Considerations for Preparing a Plan Review Report

Participants with Complex Needs

Prepared by: Peter Gregory

Date: 22.05.2026

Purpose of Writing This Document

The purpose of writing this document is to provide guidance for practitioners, families, advocates, and support teams preparing reports for participants with complex needs within the evolving decision-making environment of the National Disability Insurance Agency. The document has been developed in response to emerging patterns in NDIA planning and Home and Living decisions, particularly those involving attempts to reduce 24/7 1:1 supports, increase reliance on shared support arrangements, and reduce funding for community participation and individualised supports.

This document seeks to assist report writers in understanding the practical and strategic realities shaping current NDIA decision-making. It recognises that recent reforms, proposed legislative amendments, and public statements made by Mark Butler suggest a significant shift toward funding models increasingly influenced by cost containment, standardisation, benchmarking, and assumptions that shared or lower-cost supports should be treated as the default position unless proven otherwise.

The document, therefore, aims to help practitioners move beyond traditional report writing approaches that focus primarily on diagnosis, impairment, or broad descriptions of need. Instead, it encourages the development of reports that provide detailed functional, operational, and safeguarding analysis explaining why particular supports are required, how those supports function in practice, and why lower-cost or shared alternatives may fail to safely and effectively meet the participant’s needs.

A central purpose of this document is to ensure that participants with complex needs are not unintentionally disadvantaged by report-writing approaches that fail to engage with the actual logic currently shaping NDIA decisions. The document acknowledges that many participants are now effectively being required to demonstrate not only that they have significant support needs, but that those needs cannot safely, consistently, or effectively be met within shared support models.

The document also seeks to support a shift away from deficit-based narratives that position the participant as the problem. Instead, it encourages report writers to focus on support design, safeguarding obligations, relational support requirements, environmental compatibility, and the operational realities of service delivery. In doing so, the document aims to preserve the dignity, autonomy, and citizenship of participants while still addressing the increasingly restrictive evidentiary environment emerging within the NDIS.

Importantly, this document is also intended to protect against the risk that stability, progress, or successful community participation may be misinterpreted as evidence that supports can be reduced. It emphasises that, for many participants with complex needs, positive outcomes exist because of intensive and carefully structured supports, not because those supports are no longer required.

Finally, the document is intended to reinforce the foundational principles upon which the NDIS was originally established.  That people with disability should be supported to live ordinary lives within the community, exercise meaningful choice and control, maintain relationships and participation, and avoid segregation, institutionalisation, and unsafe service models. The guidance within this document therefore seeks to assist practitioners to prepare reports that are not only clinically and operationally robust, but also grounded in contemporary safeguarding practice, human rights principles, and the lived realities of people with complex support needs.

This document does not:

• provide information about how to undertake an S100 Review should you receive a plan you do not agree with.

• provide information about how to engage with the Administrative Review Tribunal process if you want to challenge a decision made by the NDIA through that system.

Introduction

Recent decision-making patterns within the National Disability Insurance Agency demonstrate that access to 24/7 1:1 support is no longer being assessed solely on the basis of the presence of disability, complex support needs, behavioural complexity, or functional impairment. Increasingly, decisions appear to be shaped by a narrower and more restrictive threshold question.  That is, whether the participant’s support needs can be delivered within a shared support arrangement.

Current decisions suggest that continuous 1:1 support is being treated as appropriate only in what the NDIA describes as “exceptional circumstances.” Although this term is not defined within legislation or publicly available policy, recent decisions indicate that the NDIA interprets exceptional circumstances to mean situations where shared support arrangements are not viable because they would foreseeably result in an extreme level of risk of harm to the participant or others.

This represents a significant shift in the type of evidence now required in reports prepared for Plan Reviews, particularly for participants seeking continuation or approval of intensive Home and Living supports.

Historically, reports may have focused primarily on describing:

• the participant’s diagnosis,

• the presence of disability,

• behavioural complexity,

• psychosocial vulnerabilities,

• or the general benefits of increased support.

However, current decision-making patterns demonstrate that this is no longer sufficient on its own.

