Concerns regarding functional capacity definition and funding reductions (Provider advocacy) | External submission

Submission 641

Australian Rehabilitation and Assistive

Technology Association (ARATA)

Submission to the Legislative Affairs Committee

National Disability Insurance Scheme

Amendment (Securing the NDIS for future generations) Bill 2026

29 May 2026

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ARATA would like to acknowledge and thank the many ARATA members who contributed their knowledge and expertise to inform this submission.

Submission 641

Executive Summary

The Australian Rehabilitation and Assistive Technology Association (ARATA) welcomes the opportunity to provide this submission regarding the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

This submission focuses specifically on the likely impact of the proposed reforms on access to assistive technology (AT) and home modifications (HM). For many NDIS participants, these supports are essential components of an effective disability support system. They enable people with disability to live safely, maintain independence, participate in their communities, reduce reliance on formal care and avoid preventable injury, hospitalisation and institutionalisation.

ARATA acknowledges the importance of ensuring the long-term sustainability of the National Disability Insurance Scheme (NDIS). However, sustainability should not be pursued through reforms that undermine access to supports which are themselves highly cost-effective and preventative in nature. Assistive technology and home modifications frequently reduce downstream expenditure across health systems, aged care, housing, carer systems and emergency services.

Several aspects of the Bill raise significant concerns for the AT and home modifications sector.

The proposed definition of “functional capacity” in proposed section 9B risks fundamentally misrepresenting the way disability occurs in real life. By excluding AT, environmental context and support systems from assessment processes, the Bill creates an artificial framework that does not align with contemporary practice or the social model of disability. Functional capacity cannot be accurately understood in isolation from the environment in which a person lives.

ARATA is additionally concerned by the proposed Ministerial powers allowing percentage based funding reductions for reasons of “financial sustainability”. These powers may directly or indirectly affect AT, HM, and therapy services without regard for individual assessed need. The proposed 10 percent reduction to therapy budgets may also significantly affect the assessment, prescription and implementation of AT and HM.

The permanence and treatment provisions may delay access to urgent AT and HM by requiring participants to undertake “all appropriate treatment” before impairments are considered permanent.This fails to recognise that many AT and HM supports are required immediately for safety, mobility, communication, pressure care, discharge from hospital and independent living.

ARATA is also concerned about the risk of increasing reliance on automated decision making, including in standardised assessment systems. Complex AT and HM needs often arise from the interaction of cumulative impairments, environmental barriers, housing conditions, and support arrangements. These needs are poorly suited to automated or highly standardised assessment models.

ARATA therefore recommends that the Bill be substantially amended to ensure AT and HM remain grounded in individualised assessment, allied health expertise, environmental accessibility principles, and participant safety.

Submission 641

ARATA Recommendations ARATA recommends that:
Proposed section 9B be amended to require functional capacity to be assessed in real- world conditions, including consideration of AT, home accessibility, environmental barriers, multiple impairments, and support systems.
The permanence and treatment provisions contained in proposed subsections 24(5), 25(1B) and proposed section 25A be amended to clarify that participants can access AT and HM while treatment pathways continue where disability/disabilities are permanent and supports are necessary for safety, mobility, communication, discharge from hospital, or independent living.
Proposed section 34A be removed or amended to expressly exclude AT and HM from percentage-based funding reductions or funding caps.
The Bill retains explicit recognition of treating allied health professional evidence in the determination of NDIS functional capacity and permanence of disability; and prescription and funding of AT and HM decisions continue to rely on appropriately qualified assessment under the Scheme.
Urgent and fast-track NDIS reassessment pathways remain available where changes occur in AT needs, housing accessibility, environmental risks, progressive conditions or caring arrangements.
Fully automated decisions relating to AT and HM be prohibited and that all such decisions involve appropriately qualified human review.
The Bill be amended to ensure participants are not excluded from the NDIS on the basis of hypothetical alternative support systems where equivalent AT or environmental supports are not genuinely available.
Transitional rules and pricing arrangements include meaningful consultation with the AT and HM sectors to avoid unintended impacts on service availability and workforce sustainability.

3. Contents

Executive Summary…………………………………………………………………………2
Recommendations…………………………………………………………………………..3
Contents………………………………………………………………………………………3
About

ARATA…………………………………………………………………………………4

Schedule 1 – Access, Planning and Funding……………………………………………..5
Schedule 2 – Fraud and Integrity Measures………………………………………………7
Schedule 3 – Governance, Pricing and Automation……………………………………..7
Schedule 4 – New Framework Planning…………………………………………………..8
Schedule 5 – Transitional Rule-Making Powers………………………………………….9
The Bill departs from core NDIS principles………………………………………………..9
Conclusion……………………………………………………………………………..……10 3

Submission 641

About ARATA The Australian Rehabilitation and Assistive Technology Association (ARATA) is the national non-profit peak body representing assistive technology (AT) stakeholders. ARATA works to advance access to rehabilitation and assistive technologies and promote practices that ensure positive outcomes from their use for people of all abilities. ARATA includes a membership of both National Disability Insurance Scheme (NDIS) participants and NDIS providers, as well as other AT stakeholders across all experiences of individual AT use, provision of AT advice (e.g. via health professionals), AT supply, AT product development, and AT research and education in Australia and internationally.

