ASD Level 2 and Level 3 — Functional Complexity, Co-occurring Conditions, and the Team-Based Support Model (Provider advocacy)

Submission 750 - Supplementary Submission

SUBMISSION TO THE SENATE COMMUNITY AFFAIRS

LEGISLATION COMMITTEE

National Disability Insurance Scheme Amendment (Securing the NDIS for

Future Generations) Bill 2026

Senate Community Affairs Legislation Committee

Submission 4 of 5: ASD Level 2 and Level 3 — Functional Complexity, Co occurring Conditions, and the Team-Based Support Model

Submitted by: Independence & Beyond Support Services (IBSS)

ACN: 658 366 360

Contact: ibss.qld@gmail.com

Phone: Not provided

Address: [Address] Date: 1 June 2026 Submission type: NDIS provider — unregistered Confidentiality: Non-confidential — the submitter consents to publication Related submissions: This is one of five complementary submissions made by Independence & Beyond Support Services (IBSS) to this inquiry. Each submission addresses distinct provisions of the Bill. A covering letter introducing the suite has been lodged separately.

1. Purpose of this Submission This submission addresses the following provisions of the Bill:

• the provisions enabling the Minister to reduce participant budget allocations for social, civic and community participation supports by up to 50 per cent by legislative instrument, effective from 1 October 2026;

• the provisions enabling a 10 per cent reduction to capacity building daily activity allocations;

• the planning framework changes that would restrict funding responsibility to a participant’s primary disability diagnosis; and

• the provisions relating to changes in support eligibility and the definition of reasonable and necessary supports.

Executive Summary

The Bill’s blanket reduction mechanism treats all community participation budgets identically

regardless  of  the  participant's  functional  presentation or support needs. This submission

demonstrates why that approach fails specifically for autistic participants with ASD Level 2 and

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Level 3 — a cohort whose co-occurring conditions, functional complexity and real-world support requirements cannot be captured by a population-level average or addressed by a percentage reduction applied without individual assessment. It further demonstrates that simultaneous cuts to both Core community participation supports and Capacity Building daily activity allocations break the structural interaction between skill development and skill application that the NDIS funding architecture is designed to create. The only support model producing meaningful outcomes for this cohort is a coordinated team in which therapists, support workers and families work from shared goals in shared environments — a model the proposed reforms structurally undermine.

IBSS has provided direct community access support to participants with ASD Level 2 and Level 3 for more than a decade. The observations in this submission are drawn from that operational experience and supported by the published evidence base.

2. The Ministerial Instrument Mechanism Creates Unchecked Executive

Power Over Individual Plans

Before addressing the specific impact on participants with ASD Level 2 and Level 3, this submission draws the Committee’s attention to the nature of the legislative mechanism itself — because it has implications that extend well beyond the current proposal.

The Bill inserts a power enabling the Minister to determine, by legislative instrument, that budget allocations for an entire support category be reduced by a fixed percentage across every participant plan simultaneously. The Bill expressly provides that this is valid even where the resulting allocation no longer covers the full cost of a participant’s reasonable and necessary

supports.  Critically,  the  Bill  does  not  subject  these  determinations  to  parliamentary

disallowance. It does not impose a sunsetting provision. It does not require the Minister to consider the impact on specific participant cohorts before making a determination. Once a determination is made it does not expire, does not require renewal, and is not subject to the ordinary parliamentary accountability mechanisms that govern primary legislation.

This is not a one-time administrative adjustment. It is a standing executive power to alter the individual support funding of NDIS participants by ministerial decision, without parliamentary debate, without individual assessment, and without expiry. The power, once enacted, is available to any future minister in any future budget cycle. There is nothing in the Bill that limits its application to the current 50 per cent figure. A subsequent determination could go further, and the mechanism for doing so would already be law.

Parliament is being asked to grant the executive branch an unchecked power to reduce the individual support funding of some of Australia’s most vulnerable citizens by ministerial instrument — a power that, once granted, requires no further parliamentary authorisation to exercise again. This submission respectfully submits that no such power should exist without

mandatory  individual assessment requirements, parliamentary disallowance, and  sunset

provisions requiring review within a defined period. The Committee has the opportunity to recommend those safeguards before the power is enacted. Once it is enacted without them, the opportunity is gone.

3. The Functional Reality of ASD Level 2 and Level 3 3.1 What these participants actually present with ASD Level 2 and Level 3 designations identify participants who require substantial to very substantial support. In practice, the functional presentations within this cohort are among the

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most complex in the NDIS participant population. A blanket 50 per cent reduction applied uniformly across all community participation budgets treats a participant with the following functional profile identically to a participant who attends a weekly social group with minimal support — and the Bill contains no mechanism to distinguish between them.

Participants with ASD Level 2 and Level 3 frequently present with, in combination:

• non-verbal or severely limited verbal communication;
• severe emotional dysregulation with rapid, unpredictable onset;
• self-injurious behaviour including head-banging, skin-picking, and biting;
• elopement risk in community environments;
• extreme sensory sensitivity to noise, crowds, light, texture and unpredictable stimuli;
• demand avoidance and transition intolerance;
• restrictive eating presentations; and
• interoceptive differences affecting awareness of hunger, pain, illness and emotional states.