Instead, reports now need to directly and explicitly address a central operational question:

Why can’t this Participant share their support and accommodation with another NDIS Participant?

The evidence presented must clearly explain why shared support arrangements are not viable in this specific case. Reports should identify the precise risks, failures, limitations, or safeguarding concerns that arise when support is shared and explain why those risks cannot be adequately mitigated through staffing ratios, environmental modifications, behavioural strategies, or other interventions.

Reports must also clearly articulate the level, intensity, continuity, and immediacy of support required, including why continuous 1:1 support is functionally necessary.

This represents a movement away from broad clinical description toward highly detailed functional, operational, and context-specific analysis. Increasingly, participants appear to be required to demonstrate not merely that they have high support needs, but that shared support arrangements are fundamentally incompatible with the nature of those needs.

The emerging policy environment surrounding the proposed 2026 NDIS amendments, together with public statements made by Mark Butler, further reinforces this direction. Government rhetoric centred on “sustainability,” “consistency,” and “value for money” strongly suggests that shared support models will be formally enshrined in public policy, through Amendments to the Legislation, as the preferred or presumed default service model unless evidence can establish that such arrangements are unsafe or ineffective, using secret criteria only known to the NDIA.

Although the term “exceptional circumstances” does not appear within the legislation itself, current decision-making patterns indicate that it is operating as an implied threshold requirement. Importantly, the parameters defining what constitutes exceptional circumstances have not been publicly disclosed.

For this reason, avoiding the issue of shared support entirely is unlikely to benefit participants seeking continuation of 24/7 1:1 support. Current NDIA decision-making patterns indicate that the question of whether support can be shared has become the central issue around which Home and Living decisions are now being organised.

The Hard Reality:

The NDIA’s Emerging Decision Logic

Current evidence suggests that the NDIA is no longer primarily asking whether a participant requires 24/7 support. Instead, the key question appears to be whether that support can be delivered within a shared support model.

Only where the answer is a clear and evidence-based “no” does it appear likely that continuous 1:1 support will be approved.

This distinction is critically important. Reports may successfully demonstrate:

• significant disability,

• complex behavioural support needs,

• emotional dysregulation,

• communication difficulties,

• trauma-related vulnerabilities,

• or substantial risks.

However, if those reports do not specifically explain why shared support arrangements fail to safely and effectively meet those needs, the NDIA may nevertheless conclude that shared support remains sufficient.

Need alone is no longer being treated as sufficient justification for individualised support delivery.

Why Avoiding the Shared Support Question Is Likely to Fail

Current decision-making patterns indicate that the NDIA approaches Home and Living decisions through a comparative framework. Rather than assessing support needs in isolation, decision-makers appear to compare:

• individual support against shared support,

• higher-cost supports against lower-cost alternatives,

• and individualised models against congregate or shared service arrangements.

If this comparison is not directly addressed within reports, the NDIA is likely to undertake that comparison independently, without the participant or practitioner shaping how the comparison is framed.

This is particularly significant in light of Section 34(1)(c) of the NDIS Act, which requires consideration of whether there is a lower-cost support option capable of achieving similar outcomes. In practice, the lower-cost alternative is interpreted as shared support.  It is also now very common for Participants to be informed, following their Plan Review Meeting, that their funding has been cut and has been allocated on a step-down model, where six months of the plan funding is allocated at the previous plan level and the following six months of Home and Living funding is allocated at the reduced level such as 1:3 shared support.

As a result, reports must now do more than establish need. They must demonstrate why lower-cost shared arrangements are incapable of safely and effectively achieving comparable outcomes in the participant’s specific circumstances.

Reframing the Argument

Although reports must engage directly with the issue of shared support, this does not mean the participant should be framed as the problem.

The strongest reports avoid deficit-based language and instead shift the focus toward:

• the operational realities of support delivery,

• safeguarding obligations,

• support design limitations,

• and the incompatibility between shared models and the participant’s actual support requirements.