ARATA provides a national forum for information sharing and liaison between people who are involved with the use, selection, customisation, supply, research and ongoing support of rehabilitation and assistive technologies. The Association promotes, develops, and supports the national rehabilitation and AT community of practice as well as contributing as a founding organisation to the Global Alliance of Assistive Technology Organizations (GAATO).1

Through its membership, ARATA represents the interests and opinions of the full range of AT stakeholders in Australia. ARATA maintains that roles for all AT stakeholders must be considered, centred around the goals and needs of people who use AT in their own lives, and their informal supporters, including family members and carers, who may engage with the NDIS.

Schedule 1 – Access, Planning and Funding Schedule 1 contains the reforms with the greatest potential impact on AT and HM..

The proposed definition of “functional capacity” in proposed section 9B is particularly concerning because it excludes consideration of AT,, support systems and environmental context when assessing disability-related functioning. The separation of functional capacity assessment (to determine eligibility) from support needs assessment (to determine support needs), essentially divorces two essential components of one process.

The proposed approach under section 9b also does not align with contemporary practice or internationally recognised disability frameworks, such as the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Isolating functional capacity from the broader context, risks a regression to a biomedical understanding of impairment. A participant’s ability to transfer safely, communicate, shower independently, access the community or manage fatigue may depend directly on environmental modifications and AT available.

For example, a person may demonstrate a limited mobility impairment during a short assessment while still being unable to safely access their bathroom, enter their home independently, or manage pressure care needs without AT and environmental supports. Similarly, participants with neurological or fatigue-related conditions may appear superficially capable in controlled environments while still requiring substantial AT supports in daily life.

1 History | GAATO

Submission 641

ARATA is concerned that standardised assessment tools will systematically underestimate complex AT and environmental support needs, particularly for people with fluctuating conditions, cumulative impairments, neurological disability, psychosocial and cognitive disability and/or fatigue-related conditions. Our member experience with functional capacity assessments indicates that people with disability can often under-report how an impairment affects their capacity. For example, a person with high level quadriplegia scores the World Health Organization Disability Assessment Schedule (2.0) mobility domain relating to moving about inside their home as “no difficulty” when they would be totally unable to move about inside their home without their powered wheelchair. A functional capacity or support needs assessment should comprehensively identify the impairments, functional limitations, and support requirements of a person with disability. Assessments conducted solely by telephone or online, without adequate observation and evaluation, risk overlooking significant AT and HM needs and may result in an incomplete understanding of the person’s circumstances.

The permanence and treatment provisions also create substantial risks for timely access to AT and HM. The requirement that participants pursue “all appropriate treatment” before impairments are considered permanent may delay access to supports that are urgently required for safety and independence.

Many AT and HM supports are immediate risk mitigation measures. Bathroom modifications, ramps, pressure care equipment, hoists, mobility aids, and communication devices are frequently necessary regardless of whether future treatment may improve singular aspects of functioning.

The Bill also overturns the principles recognised in NDIA v Davis [2022] FCA 1002 by enabling practical barriers to treatment access to be disregarded. This is particularly concerning in regional and remote Australia where access to specialists and specialist treatment is already limited.

ARATA is also concerned by proposed section 25B, which allows participants to be excluded from the NDIS where another service system is considered responsible for support provision. In practice, access to AT and HM is already fragmented across health, aged care, housing, workers compensation and state equipment systems. Many of these systems have long waiting lists, limited eligibility criteria, and/or restricted equipment availability.

Participants should not be excluded from the NDIS on the basis of hypothetical or inadequate alternative support systems.

The repeal of section 31 and the broader shift from individualised funding toward sustainability-focused planning principles also raises significant concerns for AT access.

AT and HM recommendations require highly individualised assessment processes. Appropriate equipment and modification selection depends on consideration of the participant’s home environment, support arrangements, transportation requirements, pressure care risks, communication needs, long-term functional goals, and future progression of disability.

ARATA is concerned that the combined effect of standardised planning approaches, funding caps, and sustainability principles may create increasing pressure toward generic or lowest cost equipment solutions that do not adequately meet participant needs.

Poorly prescribed AT frequently results in equipment abandonment, increased injury risk, falls, pressure injuries, reduced independence and increased long-term care costs.

