Submission 468
Optimum Movement Senate Submission – May 2026
SUBMISSION TO THE SENATE COMMUNITY AFFAIRS LEGISLATION COMMITTEE
National Disability Insurance Scheme Amendment
(Securing the NDIS for Future Generations) Bill 2026
Submitted by: Fiona Canny, Senior Occupational Therapist/Director
Registration: AHPRA Registration No:
Business: Optimum Movement Pty Ltd, South- East Qld
Clinics – Gold Coast, Redlands, Brisbane South, Sunshine Coast
Date: 28 May 2026 Contact details:
About Me
I am a passionate paediatric Occupational Therapist (OT) with 29 years of clinical experience working with NDIS participants across paediatric and young adult populations. I submit this response on multiple fronts both in a personal professional capacity as a treating therapist; as an employer representing the voices of my worried team; and as an advocate for the many families and participants that this will affect.
I support the Government’s stated goal of placing the NDIS on a sustainable footing. Waste, inconsistency, and misuse must be addressed. I understand the overspend; the wasted funds; the lack of quality assurance across the sector; the vulnerability of families being exposed by some less than reputable businesses and therapies that are not evidenced based.
I’m older enough to have known the previous system and the system before that. I strongly believe that the NDIS have given families and participants the access to therapy and assistive technology that has made significant contribution to their quality of life, their ability to contribute to the community; reduced the burden on the health system providing early intervention and decreased the lifelong impairments that disability may have caused them. I’m a strong advocate for early intervention and work to reduce therapy intervention as soon as practicable and transfer to community-based supports.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
However, as currently drafted, the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 will cause foreseeable and serious harm to some of the most vulnerable people in Australia, including children who stand to benefit most from early intervention.
My business is Optimum Movement. We are an employer of occupational therapists, physiotherapists, allied health assistants and an administration team. Our business was started well before the NDIS, so I see the difference it has made to:
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Participants, families and children Being able to get the assistive technology such as a wheelchair that best suits their child not the one they can afford due to the part payment required in the old MASS scheme Accessing therapy at the right time and the right dose which means they no longer require any therapy when they start school as goals have been achieved. Being given some choice and control about who and where they live; accessing further study and work because they have support and increased involvement in the community. Being supported to cope with significant grief of a diagnosis and being supported by a knowledgeable team of therapists that can support and walk beside them on their journey, helping to establish and work on goals, achieve and celebrate the wins and be strengths based on the next achievable goals for their child. Feeling a sense of belonging and community within an organisation from therapist to admin team where the progress is celebrated.
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Community People and children with disabilities are now more visible in the community Increased community participation options for people with a disability that are “all abilities” A community that looks towards inclusion, reviews environmental access and supports access
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Therapists and health professionals Being supported to develop skills in small privately owned and operated businesses where the business owner is a treating therapist. Working in small to medium sized businesses have allowed therapists to have some flexibility and demonstrate their integrity with NDIS participants being at the heart of the business, where outcomes and goals are individually set and goal attainment driven by passionate therapists rather than motivated by dollars.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Summary
My submission raises four interconnected clinical concerns:
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The Bill’s new functional capacity threshold, definition and tightened access criteria will exclude clients who meet the original intent of the NDIS but whose needs do not present as a single, severe, primary impairment;
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The shift to standardised assessment tools risks producing plans that are insufficiently responsive to dose, frequency, the environment where it might be completed and modality of therapy — fundamentally misunderstanding how effective allied health intervention works;
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The requirement that supports arise ‘directly’ from the eligible impairment fractures the whole- person framework that underpins OT practice. We understand that sometimes it is the co-morbidities that are presenting the most significant contributor to the impairment not the primary diagnosis. We assess the participant on their functional capacity not their diagnosis and strongly believe in seeing and treating the whole person. Without acknowledging co-morbidities this leaves complex clients without support for needs that are clinically inseparable from their disability. This particularly affects our paediatric population who often have several co-morbidities that are significant contributors to the functional impairment such as a visual impairment, intellectual impairment, ADHD and/or epilepsy.
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Allocating Ministerial power to make changes and cuts to the NDIS and pricing guidelines will bring in the possibility of instability. It would mean that NDIS funding and pricing could be reviewed or changed based on a change of a Minister, change of a government. Ministerial power would undermine the therapy plan, continuity of supports and bring a feeling of fear and instability to participants.