Three particularly important reframing approaches are emerging:

Reframing Support as Non-Substitutable

Rather than arguing that “the participant cannot share support,” reports should explain that the support itself is functionally non-shareable.

Some support tasks require:

• immediate response,

• uninterrupted monitoring,

• relational continuity,

• line-of-sight supervision,

• rapid behavioural intervention,

• continuous emotional co-regulation,

• or highly individualised communication responses.

These supports are not divisible between multiple participants without fundamentally compromising their effectiveness.

In this framing, the issue is not the participant’s deficits but the operational nature of the support required.

Reframing Shared Support as a Service Model Mismatch

Reports should also explain that shared support arrangements may be fundamentally incompatible with the participant’s support environment.

Shared support models often introduce:

• competing staff demands,

• delayed response times,

• increased sensory input,

• environmental unpredictability,

• relational inconsistency,

• and reduced capacity for continuous attunement and regulation.

Where these conditions create escalation, dysregulation, distress, or increased risk, the issue is not that the participant has “failed” shared support. Rather, the service model itself is incapable of safely meeting the participant’s support requirements.

Reframing the Issue as Safeguarding Incompatibility

One of the strongest approaches is to frame continuous 1:1 support as a safeguarding requirement.

Reports should explain that shared support arrangements create foreseeable safeguarding risks, including:

• escalation,

• emotional dysregulation,

• trauma responses,

• behavioural deterioration,

• exposure to harm,

• increased use of restrictive practices,

• withdrawal from community participation,

• and breakdowns in functional stability.

Importantly, the report should demonstrate that the support itself functions as the safeguard.

The argument does not attempt to enter into a philosophical debate about the efficacy of shared support. Rather, the evidence demonstrates that, in this particular case, shared arrangements are incompatible with safe and effective support delivery.

The Impact of the 2026 NDIS Amendments and Reform Narrative

The proposed 2026 NDIS amendments and recent government statements suggest an increasing emphasis on cost containment, standardisation, benchmarking, and reducing what government representatives describe as “over-support.”

This creates a significant risk that:

• stability will be interpreted as evidence that support can be reduced,

• intensive supports will be characterised as excessive,

• and independence will be incorrectly equated with reduced funded support.

Reports must actively challenge these assumptions.

Where participants are stable, regulated, safe, connected to community, or avoiding crisis, reports should clearly explain that these outcomes exist because of the support structure, not in the absence of it.

The reduction of visible crisis does not mean the participant no longer requires support. Often, it demonstrates that the support is functioning effectively.

Similarly, reports should clearly explain that independence is not measured by the absence of support. For many participants with complex needs, independence is only achievable through intensive, individualised, and continuous support arrangements.

The existence of extensive support does not diminish autonomy. In many cases, it is the mechanism through which autonomy, participation, communication, and self-determination become possible.

Moving Beyond Diagnostic Description

Current reform directions also suggest that diagnostic labels alone may carry diminishing weight in future decision-making processes.

For this reason, reports should move beyond broad descriptions of disability and instead provide highly detailed operational analysis describing:

• what support tasks are required,

• how frequently they occur,

• how rapidly staff must respond,

• what occurs if support is delayed,

• why support cannot be interrupted,

• why support cannot be divided between multiple participants,

• and why continuous 1:1 delivery is functionally necessary.

The strongest reports clearly demonstrate:

• support intensity,

• support frequency,

• support immediacy,

• support continuity,

• and support indivisibility.

This shifts the focus away from abstract descriptions of need and toward the concrete realities of support delivery.

Community Participation:

Addressing Proposed Reductions to Social and Community Access Supports

Recent public statements by Mark Butler, together with emerging reform discussions surrounding the proposed 2026 NDIS amendments, indicate increasing scrutiny of supports associated with community participation, social access, and activities that decision-makers may characterise as “non-essential,” “lifestyle-based,” or insufficiently connected to functional outcomes.

There appears to be a growing policy narrative suggesting that some forms of community participation support are being viewed as excessive, insufficiently therapeutic, or not aligned with what government representatives describe as the “original intent” of the NDIS. This creates a substantial risk that supports enabling social connection, community engagement, emotional regulation, relationship development, recreational participation, and ordinary citizenship may increasingly be reframed as discretionary rather than essential.

