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I-CAN Needs Assessments: what’s going on? Why are so many people worried?

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Last week, NDIS needs assessments became mainstream news, thanks to Kate Lyons’ reporting in The Guardian: “NDIS plans will be computer-generated, with human involvement dramatically cut under sweeping overhaul“. 

A few people were confused by what’s happening and reached out with questions.

Your right to know:

Before big NDIS changes are rolled out, everyone affected:

  • has a right to know what’s happening; and
  • should be given an opportunity to share their views with the Government and the NDIA. 

The challenge:

Legal-policy details and jargon make it hard to get to the bottom of what’s happening without losing sight of the big picture. 

Context:

Much of the new system is already baked into the NDIS Act:

  • In October 2024, the Act was amended.  
  • Lots of changes were made to Part 2 of Chapter 3 the Act. 
  • This Part is about participant plans.
  • The amendments introduced a new planning framework.
  • Over time, the Government wants all participants to transition to new framework plans. 

New framework plans 

  • The new planning framework is based on a needs assessment.
  • The needs assessment must be undertaken using an assessment tool.
  • The needs assessment will generate a needs assessment report.
  • The needs assessment report will be:
    • factored into a method; and
    • used to calculate a participant’s reasonable and necessary budget.
  • A participant’s total funding amounts for their reasonable and necessary budget:
    • will be made up of flexible funding and stated supports; and
    • must be worked out by applying:
      • information in the needs assessment report; and
      • the method.

Each of the bold words has – or will have – a specific legal meaning.  

State of play:

The NDIA has announced that it:

  • wants to start transitioning participants aged 16 years and older to new framework plans from mid-2026;
  • has bought a licence for a tool, known as the Instrument for Classification and Assessment of Support Needs version 6 (I-CAN), which it plans to modify; and
  • will train and accredit employed public servants as assessors to assess participants as part of the new planning framework.  

What the Government told participants and the disability community to expect 

In a Further Revised Supplementary Explanatory Memorandum to the Bill that amended the NDIS Act in 2024 to make these changes, the Government explained that needs assessments will:

  • “assess a person holistically, looking at all their disability support needs, consistent with recommendations of the [2023 Independent NDIS Review]”; and 
  • be “undertaken on a whole person basis”; and
  • result in assessment reports that:
    • contain “all relevant and appropriate information about a participant and their disability”; and
    • can be used with each participant to “calculate a participant’s reasonable and necessary budget” that reflects the “range” of the participant’s support needs.

In the same document, the Government committed to “ensuring that the design  and implementation of these changes will include extensive consultation and co-design with the disability community” (emphasis added).

Why are so many people concerned?

  • People are worried and frustrated about several aspects of the proposal, including:
    • the sufficiency of consultation and co-design;
    • whether assessments will assess people holistically on a whole-person basis;
    • the assessment tool;
    • the assessors’ skills, qualifications, training, supervision, and accountability to participants;
    • how assessments will be administered in practice;
    • whether assessment reports will include enough detail to generate therapy management plans without allied health providers having to do additional work; and
    • method details, including the potential role of AI/algorithms in calculating budgets. 
  • There’s a lot we still don’t know. For example:
    • how the I-CAN tool will be modified and tested so it’s fit for purpose; 
    • assessor accreditation and experience criteria, training and supervision requirements, and conflict of interest/oversight controls*; 
    • we don’t have drafts of the NDIS Rules that will:
      • set out the information that must be included in needs assessment reports; and
      • specify the method that must be used to work out total funding amounts; and
    • we don’t know which NDIA decisions will be reviewable by the Administrative Review Tribunal and the Courts:
      • media reports suggest review rights will be more limited than for old framework plans, and may be limited to ordering that a new assessment be conducted using the same tool;
      • we don’t know how rules about varying and replacing participants’ plans in Division 4 of Part 2 of Chapter 3 of the Act will work in practice.   

Speak Up:

If you’re concerned about the new needs assessment system or process, you’re not alone. Every Australian Counts is hosting a community forum on 12 December for people to share their thoughts (see links below to register). 

