Ensuring Equitable Access to the NDIS for
Rural, Regional, and Remote Australians
with Disabilities
A Submission to the Joint Standing Committee on the National Disability Insurance Scheme
wy Lifely
Ensuring Equitable Access to the NDIS for Rural, Regional, and
Remote Australians with
Disabilities
A Submission to the Joint Standing Committee on the
National Disability Insurance Scheme
Acknowledgement
We would like to extend our heartfelt gratitude to Professor Stuart Wark from the University of New England for his invaluable contribution to this work.
His generosity in sharing his time, insights, and access to research has been
instrumental in the development of this submission.
His support reassured us that Lifely’s experiences, along with the lived experiences of the NDIS participants, carers, and communities we support,
reflect universal experiences shared by regional, rural, and remote Australians.
We are committed to ensuring that their voices are amplified and heard.
Table of Contents
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Understanding and Improving Classification Systems for Equitable Disability
SUPPOFT IN RULAl AUSEINIC. eee cesesetseceseeeeseseseeceseseeeeseseeeeseeeeseseseseeseseeeeseseeecseeeeeeseeeaeaeees 9 What is the Modified Mondsh Model? ……eesesssesssesesesesssseseseseseseceeeeeseenetetsteneeeseaeees 10 How Does the NDIS Use the MMM? ou eesesesseseseseeseseeeceeeeeseacaeeeseeeeereeseeeeeeeees 10 PHiC€ VIMICS eee ee eeeseeesenescsescecscscsccescscscscsescssssescsceeacacacseuescssscaeaceesesesesesseeessacaceeeeeeeereeaes 11 Challenges with the MMM in NDIS Service DeliVEry……. cee eeeeeeeeeteteteeeeteees 11 Alternatives models for Classifying rUrdlity ne cceeceeseseeteeseeteseeceseseseseeeeceeeeseaesees 12 Statistical Area LeVel 2 oc eeeeeeeessesesesseseseeeteeeeseseseseseeeeeeeeseseeeseeeeeseeeseeseseaeeceeeeeeeees 12 Rural, Remote, and Metropolitan Area (RRMA)…..ccccsesesesesesesesesesteseseseseseseseees 12 Accessibility/Remoteness Index of Australia (ARIAF)…. cesses: 13 Challenges and Benefits of Each Model for NDIS Service Delivery… 14 Developing a New Disability-Focused Rurality MECSULE…… ce eeeteeeeeteteeeeees 15 Key Components of a Disability-Focused Rurality MECSULE ou… eects 15 Application of the New Disability-Specific Rurality MEQSUre uu… eee: 17
Navigating NDIS Planning in Regional, Rural, and Remote Australid………….. 18
The Role of Local Are COOrdinators …..e. ee eeesssseseseseseseseseseeeseeseseseseseseseeeseeeeeeeeteneeeeeeeees 18 The Role of NDIS PIONNESS ……. ce eeesesesesesessseeeeseseseseseseseenseseeseseeseseseseeeeeeeseenseeeeeeeeeeneees 19
The Impact of Limited Regional Knowledge and Classification Systems…….19
Challenges in the NDIS Planning Process for Non-metropolitan Participants
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Insufficient Consideration of Evidence in Regional and Remote NDIS
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Recommendations for Improving Regional and Remote NDIS Planning…….. 21
Insufficient Travel Funding and Flexibility for Rural Participants… 23
Essential Disability Services on the Move: Reaching Rural and Remote
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National Disability Insurance Agency (NDIA)……ccccessssssssssesesesessecseseeseseteeeeeesees 32
Professor Stuart Wark, University of New England… cccseseseeteteecseteeeeeesesees 32
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Introduction
This submission to the Joint Standing Committee on the National Disability
Insurance Scheme (NDIS) Inquiry into Participants’ Experiences in Rural,
Regional, and Remote Australia draws on our extensive experience supporting
people with disabilities in nonmetropolitan areas.
Lifely, a registered NDIS provider, has been working for over 40 years to ensure that people with disabilities in regional and outer metropolitan areas of Victoria, as well as border communities in New South Wales and South
Australia, receive equitable access to high-quality services.
As an organisation committed to improving outcomes for participants in underserved areas, we want to bring to light the substantial barriers
impacting the accessibility and effectiveness of NDIS support in rural Australia.
The NDIS was introduced as a transformative scheme to increase service access and empower Australians with disabilities through tailored support, driven by the principles of choice, control, and a consistent national approach. However, despite these principles, significant challenges persist for those in rural and regional areas, where geographic isolation, limited infrastructure,
and fewer service options constrain the scheme’s impact.