These presentations are not independent of each other. They interact, compound, and shift in real time in ways that require skilled, experienced, individually knowledgeable support to manage safely. No percentage applied by ministerial instrument can reflect this.

3.2 Co-occurring conditions and the failure of the primary disability restriction A large-scale analysis of 42,569 individuals with ASD published in Translational Psychiatry (2023) found that 74 per cent of autistic individuals had at least one co-occurring condition. The most prevalent included ADHD (35 per cent), learning disability (23.5 per cent) and intellectual disability (21.7 per cent). Epilepsy affects approximately 12 per cent of the autistic population — twelve times the rate in the general Australian population.

For participants assessed at ASD Level 2 and Level 3, rates of co-occurring intellectual disability, anxiety, ADHD, sleep disorders and gastrointestinal conditions are substantially higher than in the broader autistic population. These conditions do not present independently.

In  day-to-day  support  delivery,  a  participant's communication  difficulty,  behavioural

dysregulation, sensory response, eating behaviour and emotional state are functionally

interconnected. They cannot be separated  into  discrete diagnostic  categories during a

community access session. A support worker does not respond to the autism and then separately respond to the anxiety. They respond to the participant — as a whole person, in the moment, with all of their conditions presenting simultaneously.

The Bill’s proposed planning framework changes would restrict funding responsibility to a participant’s primary disability diagnosis alone. This imposes an artificial diagnostic separation on functional presentations that do not operate in silos. Funding that reflects only the primary

diagnosis  cannot  adequately  fund  the  support  that  the  participant's  actual combined

presentation requires. It is not a simplification. It is a structural mismatch between how the funding is calculated and how the support must be delivered.

4. Simultaneous Cuts to Core and Capacity Building Break the System 4.1 How the two categories are designed to work together

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The NDIS funding architecture separates supports into Core and Capacity Building categories with distinct but complementary purposes. Core supports fund ongoing assistance with daily

activities and immediate  disability-related needs — including community  participation

delivered by support workers. Capacity Building supports fund skill development, therapy, training and supports aimed at building independence — including occupational therapy, speech pathology, behaviour support and social participation programs.

The design intent is sequential and coordinated. Capacity Building funds the development of skills and strategies. Core funds the application and reinforcement of those skills in daily life. A therapist funds a communication program through Capacity Building. A support worker reinforces and generalises those communication strategies in a real café, on a real bus, at a real checkout through Core. The categories are not alternatives. They are a coordinated system in which each depends on the other to produce outcomes.

4.2 Cutting both simultaneously severs skill development from skill application The Bill proposes to reduce community participation Core supports by 50 per cent and capacity building daily activity allocations by 10 per cent simultaneously. For participants with ASD Level 2 and Level 3, this breaks the coordinated system the funding architecture is designed to create.

Capacity Building therapy produces strategies, plans and skill targets. Those strategies have no pathway to real-world application if the Core community participation hours in which they are implemented and generalised are halved. A behaviour support plan that cannot be implemented in community settings because support hours have been reduced is not a functioning plan. It is a document. A communication strategy rehearsed fortnightly in a clinic but never applied in a supermarket, a café or on a bus does not produce community communication competence.

Cutting Core community participation by 50 per cent while Capacity Building therapy billing continues unchanged does not reduce the system by 50 per cent. It severs the connection between skill development and skill application — rendering a significant portion of the remaining Capacity Building investment functionally ineffective for this cohort. The scheme pays for the strategy. It removes the environment in which the strategy is implemented. The outcome is neither independence nor savings. It is wasted investment.

5. The Team-Based Support Model: What Actually Produces Outcomes

for This Cohort

5.1 Therapists alone cannot produce community outcomes for this cohort Allied health professionals play an essential role in supporting participants with ASD Level 2 and Level 3. This submission does not minimise that role. It submits that the current funding architecture positions therapists as the primary evidence base and budget driver for planning decisions without adequately reflecting the operational limitations of clinic-based therapy delivery for this cohort.

A therapist who sees a participant once a fortnight for one hour accumulates 24 contact hours per year in a controlled clinical environment. A support worker delivering three hours of skilled community access per week accumulates 156 hours of real-world developmental contact in the same period. The support worker is present when a sensory trigger occurs in a supermarket, when a transition fails on a bus, when a communication attempt breaks down at a café counter. The therapeutic strategy either works in that moment or it does not — and the evidence of whether it works lives with the support worker and the family, not in the clinician’s fortnightly

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notes. Yet the current funding model gives the clinician’s assessment report determinative weight in planning decisions, while the support worker’s accumulated real-world observations carry no equivalent evidentiary standing. That is a structural misalignment between where functional knowledge is generated and where funding decisions are made.

