Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538Submission 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: Michael Stafford & Jasmin Laffy Submitted On: 30 May 2026
About the Submitters
We are the directors of an unregistered allied health practice and are also NDIS participants. As providers, we have an interest in the service delivery model this Bill alters, and we declare that interest plainly. This submission does not rest on our experience alone. It draws on published research, government data, and the findings of the independent NDIS Review (2023). A full reference list with links to every cited source appears at the end of this document.
Executive Summary
The Bill fails its three stated objectives of combating fraud, improving quality, and ensuring fiscal sustainability, and it contradicts the Government’s commitment, under Working for Women, to put “consideration of gender impacts at the heart of policy design and Budget decisions.”
The Bill undermines quality by replacing clinical judgment with an adapted, unvalidated assessment tool and an undisclosed algorithm; it directs penalties at participants rather than at providers where serious fraud is concentrated; it proceeds without a gender impact analysis despite disproportionately affecting women; and its market changes threaten the scheme’s own sustainability. It also causes harm that none of its objectives address: removing participants’ supports before foundational replacements are available.
To advance the Government’s stated goals, we recommend that the Committee require:
1. Independent validation of the NDIS-adapted assessment tool and the budget-model algorithm, before implementation, with assessment conducted by the participant’s treating clinician. Publish the algorithm, its weightings, and its validation data, and make any Ministerial determination subject to independent clinical review.
2. Compliance powers be directed at the demonstrated source of fraud, which is providers, rather than at people with disability. Extend the 90-day claim window to account for documented administrative barriers.
3. A gender impact analysis of the Bill before it proceeds, with particular attention to the functional-capacity test’s treatment of episodic and treatable conditions,
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538consistent with the Government’s stated commitment to gender-responsive budgeting.
4. A market impact assessment and a full cost-benefit analysis, including downstream costs to the health, justice, and welfare systems, before the commissioning provisions take effect.
5. No participant should be removed until foundational supports are independently verified as operating in their location, and no child should be transitioned to Thriving Kids until the program is demonstrably at scale.
- Improving quality (Parts 1, 4) Part 1 replaces diagnosis-based access with a test of “substantially reduced functional capacity,” assessed through standardised tools the Government describes as evidence-based. The instrument, named the I-CAN v6, is itself a validated tool. But the NDIA is adapting it for the NDIS, with the University of Melbourne and the Centre for Disability Studies, and pairing it with a separate “budget model engine” that converts assessment results into funding. A validated instrument’s evidence base applies only to the validated version used as designed; the adapted tool and the budget algorithm have not been independently validated or published, so the evidence-based description does not yet hold for what the Bill will deploy.
Functional capacity assessments are well established when a participant’s own occupational therapist conducts them over weeks of observation. The Bill does not preserve that process; it relies on short assessments by unfamiliar assessors, with outputs processed through an algorithm rather than clinical judgment. Capacity fluctuates, and observational task analysis by a treating clinician captures limitations that self-report instruments miss. This is consistent with the NDIS Review’s finding that clinicians’ views are “not always considered,” and standardised tools introduce a bias that tends to underestimate impairment in people who mask.
The effect falls hardest on neurodivergent participants. Autistic people often mask, so a brief assessment by an unfamiliar assessor cannot capture their actual capacity (APH, 2024). Many people with ADHD have reduced insight into their own functional limitations, so self-report tools systematically understate impairment (The Conversation, 2025). For psychosocial disability, functional impact is episodic and cannot be captured at a single point in time. The Bill also requires applicants to show their impairment cannot be substantially remedied by treatment (Part 3), which creates a barrier for conditions described as “treatable,” such as ADHD, where medication improves symptoms while substantial impairment persists (Kosheleff et al., 2023).
Part 4 compounds this by allowing the Minister to reduce funding for entire categories of support. Down Syndrome Australia reports proposed reductions of 50 per cent to social
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538and community participation and 10 per cent to capacity building from October 2026. These are fiscal ceilings applied regardless of individual clinical recommendations, in tension with Article 19 of the UNCRPD. As participants, we have experienced planners overriding clinical recommendations and arriving at meetings with budgets that appear pre-determined, which reduces actual therapy time as clinicians help clients through the distress of inadequate plans and the review process.