As research by Stuart Wark (2020) demonstrates, the social and economic disadvantages experienced in rural Australia create distinct obstacles to equitable service delivery. People with disabilities in these areas face compounded difficulties, from increased healthcare needs due to socio economic and environmental factors to limited access to transport, housing,
and specialist professionals.
We recognise the need to examine the NDIS planning process and Local Area Coordinator (LAC) support systems more closely. LACs and NDIS Planners play an essential role in guiding participants and developing support plans; however, they often lack the regional knowledge required to understand the
unique challenges of rural and remote living.
These issues are further compounded by insufficient travel funding, as current NDIS budgets and funding models fail to cover the extended distances and
additional costs required for accessing services in rural areas. This lack of travel funding limits participants’ ability to access essential support, especially for those with mobility or financial constraints.
In this submission, we examine these pressing issues, advocate for critical policy adaptations, and propose solutions to address the significant gaps in NDIS planning, service funding, and support for regional, rural, and remote participants.
We emphasise the need to “rural proof” the NDIS to ensure that the scheme evolves to meet the unique needs of rural Australians with disabilities, promoting equitable access to essential support services across all regions (Quilliam & Bourke, 2020). By addressing these barriers, we can work towards a NDIS that genuinely upholds its mission to provide choice, control, and
inclusive support for all Australians with disabilities.
Rurality is Important to Consider in Disability
Support
The National Disability Insurance Scheme (NDIS) was a landmark reform aimed at enhancing service access for people with disabilities across Australia, including rural and regional areas. It transformed funding models for health and human services, presenting both new opportunities and challenges in
delivering support to Australians with disabilities.
The legislation, as outlined by Stuart Wark (2020), has three core objectives: to provide reasonable and necessary supports, to empower recipients with choice and control, and to establish a consistent national approach to access,
planning, and funding.
Despite these aims, evidence suggests the NDIS has not fully addressed longstanding inequalities faced by people with disabilities in rural areas, where limited infrastructure, reduced service access, and fewer choices
constrain the scheme’s impact.
Social role valorisation (SRV) and normalisation principles advocate for people with disabilities to be recognised as valued community members with autonomy over their lives, and while these approaches have improved social acceptance and life expectancy globally, significant barriers persist in rural Australia (Wark, 2020).
Rural Australians face compounded socio-economic disadvantages compared to urban populations, with poorer health outcomes, fewer employment opportunities, and limited state and federal infrastructure, including
community housing, transport, and health services (Wark, 2020).
Environmental challenges, such as drought, floods, bushfires, and pandemics, further amplify these issues, affecting economic stability and well-being. This ongoing crisis has created higher healthcare needs and strained access to services (Wark, 2020).
In rural areas, individuals struggle to access general and specialised support services, let alone make informed choices among them. Access to general practitioners and allied health professionals is significantly lower in rural
regions, contributing to higher mortality and morbidity rates than those observed in metropolitan areas (Australian Institute of Health and Welfare, 2022).
Research highlights concerns that the NDIS’s objectives are unmet in rural, regional, and remote areas, where accessibility limitations, travel barriers, and a shortage of health professionals hinder choice and control over services.
“
Studies, such as Quilliam and Bourke’s “Rural Victorian Service Provider Responses to the National Disability Insurance Scheme,” reveal that rural providers face distinct challenges in implementing the NDIS, leading to
frequent restructuring and workforce changes to meet community needs.
Nonetheless, the extent to which these adaptations are supported by the NDIS remains in question, with calls for the scheme to be “rural-proofed” to address the unique circumstances of rural service providers (Quilliam & Bourke, 2020).
Current evidence (Dintino et al., 2019; Garnham et al., 2019; Veli-Gold et al.,
- suggests that rural Australians with disabilities do not benefit from the NDIS as substantially as their metropolitan counterparts, raising the question of whether further policy refinement is needed to ensure equitable access to
services for these communities.
Australia’s rural regions, encompassing about 30 per cent of the population through the Modified Monash Model, have notably higher disability rates than urban areas. For instance, 23.4 per cent of people in inner regional areas and 19.1 per cent in outer regional and remote areas live with a disability, compared to just 15.4 per cent in major cities (Australian Institute of Health and Welfare, 2022).
Access disparities are even more pronounced for younger people under 65, and for Aboriginal and Torres Strait Islander communities, who experience higher disability rates and greater limitations in rural areas (Australian Institute of Health and Welfare, 2022).