Submission 641

The proposed Ministerial funding reduction powers in section 34A create additional concern. The Bill would allow percentage-based reductions to categories of supports for reasons of “financial sustainability”, even where participants have been assessed as requiring those supports.

AT and HM are frequently safety-critical supports. Delays or reductions in funding can lead directly to falls, hospitalisation, inability to discharge from hospital, carer burden/injury, and institutionalisation.

ARATA is particularly concerned that reductions to therapy budgets may indirectly reduce access to AT and HM. Assessment, trialling, prescription, implementation and review of AT and HM depend heavily on allied health services. The proposed 10 per cent reduction to therapy budgets may therefore have substantial downstream impacts on AT and HM access and outcomes. Feedback from members suggests that the NDIA is increasingly reducing therapy budgets within five-year plans, including the application of three-month funding periods to Improved Daily Living budgets, which may create barriers to timely and consistent access to therapy supports.The funding available has been inadequate to provide in-context AT and HM assessments within the 3-month funding period.The NDIA could instead respond in the same way as state injury insurance schemes do, requesting a quote for the AT and/or HM assessment, then adding this funding to the participant’s plan so the assessment can proceed in a timely manner.

The Bill’s proposed evidentiary framework also risks weakening evidence-based AT and HM decision-making.

AT prescription and HM recommendations are highly individualised and depend not only on published research, but also on direct environmental assessment, participant goals, trial outcomes, postural assessment, fatigue management, cognitive assessment, and long-term functional outcomes.

There is often limited large-scale research relating to highly specialised or customised assistive technologies and home modifications, particularly for participants with rare or complex disabilities. A rigid evidentiary hierarchy risks privileging standardisation over clinical expertise.

ARATA is concerned this may lead to rejection of clinically justified recommendations, reduced access to customised equipment, and underfunding of complex home modifications.

Finally, the proposed reassessment and plan renewal provisions may create additional barriers for participants requiring changes to assistive technology or environmental supports.

AT and HM needs frequently change because of progressive conditions, housing changes, equipment breakdown, changing manual handling requirements, ageing carer, or deterioration in mobility.

The Bill specifically states that one-off supports such as AT and HM will not automatically carry over into renewed plans. Without accessible reassessment pathways, participants may face delays replacing critical equipment or modifying new housing environments.

Submission 641

Schedule 2 – Fraud and Integrity Measures ARATA supports the importance of maintaining integrity within the NDIS and ensuring public funds are protected from fraud and misuse.

However, the proposed compliance and integrity measures may create unintended consequences for participants requiring AT and HM.

AT processes often involve extensive documentation, quotations, clinical reports, supplier communication and staged implementation arrangements. Participants with complex disability, cognitive impairment, communication barriers, or executive functioning impairments may experience substantial difficulty navigating increasingly complex administrative requirements.

ARATA is concerned that overly burdensome compliance processes may discourage participants from pursuing necessary AT and HM supports or create delays in implementation.

The AT sector also includes many small and specialised providers who may face increased administrative burden under expanded compliance frameworks.

Integrity measures should therefore be implemented proportionately and with appropriate safeguards to ensure they do not unintentionally reduce access to clinically necessary AT and HM.

Schedule 3 – Governance, Pricing and

Automation

Schedule 3 raises significant concerns regarding pricing arrangements and automated decision-making.

The proposed expansion of Ministerial pricing powers may affect the long-term sustainability of the assistive technology and rehabilitation workforce.

Assessment and implementation of AT and HM frequently require lengthy home visits, environmental assessment, equipment trialling, supplier coordination, risk assessment, report writing, and participant and carer education and training. Pricing arrangements that fail to reflect the actual complexity of these services may reduce provider availability, particularly in regional, rural and remote areas.

ARATA supports independent and transparent pricing processes that appropriately recognise the complexity of AT and HM assessment.

The proposed automation provisions also create substantial risks.

AT assessment involves complex clinical judgement that cannot be reliably reduced to automated scoring systems or simplified assessment pathways.

Submission 641

HM assessment requires detailed consideration of housing layout, structural limitations, transfer techniques, future progression of disability, pressure care, behavioural considerations, sensory needs, and manual handling risks.

ARATA is concerned that automated systems may underestimate environmental complexity, privilege standardised equipment pathways and reduce professional discretion.

The Bill also permits future expansion of automated decision-making powers through legislative instruments.

ARATA submits that fully automated decisions should not be permitted for AT and HM and that all such decisions should involve appropriately qualified human clinical review.

Schedule 4 – New Framework Planning The proposed New Framework Planning model appears designed around increased standardisation and expenditure control.

ARATA is concerned that this approach may not adequately accommodate the complexity and individualisation required for AT and HM planning.

Disability-related environmental needs are rarely straightforward or attributable to a single impairment category. Participants often require AT because of the interaction between physical disability, neurological conditions, fatigue, housing design, cognitive impairment, and support arrangements.