I have read the read the proposed legislation and urge the Committee to recommend amendments that protect access for: clients with complex needs and acknowledges the whole person inclusive of all diagnoses
clients with numerous co-morbidities that contribute to the primary “mild to moderate”
impairment/diagnosis; ensure early intervention funding is adequate in dose and duration to deliver outcomes, ensures early intervention is individualised and specific to the goals of the child and not following a generic program recognises the specialists’ skills of early intervention therapists and preserves the clinical integrity of the therapist’s role in assessment and planning and ensuring therapy is individualised to meet the needs and goals of participants Recognises that a experienced and education therapy workforce already exists in the private sector that can support participants and is able and skilled to contribute to Foundational Supports
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
I urge the Committee to be open to the ideas of therapists who make suggestions of how and where to cut the over-spend and the waste. I urge the Committee to amend: The Minister being in charge of the price guide The proposed changes to “reasonable and necessary’ The proposed changes to expectations of informal supports without clear guidelines being added about what level of informal supports are required at specific ages for self-cares, transport, emotional support and behavioural supports.
About This Submission
I am a registered Occupational Therapist practising in Qld and a business owner representing 24 therapists. Our team supports a (largely) paediatric caseload with both NDIS participants and other funding models including NIISQ, CTP, Medicare and privately paying. We support NDIS participants including children with
autism spectrum disorder (ASD), developmental coordination disorder, intellectual impairments,
neurological impairments such as cerebral palsy and acquired brain injury and children and teens with psychosocial disability arising from complex mental health conditions. Many of my clients present with more than one impairment.
We have an experienced therapy team that have supported the needs of our families throughout the NDIS journey. We have supported the NDIS processes including writing functional capacity assessments, writing NDIS access applications, submitting NDIS review reports, and writing Assistive Technology applications. We have supported families going to ART and through plan re-assessments when funding has not been adequate.
I have direct experience of the consequences when plans do not fund adequate therapy intensity: children plateau and regress; equipment is not funded and valuable therapy resources are used in support for basic therapy and equipment needs. Families are then directed to ART which is costly and often costs more for the government to fund the tribunal than the original request.
My submission focuses on four areas of the Bill where, in my clinical view, the current drafting is likely to produce outcomes inconsistent with evidence-based best practice.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Concern 1: The ‘Directly From an Eligible Impairment’ Requirement Fragments Whole-Person Care
What the Bill Proposes
The Bill amends the NDIS Act to require that supports arise ‘directly’ from an eligible impairment, rather than simply ‘arising from’ an impairment as the current Act provides. In addition, the Bill clarifies that access, and planning decisions will be anchored to impairments that meet the eligibility threshold. The Explanatory Memorandum confirms the Government’s intent is to limit funding to the impairment that qualifies the person for the Scheme.
The Clinical Problem
As therapists we have been trained to see “the whole child”, the family-child relationship and the influence of environment on a child’s participation in a task. A diagnosis does not tell us of a person’s functional capacity nor their level of participation. The impact of a disability can be increased through presence of co morbidities and environmental factors. The International Classification of Functioning, Disability and Health (ICF) — the framework explicitly referenced in the original NDIS Act — recognises that a person’s capacity is shaped by the interaction of
health conditions, body structures, activity, participation, and environmental and personal factors
simultaneously. For many of my clients, the impairment that qualified them for the NDIS is inseparable from a constellation of co-occurring needs. In paediatrics we will often see a primary impairment first and then other co-morbidities follow. The impairment affecting participation may have very little to do with the primary diagnosis. Isolating the ‘eligible’ impairment and funding only supports that flow ‘directly’ from it will, in practice:
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Leave co-occurring needs unaddressed even where those needs amplify or are clinically driven by the primary impairment;
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Produce plans that fund partial intervention — which is inadequate to address the whole goal;
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Require therapists to treat a single diagnosis, ignoring their clinical reasoning and ignoring the change that is required.
I note that other submissions have raised concerns that this single word — ‘directly’ — has no statutory or regulatory definition in the Bill. The absence of guidance creates a risk that planners and assessors will apply it inconsistently, with participants who present with multiple needs bearing the consequences of that inconsistency.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Case Vignette 1: Jaylen, Age 7
Jaylen is a 7-year-old boy with a confirmed diagnosis of cerebral palsy (hemiplegia) and is eligible for the NDIS. Jaylen also presents with autistic spectrum disorder and a co-occurring anxiety disorder. He has significant chronic constipation and regulation issues.
These presentations are clinically interconnected. His toileting issues is not a separate condition. It is well-documented comorbidity of ASD and CP. His behavioural regulation and anxiety affect his toileting.