The shortage of healthcare professionals in rural regions affects healthcare quality and results in poorer health outcomes, such as shorter life expectancy
and higher levels of disease and injury. Consequently, people with disabilities 7
in these areas are less likely to access GPs or specialists and more likely to rely on emergency departments for essential care (Australian Institute of Health and Welfare, 2024).
These challenges underscore the critical need for targeted interventions to close service gaps and improve healthcare access for rural Australians with
disabilities.
Although the NDIS aims to ensure equitable service access, substantial barriers remain for rural populations, emphasising the need for tailored policy
support for rural Australians with disabilities.
Understanding and Improving Classification
Systems for Equitable Disability Support in
Rural Australia
The identification and classification of regional, rural, and remote communities are crucial in government policy, particularly for ensuring equitable access to health and disability support services.
In Australia, several classification models, including the Modified Monash Model (MMM), are used to guide funding and resource allocation to address
the unique challenges faced by communities outside major urban centres.
The MMM, developed by the Department of Health, categorises areas based on remoteness and population size, ranging from major cities to very remote regions. This system is integral to government policies, such as the NDIS, for
setting regional pricing structures and travel support allowances.
However, while the MMM directs healthcare resources, it has limitations when applied to disability services. The model overlooks disability-specific factors, transport accessibility, and evolving community needs, often resulting in
inconsistent support for those living in rural areas.
These limitations have led to discussions about adapting or supplementing it with other classification models to improve support for NDIS participants and rural Australians more broadly. Models like the Accessibility/Remoteness Index of Australia (ARIA+), the Rural, Remote, and Metropolitan Area (RRMA) classification, and the Australian Statistical Geography Standard’s (ASGS) Statistical Area Level 2 (SA2) offer alternative methods for defining regional
and remote areas.
There is potential to develop a new model that combines the strengths of existing systems, creating a more adaptive, disability-focused approach. Combining the MMM with elements from complementary models could ensure that rural Australians with disabilities access the same quality of services as urban residents, promoting a fairer and more inclusive system
nationwide.
The following section will provide an examination of the each of these models.
What is the Modified Monash Model? The Modified Monash Model (MMM) is an Australian classification system that
categorises areas based on their remoteness and population size.
The MMM is widely applied to allocate resources, funding, and workforce incentives to improve access to healthcare and essential services in regional, rural and remote regions. (Department of Health and Aged Care, 2024)
The MMM combines two main factors to classify regions:
e Remoteness Areas (RA): Based on the Australian Statistical Geography Standard (ASGS), areas are categorised from RAI (major cities) to RAS (very remote).
e Population Size: This reflects the general availability of services, as smaller populations often correlate with fewer healthcare resources.
The MMM categorises areas into seven levels:
e MM1: Major cities with large populations and extensive healthcare services.
e MMz2: Regional centres with relatively high populations and good access to healthcare.
e MMz3: Large rural towns with fewer healthcare services than metro areas.
e MMé4: Medium-sized rural towns with limited healthcare options.
e MMb5: Smaller rural towns with minimal access to healthcare.
e MMe6: Remote areas with very restricted healthcare services.
e MM7: Very remote areas with the least access to healthcare facilities. How Does the NDIS Use the MMM?
The NDIS uses the Modified Monash Model (MMM) to set pricing based on the remoteness of service delivery areas. Service costs increase with the
remoteness of the location:
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e MMM1-5: Classified as National Non-Remote, these areas use the standard NDIS price rate.
e MMM 6: Classified as National Remote, with prices typically 40 percent higher than standard rates.
e MMM 7: Classified as National Very Remote, with rates usually 50 percent higher.
e The NDIA occasionally reclassifies isolated towns surrounded by remote or very remote areas, treating them as remote areas to ensure fair
pricing and planning.
For services delivered online, the provider’s location determines the price. Even if a participant is in a remote area (MMM 6 or 7), if the provider is based in an
MMM 1-5 location, standard rates apply.
The MMM was originally developed to guide healthcare policy and resource allocation. While it helps to identify underserved regions, it has significant
limitations that undermine equitable disability support for NDIS participants. Price limits
Price limits depend on where the support is delivered. For in-person services, the price aligns with the location of the service (e.g., MMM4 if in a regional
area).
For telehealth services, the rate is based on the provider’s location rather than
the participant’s. Challenges with the MMM in NDIS Service Delivery
We outline below the main issues with the MMM as it impacts our work and
the experiences of NDIS participants.
