Keeping Supports Steady: Psychosocial Disability and NDIS Changes

The NDIS is changing quickly and it can be hard to keep up. Many people with disability aren’t seeing the updates, yet the impacts are real. Here's a recap on what’s shifting and how OTs can respond.

Psychosocial disability needs steady, long-term support

Early intervention matters, but it won’t replace the NDIS for everyone. Many people with psychosocial disability have ongoing, fluctuating needs. They benefit from stable, wraparound supports across home, community, education and work.

OTs understand everyday life. We translate goals into routines, coordinate teams and show how supports improve function. Our voice is essential in this debate.

The information gap is real

Policy moves fast. Participants often hear last. That isn’t co-design. Let’s keep updates simple, timely and accessible so people can make informed choices.

What’s turning up in plans

Therapists are seeing plans with sharp reductions or odd phasing that block setup and continuity. Example: a five-year plan with only 10 hours of capacity building released in quarter one, then nothing. Without clear reasons or a pathway to adjust, progress stalls.

Another risk sits with people who rely on larger core budgets to live independently. If those budgets drop without alternatives, we’ll see more hospital presentations, housing stress and crisis care. Short-term cuts don’t save money if they shift costs elsewhere.

Support needs assessments are delayed

The Support Needs Assessment is now pushed to mid-2026. Decision rules are unclear in the meantime. Transparency helps everyone plan and keeps decisions accountable.

Foundational supports and ‘Thriving Kids’

Early childhood changes sound promising but details are thin. If services outside the NDIS aren’t real, funded and available, families will miss out. OTs know what works for children and caregivers – our practical input should shape any new model.

Pricing and the IHAPCA work

Consultation feedback shows current pricing often fails to cover the true cost of quality services, especially in regional and remote areas. When prices don’t match delivery, access shrinks and innovation slows. Evidence-based pricing supports equity and a stable workforce.

Art and music therapy

Their evidence base has been recognised, yet recent price cuts send a poor signal to a highly trained, largely female workforce. When rates fall, participants lose access to skilled, consistent support.

Section 10 and housing

The transitional Section 10 rule has changed what’s considered mainstream versus reasonable and necessary. In practice, some people are being pushed toward costly home modifications when relocation would be safer, faster and cheaper. Permanent rules should weigh lifetime cost, safety and function – not just categories.

What OTs can do right now

• Strengthen assessments: Cover permanence, functional capacity and support needs in every report. Use the ICF and make your reasoning easy to follow.
•   Log impacts: Track plan changes, delays and risks. Share trends through peer groups to support advocacy.
•   Keep participants informed: Use plain-English updates, timelines and checklists for reassessments.
•   Plan for continuity: If funding is phased, map what can start now, what needs bridging and what will stall.
•   Back the ecosystem: Stand with allied health peers on pricing and access. A strong network helps participants most. 

Key takeaways

•   Psychosocial disability often needs lifelong, wraparound supports – early intervention alone won’t replace the NDIS.
•   People with disability must be included and informed or reforms will miss the mark.
•   Current plan structures are creating gaps in setup and continuity, with hidden risks in housing and core supports.
•   Pricing should reflect real delivery costs to protect access, quality and workforce stability.

NDIS reforms are moving, but not always in straight lines. Here’s a clear, practice-first update based entirely on the issues raised in your discussion: consultation fatigue, the Evidence Advisory Committee, delays to the planning framework and support needs assessments, what impairment notices might mean, mandatory registration realities, audits in practice and the latest OTA pricing survey.

Clinics are feeling tapped out after repeated consultations and still-unreleased best practice guidelines. Yet advocacy remains important. A Senate inquiry into Thriving Kids was noted with limited specifics available. Given uncertainty, clinics should plan conservatively – avoid locking in long leases and keep service models flexible over the next two years.

