Risk of unintended adverse consequences for participants with complex disability (Provider advocacy)

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 831

Since 1953

Date: 27 May 2026

Organisation: Eurella Community Services Incorporated

Address: 2a Eurella Street Burwood, NSW, 2134

Submitted by: Patricia Abraham Chief Executive Officer

Executive Summary

Eurella Community Services welcomes the opportunity to provide this submission to the Senate Community Affairs Legislation Committee.

Eurella Community Services Incorporated supports the objectives of the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 to clarify eligibility, define funded supports and improve sustainability.

While these objectives are supported, Eurella’s 73 years of industry and operational experience supporting participants with complex disability and high-risk needs indicates that the combined effect of reforms to eligibility, support definitions and funding arrangements may create a material risk of unintended adverse consequences in practice, necessitating appropriate safeguards for this cohort.

Reductions in access to social and community participation supports arising from changes to funded supports may create a material risk of decreased functional capacity, increased behavioural instability, and diminished pathways to supported employment and economic participation and other social and community participation services for participants with complex and high-risk needs.

These risks extend beyond participants to include increased safety risks for staff and may reduce the availability of services where providers are unable to safely deliver supports within existing funding constraints.

As Persons Conducting a Business or Undertaking (PCBUs), providers are required to ensure, so far as is reasonably practicable, the health and safety of workers and others; where funding does not align with these obligations, this creates a direct tension between service delivery and legal responsibilities.

In such circumstances, providers may be unable to sustain service provision under current settings. Appropriate funding on a case-by-case basis needs to be factored in considering all legislation the NDIS Quality and Safeguards Commission and Work Health Safety into each plan so that services can continue to be delivered safely and effectively.

Eurella is concerned that changes to the types and levels of funded supports if not properly assessed may reduce access to participation supports that are critical to support and in addition for those development and employment pathways. There is also a risk that increasingly structured and prescriptive planning and funding models will limit responsiveness to the complex and variable needs of participants. Where funding does not align with actual support requirements, this may give rise to safeguarding risks. These challenges are compounded by the lack of operational foundational supports and clearly defined transition pathways, increasing the likelihood of service gaps. In this context, there is a significant risk of cost-shifting to families, health systems and emergency services.

Eurella recommends the introduction of safeguards for participants with high complexity supports, monitoring of workforce impacts, embedding of safeguarding considerations in funding decisions, and careful sequencing of reforms.

Eurella further recommends that functional capacity assessments used to inform funding decisions accurately capture participants’ needs as experienced in practice, including consideration of support needs profiles, risk management plans, incident history, and existing support documentation such as behaviour support plans, mealtime

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

management plans, mobility care plans behaviour support plans and the use of restrictive practices where applicable, informed by the clinical and operational expertise of staff directly supporting participants.

These assessment and funding settings must operate in conjunction with the NDIS Quality and Safeguarding Framework and Work Health and Safety obligations, including the duties of providers as Persons Conducting a Business or Undertaking (PCBUs). Where funding does not align with these regulatory requirements, this creates a direct tension between safe and continuous service delivery and financial viability. Addressing this through appropriate funding and safeguards will reduce the risk of service withdrawal, ensure continuity of supports, a safe workplace for staff and enable participants with complex and high-risk needs to receive the supports required in a safe and compliant manner.

Eurella is a long-established not-for-profit provider with 73 years of experience supporting individuals with severe and complex intellectual disability, autism spectrum disorder, psychosocial disability, behavioural complexity, and high-level support needs. Eurella supports reforms designed to strengthen the long-term sustainability and integrity of the NDIS.

However, Eurella submits that careful consideration must be given to the practical impact of proposed changes on participants with high level support needs. These participants rely on highly structured, flexible and responsive supports to maintain stability, safety and opportunities for participation, essential supports and development. Their support environments often require highly trained, consistent and knowledgeable staff, whose ability to provide safe and effective support is critical to participant outcomes.