Under the current Bill’s drafting, Jaylen’s plan could be restricted to supports ‘directly’ arising from his CP diagnosis. In practice, this risks excluding the behavioural toileting therapy approach and anxiety management strategies that form his toileting therapy plan. It might address only the postural support element associated with toileting as this relates “directly” to the primary diagnosis. Treating his CP in isolation is not clinically coherent. It is not possible to separate the threads of his presentation without unravelling the whole.
Recommendation
The Committee should recommend that:
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The term ‘directly’ in the amended support linkage test be removed or replaced with ‘arising from or related to’ an eligible impairment, consistent with the original Act’s intent;
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Guidance explicitly acknowledge that co-occurring conditions that are clinically connected to an eligible impairment should remain fundable;
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The Bill’s drafting be reviewed to align with the ICF framework, which the NDIS has always nominally endorsed.
Concern 2: The Bill Does Not Protect Adequate Early Intervention Dose or Duration
What the Bill Proposes
The Bill tightens eligibility criteria and introduces standardised functional capacity assessment tools as the primary mechanism for determining access and plan budgets. Plan rollovers are to be ended, with budgets reset to align with assessed need. Unscheduled reassessments are restricted to circumstances where there has been a ‘significant and ongoing’ change in functional capacity.
The Clinical Problem
In early intervention, we often see the emergence of a diagnosis. Umbrella terms such as Global Developmental Delay indicates that additional testing is still being undertaken. Additional diagnoses are
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
often added in early years. Not being able to request a reassessment due to this is unfair and doesn’t recognise the needs of the child. Only allowing for “significant” change in functional capacity rather than a clearer presentation of a child and their needs means therapy may not be targeted at the right time or dose. Early intervention for children with disability is one of the most evidence-supported areas in all of allied health. The research base — across ASD, cerebral palsy, developmental language disorder, Down syndrome, and acquired brain injury — is unambiguous: outcomes are maximised by early, intensive, sustained intervention delivered by qualified therapists working collaboratively with families. Many of the recently published clinical guidelines have evaluated “dose” as well as collaboratively working and recognition of the environment being key. The word ‘dose’ matters a lot in the therapy world. It underpins what we provide and the outcomes achieved. Frequency and duration are key drives to evaluate if a therapy approach is successful.
Therapy approaches such as Cognitive Orientation to daily Occupational Performance (CO-OP) needs therapy to be completed weekly for 10 weeks - not 10 sessions over 20 weeks. From the untrained eye, it looks like the same number of sessions but dose matters. Does incorporates amount + frequency. Dose affects therapy outcomes. Different therapy approaches will recommend a different dose. Some therapy approaches are diagnosis specific and the presence of co-morbidities such as an intellectual impairment affects its’ effectiveness. To treat a child effectively we look at the whole child, consider all diagnoses, the environment and other psycho-social and environment factors.
Standardised functional capacity assessments, by design, measure current function. They do not model trajectory; they don’t recommend responsiveness to change; nor adequately measure the additional capacity around the person to elicit the required change. They do not capture the dosage required to close a gap nor suggest which therapy approach would be most beneficial.
My clinical concern is that budgets calculated from point-in-time functional capacity assessments will routinely underestimate the therapy intensity needed to produce genuine developmental change — and that the new restrictions on unscheduled reassessments will prevent rapid correction when this happens.
The current requirement that reassessment only be triggered by ‘significant and ongoing’ changes in functional capacity creates a perverse situation for early intervention clients. Children in effective therapy are specifically intended NOT to show declining function — they are improving. But if their plan underfunds the therapy intensity required to maintain that trajectory, they will plateau or regress before a reassessment threshold is met. By the time the system responds, the developmental window has narrowed. The basis of early intervention is to provide time specific, evidence-based therapy to builds the capacity of the child in the hope that goals can be achieved and prevent lifelong disability.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Case Vignette 2: Amara, Age 4
Amara is a 4-year-old girl diagnosed with developmental coordination disorder (DCD) and expressive language delay. She accessed the NDIS under the early intervention pathway. Her initial plan was set following a functional capacity assessment that captured her current function accurately — she was behind same-age peers in gross and fine motor skills and was using fewer than 50 words at age 3.
Her therapy team recommended fortnightly occupational therapy, weekly speech pathology, and a home program with family coaching — an evidence-based intensity for a child of her profile. The plan allocated funding equivalent to approximately monthly OT and fortnightly speech pathology. The discrepancy between recommended and funded intensity was not the result of an unreasonable recommendation. It reflected a budget calculation that did not model what the therapy literature says is needed to close the developmental gap.
Amara’s mother has begun limiting therapy attendance to preserve funds for the full plan year. At Amara’s last review, her speech pathologist noted she had made some progress but remained significantly delayed. The window for the most impactful early intervention is narrowing. The plan has not been reassessed because there has been no ‘significant and ongoing change in functional capacity’ — she has been making slow progress, not deteriorating. The system does not have a
mechanism to respond to 'progress is happening but at too slow a rate because intensity is
insufficient.’
