with significant clinical experience working directly with NDIS participants across a wide range of complex disability presentations and permanent and lifelong conditions. I submit this letter in a professional capacity to the Senate Community Affairs Legislation Committee in response to the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026. I wish to place on record my strong and evidence-based objection to several proposals contained within this Bill. Whilst I acknowledge and support the government’s stated intention to ensure the long term sustainability of the NDIS, I am deeply concerned that several of the proposed amendments will cause serious, measurable, and in some cases irreversible harm to Australians living with permanent and complex disabilities, the very people the Scheme was created to support. I respectfully but firmly urge the Committee to carefully consider the following objections before recommending the Bill for passage.
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Proposed Change to the Definition of ‘Functional Capacity’ The proposed amendment to the definition of functional capacity represents one of the most clinically significant and concerning changes in this Bill. The World Health Organisation’s International Classification of Functioning, Disability and Health (ICF) define capacity as an individual’s intrinsic ability to execute a task or action within a standardised environment, representing the highest probable level of functioning. This internationally recognised and clinically validated definition forms the foundation of best practice functional assessment globally and is the standard against which qualified allied health professionals conduct Functional Capacity Assessments for NDIS participants. The proposed narrowing of this definition risks departing from this internationally recognised framework in ways that are clinically unsound and potentially harmful. Functional capacity, as currently understood and applied in clinical practice, encompasses the full range of a person’s ability to perform activities across all domains of daily life, considering the interaction between their disability, their environment, and the supports available to them. It is a holistic, evidence-based, and clinically validated concept that sits at the heart of every Functional Capacity Assessment conducted by allied health professionals across the country. A critical and often overlooked clinical reality is that participants frequently report a higher level of functional capacity than they actually possess. In my experience, participants often tell me they can complete a task or activity independently — and when I observe them attempting to do so, it becomes immediately apparent that they cannot. This discrepancy between self reported and observed functional capacity is well documented in the clinical literature and is precisely why skilled clinical observation and assessment by a qualified allied health professional is irreplaceable. I strongly recommend that the ICF definition of functional capacity be explicitly adopted and enshrined within the NDIS framework, and that any amendment to the definition of functional capacity be developed in genuine and meaningful consultation with allied health professionals, disability advocates, and participants before being legislated.
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Submission 457
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Proposed Change to the Definition of Reasonable and Necessary Criteria – removal of ‘achieve the same outcome’ The reasonable and necessary criteria under Section 34 of the NDIS Act 2013 represent the foundational framework against which all funding decisions are made. These criteria exist to ensure that participants receive the supports they genuinely need to live an ordinary life and to participate in their community on the same basis as people without disability. They are not a loophole; they are the legislative embodiment of the NDIS’s core purpose. The proposed amendment has changed the wording of the reasonable and necessary criteria with a primary focus on cost and has removed – achieve the same outcome provision. I am deeply concerned that this reframing subordinates clinical need to financial consideration in a way that is fundamentally inconsistent with the purpose of the NDIS and the rights of people with disability under both the NDIS Act and the United Nations Convention on the Rights of Persons with Disabilities, which Australia has ratified. The ‘achieves the same outcome’ provision is a critical and clinically essential safeguard that ensures cost considerations do not override clinical appropriateness in funding decisions. In my practice I have recommended assistive technology and supports that may not be the cheapest available option but are the most clinically appropriate solution for a participant’s specific and complex needs. The same outcome provision currently protects participants from being funded for cheaper alternatives that do not achieve the same functional result, an essential safeguard for people whose support needs are highly individualised and cannot be met by a one-size-fits-all approach. Removing this provision and reorienting the criteria around cost will expose participants to the risk of being funded for lower cost supports that are clinically inferior and that fail to achieve the outcomes that more appropriate supports would deliver. This is a false economy. The short term cost savings achieved by removing the achieve the same outcome provision will be offset by the longer term costs of inadequate supports, including increased health system utilisation, repeated reassessments, carer breakdown, and deterioration in participant wellbeing and functional capacity. Getting the funding allocation right the first time is significantly more cost-effective than the ongoing costs associated with reassessment, appeals, and the compounding consequences of unmet need. I strongly recommend that ‘achieves the same outcome’ provision be reinstated within the reasonable and necessary criteria, that clinical appropriateness be explicitly prioritised over cost considerations in the legislative framework, and that any proposed amendment to these criteria be subject to rigorous clinical and community consultation and independent impact assessment before being legislated.
