Funding and support plans for national disability insurance scheme participants will be generated by a computer program and staff will have no discretion to amend them, under a major overhaul of the NDIS to be rolled out next year, Guardian Australia can reveal.
Under the changes, human involvement in deciding support for NDIS participants will be dramatically reduced.
Details of the sweeping changes to the way NDIS plans are made were outlined in a recent internal briefing to National Disability Insurance Agency (NDIA) staff, seen by Guardian Australia.
The changes, which are due to be rolled out from mid-2026 under the NDIS’s New Framework Planning model, will also significantly affect a participant’s right to appeal decisions about their funding. If NDIS participants appeal against their plans to the administrative review tribunal, the ART will no longer have the authority to alter a person’s plan or reinstate funding, according to the staff briefing.
Instead, an NDIA manager said the agency had received legal advice that the ART would be able to send the plan back to the NDIA, for the agency to conduct another assessment, and cannot get an external party to amend the plan.
Another senior manager said there would be no requirement for staff to consider independent medical evidence provided by NDIS participants in the development of plans.
How the funding tool will work
The government announced in September that it would be introducing a new way of determining the funding received by NDIS participants, procuring a licence for a new needs assessment tool, called the Instrument for Classification and Assessment of Support Needs (I-CAN) version 6, which was developed by the University of Melbourne and the Centre for Disability Studies and has been used across the Australian disability sector for 20 years.
An NDIA spokesperson told Guardian Australia: “The NDIS Review received thousands of submissions calling for a simpler and more consistent assessment of the needs of participants.” The I-CAN tool was procured “in line with the NDIS Review’s recommendations which call for a simpler, fairer pathway for NDIS participants to access the disability supports they need,” they said.
The NDIA said this model would reduce human error and increase consistency in the development of support plans, and would remove the need for participants to spend money and time collecting medical evidence that is now relied upon in the development of plans.
The government has set its sights on reducing the cost of the NDIS, which now supports about 750,000 Australians. The health minister, Mark Butler, has said the government aims to get the growth rate of new participants down from 12% to 5-6% a year.
The new I-CAN planning model is due to be rolled out in stages and the NDIA is now conducting information sessions with participants and staff about how it will work.
Disability rights groups have called for more details to be released, particularly about the training and background of assessors, the way independent medical evidence would be considered in the process and the right of appeal for participants.
Many of these questions were also raised by NDIS staff in Queensland with their managers during the online information session attended by several hundred NDIA Queensland staff on 13 November.
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Desmond Lee, the general manager of Queensland regional services for the NDIS, who ran the information session, said the new model was designed to “provide a better experience for participants”.
Lee said it would “provide stronger assessment oversight” and “clearer budget rules”, leading to a “a fairer scheme for everybody and a scheme that will endure into the future”.
He outlined the new process for determining NDIS participants’ support plans.
First, an “assessor” conducts a support needs assessment, which Lee described as a “guided semi-structured conversation”. The assessor roles will be filled by Australian Public Service level 6 employees.
This will be used alongside a questionnaire to assess an individual’s personal and environmental circumstances, which Lee stressed was a “really important part of the assessment”.
Further targeted assessments could also be used if people’s needs are more complex, for example if they need home modifications, assistive technology, or if things like hospitalisations or compensation need to be factored into their support.
The information gathered by the assessor is checked with participants and their representatives to make sure all relevant information is captured, and it is then put into the I-CAN tool, which Lee described as a “very highly respected and heavily used tool in the allied health industry for doing functional capacity assessments”.
Lee stressed the importance of NDIA staff – or “delegates” – under the new model, saying: “We believe the role of the delegate will be extremely important for us as that quality assurer … As a delegate you’ll need to be able to say, ‘we’ve got the right quality of plan for the right person here and as the funding authority I’m happy to sign off on that’.”
Lee was asked by a staff member to clarify who was actually responsible for making a decision about funding for participants.
“It wasn’t actually clear who was making the decision about funding,” she said. “Obviously it’s the planner [NDIA staff member] now, but in this new framework is it going to be the assessor?”
“No, the assessor won’t, but that’s a really good question,” Lee said.
His colleague, Lawrie Thomas, an NDIS executive from the scheme reforms and transition branch, later interjected to make it clear that under the new system, once the I-CAN generates a budget for a participant there is no way for the NDIS staff member to alter it, only to request a new assessment is done by the I-CAN tool with different inputs.