Expressions of interest for the NDIS Evidence Advisory Committee (EAC) have concluded with appointments described as largely academic. Subcommittees include assistive technology and capital, capacity building and therapy and economics. The first public consultation is expected “in the coming weeks”. Open questions remain about how EAC advice intersects with operations on the ground and with the Enduring Supports Rule process.

The new planning framework has been pushed back and support needs assessments are delayed. It’s unclear whether impairment notices are also delayed – timing wasn’t confirmed. Takeaway: keep documentation consistent, stay transparent in service agreements and avoid assumptions about start dates.

Consultation outcomes reflected familiar themes: registration costs and admin load, fairness for different provider sizes and locations and continuity of trusted supports. Priority areas flagged elsewhere remain supported independent living, support coordination and platform providers. Large-scale rollout faces capacity constraints – auditors are limited and processing times can already stretch towards a year. Expect staged change with grace periods to signal intent followed by a longer window to complete audits.

Audits can be onsite or remote. Providers reported costs for auditor travel and accommodation for certification audits, document sampling across caseloads, client and staff interviews and close scrutiny of policies, records and safeguards. Experiences vary by auditor background and demand and timelines can extend beyond initial expectations.

From OTA’s recent survey of 600 OTs, key data points discussed were:

14% of providers expect to exit in the short term – estimated as 1,267 practices – potentially affecting up to 17,320 participants

39% don’t expect to remain profitable under current settings, 43% are unsure and 55% reported no profit in 2024–25

79% already have a waitlist; 52% report waits of 12 weeks or more

Travel matters: 95% provide some travel, 56% travel daily, 98% say travel reimbursement is important to viability, 51% say it’s critical to deliver assessments and therapy in natural environments

85% exceed travel caps at least some of the time; 29% do so more than 70% of the time

If caps remain, 92% plan to reduce travel and outreach, 63% to reduce regional and remote services, 33% to stop home and community visits and 24% to stop taking complex cases

OTA’s asks discussed: reverse the travel cut, apply an immediate 7% uplift to OT hourly rates and co-design a fit-for-purpose allied health pricing model that properly accounts for travel, reports and multidisciplinary work.

A modest profit buffer is a safeguard, not a luxury. It’s what allows services to ride policy pivots, delays and compliance costs. Until reforms settle, prefer flexible overheads over long commitments. Document processes now – it pays off later.

Expect staggered change rather than a single switch

Keep service agreements clear and documentation tight

Model scenarios for travel, outreach and home visits

Build a small profit buffer to cushion policy shifts

Stay vocal in consultations, even when it feels thankless

Working within the NDIS can be rewarding but it also comes with complex responsibilities. For allied health providers, support coordinators and practice owners, ensuring participant safety isn’t always straightforward. Even when the right steps are taken, reporting concerns can lead to frustrating delays, unexpected consequences and, in the most tragic cases, life-or-death outcomes.

This article explores the realities of raising concerns in the NDIS – from understanding who to report to through to the emotional toll of speaking up when systems don’t respond as they should.

Many providers share the same difficult question: what happens when you do the right thing, report an issue, and no one follows up? Some have seen investigations stall until it was too late while others have been disengaged from service arrangements after raising concerns. The reality is that compliance processes can be slow and fragmented and providers who step forward often face unexpected risks.

One of the biggest challenges is knowing where to send a complaint. Different issues fall under different bodies:

NDIA – for fraud, misuse of funds and suspicious claims

NDIS Commission – for provider conduct, safeguarding and quality of care

Police and state-based agencies – for criminal, abuse or neglect concerns (for example, the NSW Ageing & Disability Commission or the Office of the Children’s Guardian)

Without clear pathways, providers can be left unsure about whether they’ve contacted the right authority and whether action will follow.

Case examples highlight the human cost of these gaps:

Fraud and non-compliance reports going unaddressed

Investigations dragging on until after a participant has died

OTs and support coordinators being disengaged after raising red flags

The heavy emotional toll of holding professional and ethical responsibilities without clear systemic support

These stories show why reporting is both necessary and, at times, incredibly difficult.