The Bill focuses on clarifying eligibility for the Scheme and the supports that the NDIS will fund. These reforms are intended to ensure the NDIS remains focused on people with permanent and significant disability, consistent with its original intent.

In parallel, broader reforms include the development of foundational supports outside the NDIS. Taken together, these reforms reshape the practical boundaries of the NDIS both in terms of who receives supports, and the type and level of supports provided.

While Eurella supports the intent of these reforms, there is concern that participants with complex and variable needs may not be fully captured through standardised assessment processes. There is also a risk that supports critical to stability, development and safety may be reduced or reclassified under more tightly defined funding frameworks.

The practical effect of these reforms may be to narrow access and support levels in ways that do not fully reflect the lived reality of participants with complex and high-risk needs.

Eurella is further concerned that the implementation of these changes is occurring in the absence of fully operational alternative supports at the state level. At present, there is limited visibility regarding the availability, scope and delivery of foundational supports, and no clearly defined transition pathway for participants who may experience reductions in NDIS-funded supports.

This creates a significant risk that participants may be left without viable support options. In practice, this may result in individuals falling between systems, with increased reliance placed on families, providers and other service systems.

Even where participants may experience a reduction in funded supports, they will continue to require an appropriate level of assistance. Whether provided through the NDIS or alternative systems, the removal or reduction of supports without accessible and operational alternatives creates a significant risk of harm. Transitioning participants out of

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

the Scheme without adequate replacement supports presents a serious and systemic risk, with potentially catastrophic consequences for individuals, families and the broader service system.

There is also uncertainty regarding the timing and sequencing of proposed changes. If reductions to funded supports occur in advance of the establishment of accessible state-based alternatives, there is a risk of immediate service disruption. Clarification is required as to whether a formal transition period will be provided to enable continuity of care and allow providers to adapt service delivery models, including where providers may participate in delivering supports within emerging state-based frameworks.

Eurella recommends that support coordination functions are recognised as a critical component of effective implementation of these reforms. Support coordinators often already have established, trusted relationships with participants and families, and are frequently locally based, providing continuity and contextual understanding of participant needs. This positions them well to support participants through periods of transition, including where there are changes to eligibility or funded supports.

Providers are aembedded within their local communities and routinely work collaboratively with local councils, state government agencies, health services and other community organisations and supports outside NDIS to coordinate supports. Leveraging these existing partnerships will strengthen system integration and provide confidence to participants and families that support continuity can be maintained. Strengthening and appropriately resourcing support coordination, alongside provider collaboration at the local level, will assist in translating assessment outcomes into practical support arrangements, reducing fragmentation, and minimising the risk of participants falling between systems during reform implementation.

Eurella notes that providers are well positioned and willing to deliver supports beyond the NDIS where appropriate, including within state-funded or foundational support frameworks. As a long-standing not-for-profit provider embedded in local communities, Eurella already works collaboratively across systems and has the capability, workforce and infrastructure to support participants through a range of service models. This approach is consistent with existing and emerging initiatives, such as Thriving Kids and broader foundational support arrangements.

Enabling established providers to participate in these frameworks will support continuity of care, reduce system fragmentation, and ensure that participants continue to receive appropriate supports regardless of funding source. Recognising and leveraging the role of existing non-government organisations could be critical to the successful implementation of reforms and to maintaining confidence in the broader disability support system.

The Bill introduces mechanisms that enable greater control over the types and levels of supports funded under the NDIS, including social, civic and community participation supports.

Social inclusion and economic participation are core objectives of the NDIS. However, for participants with complex disability, these outcomes are not achieved independently they are enabled through structured and appropriately funded supports.

For many participants with complex and high-risk needs, supports classified as participation supports form a critical component of their broader support system. These supports provide responsive and structured environments in which participants develop communication skills, social engagement, behavioural regulation, routine and predictability, and independence in daily living. The staff the deliver these supports are highly trained.

