S10 E5 - The NDIS Is Changing: Here’s What We Know

The latest NDIS reforms bring another significant period of change for participants, families, OTs and providers. While legislation has progressed, many of the practical details still depend on rules, guidance and implementation processes that are yet to be developed.

For OTs, the priority is understanding what has changed, what is coming and what remains uncertain – without trying to predict decisions before the details are available.

New planning and support needs assessments

One of the biggest changes ahead is the introduction of new framework planning and support needs assessments. There is still uncertainty about exactly how these assessments will translate into participant budgets and how complex supports such as assistive technology and home modifications will be considered.

The role of professional evidence will also be important. Consultation feedback has highlighted the need for evidence from treating practitioners who understand a participant’s function and support needs over time. Testing of the iCAN tool is continuing, so there is still more to learn about how the assessment process will work in practice.

Functional capacity assessments are also coming

From 1 January 2028, access to the NDIS is expected to involve a standardised assessment of functional capacity. The reforms clarify that people can use common forms of assistance, such as glasses, hearing aids and walking sticks, during these assessments, while children can receive age-appropriate assistance.

The bigger question is how a standardised assessment will capture the complexity of everyday function. Occupational performance is influenced by environment, equipment, assistance and context, making the implementation of these assessments particularly important for OTs to watch.

Review rights could look different

The introduction of support needs assessments may also change what happens when a participant disagrees with their budget.

Rather than directly challenging the resulting level of funding, the review pathway described in the reforms may lead to another support needs assessment being completed. This raises questions about whether participants could find themselves repeating assessments when they believe their needs have not been adequately captured.

Changes to unscheduled reassessments

Participants will be able to request an unscheduled reassessment following a significant and ongoing change. Importantly, that change no longer needs to be ‘unanticipated’, which may better reflect the experiences of people living with complex or fluctuating disability.

However, the timeframe remains significant. If the NDIA does not decide on a reassessment request within 90 days, it is treated as refused, allowing the participant to move to a review rather than repeatedly submitting reassessment requests.

Greater clarity around parental responsibility

The reforms also clarify the distinction between ordinary parental responsibility and additional support required because of disability.

Parents are ordinarily expected to provide supervision, personal care, transport, emotional support and behaviour support. However, this does not include additional assistance a child requires because of their disability compared with a child of a similar age without disability.

For paediatric OTs, clearly describing this difference in functional evidence will remain important. The NDIS must also consider potential harm to informal supports, family relationships and informal networks if disability-related support is not funded.

Support determinations and critical supports

The reforms introduce mechanisms that could allow broader funding changes to particular categories of support. However, protections have been included for critical supports such as assistance with personal care and medication, mobility equipment, vehicle modifications, certain consumables and specialist disability accommodation.

Additional safeguards are intended for participants requiring continuous