Prove You Can’t Share Support

When the NDIA demands you justify why you want to be safe.

In my community, where we are collaborating with disabled people with very complex support requirements, their families and allies, there’s a trend that has been building for a few years now.  People who have established that it is reasonable and necessary for them to be funded for 24/7 1:1 supports (For example, 16 hours/day 1:1 for 7 days per week and 7 sleepovers/week) are being informed that their funding has been cut during their plan review.  It is rare that an explanation for this decision will be given.  You often find out when your new plan appears in the mail or on the portal.  When you inquire about why there has been a change in your funding when no request for a change in circumstances has been submitted, you will receive a form letter response (Sometimes this will even include the name of another Participant). This letter will:

1. Pleasantly explain that your funding has been reduced using a well known strategy called “step down support”.  That is, you receive 6months funding, at your original rate, to make adjustments to your support arrangements and then the Home and Living or assistance with daily living funding is reduced to the equivalent of 1:2 or 1:3 shared support.  There may be consideration for 1:1 support for personal care and mealtimes but that is all.

2. The letter will present no quantifiable evidence for the decision and make vague references to not being value for money and that you failed to demonstrate that you can’t share support or your living arrangements with other people with disabilities.

3. The letter will be structured in a way that communicated that the author is not concerned with the realities of your past experiences in shared support, such as experiencing exploitation, abuse, domestic violence and neglect.  This decision is non-negotiable.

4. There may also be a little gem of ableist entitlement where the author suggests you will be better off sharing your life with strangers.

5. The letter will very likely make an interesting statement that “24/7 1:1 support will only be approved in exceptional circumstances”.

Of course, after receiving such a response and realising that there is no evidence to support the decision, that you will have to move out of your home to share with another person(s) who you don’t know just because a faceless bureaucrat in the Home and Living Team has decimated your funding and thinks you will better off in shared accommodation and that pompous value judgements about what is in your best interests cannot possibly be upheld so you submitted your S100 “Review of a Reviewable Decision Form” and wait… up to 90 days. When that blessed day arrives, and you receive your review request response, your hopes that common sense will prevail will invariably be dashed.  The person reviewing the decision will, close to 100% of the time, uphold the original decision, claiming that you have failed to demonstrate why you can’t share your support or your home with other persons with disabilities.  They will go on to make statements they claim are evidence why the decision is upheld, but you will soon realise that what you are reading is predominantly unsubstantiated personal opinion that has little or no basis in fact that can be tested.

You will also notice that phrase that is now being used more often in these decision form letters: “24/7 1:1 support will only be approved in exceptional circumstances”.

This is an interesting phrase.  Let’s look at it a little more closely, because the principle of “exceptional circumstances” does not appear in NDIS legislation; specifically, it is not a criterion for determining reasonable and necessary support

The Implied NDIA Definition of “Exceptional Circumstances”

Because there is no definition of “exceptional circumstances”, we have to infer what it might be from the few clues given to us in the correspondence.

When the reasoning within the decision is considered as a whole, the NDIA appears to define “exceptional circumstances” as a situation in which shared support is demonstrably unsafe or impossible. This determination must be supported by highly detailed, quantified, and disability-specific evidence that clearly demonstrates a continuous, high-intensity level of need across all domains of functioning. Importantly, this includes evidence of frequent active intervention requirements, including during overnight periods.

What This Reveals (Critical Insight)

1. “Exceptional” operates as a system control mechanism: Rather than functioning as a neutral or descriptive category, the term “exceptional” operates as a mechanism of system control. It establishes a gatekeeping threshold for access to high-cost supports and, in doing so, reinforces a default position that participants should be directed toward shared support models unless they can meet this elevated threshold.

2. The burden of proof is extremely high: The evidentiary burden placed on participants is exceptionally high. It is not sufficient to demonstrate the presence of need alone. Instead, participants are required to demonstrate that all lower-cost or shared support alternatives have been considered and are unsuitable, ineffective, or unsafe. This effectively shifts the task from describing support needs to disproving the viability of cost-saving options.