Go deeper:

Every Australian Counts: More Questions Than Answers: New NDIS Support Needs Assessments – Community Forum

NDIS plans will be computer-generated, with human involvement dramatically cut under sweeping overhaul | National disability insurance scheme | The Guardian

Algorithms! Robots! Hubris! Is robodebt-style cruelty coming to the NDIS? | First Dog on the Moon | The Guardian

NDIS Act – see especially Subdivision B of Part 2, including  sections 32K and 32L, and Division 4 of Part 2, including sections 47 and 47A

Further Revised Supplementary Memorandum NATIONAL DISABILITY INSURANCE SCHEME AMENDMENT (GETTING THE NDIS BACK ON TRACK NO. 1) BILL 2024   

New tool to deliver simpler pathway to disability supports | NDIS

*A note on assessors: The Act is silent on assessor identity, qualifications or experience. At this stage, it does not look like assessors will be allied health professionals, meaning they will not be subject to allied health regulations, professional Codes of Ethics requirements, professional standards, or even the NDIS Code of Conduct with respect to participants. Open questions include whether assessors will have professional duties of care to participants, and how will they handle conflicts between their duties of good faith and fidelity to their employer (probably the NDIA) and their ethical responsibilities to participants. An interesting question is whether they can be sued personally, e.g. for negligence, conflicts of interest, or other acts that wrong participants, and whether they can be subpoenaed to testify before the ART or Courts to account for their actions.

Breaking news: “Thriving Kids” – more than just a new name for Foundational Supports for children?

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“Thriving Kids”, announced by Minister Mark Butler on 20 August 2025, is the snappy new name for Foundational Supports for children.

But is it more than that?

We don’t have a lot of details right now. But it sounds different from the original proposal for Targeted Foundational supports (discussed in 2024), and a lot more like what the Grattan Institute recommended (back in June 2025 – see below):

  • The Federal Government to take leadership of the new national system (to avoid eight different State systems).
  • Limiting NDIS access for children to only those children with significant and permanent disability (i.e. children who are likely to need lifelong support).
  • Funded programs, like Inklings, MHiPS and Positive Partnerships for children with mild and moderate developmental delay or autism to be delivered in mainstream settings, like community health centres, supported playgroups, and schools. 
  • Increased scrutiny over consistent pricing and value for money of allied health and other services across disability, health and aged-care sectors.

If this is right, the new system may mean:

  • the end of the early intervention NDIS pathway and individualised supports for most children who would otherwise qualify for the NDIS under current rules; and 
  • the creation of new (block-funded?) programmed services to be delivered in mainstream settings, like early community childcare settings and schools.

There was also talk of creating a new Medicare bulk-billed item for GPs to check 3-year-olds for developmental issues, and providing access to new Medicare allied health items.

Of course, we’re yet to hear from the States, who will be paying for half of it. (Some States like NSW have been working and consulting on the earlier Foundational Supports proposal.)

This new system is due to start rolling out from 1 July 2026, with major NDIS access changes flagged for sometime in 2027.

We await more details! 

But, in the meantime, there is already a lot for us all to work through as we think about choice and control and service delivery models for children with developmental delay or disability and their families. 

Related reading:

In deep water: paediatric allied health NDIS providers should read the Grattan Report

Targeted Foundational Supports consultations: an “idea salad” with more questions than answers for allied health providers?

Speech from Minister Butler, National Press Club – 20 August 2025

In deep water: paediatric allied health NDIS providers should read the Grattan Report

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The Big Picture:

On 29 June 2025, the influential Grattan Institute published a 108-page report with proposals to save the NDIS (link below).

Many allied health providers were distracted by financial year-end and compliance tasks to comply with the (now live) Pricing Limits for 2025-26.

But the report is well worth a read – particularly for paediatric allied health providers who own or work out of clinics.