Progression towards inclusion cannot be achieved in isolation; it is enabled through structured supports that build capacity, stability and facilitate safe and responsive participation in employment and community life.

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

Social and Community Participation supports should be understood not as discretionary or purely social activities for all. For some these are essential support services that enable essential service delivery to maintain activities of daily living, functional development, stability, emotional regulation and progression toward employment and economic participation.

Participants support also play a central role in preparing participants for engagement in pathway-based and employment-related activities.

In practice, many participants access supports that enable engagement in employment and enterprise activities through core supports funding arrangements. This creates an important policy consideration as to how employment pathways, including supported employment, will be maintained where participation-related supports are reduced, reclassified or constrained under revised funding settings.

Supported employment and meaningful economic participation are the outcome; participation supports are the mechanism through which that outcome is achieved. Without these supports, participants may be unable to develop or sustain the capability required to engage in employment or enterprise-based activities.

In addition, for participants who are currently engaged in supported employment, it is critical that the supports enabling their ongoing participation in work are safeguarded. Many individuals rely on supports funded within core supports to maintain routines, manage behaviours, travel to workplaces, and sustain engagement in employment environments. Where these supports are reduced or restructured, there is a risk that participants may lose not only access to employment pathways, but existing employment outcomes.

Ensuring continuity of supports for individuals already participating in supported employment will be essential to maintaining workforce participation and preventing regression. Loss of these supports risks reversing employment gains and undermining the economic participation of people with disability.

Reducing the supports without careful consideration for an individual’s level of need does not enable participation, inclusion or employment opportunities and may compromise both social and economic participation outcomes for people currently receiving these supports.

While foundational supports have been identified as part of broader reform, they are not yet operational at scale in NSW. At present, there is limited visibility regarding their scope, accessibility and delivery, and there is no clearly defined, accessible or assured transition pathway for participants who may be affected by changes to funded supports.

In the absence of clearly established alternative supports, there is a material risk that participants will experience disruption or loss of services. This creates a high likelihood that individuals may fall between systems without adequate support, resulting in increased reliance on families and informal carers, additional pressure on health, emergency and community services, and destabilisation of established support arrangements that are critical to participant safety and wellbeing.

Even where participants may experience a reduction in funded supports, their underlying support needs do not diminish. Without accessible and operational alternatives, these individuals remain at risk of being transitioned out of one system without effective entry into another. This creates a structural gap in the service system, rather than a reallocation of supports.

In practice, the absence of operational foundational supports and clearly defined transition pathways risks creating service discontinuity, increased safeguarding concerns, and system level inefficiencies, rather than delivering the intended outcomes of reform.

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

There is also uncertainty regarding the timing and sequencing of proposed changes. Where reductions to NDIS funded supports occur in advance of the establishment of accessible state-based alternatives, there is a risk of immediate and sustained service disruption. This risk is not theoretical, as a provider we are already observing reductions in funded supports occurring ahead of the establishment of alternative systems.

In practice, there are emerging examples of participants with lower or moderate support needs experiencing loss or reduction of supports without access to appropriate alternative services. This is giving rise to significant and escalating safeguarding concerns, including financial exploitation, self-neglect arising from an inability to manage essential daily living activities without appropriate supports, and deterioration in health and living conditions.

Without appropriate supports, some participants are unable to safely manage fundamental aspects of daily life. This includes the inability to plan and prepare meals, safely store food, maintain personal hygiene, manage continence related cleaning, maintain a sanitary living environment, attend medical appointments, and manage finances or pay bills. In these circumstances, individuals are at increased risk of malnutrition, untreated health conditions, financial abuse, and living in environments that pose serious risks to both their health and dignity.

These are not minor or incidental impacts. Where supports are withdrawn without suitable alternatives, the consequences can escalate rapidly, resulting in avoidable harm, significant health decline, and increased reliance on crisis, hospital and emergency services.