It’s no surprise that many providers think twice before submitting a complaint. 

The risks can feel personal and professional – from being removed from service arrangements to dealing with prolonged uncertainty to facing an overwhelming administrative burden. Yet not reporting also carries serious consequences.

The most effective approach is to put clear internal processes in place. This means:

Having a set threshold for when a matter requires reporting

Documenting everything – case notes, emails and conversations

Submitting reports to multiple bodies where appropriate (more is more)

Taking the emotion out of decision-making by following established procedures

Knowing when and how to escalate concerns further – whether to the media, local MPs or Ministers’ offices – if systems fail to act

There is no one-size-fits-all reporting pathway – knowing who to contact is crucial

Delayed action can have devastating outcomes including loss of life

Reporting can carry risks for providers but silence carries greater risks for participants

Internal documentation is essential for accountability and protection

Escalation beyond the NDIS is sometimes necessary when urgent risks are ignored

If in doubt, report – it’s better to act and be safe than to remain silent

NDIS Fraud Reporting and Scams Helpline – 1800 650 717 | [email protected] 

NDIS Commission – www.ndiscommission.gov.au 

NSW Ageing & Disability Commission – www.ageingdisabilitycommission.nsw.gov.au 

Office of the Children’s Guardian – for matters involving children

(Each state and territory may have its own equivalent reporting bodies.)

Reporting under the NDIS is rarely simple and providers often find themselves caught in grey areas between compliance, safeguarding and professional ethics. But having clear procedures, documenting thoroughly and knowing when and how to escalate can help protect both participants and providers.

Above all, the message is clear: if you see something, report it. Even when the system feels slow or unresponsive, speaking up remains a crucial safeguard for the people we support.

In this episode, we dive into two big conversations every occupational therapist, and anyone in the disability space, needs to hear.

First, we reflect on the reality of career uncertainty in OT. Whether you're in private practice, working for yourself, or exploring other sectors, we talk about the importance of backup plans, transferable skills, and why it’s okay to reassess your path without guilt or panic. You’ll hear honest reflections on transitioning between roles, recalibrating expectations, and staying grounded while thinking about “what’s next?”

From there, we shift gears to the recently released NDIS Ministerial Brief, obtained under Freedom of Information. We unpack:

The upcoming Notice of Impairment rollout (and the red flags it’s raising)

The move from function-based to support-needs-based planning

Concerns around simplified plans and what they might mean for funding

The confusion around new support needs assessment tools

Pilot plans for navigator roles and early intervention pathways

The NDIS’ updated debt recovery approach and examples of flagged claims

What OTs and AT suppliers need to know, especially around maintenance claims

We also reflect on what these reforms mean for participants, practitioners, and the broader workforce as we all brace for the next wave of change.

Tune in to stay informed, feel less alone in the chaos, and share a few laughs along the way.

Links & Resources:

NDIS Ministerial Brief (PDF) – available in the OT Facebook group file section

Debt Recovery Summary on the NDIS website - https://www.ndis.gov.au/about-us/improving-integrity-and-preventing-fraud/recovering-funds-owed-ndia

This week on OT Unplugged, Sarah, Nikki, and Alyce swap Oodie stories (pandas vs. champagne avocados), laugh about missing wine bottles and Lego office décor, and then get serious about something far less cozy — the way NDIS policy shifts often reach providers first through the media rather than direct communication.

The Numbers Game: What the latest NDIS quarterly report reveals — more than 739,000 participants on the scheme and growth well above original forecasts.

Children and the Scheme: Why kids under 15 continue to dominate new entrants, and what this means for families with limited alternatives outside the NDIS.

Foundational Supports on Shaky Ground: Reports suggest state governments are backing away from foundational supports, leaving families and providers with even more uncertainty.