Attention-grabbers:

The report authors, led by former NDIA senior policy advisor Dr Sam Bennett, propose several very significant changes:

  • Abolish the early intervention pathway (i.e. section 25 of the NDIS Act) (pp57, 83).
  • Abolish individualised funding for all children under 18 who are or would have otherwise been supported through the early intervention pathway (pp31, 57).
  • Redirect funds to replace the early intervention pathway with “muscular” Foundational Supports (pp56-59):
    • general supports: information and education; and
    • targeted supports, including “low-to-mid-level allied health supports to improve the long-term capabilities of children” (p13).
  • Governments to co-commission Foundational Supports:
    • with 3-5 year contracts (pp49, 71), including for “evidence-based services” to “encourage providers to offer higher-quality programs” (p57); and
    • from “lead providers” that have the capacity and systems to manage a group of sub-contractors (pp50, 73).
  • Adopt a Key Worker model to help families navigate options (p54).
  • 5-year transition to avoid service gaps and give providers “sufficient time to prepare” but with the transition to start from 1 July 2026 (p60).
  • All Foundational Supports – and thus all early intervention therapies – for children to be delivered in natural environments – not clinics – including in “supported playgroups, early childhood education settings, health and community hubs, libraries, and family- and community-led organisations” (pp30, 57).
  • No mandatory registration of allied health providers to provide Foundational Supports. Recognition of AHPRA registration/regulation by a professional body (p75).
  • Better national sharing of provider information, and better integration of provider registration and worker screening checks (pp75-76).
  • Retain individualised plan funding for children with lifelong and severe disability (i.e. for children who meet the disability requirements under s 24 of the NDIS Act) (p57).

Reality check:

These are proposals from a think tank – not government policies. But the report is well-researched and written, and is likely to get the attention of policy decision-makers, as well as media and social media critics of the NDIS.

Bottom line:

Participant and disability advocacy groups will have a lot more to say about the report and the implications for access, and for choice and control over allied health early intervention services.

But paediatric allied health providers should also consider the report when reviewing their business strategies and risks for 2025-26 and beyond.

If implemented, the Grattan proposals would:

  • transform early intervention allied health service-delivery across Australia; and
  • accelerate the sector-wide shake-out of paediatric allied health service providers.

Go deeper:

Bennett, S., Jessurun, M., and Orban, H. (2025). Saving the NDIS: How to rebalance disability services to get better results. Grattan Institute.

NDIS access denied: even without the reforms, things are getting tougher for NDIS applicants

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The big picture:

A recent Administrative Review Tribunal (Tribunal) decision in Sydney suggests that it’s getting harder for applicants to meet the disability access criteria to become an NDIS participant. 

Context:

To get access to the NDIS, applicants must meet a number of disability-related tests under section 24 of the NDIS Act. Among other things, they must prove:

  • they have a disability attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments, or one or more impairments to which a psychosocial disability is attributable;
  • the impairment(s)are likely to be permanent; and
  • the impairment(s) result in substantially reduced functional capacity to undertake one or more of the following activities: (i) communication; (ii) social interaction (iii) learning; (iv) mobility; (v) self-care; (vi) self-management (the “six activity areas”).

Case in Point: 

  • In a decision published on 26 May 2025, the Tribunal took a close look at the meaning of “substantially reduced functional capacity” in each of the six activity areas. 
  • There was no doubt that the applicant lived (and lives) with a permanent disability arising from impairments that reduce her capacity to perform life activities.
  • But the Tribunal decided the applicant’s impairments did not result in substantially reduced functional capacity in any of the six activity areas. This means the applicant did not qualify for access. 

Zoom in:

The Tribunal’s decision was striking for a number of reasons. The Tribunal decided that: 

  • Rule 5.8 of the National Disability Insurance Scheme (Becoming a Participant) Rules 2013* deems some applicants to have met the “substantially reduced functional capacity” test – but it is not exhaustive. If the applicant isn’t deemed to satisfy the test by Rule 5.8, the Tribunal must make the decision based on statutory interpretation;
  • NDIS disability access requirements should be interpreted and applied in conformity with the World Health Organisation (WHO) International Classification of Functioning, Disability, and Health (the ICF);
  • the WHO Disability Assessment Schedule (WHODAS 2.0), a standardised method for measuring health and disability under the ICF, is a helpful analytical framework to give meaning of “substantially reduced function”; 
  • “substantially” means more than “moderate”, and interpreted this to mean more than 50% reduced functional capacity to perform the activity;
  • “reduced” should be understood as being one or more of four ways specified as difficulty factors under the WHODAS 2.0, namely (i) increased effort; (ii) discomfort or pain; (iii) slowness; and (iv) changes in the way a person does the activity; and  
  • an assessment of reduced capacity in one of the six activity areas:
    • should ignore environmental factors that affect performance (rather the capacity), e.g. a lack of local transport options or other services;
    • should not be measured against an earlier stage of life or someone who has prowess at the activity; but 
    • should be measured relative to a person who does not have the applicant’s impairments according to an objective standard of a level of basic function “consistent with day-to-day subsistence”.