For participants with complex needs, this distinction is deeply problematic because community participation is often not separate from functional capacity, behavioural stability, safeguarding, emotional regulation, communication development, or mental health maintenance. In many cases, participation in community life is itself a core support mechanism that prevents deterioration, isolation, institutionalisation, trauma escalation, behavioural crisis, and loss of functional capacity.

Reports prepared for Plan Reviews should therefore explicitly challenge any artificial separation between “community participation” and “functional support.” The evidence should clearly demonstrate that community access supports are not simply recreational or social activities layered on top of a participant’s life. Rather, they are frequently the primary mechanism through which the participant:

• maintains emotional and behavioural regulation,

• develops and sustains communication skills,

• builds tolerance for environments and social interaction,

• prevents social isolation,

• maintains psychological wellbeing,

• develops identity and self-worth,

• sustains relationships and informal support networks,

• practices daily living and decision-making skills,

• and experiences inclusion as a citizen within ordinary community life.

For many participants with complex needs, community participation cannot be disentangled from safeguarding. Isolation, confinement to the home environment, lack of stimulation, social exclusion, and withdrawal from meaningful activity frequently result in deterioration in mental health, increased distress, behavioural escalation, increased vulnerability to abuse or restrictive practices, and loss of functional capacity.

Reports should therefore clearly explain the foreseeable consequences of reducing community participation funding. This analysis should move beyond broad statements about “quality of life” and instead identify the specific functional, psychological, behavioural, and safeguarding impacts likely to occur if these supports are reduced.

Where relevant, reports should explain that reduced community participation may reasonably be expected to result in:

• increased dysregulation,

• escalation in behaviours of distress or protest,

• deterioration in communication,

• increased social withdrawal,

• loss of confidence and routine,

• increased mental health vulnerability,

• reduced resilience,

• increased dependence on restrictive or crisis-based interventions,

• breakdown in community relationships,

• and overall decline in functional stability.

Importantly, reports should also challenge any suggestion that community participation can simply occur without funded support. For many participants with complex needs, meaningful access to community life is only possible because trained support workers provide:

• behavioural support,

  emotional co-regulation,

• environmental monitoring,

• communication assistance,

• sensory regulation,

• transport assistance,

• risk management,

• and continuous relational support.

Without these supports, participation may become unsafe, inaccessible, overwhelming, or impossible.

Reports should further emphasise that community participation is not an optional extra within the philosophy of the NDIS. The Scheme was originally established to support people with disability to live ordinary lives within the community rather than being segregated, isolated, or confined to service systems. Participation in community life is therefore directly connected to the foundational principles of social inclusion, citizenship, autonomy, dignity, and self-determination underpinning both the NDIS and the United Nations Convention on the Rights of Persons with Disabilities, particularly Article 19.

Where participants require 1:1 support in order to safely access community environments, reports should clearly explain why these supports are functionally indivisible and cannot be diluted through shared staffing models. Community participation often requires rapid, individualised, and highly responsive support that cannot safely be divided across multiple participants without compromising regulation, safety, communication, or access itself.

The strongest reports will therefore position community participation not as a discretionary lifestyle enhancement, but as an essential safeguarding, functional, relational, and citizenship support that is fundamental to maintaining the participant’s overall stability, wellbeing, and inclusion within society.

The Most Effective Strategic Position

The strongest reports avoid framing the participant as incapable, problematic, or resistant to sharing support.

Instead, they demonstrate that the support required cannot safely, effectively, consistently, or sustainably be delivered within a shared support model.  Using NDIA logic:

“This is 24/7 1:1 support, the lowest cost option for this Participant.”

The most strategically effective formulation may therefore be:

“This is not a question of whether the participant prefers individual support over shared support. It is a question of whether the support required can be delivered safely, effectively, consistently, and in a manner compatible with safeguarding obligations within a shared model. The evidence demonstrates that it cannot.”

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