3. Lived experience is insufficient on its own: Lived experience, even when it involves significant distress, risk, or harm, is not treated as sufficient evidence in its own right. Such experiences must be translated into forms of evidence that are measurable, quantified, and operationalised. Without this transformation into formalised data, the significance of lived experience is often diminished within decision-making processes.

4. It privileges a narrow model of disability: The NDIA’s approach privileges a particular model of disability that places greater weight on physical dependency and observable functional deficits. In contrast, it affords comparatively less recognition to forms of disability characterised by trauma, behavioural complexity, or relational and environmental risks. This creates a structural bias in how need is recognised and validated.

Bottom Line:

This formulation of “exceptional circumstances” has far-reaching implications that extend well beyond individual funding decisions. It signals a fundamental shift in how need is interpreted, how supports are justified, and how the Scheme positions the lives of people with complex disability.

At its core, the classification reframes the question from “What does this person need to live safely and well?” to “Can this person be fitted into a shared support model?”

This is not a neutral reframing. It establishes shared support as the default organising principle of Home and Living, with individualised arrangements treated as deviations that must be justified under heightened scrutiny.

As a result, the seriousness or complexity of a person’s circumstances becomes secondary to their compatibility with a pre-determined service model. A person may experience profound risk, distress, or instability, yet still be deemed ineligible for 1:1 support if those experiences cannot be translated into evidence that definitively rules out shared support.  In this way, the classification does not measure need directly.  It measures resistance to standardisation.

This creates a system in which:

• The baseline assumption is institutional logic, even when expressed in contemporary language such as “shared supports” or “community living.”

• The burden shifts onto the participant to prove why they cannot safely participate in this model, rather than on the Scheme to justify why such a model is appropriate. The threshold for individualised support becomes artificially elevated, requiring not only demonstration of need but proof of non-compatibility with lower-cost configurations.

• Importantly, this approach privileges forms of evidence that align with administrative and economic reasoning. Needs must be rendered legible in ways that can be compared, costed, and standardised. This disadvantages individuals whose support needs are:

  • Context-dependent

  • Relational in nature

  • Fluctuating or episodic

  • Rooted in trauma or behavioural complexity

These forms of need are often the very factors that make shared support unsafe or unsustainable, yet they are also the hardest to quantify within the NDIA’s secret evidentiary framework. The result is a paradox:  Those most at risk of harm within shared arrangements are often the least able to meet the evidentiary standard required to avoid them.

The implications for safeguarding are particularly significant. By requiring individuals to demonstrate exceptional risk before approving 1:1 support, the system effectively positions harm as a precondition for prevention. Participants may need to experience escalation, breakdown, or crisis before their circumstances are recognised as sufficiently “exceptional.” This is fundamentally at odds with preventative and rights-based approaches to support.

There are also broader systemic consequences. Over time, this classification:

• Normalises shared support as the default, regardless of individual preference or suitability.

• Compresses diversity of living arrangements, reducing the viability of “service for one” or individually governed/self-directed models.

• Reinforces provider-driven economies of scale, where financial efficiency outweighs personalisation.

• Weakens the practical meaning of “choice and control”, as options become constrained by what can be justified within the model.

Ultimately, this interpretation of “exceptional circumstances” operates less as a safeguard for rare cases and more as a regulatory mechanism that shapes the entire system. It defines not only who qualifies for higher levels of support, but also what kinds of lives are considered reasonable, fundable, and possible within the NDIS.

In taking this position the Ministers and the bureaucrats:

1. Ignore their obligations under the NDIS Legislation.

2. Ignore their obligations under Article 19 of the UNCRPD.

3. Ignore the promises made to the disability community that not person will have their funding cut and not person will be worse off as a result of the “reforms”.

4. Return disability care and support to the institutional models that have been overwhelmingly discredited.

5. Ignore the overwhelming evidence of exceptional outcomes that derive from personalised self-directed models of support.

The critical implication is this: When “exceptional” is defined by incompatibility with a system model, rather than by the lived reality of the person, the system begins to prioritise its own structure over the person it is meant to support.