The proposed framework risks encouraging simplified budgeting approaches that fail to adequately recognise these interactions.

ARATA is also concerned that the proposed evidentiary hierarchy may reduce the weight given to participant lived experience and AT advisor recommendations.

AT and HM outcomes are highly individual. Participants with rare conditions, progressive disabilities and/or highly customised equipment needs may not fit neatly within standardised evidence frameworks.

Evidence based practice relating to AT and HM is guided by published research and systematic reviews, but is also guided by expert opinion, consensus statements, and the lived experience of individuals with disability. There is no justification for published research overriding these other factors in decisions made relating to AT and HM. As is often stated in medicine, the evidence lags 20 years behind what is occurring in practice. This is arguably an understatement in the context of AT and HM. Published research is frequently confined to individual interventions or specific groups of supports, whereas real-world practice requires consideration of emerging technologies, diverse impairments, individual preferences, and environmental factors to identify solutions that best meet the needs of the person/s with disability.

Published research also is but one part of a much more complex puzzle, or one link in a chain of evidence to guide practice. Published research cannot become a gatekeeper as to whether an AT or HM is approved or not approved. Good practice is cognisant of published

Submission 641

research, emerging technology, new interventions, lived experience, and feedback from those involved in providing disability support to determine the most appropriate AT or HM solution.

The New Framework Planning model should therefore retain strong participant-centred planning principles and preserve the role of detailed allied health assessment and clinical judgement.

Schedule 5 – Transitional Rule-Making Powers Schedule 5 grants broad transitional rule-making powers to the Minister.

ARATA is concerned that these powers may permit substantial changes affecting AT, HM, and rehabilitation supports with limited parliamentary scrutiny.

Given the complexity of the assistive technology sector and the potential safety implications of funding changes, it is important that any transitional arrangements involve consultation with the rehabilitation, AT and HM sectors.

Changes affecting equipment funding, pricing, assessment requirements or planning processes may have significant consequences for participants, clinicians, suppliers and housing accessibility outcomes.

ARATA therefore supports stronger oversight and transparency mechanisms in relation to transitional rule-making powers.

The Bill departs from core NDIS principles The proposed changes to the objects and principles of the NDIS Act represent a fundamental shift in how “reasonable and necessary” supports are understood and determined. By removing section 31 and replacing references to “reasonable and necessary supports” with supports that are “consistent with the financial sustainability of the Scheme,” the Bill moves the focus of decision-making away from individual need, functional impact, goals and choice and control, and toward fiscal constraint.

This shift has significant implications for access to AT and HM, which are often essential disability-related supports but can involve substantial upfront costs. Under the proposed framework, there is a heightened risk that these supports will increasingly be viewed through a cost-containment lens rather than as critical investments in safety, independence, participation and long-term quality of life.

The new principles in proposed section 17B, including greater emphasis on “day-to-day living costs,” informal supports, and consistency of funding across participants, may create additional barriers to accessing AT, HM, and environmental supports that are highly individualised and responsive to a person’s specific circumstances.

Submission 641

These supports frequently cannot be standardised across participants with “similar” diagnoses or impairments, as suitability depends on a person’s home environment, functional capacity, health risks, informal support availability and lived experience. There is concern that the proposed changes may lead to narrower interpretations of what constitutes disability-specific support, increased refusals of essential equipment and modifications, and reduced recognition of the preventative value of these supports in avoiding injury, hospitalisation, carer burnout, institutionalisation and crisis service use.

The changes also risk undermining the original intent of the Scheme as a person-centred support system grounded in individualised assessment rather than administrative consistency or financial sustainability targets.

Conclusion AT and HM are foundational disability supports that enable safety, mobility, communication, independence, and participation.

The National Disability Insurance Scheme Amendment (Securing the NDIS for Future

Generations) Bill 2026 contains a range of provisions that may unintentionally reduce access to these essential supports through increasingly standardised, fiscally driven and administratively restrictive approaches.

ARATA is particularly concerned about the exclusion of AT and environmental factors from functional capacity assessments, reduced reliance on allied health evidence, broad funding reduction powers, delays arising from permanence and treatment requirements, and the expansion of automated decision-making.

The cumulative effect of these reforms risks shifting the Scheme away from individualised planning and towards simplified administrative models that do not adequately reflect the complexity needs, particularly AT and HM needs.

AT and HM are frequently highly cost-effective supports that reduce downstream expenditure across hospitals, aged care, housing, emergency services, and informal care systems.

A sustainable NDIS must continue to support timely access to clinically appropriate AT and accessible environments.

ARATA therefore urges the Committee to substantially amend the Bill to ensure AT and HM supports remain grounded in individualised assessment, relevant allied health expertise, equity principles, and participant safety.

Submission 641