Big Announcements, Little Warning: The upcoming productivity summit and what it signals for future scheme reforms — from eligibility pathways to funding constraints.

Diversifying Beyond the NDIS: Why pivoting to Medicare, private, aged care, and DVA isn’t straightforward, and the pitfalls for OTs stepping into new systems without proper guidance.

The “Goal” Debate: Do we expect too much from participants to frame their lives in NDIS goals? A candid chat about capacity building, maintaining skills, and what really matters.

The eternal debate: Oodies, Squiddy hoodies, or dressing gowns?

Sarah’s victory in finally evicting a Wallabies jersey from her office (although they did win, apparently).

Our upcoming Perth workshops in September with OT Services Group — and an open invite to dinner if you’re local!

Links & Resources:

Subscribe to the Verve OT Learning Newsletter  for weekly NDIS updates and training opportunities - https://www.verveotlearning.com.au/subscribe 

AFR article on foundational supports and state negotiations - https://www.afr.com/politics/federal/ndis-black-hole-risk-as-states-back-away-from-savings-measures-20250815-p5mna7

Intro to Aged Care for OTs webinar resource - https://www.wayforwardot.com/courses

This week on OT Unplugged, Sarah, Nikki and Alyce take you from heartwarming wheelchair wins to head-scratching NDIS decisions and everything in between.

We share a six-year success story that proves sometimes you don’t have to reinvent the wheel… while also diving into a “Dick Decision of the Week” that left one client trapped in their home thanks to baffling bureaucratic delays.

We unpack what the latest NDIS AAT stats really mean for OTs and participants, explore the headaches of funding periods, and share a few productivity hacks that might just change your work life (yes, including how to hide your inbox).

And because it’s never too early for some festive debate, we swap ideas for Christmas parties from sailing on shark-infested lakes to lawn bowls, dumpling-making, and maybe even axe throwing.

In this episode, we cover:

🎯 A six-year wheelchair script success story and why small tweaks can be the big win

🚫 The “Dick Decision of the Week” and the reality of NDIS delays

📊 Why 72% of NDIS AAT decisions are overturned and what that says about the system

💸 Funding period dramas and being the guinea pig to test what really works

📧 The game-changing inbox-hiding tool for email focus

🤖 Using AI tools like Heidi Health and Dictate to make case notes easier

🎄 Creative (and slightly chaotic) OT Christmas party ideas

Resources & Links:

Funding Periods Webinar with Nikki & Chris – https://www.verveotlearning.com.au/live-mastering-funding-periods-spreadsheet-tool

Heidi Health – https://www.heidihealth.com/au

Dictate App – Dictate Speech to Text on the App store

In this lively and unfiltered episode of OT Unplugged, Sarah, Nikki and Alyce dive deep into the real behind-the-scenes of OT life. From forgotten billing and chaotic clinical loads to dodgy grocery deliveries and what not to do with the NDIS logo. You'll laugh, nod in solidarity, and feel the fire of advocacy as the team navigates everything from hosting students and juggling admin to prepping for what could be a major national NDIS protest in Canberra. They also uncover some critical changes in NDIS branding rules and the disappointing disappearance of key AHPA registration resources. Whether you're buried in clinical notes, prepping for accreditation, or dreaming of blocked-out admin days (that actually stay blocked), this one's for you.

What We Cover:

✅ The "quiche from a box" lifestyle & what it says about OT survival mode

✅ NDIS logo use: what’s changing, what’s allowed, and how one brochure mishap cost a lot of stickers

✅ The silent disappearance of ARPA’s OT registration resources

✅ Burnout, boundaries & billing: why even experienced OTs forget to charge for their time

✅ Kids, clients & chaos: the impossible juggle of modern OT practice

✅ A shout-out to the amazing Samantha Connor and her challenge to Allied Health

✅ Real talk about clinical load creep, admin chaos, and the danger of too many browser tabs

✅ What's coming up in training, workshops & CPD

This week Nikki, Alyce and Sarah dive deep into the often wild, always unpredictable world of community occupational therapy. From ferrets and replica Rambo knives to renovation chaos and rogue spiders, the trio share some of their most unforgettable home visit moments and and the crucial safety lessons they’ve learned along the way. But this isn’t just a collection of wild stories. We explore the serious side of safety in OT practice:

Why risk assessments are essential and often overlooked in community and paediatric settings.