Recommendation
The Committee should recommend that:
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Early intervention plans be subject to a distinct funding framework that incorporates evidence-based dosage standards for the relevant disability types, not solely point-in-time functional capacity measures;
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A clinical review mechanism — separate from the ‘significant and ongoing change’ threshold — be available for early intervention participants where a treating therapist has clinical evidence in line with best practice guidelines that illustrates that funded intensity is insufficient to maintain the intended developmental trajectory;
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The rules governing early intervention planning be co-designed with the relevant allied health professional peak bodies, including Australian Physiotherapy Association, Occupational Therapy Australia and Speech Pathology Australia, before implementation.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Concern 3: Standardised Functional Capacity Assessments Are Not Sufficient to Capture Complex Needs
What the Bill Proposes
The Bill establishes a legal framework for standardised, functional capacity-based access decisions. Assessments will be conducted using tools determined by a Technical Advisory Group. The Bill provides Ministerial power to determine the assessment methodology, with limited Parliamentary oversight.
The Clinical Problem
I have significant concerns about the use of standardised functional capacity tools as the primary — and potentially sole — mechanism for determining NDIS access and planning budgets for complex clients. It reduces clinical discretion; it doesn’t understand the impact of invisible factors such as fatigue and endurance and may evaluate the participant in “best case” scenarios. No standardised tool currently available captures the full clinical picture of a person with complex disability. Tools such as the WHODAS 2.0 or the ABAS3 provides useful snapshots of current functional capacity in defined domains. However, they do not capture:
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Fluctuating presentation — how a person functions on a bad day versus a good day, which for conditions where factors such as emotional regulation, learning difficulties, brain fog, fatigue, psychosocial disability, or variable neurological conditions can vary enormously;
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The interdependence of supports — how a reduction in one type of support cascades into deterioration in multiple domains. A reduction in social and community participation supports may not reduce a person’s need for supports. If a person continues to require support at home then this support need will then be increased in the home environment;
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Environmental and contextual factors — a participant’s function and participation at home with skilled support is not the same as their function in an unfamiliar environment without support;
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The expertise of the treating team — a one-off assessment by an NDIA-contracted assessor who does not know the participant cannot replicate the clinical picture that emerges from an ongoing therapeutic relationship.
Previous proposals for NDIS “independent assessments”— which were ultimately abandoned following widespread professional opposition — raised precisely these concerns. The ongoing therapeutic relationship and deep understanding of a participant’s needs cannot be replaced at the same level of understanding with a new unfamiliar functional capacity assessment conducted in one environment only. The Bill does not appear to have resolved the issue of an independent assessment not giving an accurate picture. The result will be a plan written based on the results of an assessment on 1 snapshot of time and may not reflect typical performance. It may not accurately reflect the needs of the participant, resulting in more applications to the tribunal.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
I note that the CEO of the NDIA acknowledged in February 2025 that NDIA staff frequently do not have time to read the clinical reports submitted by participants and treating teams. Introducing a system where budgets are set by standardised tools, while the existing framework for treating-team evidence is already not being read, compounds rather than addresses this problem.
Case Vignette 3: David, Age 34
David is a 34-year-old man with a primary NDIS eligibility on the basis of a diagnosis of cerebral palsy (dystonia). He lives alone with support. He has co-morbidities including anxiety and pain. He suffers from considerable fatigue due to his physical disability.
David’s dystonic CP produces significant variability in his physical functioning. His dystonia and anxiety are corelated, and both considerably affect his fatigue. His diagnosis of anxiety which was not the basis of his NDIS eligibility remains clinically inseparable from his CP. Anxiety affects dystonia and shifts the physical capabilities of what David is able to do. The variability of his participation is large.
A standardised functional capacity assessment conducted on a day when David was adequately rested and had received his full suite of supports would rate his capacity materially much higher than an assessment conducted at another time when anxiety has increased due to life/work stresses, fatigue has accumulated and emotional regulation is at its lowest. David’s function fluctuates significantly across the week. This is a core feature of dystonic cerebral palsy.
A budget set from a single point-in-time assessment would very likely be calibrated to his ‘good’ function. A day when he can participate in standing transfers. It doesn’t recognise the day when he cannot complete a standing transfer even with support from a standing hoist and support worker.