These early indicators highlight the importance of careful sequencing and appropriate safeguards. Clarification is therefore required as to whether a formal transition period will be provided to ensure continuity of care, and to enable providers and systems to adapt appropriately.

There is also a need for clarity regarding the treatment of participants whose needs may be assessed as not meeting revised funding thresholds, particularly where there remains clear evidence of ongoing functional impairment and support requirements. In practice, providers are observing situations where supports are being reduced on the basis that needs are no longer assessed as justifying funding, despite documented evidence to the contrary. This raises an important question as to whether these participants will continue to be supported within the NDIS, or how their needs will be met in the absence of accessible alternative services.

Ensuring that alternative supports are fully operational, accessible and integrated prior to any reduction in NDIS funded supports is essential to avoiding service gaps and maintaining system integrity.

The Bill introduces greater reliance on structured planning and funding mechanisms, including defined budgets, needs-based assessments, and specified support categories.

While these measures are intended to improve consistency and sustainability, there is a risk that they may not adequately reflect the complexity of participants with high and variable support needs. In particular, structured funding models may limit the flexibility required to respond to non-linear development, fluctuating capacity, and changing behavioural and environmental circumstances.

Participants with complex disability often require highly individualised and adaptive supports that respond in real time to risk, behaviour and sensory needs. For participants with significant behavioural complexity, including those subject to behaviour support plans and restrictive practices, support delivery must align with strict regulatory requirements and dynamic risk management approaches.

In these contexts, support is not static. It requires ongoing adjustment, staff familiarity, and implementation of current support and behaviour management plans to ensure safety.

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

Providers are required to operate within the NDIS Quality and Safeguards Framework and comply with Work Health and Safety obligations as Persons Conducting a Business or Undertaking (PCBUs). This includes ensuring that staff are appropriately trained, supervised and competent in accordance with the NDIS Practice Standards, including alignment with relevant high-intensity support skill descriptors where applicable.

This requires that staff are familiar with and able to implement current support plans, behaviour support plans, and any requirements relating to restrictive practices, which are regulated and must be authorised, documented and reported in accordance with Commission requirements.

These are not discretionary requirements, but form part of the regulatory obligations governing the safe delivery of supports. Where funding arrangements do not adequately account for these requirements, there is a risk that supports cannot be delivered safely or in compliance with regulatory obligations, creating a direct tension between funding constraints and the legal and safeguarding responsibilities of providers.

Participants with complex disability require adaptive and responsive support models, supported by flexible funding arrangements that align with regulatory obligations and real-world service delivery.

Funding decisions directly impact the ability to deliver supports safely, as they determine the level of staffing, skill mix, supervision, and intensity of support that can be provided to participants with complex needs. These factors are critical to maintaining safe environments and effectively managing behavioural, governance, clinical and environmental risks.

Misalignment between funding and participant needs creates material safety risks for participants, staff and the broader community.

Participants with complex needs often require skilled staff, structured environments and periods of increased support intensity to maintain stability and effectively respond to behavioural and environmental risks. Where funding does not adequately reflect these requirements, the capacity to deliver safe and appropriate supports is compromised.

This may result in increased behavioural escalation, reduced ability to implement behaviour support strategies effectively, and diminished capacity to maintain stable and predictable support environments. It may also limit the ability to provide appropriate staff training, supervision and continuity of care, which are essential for safe service delivery in high-complexity settings.

Over time, this can lead to heightened risk for participants and staff, disruption to service continuity, and increased likelihood of incidents requiring escalation, including involvement of emergency or health services.

Ensuring that funding arrangements are appropriately aligned with participant needs is therefore critical to maintaining safe, stable and effective support delivery, and to meeting the safeguarding and duty of care obligations that underpin the NDIS.