The system already makes poor decisions at scale. At Senate Estimates in February 2025, the NDIA CEO acknowledged that staff often cannot read the lengthy clinical reports participants are required to submit. Of the 110 external-review matters that reached a hearing decision in 2023–24, half (55) were varied or set aside (NDIA Annual Report 2023–24). If a clinical decision requires clinical qualifications when a practitioner makes it, the basis for allowing the same decision to be made by an algorithm, a planner with no clinical requirement, or a Minister is unclear. Under the AHPRA Shared Code of Conduct, a registered health practitioner must “recognise and work within the limits of [their] skills and competence,” and an occupational therapist who practises beyond their scope faces disciplinary action. The Robodebt Royal Commission documented the cost of opaque automated decisions applied to vulnerable people: about $1.76 billion in unlawfully raised debts against roughly 433,000 people, settled for $1.8 billion (Robodebt Royal Commission, 2023).
- Combating fraud (Parts 1, 2, 5) Fraud is real, but it does not account for the Bill’s burden on participants. The projected savings come overwhelmingly from tighter eligibility, reassessment, and reduced budgets, not from recovering fraud. When the Government’s earlier four-year savings forecast of about $19 billion was examined, fraud enforcement accounted for just 1.05 per cent of it (Morton, The Saturday Paper, January 2025).
The $37.8 billion headline is a reduction in projected growth, not recovered fraud. The Fraud Fusion Taskforce had identified roughly $60 million in suspected fraud against a scheme costing over $50 billion, a fraction of one per cent, and the most serious identified fraud involves providers, not participants (UNSW AHRI, 2022).
The Bill nonetheless imposes new civil penalties and record-keeping obligations on participants (Parts 2 and 5). Tighter eligibility, algorithmic planning, and blanket reductions will also generate a wave of new appeals whose cost the savings projection does not appear to reflect.
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 5383. Putting gender impacts at the heart of policy and budget decisions (Parts 1, 3, 4) The Government’s Working for Women strategy commits it to put “consideration of gender impacts at the heart of policy design and Budget decisions” (Working for Women, 2024). As a budget measure, the Bill is bound by that commitment but does not meet it.
Women are about half the working-age disability population, but as of 2022, only 37 per cent of NDIS participants (The Conversation, 2022). The new functional-capacity test is likely to widen that gap rather than close it. It favours impairment that is permanent and readily observed, and disadvantages conditions that are episodic or described as treatable. That is the profile of psychosocial disability, chronic pain, and trauma-related conditions, which fall disproportionately on women, and the masking and self-report problems set out in section 1 compound the effect.
The consequences extend beyond eligibility. Where supports are withdrawn, the unpaid care that replaces them falls mainly on women, who are about two-thirds of Australia’s primary carers (ABS Survey of Disability, Ageing and Carers, 2022). Women also make up most of the workforce that the projected job losses will hit: roughly 70 per cent of disability support workers, and close to 90 per cent of allied health staff (National Disability Services). AIHW data for 2013–2018 show women aged 50–64 who used disability services died by suicide at nearly four times the general population rate. WWDA warns that the Bill will deepen these inequalities unless a gender impact analysis is conducted (WWDA, 2026). The eligibility restrictions engage Australia’s obligations under the UNCRPD, including Article 6 (women with disabilities) alongside Articles 19, 26, and 28.
- Ensuring fiscal sustainability (Parts 1, 6) Cost growth was already moderating, from about 22 per cent to roughly 11 per cent, without this legislation, and the NDIS Review envisaged a phased five-year transition rather than the Bill’s compressed timeline. Per Capita’s 2021 modelling, using NATSEM, estimates the scheme returns about $2.25 in economic activity for every $1 spent, so reductions carry offsetting losses that the savings figure does not capture.