- Lack of Disability-Focused Criteria in MMM Framework e The MMM system overlooks the specific needs of people with disabilities in rural areas, leading to inconsistent service provision. It fails to address essential support for everyday tasks like personal care, shopping, running errands, community participation and accessing therapies. A fairer model would account for these unique needs, ensuring better resource allocation for NDIS participants.
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- Inadequate Focus on Accessible and Public Transport Needs e The MMM overlooks access to public and accessible transport, a crucial factor for people with disabilities in rural areas.
e By focusing solely on remoteness and population, it misses the reality that limited, or no accessible transport severely restricts NDIS participants’ ability to reach vital services like therapies and community programs. This gap leads to misrepresenting access levels, as similarly classified areas may face vastly different transport challenges.
- Cross-Border Inconsistencies and Impact on Participants e The MMM’s fixed geographic boundaries fail to capture the service access patterns of NDIS participants in border communities, creating barriers to essential services.
e By overlooking cross-border realities, the MMM disrupts service continuity and disadvantages participants who rely on shared service hubs but face differing regional classifications.
Alternatives models for classifying rurality
Statistical Area Level 2
Statistical Area Level 2 (SA2), a key part of the Australian Statistical Geography
Standard (ASGS), is a geographic classification used by the ABS to collect and publish data.
SA2s generally represent functional communities with populations of 3,000 to 25,000 people. Urban SA2s cover suburbs or groups of suburbs, while rural
SA2s span larger areas to capture smaller populations.
Defined using criteria like demographic consistency and geographic connectivity, SA2s support the analysis of socio-economic trends and
community services.
Regular updates to SA2 boundaries ensure accuracy in reflecting population changes and aid in regional planning and service provision.
Rural, Remote, and Metropolitan Area (RRMA)
The Rural, Remote, and Metropolitan Area (RRMA) methodology, developed in 12
1994, categorises regions by population size and location, focusing on service distribution across metropolitan, rural, and remote areas. Though less detailed than the MM\MM, it provides a basic structure for allocating resources in health and public services. (Department of Health and Aged Care, 2021)
The RRMA classifies areas into three main groups with subcategories to
distinguish between varying levels of population density and remoteness:
- Metropolitan Areas o Includes major cities and large urban centres, divided into categories based on population size, serving as hubs with the highest service density.
e Class 1: Capital Cities e Class 2: Other Metropolitan Centres (urban centres with populations over 100,000)
- Rural Areas o Categorised into three levels, ranging from larger regional centres to small rural towns, providing a tiered approach for towns with moderate service access.
e Class 3: Large Rural Centres (urban centres with populations between 25,000 and 99,999)
e Class 4: Small Rural Centres (urban centres with populations between 10,000 and 24,999)
e Class 5: Other Rural Areas (areas not included in Classes 3 or 4)
- Remote Areas o Further divided by the degree of remoteness, capturing sparsely populated areas where service accessibility is lowest. e Class 6: Remote Centres (urban centres with populations between 5,000 and 9,999)
e Class 7: Other Remote Areas (areas not included in Class 6)
Accessibility/Remoteness Index of Australia (ARIA+)
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The Accessibility/Remoteness Index of Australia (ARIA+) is a geographic
measure of service accessibility, assessing road distances from population
centres to classify areas into five categories: Major Cities, Inner Regional,
Outer Regional, Remote, and Very Remote.
Developed by the Australian Government, ARIA+ supports policymaking for
health, education, and infrastructure in rural and remote areas by quantifying
remoteness. Each location is scored based on its road distance to service hubs,
using a scale from O (high accessibility) to 15 (extreme remoteness), ensuring
consistent assessments for equitable resource allocation across Australia.
Challenges and Benefits of Each Model for NDIS Service Delivery
Modified Monash Model (MMM)
Challenges: Its broad categories overlook local differences, and it does not consider non-health factors critical for NDIS participants; uses outdated data.
Benefits: Effective for health workforce planning and recognised in policy, supporting health-focused NDIS services in rural and remote
areas. Accessibility/Remoteness Index of Australia (ARIA+)
Challenges: Focuses solely on physical distance and does not consider socio-economic or infrastructural barriers that affect accessibility.
Benefits: Detailed remoteness classifications and adaptable across various sectors, supports targeted resource allocation for NDIS
services in remote areas.
Rural, Remote and Metropolitan Areas (RRMA)
Challenges: Its broad categories may oversimplify regional differences and limit suitability for detailed NDIS planning. Benefits: Provides a straightforward framework for large-scale service planning, highlights social needs beyond healthcare, and supports general service allocation.