Changes to funding levels directly impact workforce sustainability and service delivery. Where funding is constrained or becomes more rigid, it creates workforce insecurity and could unintendedly contributes to increased casualisation and an insecure workforce, making it more difficult to attract and retain a stable, skilled and experienced workforce.

Eurella has made significant and sustained investment in building a skilled and capable workforce, including working in partnership with peak bodies and workforce representatives such as the Australian Services Union to support fair conditions, workforce stability and the development of a trained and respected disability workforce. Maintaining this level of workforce capability is challenging, particularly in high-complexity environments where the work requires

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

specialised skills, consistency and ongoing training. Funding instability risks undermining these efforts and contributes to the loss of experienced staff from the sector.

In high-complexity service environments, continuity of staffing, workforce capability and supervision are critical to ensuring safe and effective support delivery. Many participants particularly those who are non-verbal or have complex behavioural, sensory and support needs rely on staff who are familiar with their routines, communication methods and behavioural support strategies. Loss of experienced staff or high turnover can significantly increase risk, reduce the effectiveness of supports, and undermine participant outcomes.

Providing safe supports in these environments requires staff to undertake and maintain a range of specialised training, including mealtime management, medication administration, infection control, behaviour support and restrictive practices, as well as mobility and manual handling. These are essential competencies aligned with regulatory and safety requirements and are not discretionary aspects of service delivery.

However, providers are not directly funded for workforce training, despite these requirements being necessary to meet NDIS Quality and Safeguards Commission standards and Work Health and Safety obligations. As a result, providers must absorb the cost of training and maintaining workforce capability within existing funding arrangements. This represents a significant and ongoing investment, particularly where staff require continual upskilling to meet high-intensity support requirements.

Where funding does not adequately account for workforce capability and training requirements, there is a risk that providers may be unable to sustain this level of investment. This can lead to workforce attrition, increased reliance on casual or less experienced staff, and reduced continuity of care.

Continuity of staffing is a safeguarding requirement, not a preference. Sustaining a capable, trained and stable workforce is critical to ensuring that participants particularly those with complex needs receive safe, consistent and effective supports.

Where access to funded supports is reduced or constrained, demand is not eliminated it is redistributed across other parts of the service system.

In the absence of adequate supports, participants’ needs remain unchanged, and unmet needs often emerge in more acute and complex forms. Where individuals are unable to maintain stability, manage daily living, or access preventative supports, issues that could otherwise be managed in community settings may escalate to crisis points.

This may result in increased reliance on families and informal carers, alongside growing pressure on hospitals, emergency departments, primary health services, mental health systems and, in some cases, the justice system. For example, where participants are unable to manage essential daily activities such as personal care, hygiene, medication, nutrition, or maintaining a safe living environment, there is an increased risk of deteriorating health, avoidable hospital presentations, and crisis intervention. Similarly, where behavioural supports are reduced or inconsistent, there is a heightened likelihood of escalation requiring emergency or acute responses.

There is also a risk of increased safeguarding concerns, including self-neglect due to participants support reducing, financial exploitation and social isolation, which may require intervention from multiple service systems. These interactions are often more intensive, less coordinated and significantly more costly than appropriately funded, preventative supports delivered through the NDIS.

This represents a shift from early intervention and preventative, community-based support to reactive and crisis driven responses, which are both less effective and more resource intensive.

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

The cost of underfunding supports is therefore not avoided it is transferred across the broader service system, often at a higher financial and human cost, and with poorer outcomes for participants.

Recommendations

The following recommendations are made in direct response to the proposed changes to eligibility, funded supports and planning arrangements outlined in the Bill:

1. Eurella recommends the introduction of transitional safeguards within eligibility and funding changes to ensure that participants with complex and high-risk needs are not exposed to sudden or unplanned reductions in supports. Pricing arrangements should be reviewed to ensure they adequately reflect the true cost of delivering safe, compliant and effective supports in high-complexity environments.

