National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 672
Senate Community Affairs Legislation Committee Inquiry National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission: 26/05/2026 From: Kit Lucas (Occupational Therapist, Neuro Life OT, Bunbury WA)
I am an occupational therapist living and working in regional Western Australia. My clients are primarily adults with invisible disabilities, such as brain injury (including stroke or traumatic brain injury) and neurodivergence (ND) that significantly impacts their daily functioning. These groups also experience a high incidence of co-occurring mental health issues.
My recent work within the WA Health system has highlighted the consequences of unmet needs in the community, leading to distress for individuals and families, and additional pressure on both inpatient and outpatient hospital services. It is evident that community- based supports, such as NDIS are essential to prevent unnecessary hospital admissions that result from inadequate support.
Concerns Regarding the Proposed Bill
I have serious concerns regarding the proposed Bill, particularly:
•Changes to the assessment of functional capacity
•The risk of excluding individuals from appropriate levels of support, including NDIS eligibility, based on generalisations about support types or client groups
•The prospect of automating aspects of the assessment process, which fundamentally requires human judgement
Key Recommendations
•Assess functional capacity in the context of individuals’ environments and personal circumstances
•Ensure such assessments are conducted by suitably qualified clinicians who understand the complexity of intersecting impairments, especially in abstract skill domains (e.g. cognition, capability vs capacity as relates to fluctuating energy levels or abilities)
•Do not grant Ministerial powers that enable broad changes to funding types or participant groups; individual need must remain central to minimise harm
•Reverse proposed cuts to capacity building and social participation supports. Any future plans for cuts should follow thorough consultation, detailed planning for suitable alternative support pathways, and comprehensive risk management
•Avoid fully automated processes; where automation is used, maintain human oversight and a clear avenue for review and reassessment
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 672
Functional Capacity: The Importance of Context and Clinical Judgement
Many of my clients have significant difficulties with emotional regulation (ER)-a capacity often taken for granted. For these individuals, managing the physical sensations triggered by daily experiences can consume much of their energy. While emotional support in childhood is expected, for those with ER difficulties meeting this support need is much harder and often very isolating. Many express shame about not being able to “self- regulate”.
Some clients can manage within their home environment, where their sensory preferences are accommodated and life is more predictable. However, when engaging in the community, the co-regulating support of another person becomes essential. The human need for a felt sense of safety is foundational to higher level thinking skills and any form of social connection. This is the important role of an attuned support worker- they effectively provide an anchor to this foundation. Such support, while it may appear to be a simple “drive and a chat”, is an essential intervention and the difference between engagement in the broader community and isolation.
Consider also those who cannot maintain regulation at home-often this relates to adults raising children with complex needs (a scenario not uncommon in ND). In-context stressors like noise, organisational challenges, or shifting supports may lead to significant dysregulation. These clients when assessed out of context can appear to manage “well”- but they do not live out of their life context. Appropriately delivered core and capacity- building supports addressing the support needs in the home benefit both the individual and their family.
The clients who often struggle most are those unable to regulate even in supportive homes, sometimes requiring intensive practical and executive function support. NDIS- funded services are crucial both for community engagement and for sustaining informal support networks, preventing hospitalisation or institutionalisation.
These examples are used in the hope of demonstrating in just this one skill domain that context is everything. Assessment outside the context of a client’s real life is not meaningful. Assessing true capacity often requires extended engagement, as human ability and support needs are nuanced, fluctuating, and not suited to “one-size-fits-all” approaches.
•Parliament should ensure functional capacity assessments are contextually informed and conducted by qualified clinicians.
•Proposed reductions in capacity building and social participation supports should be reversed.
•Draft Bill provisions enabling Ministerial discretion for broad funding cuts should be removed, as these disproportionately impact those with invisible disabilities.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 672
Executive Function: The Need for Sensitive Assessment
Executive function difficulties-critical to everyday self-management-are often underestimated. Daily living relies on skills such as organisation, time management, planning, and problem solving, all profoundly impacted by neurological injury or neurodivergence. It is also worth pointing out that never before has executive function been so stretched in our everyday lives, particularly with the continual inflow of information and demands from multiple sources.
Clients may mask their difficulties or lack insight into their impairments. For instance, some ND clients present as highly capable during sessions but later report needing days to recover due to the effort involved in masking and or the activation of the nervous system as it response to stress. Standardised assessments may therefore not reflect their true functional abilities, particularly if tools do not adequately assess the breadth of executive functioning or the impact of cognitive effort on energy resources. Where insight is impaired the client may not self report a problem or very literally interpreting clients may miss the broader implication of questions and under report difficulties.
•Parliament should ensure assessments of functional capacity and support needs accurately recognise executive functioning, undertaken by suitably qualified and experienced clinicians.
•Changes to capacity building and participation supports should be decided based on clear and demonstrated individual need, not broad policy changes.
Risks and Broader Impacts
The question of “how disabled is disabled enough for NDIS” has grave implications. Data from the AIHW indicates people under 65 using disability services are three times more likely to die by suicide than the general population. A 2021 meta-analysis (link below) reported autistic individuals without intellectual disability (those I often work with) are more than five times more likely to die by suicide than non-autistic peers.
Current uncertainty is profoundly distressing for many clients and families. Progress for these clients is slow and complex, often requiring long-term, specialist support not available through Medicare-subsidised systems, where significant out-of-pocket costs remain a barrier for most.
•Parliament must recognise the serious harm that could result from policy changes; individual needs must be assessed rather than making sweeping category-based cuts.
•Any automation or algorithmic processes around eligibility or funding decisions must retain human oversight and capacity for ongoing review.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 672
•Reform should be consultative, ensuring alternative services are suitable and accessible prior to transitioning participants.
I acknowledge the importance of making the NDIS sustainable. I urge Parliament to ensure that reform is approached methodically and humanistically, to minimise adverse impacts on some of Australia’s most vulnerable citizens.
Sincerely,
Kit Lucas
Principal Occupational Therapist Neuro Life OT Bunbury, WA 26/05/2026
Mortality patterns among people using disability support services: 1 July 2013 to 30 June 2018 https://www.sciencedirect.com/science/article/pii/S0165178124004359?via%3Dihub
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