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- Statistical Area Level 2 (SA2) Challenges: Does not include physical accessibility data; limited focus on transportation needs.
Benefits: Offers fine resolution and stable boundaries, accurately reflects community demographics, and aligns well with the specific
needs of NDIS planning.
Developing a New Disability-Focused Rurality Measure
A rurality measure tailored to NDIS needs would integrate disability-specific
criteria, focusing on access to specialist housing and critical support services.
By blending insights from existing rurality models with new, disability-focused
metrics, this model would offer the NDIS a comprehensive tool for planning
and resource allocation across Australia’s varied regions.
Key Components of a Disability-Focused Rurality Measure
Disability-Specific Criteria
Prioritise access to disability-specific services (personal care, allied health, assistive technology), especially in rural areas.
Consider complex disability needs with regional variations in specialised supports.
Include average service wait times to identify regions requiring
resource allocation.
Accessibility of Public and Accessible Transport
Recognise accessible transport options as essential in rural areas to clarify service accessibility.
Highlight regions where transport barriers limit service access.
Access to Appropriate, Accessible Accommodation
Include access to suitable accommodation, like Specialist Disability Accommodation (SDA), recognising limited rural availability. Assess both private and social housing to reflect real options,
supporting new or modified housing where needed.
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Focus on SDA and other accommodations to reduce barriers to
independence in underserved areas.
. Dynamic Population and Service Demand
Regularly update data to reflect demographic shifts, such as increased regional populations due to COVID-19. Enable disability providers to meet evolving community needs with
real-time data.
. Cross-Border Community Needs
Account for cross-border service reliance Ensure continuity of support for those relying on services across state
lines. . Levels of Socio-Economic Disadvantage
Consider regional socio-economic profiles to prioritise additional support in disadvantaged areas. Highlight regions where economic constraints limit access to
essential supports.
. Indigenous Communities and Cultural Considerations
Include criteria for Indigenous communities, recognising cultural needs and access barriers in remote areas. Target resources for culturally tailored services to ensure respectful,
effective support.
. Access to State-Funded Foundation Support Services
Address gaps for those needing assistance but ineligible for NDIS by including Foundation Support access.
Identify areas where supplementary services can support those just outside NDIS eligibility.
. Access to Key Healthcare Professionals for NDIS Evidence
Collection
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e Factor in access to healthcare professionals for NDIS assessments, addressing rural delays in evidence collection. e Identify regions where limited professional access impedes timely
service Access.
- Availability of Advocacy and Community Legal Services e Recognise advocacy and legal services’ role in helping participants navigate the NDIS.
e Highlight rural areas where advocacy services are limited, guiding resource allocation for improvement.
- Community and Stakeholder Consultation e Engage people with disabilities, providers, and stakeholders in shaping the measure to reflect real needs. e Maintain adaptability through ongoing consultations, ensuring a
responsive framework.
Application of the New Disability-Specific Rurality Measure
This model would classify areas as metropolitan, outer metropolitan, regional fringe, rural, remote, very remote, and extremely remote, enabling the NDIS to:
e Set pricing structures that reflect the higher costs of delivering disability services in remote and disadvantaged regions.
e Provide fair travel reimbursements, covering realistic distances for providers in remote areas.
e Target resources to regions with long wait times for accommodation,
healthcare assessments, and advocacy support.
A disability-focused rurality measure would help the NDIS address accessibility challenges and promote equitable service delivery by considering accessible housing, transport, socio-economic disadvantage, Indigenous community needs, and advocacy support. This model would ensure that people with disabilities in rural and remote areas receive timely, appropriate support, fostering inclusion and improving quality of life across Australia.
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Navigating NDIS Planning in Regional, Rural,
and Remote Australia
The NDIS aims to empower Australians with disabilities through tailored funding and support, yet structural barriers persist for those in regional, rural,
and remote areas.
Limited understanding within the NDIS planning framework of nonmetropolitan conditions compounds this challenge. Local Area Coordinators (LACs) and NDIS Planners, essential to the process, often lack awareness of the unique geographic, transport, and service access barriers faced by these communities.
Research by Veli-Gold et al. (2023) shows that without regional knowledge,
these professionals may overlook critical barriers, leading to inadequate plans.
This paper examines how the lack of regional understanding among NDIS professionals and an imprecise classification system contribute to these challenges, drawing on insights from ‘Understanding and Improving
Classification Systems for Equitable Disability Support in Rural Australia’ and
the work of Veli-Gold et al. (2023).