2. Planning and funding arrangements must retain sufficient flexibility to respond to variable, non-linear and evolving support needs, particularly for participants requiring dynamic and risk-responsive supports.

3. Eurella further recommends that functional capacity assessments used to inform funding decisions accurately capture participants’ needs as experienced in practice. This should include consideration of support needs profiles, behavioural and risk assessments, incident history, and existing support documentation such as behaviour support plans, mealtime management plans, mobility care plans and the use of restrictive practices where applicable, informed by the clinical and operational expertise of staff directly supporting participants.

4. Eurella also recommends that reassessment processes and tools used to inform funding decisions are aligned with the NDIS Quality and Safeguards Commission framework. Reassessments must accurately capture behavioural complexity, risk, and support requirements in a manner consistent with regulatory obligations, including behaviour support plans, restrictive practices and high-intensity support needs. Without this alignment, there is a risk that funding decisions may not reflect the safeguards required for safe service delivery, creating potential gaps between assessed need, funding allocation and regulatory compliance.

5. It is also recommended that the impacts of funding reforms on workforce stability, capability and continuity of care are actively monitored. Funding models must recognise the cost and necessity of workforce training, supervision and capability development, including alignment with high-intensity support skill descriptors and regulatory requirements.

6. Safeguarding considerations, including behavioural risk, supervision requirements and regulatory obligations, should be explicitly embedded in funding and planning decisions.

7. Reforms should be carefully sequenced so that any reduction in NDIS-funded supports is matched by the availability of accessible, operational and adequately resourced alternative supports. This includes ensuring that participants are not transitioned out of the Scheme without viable support pathways.

8. Eurella also recommends that support coordination functions are recognised and appropriately resourced as a critical component of reform implementation, particularly to support participants through transition, maintain continuity of care and reduce the risk of individuals falling between systems. Page 8 of 9

9. Eurella also notes that, for participants living in Eurella Supported Independent Living (SIL), rosters of care are already developed, assessed and funded as reasonable and necessary supports that reflect the participant’s level of need, risk profile and required supervision. These rosters are grounded in detailed assessments, behaviour support requirements, support plan requirements and day-to-day support delivery practices. There is concern that under revised funding and assessment arrangements, elements of these supports may no longer be fully recognised or funded, creating a risk of unfunded support requirements. Where this occurs, it may not be possible to safely or effectively deliver supports within approved models of care. Ensuring that existing, evidence-based support arrangements such as SIL rosters of care are

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.

Submission 831

Since 1953

appropriately recognised and funded under new planning frameworks will be critical to maintaining continuity of care, safety and service viability.

10. Finally, existing non-government providers should be enabled to deliver supports within emerging foundational and state-based systems, recognising their established capability, local networks and existing relationships with participants.

Eurella supports the long-term sustainability of the NDIS and the intent of the proposed reforms.

Eurella supports the intent of reforms aimed at strengthening the integrity and sustainability of the NDIS, including targeted measures to address fraud and improve oversight of NDIS providers. In particular, Eurella supports strengthened provider registration frameworks that promote accountability, transparency and quality across the sector.

A robust and well-regulated provider environment is essential to ensuring that participants receive safe, high-quality and compliant supports. These measures play an important role in maintaining public confidence in the Scheme and supporting its long-term sustainability.

However, sustainability must not come at the expense of participant safety, continuity of supports, inclusion and economic participation.

For participants with complex disability, funding is not simply an allocation of resources it is the foundation for safe, consistent and effective support, and is inseparable from dignity, wellbeing and opportunity.

Ensuring that reforms are implemented with appropriate safeguards, aligned funding, and a strong and capable workforce will be critical to achieving the intended outcomes of the Scheme, without creating unintended harm or system-level risk.

Page 9 of 9

PO Box 1171, Burwood North. NSW 2134. 2A Eurella Street, Burwood NSW 2134. Tel: 9747 4810. Fax: 9744 5228.