David’s NDIS budget would not sustain the daily support hours required to maintain his safety on his worst days nor recognise that increase AT may be required to provide hoisting support of the harder days. The consequences of underfunding David’s plan are not inconvenience. They result in long hospital stays, accommodation and support difficulties and greater cost to the system than the therapy and supports that would have prevented the crisis.
Long periods of hospitalisation due to incorrectly funded AT or support workers equates to a much larger expense for the government.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Recommendation
The Committee should recommend that:
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Standardised functional capacity tools be used as one input into planning decisions, not as the determinative or primary mechanism for budget-setting;
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Treating therapist reports and functional assessments conducted by the participant’s ongoing clinical team be given explicit statutory weight in planning decisions, alongside standardised tool outputs;
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The rules governing functional capacity assessment methodology be disallowable instruments, subject to full Parliamentary oversight, rather than purely Ministerial determinations;
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Participants with fluctuating conditions or complex multi-system presentations be assessed across multiple timepoints, not from a single interaction.
Concern 4: Ministerial Powers for Funding
What the Bill Proposes
The Bill grants the Minister broad powers to reduce funding for specific groups through support determination. Proposed section 34A would create an extraordinary power permitting across the board percentage reduction to funding components in current plans. The Bill also transfers responsibility for pricing decisions to the Minister.
The Clinical Problem
This creates the possibility of multiple changes and cuts to NDIS based on a change of a Minister, change of a government and is not in the best interest of the participants. It would undermine the therapy plan, continuity of supports and put at risk necessary assistive technology and/or home modifications that are being planned.
Resetting the capacity building budget and reducing this by 10% as well as reducing the social and community participation budgets by 50% fails to recognise the community participation is about life skills and not just social activities. It cannot be replaced by the Inclusive Communities Funding. Community participation includes grocery shopping, visiting the doctor and going to the bank.
Cutting the social and community participation budgets also fails to recognise that cutting this support may lead to increased need for at home supports.
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
Recommendation: The Committee should recommend that:
- There is no change of powers being allocated to the Minister for both the price guide and also the extraordinary power to cut NDIS funding across the board.
Cross-Cutting Concern: Foundational Supports Are Not Ready to Catch Those Who Exit the NDIS
The Bill is premised in part on the assumption that participants who no longer meet NDIS access criteria will transition to ‘foundational supports’ delivered through mainstream services. As Occupational Therapy Australia noted in its submission to the earlier NDIS Amendment inquiry, it is not clear what those services will look like, where they will be, how they will be funded, or when they will be available — and whether they will differ meaningfully depending on which state a person lives in.
From a clinical perspective, I am concerned that clients who are transitioned out of the NDIS on the basis of new functional capacity thresholds will be referred to services that do not yet exist, or that will not offer the specialist allied health expertise their presentations require. Foundational supports designed for ‘lower needs’ participants will not be appropriate for a child like Amara, whose developmental trajectory depends on specialist OT and speech pathology intervention.
I urge the Committee to recommend that no participant be transitioned out of the NDIS under the new eligibility framework until the foundational supports that are intended to replace their NDIS access are operational, funded, and available in their jurisdiction.
Conclusion
The NDIS is worth protecting. The principles it was built on — early intervention, reasonable and necessary support, whole-person care, and the right to participate fully in Australian life — remain sound. My concern is not with reform. My concern is that the Bill, as currently drafted, implements reform in ways that will predictably harm the clients I work with every day.
Restricting supports to those arising ‘directly’ from a single eligible impairment does not reflect how disability works in the body or in daily life. Not recognising that “therapy dose” is vital. Funding therapy at intensities that the evidence tells us are insufficient to produce outcomes is not saving money — it is deferring cost and delaying development in ways that are very difficult to reverse. Replacing the clinical picture built over a
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama
PO Box 762, Cleveland Qld 4163
Submission 468
Optimum Movement Senate Submission – May 2026
therapeutic relationship with a single standardised assessment risks making consequential decisions on the basis of incomplete information that doesn’t consider the variability of a clinical picture and the influence and contribution of co-morbidities on functional capacity.
I ask the Committee to give weight to the clinical expertise of therapist and other allied health professionals who have direct, sustained relationships with the people this legislation will affect. We are not opposing reform. We are asking that reform be done in a way that does not abandon the people the NDIS was designed to serve. We are asking for experienced therapist workforce in the community sector to be recognised and this voice heard in contributing to a reform that optimises outcomes and minimises waste.
I would welcome the opportunity to speak at the hearing regarding this submission.
Fiona Canny
Principal Occupational Therapist/Director
Optimum Movement
Date: 28 May 2026
Optimum Movement Pty Ltd ABN: 74 65911 6803
Cleveland Varsity Lakes Minyama