Friction Points:

Perhaps most controversially, the Tribunal held that as a matter of statutory interpretation, domestic tasks such as laundry, domestic cleaning, gardening and maintenance, do not fall within any of the six activity areas. This is a marked departure from several previous Tribunal decisions, in which the decision-maker has concluded that such tasks fall within mobility, self-care and/or self-management activities. (The Tribunal decided that tasks within the self-management activity area are limited to cognitive tasks associated with personal organisation, planning, decision-making, self-care, problem solving and financial management.)

On the facts:

The Tribunal decided the applicant’s reduced functional capacity for communication, social interaction, learning, mobility, self-care, and self-management were not substantially reduced. As such, the applicant did not get access to the NDIS. 

Yes, but:

Arguably, parts of the Tribunal’s statutory interpretation in this case do not sit easily with parts of the Federal Court’s 2023 decision in Foster. As noted, the Tribunal’s comments on domestic tasks are inconsistent with several previous Tribunal and AAT decisions. For applicants and the NDIA, it would be helpful if this decision were appealed, so that the Federal Court could clarify the law. (A Federal Court decision would bind the Tribunal.)

Reforms add to barriers:

This decision is based on the law as it stood before the reforms of October 2024. Since then, applicants also need to show they are likely to require NDIS Supports (as defined in section 10 of the NDIS Act, and transitional rules) under the scheme for the person’s lifetime.

Read the decision:

Burrows and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 607

Note:

* Rule 5.8 says: An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities – communication, social interaction, learning, mobility, self-care, self-management…- if its result is that:

(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or

(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or

(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person. 

(Emphasis added.)

For the purposes of this Rule, the Tribunal held that adaptive techniques to record and remember information (e.g. notes and diaries) do not amount to “assistive technology” or “equipment” because “these are memory aides that might be used by anyone who does not have [an impairment].”  

NDIS Providers: 5 basic things to know about the NDIS (Getting the NDIS Back on Track No. 1) Bill 2024

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With today’s news, we don’t yet know the final form of the NDIS (Getting the NDIS Back on Track No.1) Bill 2024 or when it will be passed into law.

But, despite the uncertainty and lack of detail on many key points, NDIS providers (including unregistered providers) need to understand some basic concepts to prepare for the big changes ahead:

  • Providers should expect increased regulation, oversight, and enforcement action. The NDIS Quality and Safeguards Commission and the NDIS Commissioner will have expanded powers.
  • NDIS access rules will be clarified so that participants know whether they meet the disability requirements, the early intervention requirements, or both.
  • NDIS pathways will change. The NDIS will work differently for participants accessing early intervention supports compared with participants receiving disability supports for lifelong disabilities. (Future reforms will create a new early intervention pathway.)
  • Significant changes to NDIS supports, assessments, reports, and budgets:
    • “NDIS Supports” will replace “reasonable and necessary supports”, narrowing supports that will be funded by the NDIS.  
    • “Needs-based assessments” will replace diagnoses-based assessments, and produce “needs assessment reports”. 
    • The needs assessment report requirements will be developed in consultation with people with a disability, health and allied health technical professionals and governments. 
    • The “reasonable and necessary budget” will be determined by the needs assessment report and replace line-by-line “reasonable and necessary supports”.  
    • Reasonable and necessary budgets will be composed of “stated supports” (fixed budgets for things like assistive technology and supported independent living), “flexible funding” (e.g. for health or rehabilitations services), or both.
  • Provider boards and senior management must understand their NDIS compliance obligations and work with participants and others to improve their governance and leadership practices to enhance safety, quality, accountability, and responses to risk.

With thanks to the presenters at the Legalwise Seminars’ NDIS Law Intensive on 20 June 2024.

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