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Administration of the iCAN Tool by Non-Health Professionals and Increase of the Plan Reassessment Time Frames ‘21 days to 90 days’ I am deeply and fundamentally opposed to the proposal to allow the Instrument for the Classification and Assessment of Support Needs (i-CAN) or a modified version for the NDIS, to be administered by individuals who are not qualified and registered health professionals. This proposal reflects a serious misunderstanding of the nature and complexity of functional capacity assessment and the clinical skills required to conduct it accurately and responsibly. The assessment of functional capacity and disability-related support needs is a complex, nuanced, and highly specialised clinical task that requires extensive professional training, clinical judgment, and professional accountability. Occupational Therapists and other allied health professionals who currently conduct these assessments are required to maintain annual AHPRA registration, meet ongoing professional development requirements, hold appropriate professional indemnity insurance, maintain clear police checks, and have no
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Submission 457
misconduct recorded against their registration. These requirements exist to protect the public and to ensure the quality and integrity of clinical assessment. They are not administrative formalities; they are essential safeguards. A critical and frequently underappreciated aspect of functional capacity assessment is the clinical skill required to know when to probe further. A participant may present as capable, articulate, and independently functioning during an assessment interview, and a skilled and experienced clinician will recognise the signs that this presentation may not reflect their true functional capacity and will ask the right questions, conduct the right observations, and apply the right assessment tools to uncover the accurate picture. A non-health professional administering the iCAN will not possess this clinical reasoning capacity, will not know what they do not know, and will not have the training to recognise when a participant’s self reported capacity does not match their observed functional performance. The consequences of this clinical gap will be systematic and potentially catastrophic underfunding of participants whose needs are not immediately apparent. This concern is compounded significantly when considering participants with progressive conditions such as Motor Neurone Disease (MND). A person living with MND may present as largely independent at one assessment and become wheelchair-bound with severely limited function within weeks or months. Under the current framework, urgent reassessment can be initiated within 21 days when a participant’s circumstances change significantly. The proposed extension of this timeframe to 90 days places participants with rapidly progressive conditions at serious and unacceptable risk of being without adequate support during a period of acute and rapid functional decline. This change, combined with the administration of assessments by non-health professionals who may lack the clinical knowledge to identify the urgency of a participant’s changing needs, creates a deeply concerning and potentially dangerous gap in the system’s ability to respond to participants who need urgent reassessment. I strongly recommend that the administration of the iCAN be restricted exclusively to qualified and AHPRA-registered allied health professionals with demonstrated competency in functional capacity assessment, that this requirement be legislated as a non-negotiable minimum standard, and that the proposed extension of the reassessment timeframe from 21 to 90 days be withdrawn and replaced with a clinical urgency pathway that enables rapid reassessment for participants with progressive or rapidly changing conditions.
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Provider Registration and Differentiated Pricing for Unregistered Providers The proposed introduction of differentiated pricing for unregistered providers raises serious concerns regarding equity of access, quality of the provider market, and the administrative burden placed on participants and their support networks. I wish to draw the Committee’s attention to an important and frequently misunderstood reality regarding unregistered providers in the NDIS. Many unregistered allied health providers, including Occupational Therapists, are already subject to rigorous and comprehensive regulatory oversight through their AHPRA registration. AHPRA-registered practitioners are required to meet annual registration requirements including mandatory continuing professional development, professional indemnity insurance, police checks, and ongoing fitness to practise requirements. Any misconduct is investigated and can result in conditions, suspension, or cancellation of registration. These practitioners are not operating outside a quality and accountability framework; they are operating within a robust Australian professional regulatory framework. The administrative burden of NDIS provider registration is disproportionate and unnecessarily complex, particularly for small practices and sole trader allied health professionals. A far more streamlined, efficient, and clinically appropriate approach would be to establish a system whereby AHPRA-registered practitioners submit evidence of their current registration
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Submission 457
and insurances to the NDIS on an annual basis as a condition of providing NDIS-funded services. This would achieve the quality and accountability objectives of provider registration without the excessive administrative burden that currently deters many high quality clinicians from obtaining and maintaining NDIS registration. Introducing differentiated pricing for unregistered providers will penalise both providers and participants without meaningfully improving quality or accountability for those providers who are already subject to robust professional regulation through AHPRA. It will drive high quality specialists out of the NDIS market, further reduce the already limited supply of specialist disability supports, particularly in regional and rural areas, and create a more complex and confusing pricing framework for participants and their support coordinators to navigate. I strongly recommend that the proposal for differentiated pricing for unregistered providers be withdrawn, that a streamlined annual AHPRA registration submission process be established as an alternative pathway to NDIS provider recognition for registered health professionals, and that any quality and safeguarding concerns regarding unregistered providers be addressed through targeted and proportionate regulatory mechanisms rather than through a blanket pricing differential.
Concluding Remarks
Across all four areas of concern addressed in this submission, a common and deeply troubling theme emerges, a shift in the NDIS’s fundamental orientation away from the needs of participants and towards the management of costs. I understand and acknowledge the importance of fiscal sustainability. However, I submit to the Committee that the proposals contained within this Bill do not achieve sustainable cost management, they achieve cost shifting, at the expense of some of the most vulnerable Australians in our community. The NDIS works best, for participants, for carers, for providers, and for the public purse, when funding decisions are made accurately, based on comprehensive clinical assessment conducted by qualified professionals, within a framework that prioritises the right support for the right person at the right time. The proposals in this Bill undermine each of these principles in ways that will generate greater long term costs through reassessment, appeals, health system utilisation, carer breakdown, and the compounding consequences of unmet need. Getting the funding allocation right the first time, based on thorough and clinically sound assessment by qualified professionals, is not only the right thing to do, it is the most cost effective approach to managing the NDIS over the long term. I urge the Committee to reject the proposals outlined in this submission and to recommend amendments that genuinely secure the NDIS for future generations, not by reducing its reach, but by strengthening its integrity, its clinical foundations, and its commitment to the people it was created to serve.
Regards,
AB
Occupational Therapist
BOcc Thy, Assoc Dip Bus Mgt
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