5.2 What the team-based model looks like in practice From more than a decade of service delivery to participants with ASD Level 2 and Level 3, IBSS submits that the support model producing meaningful functional outcomes for this cohort is a coordinated team in which the participant’s therapists, support workers and family work from a shared understanding of the participant’s goals, triggers, communication strategies and behavioural history — using the same language, the same approaches, and the same responses to the same situations across all settings.

The Autism CRC National Guideline (2023), approved by the NHMRC, explicitly identifies coordinated, team-based approaches and family capacity building as consistent with best practice for autistic children and their families. The proposed reforms do not support this model. By cutting the Core hours through which support workers operate while leaving Capacity Building therapy funding unchanged, the Bill structurally reinforces the isolation of clinical intervention from real-world application — the very pattern the Australian evidence base has identified as producing poor outcomes for this cohort.

Consistency of approach across all settings is not a preference. For participants with ASD Level 2 and Level 3, it is a functional necessity. A participant whose behaviour support plan is implemented one way by their support worker and a different way by their family, and not at

all  in community  settings because support hours have been  cut, does not experience

consistency. They experience unpredictability — and unpredictability is one of the primary drivers of behavioural escalation in this cohort.

6. Recommendations This submission respectfully recommends that the Committee:

7. Recommend that the Bill be amended to require that any ministerial determination reducing community participation budget allocations be subject to parliamentary disallowance and a mandatory sunset clause requiring review within a defined period — consistent with standard legislative instrument governance — and that no such determination take effect without prior individual functional assessment for participants with ASD Level 2 or Level 3.

8. Recognise that the functional complexity and co-occurring conditions profile of ASD Level 2 and Level 3 participants is not adequately addressed by a blanket percentage reduction mechanism that does not distinguish by functional level, support need, or diagnostic complexity.

9. Recommend that the Bill’s planning framework provisions be amended to require holistic functional assessment across all co-occurring conditions rather than restricting funding responsibility to a participant’s primary disability diagnosis, on the basis that co-occurring conditions in this cohort present in functionally integrated ways that cannot be separated during support delivery.

10. Recognise that simultaneous cuts to both community participation Core supports and capacity building daily activity allocations break the structural interaction between skill development and skill application that the NDIS funding architecture is designed

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to create, and recommend that the impact of this interaction be independently assessed before the provisions commence.

5. Recommend that the planning framework give evidentiary weight to support worker and family observations of functional capacity in real-world environments, alongside allied health reports, in determining what constitutes reasonable and necessary support for participants with ASD Level 2 and Level 3.

6. Conclusion The Bill inserts into Australian law an unchecked executive power to reduce the individual

   support funding of NDIS participants by ministerial instrument — without individual

assessment, without parliamentary disallowance, without expiry, and without limitation on future exercise. That power, once enacted, belongs to every future minister and every future

budget  cycle. Parliament should  not  grant  it without  the  safeguards  that democratic

accountability requires.

For participants with ASD Level 2 and Level 3, the specific exercise of that power in this Bill — a 50 per cent reduction to community participation Core supports combined with a 10 per cent reduction to Capacity Building daily activities — breaks the coordinated system the NDIS

funding  architecture  is designed  to  create, imposes  artificial diagnostic boundaries on

functional presentations that do not operate in silos, and structurally undermines the team-based approach that the Australian evidence base identifies as the only model producing meaningful outcomes for this cohort.

This submission respectfully urges the Committee to recommend amendments that restore the individual assessment requirement, require democratic oversight of ministerial reduction instruments, and protect the functional integrity of the support system for participants whose presentations the Bill’s mechanism was not designed to reflect.

Thank you for considering this submission.

Authorised by:

The Directors

Independence & Beyond Support Services (IBSS)

Date: 1 June 2026

References

Autism CRC (2023). National Guideline for supporting the learning, participation and wellbeing of autistic children and their families in Australia (2nd ed.). NHMRC-approved. Available at: https://www.autismcrc.com.au/best-practice

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Bai, D. et al. (2023). Comorbidities in autism spectrum disorder and their etiologies. Translational Psychiatry, 13, 71. https://doi.org/10.1038/s41398-023-02374-w [Study of 42,569 individuals with ASD — 74% had at least one co-occurring condition]

Autism    Awareness    Australia    (2024).    Co-occurring    conditions.    Available     at:

https://www.autismawareness.com.au/navigating-autism/autism-and-co-occurring-conditions [Epilepsy prevalence: 12% of autistic population vs 1% general Australian population]

Department of Social Services (2024). Draft National Autism Strategy. Australian Government.

Available   at:  https://engage.dss.gov.au/wp-content/uploads/2024/04/draft-national-autism-

strategy.pdf

NDIA Research and Evaluation Branch (2022). “Getting out into the world”: pathways to community participation and connectedness for NDIS participants with intellectual disability, on the autism spectrum and/or with psychosocial disability. Policy, Advice and Research Division, NDIA. Available at: https://www.ndis.gov.au/research-and-data/research-and-evaluation-reports

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill

2026       (Cth),      introduced     14    May      2026.      Available        at:

https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/ND ISFutureGenBill

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