The Role of Local Area Coordinators
Local Area Coordinators (LACs) are key to guiding participants through the
NDIS process, setting support goals, and connecting them with local resources—an especially vital role in nonmetropolitan areas where access to services, transport, and healthcare is limited.
However, research by Veli-Gold et al. (2023) and others indicates that many LACs lack familiarity with the specific geographic, economic, and social challenges of rural and remote participants.
Often based in metropolitan centres, LACs and NDIS Planners may have limited insight into issues like scarce allied health and disability providers, limited transport, and fewer specialised services. This results in support that
may not fully meet the needs of regional participants (Veli-Gold et al., 2023).
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As Veli-Gold et al. (2023) highlight, without a deep understanding of these challenges, LACs are unable to deliver the level of tailored support essential for participants in regional, rural, and remote locations.
The Role of NDIS Planners
NDIS Planners are responsible for assessing participant needs, creating plans, and allocating funding to support independence and quality of life. However, many planners, particularly those unfamiliar with rural settings, struggle to
fully grasp the challenges faced by participants in nonmetropolitan areas.
Studies by Tune (2019) and Lloyd et al. (2021) reveal that carers and participants in rural regions often feel frustrated by planners’ lack of
understanding of local service limitations.
Planners tend to rely on assumptions or generic templates, overlooking specific barriers and the evidence participants provide, such as healthcare reports. This lack of engagement with participants’ lived experiences often results in plans that fail to deliver essential support.
The Impact of Limited Regional Knowledge and Classification
Systems
LACs and NDIS Planners play a vital role in guiding participants and allocating resources within the NDIS. However, their effectiveness in regional, rural, and remote areas is limited by insufficient regional knowledge. As Veli-Gold et al. (2023) note, many planners operate from metropolitan centres and lack
experience with rural conditions, leading to plans that overlook specific needs.
Additionally, the NDIS classification system lacks the granularity needed to capture the diversity within nonmetropolitan settings, failing to consider variations in access to resources, transport, and healthcare. This results in an oversimplified approach that doesn’t fully address the geographic, social, and
economic barriers faced by participants in rural areas.
Without targeted training for planners, a refined classification system, and a commitment to understanding rural needs, the NDIS planning process cannot
deliver equitable support to Australians with disabilities in regional settings.
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Challenges in the NDIS Planning Process for Non-metropolitan
Participants
Research by Tune (2019), Lloyd et al. (2021), and Howard et al. (2023) reveals that LACs and NDIS Planners often fail to consider social determinants of health, such as lower incomes, limited healthcare, and transport barriers, which greatly affect service access.
In “thin markets,” participants may struggle to find qualified support workers, rendering allocated funding ineffective. Additionally, participants seeking assistance are often directed to online resources, which are inaccessible for those with limited internet, leaving them feeling unsupported and isolated
(Mavromaras et al., 2021).
Insufficient Consideration of Evidence in Regional and Remote
NDIS Planning
Studies show a recurring issue in the NDIS experience for regional and remote participants: LACs and NDIS Planners often fail to review the extensive
evidence submitted by participants.
Families invest significant time and resources into gathering reports detailing functional barriers and location-specific challenges, yet, as noted by Veli-Gold et al. (2023) and Loadsman and Donelly (2023), these documents are frequently disregarded.
This oversight leads to plans that do not meet participants’ full needs, with inadequate travel funding a common issue. Many participants cannot afford travel to medical or allied health appointments, despite funds allocated for
provider visits, reflecting planners’ limited understanding of rural realities.
The Emotional Burden of Navigating NDIS for Rural Participants
Navigating the NDIS is both logistically and emotionally challenging for participants and carers in regional, rural, and remote Australia. Research by Tune (2019), Mavromaras et al. (2021), Barrett et al. (2023), and Howard et al. (2023) shows that many find the planning process traumatic, as they must repeatedly “prove” their disability and explain its impact.
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This process is especially taxing when working with planners who lack an understanding of rural challenges. Carers often feel overwhelmed by the dual burden of daily care and navigating a complex system (Wark and Hussain, 2018), with limited support from LACs and planners, leading to increased stress
and anxiety.
Recommendations for Improving Regional and Remote NDIS
Planning
To better serve people in regional, rural, and remote Australia, the NDIS planning process should incorporate the following recommendations:
- Regional Training for LACs and NDIS Planners e Implement training on regional-specific barriers, including social determinants of health, transportation limitations, thin markets, and
local economic challenges.
- Enhanced Engagement with Participant Evidence e Require LACs and NDIS Planners to review all participant-submitted evidence and incorporate it into planning, with a feedback system
allowing participants to confirm evidence consideration.