This differs from the current system, where computer-based tools, such as plan conversation support tool (PCST) and typical support package (TSP), help to generate and cost draft plans that can then be amended by NDIA staff, before being finalised.
“To further clarify … [the I-CAN-generated plan is] not a recommendation,” Thomas said. “The budget generation will provide a funding package or a budget for the participant, the only decision the delegate makes on that front is whether or not they accept the assessment which generated the budget, or if they request a replacement assessment.
“So it doesn’t provide a recommendation like the TSP, it will actually provide a budget. The only decision point around that is whether the assessment was completed correctly, therefore the budget had been generated with the correct inputs.”
An NDIA spokesperson said: “It is not an automated system. Assessments will be conducted by trained and accredited assessors.”
In the briefing, Lee told staff that assessors would initially be internal hires from within the NDIA. It would be “highly desirable but not mandatory” that they have an allied health background and/or lived experience of disability, he said.
Currently, the Centre for Disability Studies, which provides accreditation for I-CAN assessors, requires assessors to be allied health clinicians, nurses, clinicians with an education degree or an NDIS Behaviour Support Practitioner, with other applicants for the training considered on a case-by-case basis.
How appeal rights will change
In the briefing session, Lee said he had sought clarification from the NDIA’s legal team about participants’ appeal rights under the new scheme.
He said the advice he had been given was that if the administrative review tribunal feels an assessment has been conducted incorrectly, it will be able to send plans back to be reassessed by the NDIA.
This would be a significant shift from the ART’s current role, which allows tribunal members to directly amend or vary an NDIS plan if they consider it is incorrect.
“Now, on the legal advice, if you’re a participant … if you feel like that assessment doesn’t truly reflect your needs or your circumstance, you can request another one, that’s an s48 review. If you’re not happy with that, we go to internal review and we conduct another assessment using our tool; if you’re not satisfied with that, you can go to the tribunal,” he said.
“But you have to remember, and this is the legal advice … if you’re able to convince the tribunal, by either bringing further information or other, that that assessment doesn’t truly reflect your circumstances, the tribunal can order the agency to conduct another assessment. They cannot get an external party or a third party to conduct our assessment. By law, it must be conducted by us. We’ll have to work out how we do that at that stage, of course.”
The comments are likely to alarm advocates, given the number of cases of people appealing NDIA decisions to the ART has surged over the last year.
In the 12 months to the end of June 2025 there were 7,132 new cases brought before the tribunal of people appealing decisions by the NDIA, a 76% increase on the year before. This was the highest rate since June 2022, when soaring appeal rates prompted fierce condemnation from the then opposition Labor party.
In 73% of these cases, the NDIA decision under review changed.
‘You can see how there might be shortfalls’
While some NDIS staff on the call expressed enthusiasm for the changes, with one saying that “this is going to be positive for our participants, for sure, for consistency”, others expressed concern about some of the proposed changes.
One staff member said they were worried about “participant wellbeing” if there were “needs not captured in that assessment and we’re under no obligation to consider independent evidence then you can see how there might be shortfalls.”
Another staff member asked about what contingencies would be put in place for participants who don’t wish to engage with NDIS staff, for instance those who are impacted by psychosocial disabilities, people who may distrust the government or may be in institutional settings.
Lee said they would still “likely have specialised teams to engage with hospitals and justice settings” and the agency would “have to work out ways to be able to best support those folk who have anxiety issues … to be able to find ways to provide a safe environment for those people to have an assessment conducted.”
Another staff member asked if the NDIS had “learned its lesson” from the failed attempt to introduce independent assessments, a policy announced in 2020 by the former Coalition government and trialled by the NDIS, which would have seen a government-contracted allied health professional conducting a one-off meeting with a prospective participant for an assessment, which would have determined someone’s eligibility for an NDIS funding plan.
The policy was scrapped in 2021 after widespread criticism from disability rights groups, which argued participants should be allowed to source medical reports from health professionals known to them.
Lee said the NDIA “absolutely have learnt from that”.
An NDIA spokesperson said the agency had listened to advice from the disability community that “more time for consultation will improve the delivery of these reforms and minimise disruption for NDIS participants.
“The rules and policy arrangements to support the new approach are currently being developed in conjunction with the commonwealth and state and territory governments, and the disability community.”
Do you know more? Contact kate.lyons@theguardian.com