The Bill’s own mechanisms also threaten sustainability. Its registration expansion, differentiated pricing, and commissioned panels risk consolidating a market already affected by thin-market failures (Parts 1 and 6). As a small unregistered provider, we face this directly: most of our costs are therapist wages, and price stagnation has already limited our capacity to keep wages in line with inflation. Further price reductions for unregistered providers would push a near-zero margin into unviability, and industry estimates put up to 140,000 disability-sector jobs at risk (HRD, 2026).
The Bill also tracks an existing body of fiscal-policy advice. The Grattan Institute’s 2025 framework mirrors its approach, the OECD’s 2026 Economic Survey identified care-sector
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538costs as a fiscal pressure, and the Australian Chamber of Commerce and Industry has called for government spending to be cut to below 25 per cent of GDP (from 27.8 per cent in 2024–25, a reduction well in excess of $50 billion a year), naming the NDIS among the structural-spending pressures it wants contained. The Committee may wish to consider whose policy preferences the Bill reflects, and whether the reduction, one fiscal choice among several of comparable scale, is a necessity or a choice.
- A harm the Bill’s objectives do not address: removing support before a replacement exists (Part 9) Part 9’s eligibility changes are projected to redirect an estimated 160,000 or more participants to “foundational supports,” governed by the National Agreement on Foundational Supports 2026–31 and funded at $10 billion over five years ($5 billion Commonwealth share). The $37.8 billion figure is a reduction in projected growth rather than a cut to current cash spending, but the direction is clear: far more support is being withdrawn than the replacement is funded to provide, and the replacement does not yet operate at scale.
Sequencing is the central problem. Autistic children with low to moderate support needs are to be redirected to Thriving Kids from October 2026, before the program reaches scale (expected January 2028). Governments have committed $4 billion over five years to Thriving Kids, and no public costing of the specific cohort to be redirected has been released, so the adequacy of that figure cannot be assessed. Early intervention is the most evidence-supported approach for autistic children, and the Bill moves them out of the scheme that funds it before the alternative is operational.
People who use disability services already face elevated mortality risk. AIHW data for 2013–2018 show that men aged 35–49 who used disability services died by suicide at 62 per 100,000, more than double the comparable general-population rate. These figures establish the baseline vulnerability of the population the Bill proposes to redirect; they do not measure the effect of removal, which has not been studied. The absence of more recent NDIS-specific mortality data is itself a safeguarding gap, and the Bill contains no safety net for participants who lose access to the NDIS.
Conclusion
The Minister has stated that Federal Court and Administrative Review Tribunal decisions have restricted the Agency’s ability to implement scheme changes. Those decisions have generally been found in favour of participants and established protections that the Bill now seeks to override by legislation. We ask the Committee to weigh the consequences of responding to court-ordered protections for disabled people by changing the law to remove them, and to recommend the amendments above so the Bill advances the Government’s stated goals rather than undermining them.