-
Locally Based Planners and LACs e Base LACs and planners within regional hubs where possible to improve their understanding of local barriers, enabling more informed and appropriate planning.
-
Increased Travel Funding for Regional and Remote Participants e Extend travel funding to participants and carers, not just service providers, covering necessary travel distances, especially in remote
areas.
- Improving Communication and Support for Carers e Provide resources and emotional support for carers, including mental health support, respite care, and accessible communication channels with NDIS staff.
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Addressing these issues is essential to ensuring that NDIS participants across Australia receive support that meets their specific needs, empowering them to live with autonomy and dignity.
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Insufficient Travel Funding and Flexibility for
Rural Participants
Travel funding, NDIS planning, and Local Area Coordinator (LAC) support are critical issues for regional and rural NDIS participants, requiring deeper
analysis.
Unlike metropolitan participants, those in regional and rural areas face unique challenges, such as long travel distances, limited public transport, and
reduced access to essential services.
The lack of regional insight among NDIS planners and LACs often leads to plans that miss these critical needs.
This section will further explore the complexities of travel funding and the shortcomings in planning and LAC support for regional participants, highlighting the necessary changes to ensure equitable support across
Australia.
How Does Inadequate Travel Funding Impact Participants?
Inadequate travel funding in NDIS plans creates significant obstacles for participants in regional, rural, and remote areas, where transport challenges
are more severe than in metropolitan settings.
Current funding does not reflect the absence of public transport, the lengthy distances to access services, or the costs of providers visiting remote communities. Many rural participants rely solely on private or community transport to reach essential services, with some unable to travel to regional hubs for specialist support due to physical or financial constraints, isolating
them from vital care.
Furthermore, the need for service providers to travel to remote areas is often overlooked, and without compensation, many providers find it financially unsustainable to serve these regions. This limits participants’ access to consistent support and essential services.
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These gaps in NDIS travel funding create substantial service inequities for nonmetropolitan participants, highlighting the need for more comprehensive travel support and a deeper understanding of rural transport barriers.
How is Travel Funded in Participants’ NDIS Plans?
NDIS participant budgets are divided into three main categories: Core, Capital, and Capacity Building, with travel funding primarily falling under Core, which includes Assistance with Daily Living, Transport, Consumables, and
Social and Community Participation.
While participants can use funds from other Core subcategories to cover additional travel costs, this flexibility often means sacrificing essential support in other areas.
Additionally, some receive transport funding as direct periodic payments, limiting their ability to reallocate funds, which National Disability Services (2018) identifies as a significant barrier to meeting extra travel needs.
The current system often fails to accommodate the complex travel requirements of rural participants, who may face long journeys to service hubs or rely on providers who travel to them.
Despite the NDIS’s focus on social participation and employment, planners seldom assess travel needs for these activities, which, as “Getting Transport on Track” (National Disability Services, 2018) argues, should be a routine part of planning.
To improve travel funding and accessibility for regional and rural participants, it is essential to adjust the pricing structure for NDIS-registered providers. Recognising the higher costs of travel and service delivery in nonmetropolitan areas would incentivise providers to serve these communities, helping to reduce participants’ travel burden and improve access to the full range of NDIS supports.
Solutions to Address Travel Funding and Accessibility Issues
- Enhanced NDIS Travel Rates for Regional Areas 24
o Introduce higher travel rates for providers serving beyond regional hubs to cover additional time and expenses. Incentives could encourage consistent services in remote areas, ensuring
continuity of care.
- Regional Loadings for Rural Service Costs o Apply regional loadings to standard service rates to cover higher operational costs like fuel and accommodation, allowing providers to sustain essential services in areas with limited
competition.
-
Long-Term Contracts for Remote Service Providers o Offer long-term contracts with guaranteed travel and service compensation to support stable, continuous care and encourage providers to establish local outreach services in rural areas.
-
- Provider Feedback on Regional Costs o Implement a feedback system to adjust rates based on real delivery costs in rural areas, with regular reviews to account for
regional inflation pressures.
These measures would foster a fairer NDIS service network across regional and rural areas, ensuring quality support and encouraging providers to operate in underserved regions, thus advancing equitable access for all participants.
Essential Disability Services on the Move: Reaching Rural and
Remote Australia
The National Rural Health Alliance highlights the significant challenges faced by people with disabilities in rural areas, such as limited access to health
professionals and essential services.
They advocate for outreach models that bring support directly to these communities, ensuring equitable service delivery to enhance health outcomes and quality of life (Rural Health, 2023).
