S9E02 - Living Through NDIS Change: The OT Perspective

The current NDIS landscape is shifting quickly, and many Occupational Therapists are being asked to make decisions without having all the information. Between proposed funding changes, evolving reporting expectations and ongoing uncertainty around registration, it’s easy to feel overwhelmed.

Rather than trying to predict every outcome, the focus right now is on understanding what’s changing, what it means in practice and how to respond in a way that is both clinically sound and sustainable for your business.

Preparing for changes to social and community participation funding

One of the biggest concerns is the proposed reduction in social and community participation funding. While details are still emerging, early indications suggest a significant cut for many participants.

What’s important to recognise is that this funding is often not just used for social outings. It supports essential daily activities such as attending medical appointments, grocery shopping and accessing community services.

If funding is reduced, the need for support does not disappear. In many cases, it simply shifts. Participants may still require assistance at home, which can increase pressure on families and create new risks if appropriate supports are not in place.

Adapting your reporting approach

These changes highlight the need to be far more explicit in reporting.

Rather than broadly referencing social participation, reports should clearly outline how funding is currently being used, why those supports are essential for daily functioning and what risks may arise if they are reduced.

It is also important to articulate what alternative supports would be required if funding is changed. This ensures that reports reflect the real-world impact on the participant, rather than abstract recommendations.

Clarity, specificity and clinical reasoning are more important than ever.

Functional assessments on file: necessary or not?

There has also been an increase in requests for updated functional assessments “just in case”. While this may feel like a protective strategy, it is not always the best use of funding.

If a participant has had a recent assessment and there have been no meaningful changes, completing another report may not provide additional value. In contrast, if circumstances have changed, eligibility is unclear or documentation is outdated, an updated assessment may be justified.

The key is shared decision-making. Presenting the pros and cons allows participants and their families to make informed choices, rather than defaulting to unnecessary reporting.

Should you register as an NDIS provider?

With all of these changes, it is no surprise that the question of registration is coming up again.

There is ongoing discussion around mandatory registration and potential pricing differences between registered and non-registered providers. However, there is still no clear timeline or confirmed model for what this will look like.

Registration is not a simple decision. It depends on your service type, business structure and financial position. Therapists providing therapeutic supports may access the verification pathway, while those in early childhood or behaviour support may face significantly higher costs through certification.

Adding to the complexity is the likelihood that the system will change again. Investing in registration now may not mean avoiding future requirements.

Understanding the true cost of registration

Registration involves far more than the initial fee.

Beyond upfront costs, there is a significant time investment in preparing documentation, undergoing audits and maintaining compliance. This includes systems for staff checks, professional development, incident management and infection control.

Importantly, it is not enough to have policies in place. You must demonstrate how they are implemented in practice. Audits often include staff interviews and evidence of real-world application.

While these systems become easier to ma