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538References
Legislation and Government
● Senate Community Affairs Legislation Committee Inquiry
● Bill text and Explanatory Memorandum (Parliament of Australia)
● Government overview of reforms
● Working for Women: A Strategy for Gender Equality, 2024 (Office for Women /
PM&C)
● Budget 2026–27: Care and Opportunity
● National Agreement on Foundational Supports 2026–31
● Thriving Kids, Department of Health
● Department of Health, ILC Program
● NDIA Annual Report 2023–24
● UNCRPD - Convention on the Rights of Persons with Disabilities, Articles 4(3), 6, 19, 26, 28
● Senate Estimates, February 2025 (NDIA CEO evidence on clinical reports)
Reviews, Inquiries and Reports
● NDIS Independent Review (Bonyhady & Paul), 2023
● NDIS Review, “What we have heard” report, 2023
● NDIS Review, Part 3: A New Compact Between Governments
● NDIS Review, Market challenges (thin markets)
● Robodebt Royal Commission Report, 2023
● OECD Economic Surveys: Australia 2026
● Grattan Institute, “Saving the NDIS,” 2025
● ANAO, Governance of the NDIS Fraud Fusion Taskforce
NDIS Data and Analysis
● NDIS Quarterly Report, March 2025
● NDIS Fraud Fusion Taskforce, Two-Year Milestone, 2024
● NDIS, “Update — a new way of planning” (I-CAN adaptation with the University of Melbourne and the Centre for Disability Studies)
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538● Morton, “Children targeted in NDIS crackdown,” The Saturday Paper, 11 January 2025
● Morton, “New NDIS reform is in chaos,” Crikey, 5 March 2026
● NDIA Rural and Remote Strategy
● ABS, Disability, Ageing and Carers, Australia: Summary of Findings, 2022 (primary carers 67.7% female)
● NDS, Workforce Census — Key Findings Report (women ~70% of disability support workers, ~92% of allied health staff)
Disability Advocacy Organisations
● PWDA, response to the 2026–27 Federal Budget, 2026
● Down Syndrome Australia, Joint Statement, May 2026
● Down Syndrome Australia, “Initial Thoughts on the NDIS Bill,” May 2026
● WWDA, Gendered Risks of the NDIS Amendment Bill 2026, 2026
● CYDA, Explainer: Federal Budget 2026–27
● Justice and Equity Centre, Bill Explainer, 2026
● Advocacy for Inclusion, NDIS Reforms 2026 Analysis
● APH Submission on Mandatory Assessments and Autism, 2024
Economic and Fiscal Research
● Per Capita, False Economy: The Economic Benefits of the NDIS, 2021
● AFDO summary of Per Capita modelling
● Australia Institute, Fossil Fuel Subsidies in Australia 2026 (~$16.3 billion in 2025–26)
● Australian Chamber of Commerce and Industry, 2026–27 Pre-Budget Submission
● 2024 National Defence Strategy and Integrated Investment Program (additional $5.7 billion over four years and $50.3 billion over the decade)
Academic, Clinical and Media
● Kosheleff, Mason, Jain, Koch & Rubin, “Functional Impairments Associated With
ADHD in Adulthood and the Impact of Pharmacological Treatment,“ Journal of
Attention Disorders, 2023
● UNSW AHRI, NDIS Fraud Analysis, 2022
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Submission 637
Divergent Health
+61 403 623 965 • contact@divergenthealth.au • https://divergenthealth.au • ABN 52 663 283 538● UNSW, “The government wants to contain NDIS growth,” 2025
● UNSW Newsroom, “How people are assessed for the NDIS is changing,” 2025
● AIHW, Suicide and Self-Harm Monitoring: Disability Service Users
● HMRI, Rising ADHD and Autism Diagnoses, 2026
● AHPRA, Shared Code of Conduct (Principle 1: recognise and work within the limits of your skills and competence)
● Morrison et al., Australian Occupational Therapy Journal, 2025
● Flower et al., Autism in Adulthood, 2025
● Liddiard et al., Choice and Control research, The Conversation, 2024
● Carey et al., BMC Public Health, 2022
● ConnectSci, Brain Impairment, 2025
● AIC, Fraud against the Commonwealth 2022–23 (Statistical Bulletin 44)
● Davy, “First Robodebt, now NDIS and aged care,” The Conversation, April 2026
● Keating, “Saving the NDIS or shrinking it?,” The Mandarin, 19 May 2026
● The Conversation, “Women make up half the disability population but just over a third of NDIS recipients,” 2022
● The Conversation, “NDIS eligibility will be based on functional capacity,” 2025
● The Nightly, “NDIS executive reveals it doesn’t know how to collect statistics on fraudulent claims,” 2026
● HRD, “Up to 140,000 disability jobs at risk,” 2026
● ClinicComply, Provider Timeline Analysis, 2026
● AERA, APA and NCME, Standards for Educational and Psychological Testing, 2014 (validity is specific to an instrument and its intended use; adaptation or repurposing requires re-validation)
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