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Like mobile health initiatives like Breast Screen, this approach would see skilled disability support teams travelling regularly to underserved areas, providing critical services like allied health, therapy, and assistive technology on-site (Rural Health, 2023).
By establishing consistent outreach schedules and using central community hubs—such as local centres, schools, or clinics—people with disabilities in remote regions would gain reliable access to support, minimising long journeys
to metropolitan centres (National Disability Services, 2018).
Implementing outreach models in rural and remote Australia has shown to improve access and care quality for individuals with disabilities, breaking down geographic barriers, building trust, and encouraging service use in isolated areas (Veli-Gold et al., 2023).
Lifely’s disability rights, advocacy and education roadshow proposal
In response to limited access to disability rights education and advocacy in rural and remote regions, Lifely has proposed a travelling roadshow to empower people with disabilities and their families across Victoria, New South Wales, and South Australia (Lifely, 2024).
This initiative will directly engage communities, delivering vital education on disability rights and addressing barriers to quality NDIS support. A dedicated Disability Rights Education Officer will provide face-to-face consultations, personalised advice, and immediate support, using plain language, visual
aids, and easy-read resources to ensure accessibility for all literacy levels.
The roadshow will also offer training for NDIS providers, raising professional
standards and safeguarding practices in regional areas.
Although Lifely was recently unsuccessful in the NDIS Quality and Safeguarding Commission’s Knowledge and Skills Grant round, it is actively seeking $500,000 to pilot this two-year roadshow.
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This concept could further be adapted to deliver allied health therapies and NDIS navigation support to underserved areas, ensuring that individuals
receive the guidance and services they need.
By expanding the roadshow model, Lifely aims to strengthen local knowledge of NDIS processes, empowering participants and families to navigate the
system with confidence and access essential support.
Conclusion
In conclusion, this submission highlights the pressing need for the NDIS to enhance its planning, funding, and support mechanisms for participants in
rural, regional, and remote areas.
While the NDIS strives for equitable service delivery across Australia, significant gaps remain for nonmetropolitan participants, often due to the insufficient adaptability of the Modified Monash Model (MMM) as a measure of rurality.
Designed primarily for healthcare resource allocation, the MMM does not account for critical factors in disability support, such as access to public transport, cross-border service needs, and socio-economic disadvantage.
Without disability-specific criteria, the MMM’s broad categorisations fail to capture the unique challenges faced by NDIS participants in diverse rural
communities.
To truly support equitable access, the NDIS must consider a more nuanced rurality measure that incorporates disability-related factors. By introducing disability-specific criteria, refining boundaries for cross-border regions,
regularly updating demographic data, and adjusting pricing to reflect the true cost of delivering services in rural areas, the NDIS can better align with
the needs of participants outside metropolitan centres.
Moreover, a collaborative approach to refining the MM\M,, involving input from NDIS participants, service providers, and local communities, would ensure the model reflects the real-world conditions faced by Australians with disabilities.
Addressing these issues is essential for creating a fairer, more inclusive NDIS. By
adopting a disability-focused rurality measure, the NDIS can better fulfil its
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mission to provide choice, control, and consistent, high-quality support for all
Australians with disabilities, regardless of where they live.
Furthermore, the experiences of people with disabilities in regional, rural, and remote Australia underscore the critical need for the NDIS to adapt its
planning, funding, and support models to better serve these communities.
Despite the NDIS’s transformative aims of enhancing choice, control, and accessibility, significant barriers remain for nonmetropolitan participants, often exacerbated by geographic isolation, limited infrastructure, and a
shortage of service options.
The NDIS planning process and the support provided by Local Area Coordinators (LACs) must evolve to reflect the unique needs of rural communities. LACs and NDIS Planners often lack the necessary regional insight, leading to plans that do not adequately address the specific
challenges faced by participants in rural settings.
Moreover, the current structure of travel funding is insufficient to cover the actual costs and logistical complexities of accessing services in remote areas, leaving participants with limited or no options for essential support. This is particularly challenging for those with mobility issues or financial constraints,
further compounding their disadvantage.
To create a genuinely inclusive and equitable NDIS, it is essential to “rural proof” the scheme. This includes increased training for planners and LACs in understanding regional challenges, improved travel funding that aligns with the realities of rural and remote living, and the introduction of higher service
rates to cover the increased costs of delivering support in these areas.
By addressing these critical issues, the NDIS can work towards achieving its mission to provide consistent, high-quality support for all Australians with
disabilities, regardless of their location.
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