What it really means to do a "vibe check" before a home visit.

How OTs can better protect themselves (and their clients) from the unexpected.

Tips on positioning, phone safety, and building safety systems that actually work.

Whether you're a seasoned OT or just starting out, this episode is a must-listen for anyone delivering services outside the clinic walls. Plus, Alyce shares an exciting update about the launch of The OT Coach Academy and The Pediatric Hub a new community for paediatric OTs seeking practical, ongoing support.

Model Code of Practice - https://www.safeworkaustralia.gov.au/doc/model-code-practice-healthcare-and-social-assistance-industry

EOI The Pediatric Hub - https://forms.gle/wvHUUcnnHtD4MGoi9 https://www.theotcoach.au/interest-expression-paediatric-hub https://www.safeworkaustralia.gov.au/doc/model-code-practice-healthcare-and-social-assistance-industry

Booking link The Supervisors Space - https://www.trybooking.com/DEESL

In this episode of OT Unplugged, Nikki, Alyce and Sarah return from the school holiday juggle and dive straight into the increasingly challenging realities of working in the NDIS space. From the chaos of school drop-offs and camp kitchens to the harsh truths of the new NDIS price guide, the team doesn’t hold back. They share what it really looks like for OT providers navigating service cuts, plan manager pushback, and a system that’s doubling down, not backing down. You’ll hear honest reflections on: The “three A’s” of surviving NDIS reform: Advocate, Accept, Adapt Business sustainability in the face of shrinking margins Strategic pivots (like dropping travel-heavy work or moving to niche assessments) The emotional weight of turning away referrals and letting go of staff The wild inconsistencies in plan manager responses Why Section 100 reviews feel like a formality and the shocking ART stats Big changes brewing in Aged Care and Support Needs Assessments Whether you’re a sole trader or running a large team, this episode is your no-fluff guide to staying afloat while staying ethical. 🛠️ Resources Mentioned: NDIS Provider Harm Tracker - https://www.thisisanpa.org/the-harm-tracker-project Nikki’s “Invoicing Simplified” workshop - https://www.verveotlearning.com.au/Invoicing-Simplified-Prompt-Payments-&-Collections Sarah’s webinar on Section 33 & funding periods - https://www.verveotlearning.com.au/ndis-insights-unpacking-changes-to-ndis-section-33 Article on use of telehealth versus in person supports for OT -https://onlinelibrary.wiley.com/doi/10.1111/1440-1630.70036?fbclid=IwY2xjawLu6HlleHRuA2FlbQIxMQABHr1mLk6JKJ7zVPXNu56uAg28ZAwHPLAPRSeQrQvW8gs90i-z9iBt_V5P_ Info on Perth live events — coming September!

The recording of "Climbing the Mountain: Maintaining OT Presence in an Evolving NDIS" is now ready. Delivered as a presentation at the recent OTA conference by Sarah Collison and Jenny Gribbin, we are sharing the recording so that every OT navigating the NDIS can listen, reflect, and reconnect with the power of our collective journey.

This talk is a love letter to our profession. It’s the story of how OTs have climbed, scrambled, adapted, and persisted through every twist and turn of the NDIS since 2014. From the early days of no roadmap, through the storm of Independent Assessments, to the recent shake-up in pricing that’s left many of us reeling. This is a story of strength, solidarity, and staying the course.

📌 Whether you were there at the trial sites, building tools from scratch, or you’ve just joined the climb - this one’s for you.

💥 It's honest. It's fierce. It's hopeful.