OT Unplugged: Community of Practice Insights

Keeping up with NDIS reforms is becoming increasingly challenging for OTs, particularly when changes to funding, planning and evidence requirements have significant implications for clinical practice. But who is responsible for ensuring clinicians understand these changes and can apply them appropriately?

From maintaining professional knowledge and strengthening clinical evidence to navigating the latest NDIS funding reductions, there are important questions about how we support informed decision-making and advocate for the people who rely on the scheme.

Who is responsible for keeping OTs informed about NDIS changes?

With NDIS legislation and operational guidance continuing to evolve, maintaining current knowledge is an ongoing responsibility for clinicians working within the scheme. However, the volume and complexity of information can make this difficult to manage independently.

Within OT practices, responsibility for monitoring and interpreting changes needs to be clearly allocated. This may sit with a practice owner, clinical leader or another designated team member who can translate relevant developments into practical guidance for clinicians.

Regular updates and opportunities to discuss clinical scenarios can help teams apply new information confidently. Without these systems, supervision may become focused on explaining basic NDIS requirements rather than developing clinical reasoning and professional skills.

Making professional development meaningful

With AHPRA registration renewal approaching, understanding continuing professional development (CPD) requirements is particularly relevant. OTs are required to complete at least 20 hours of CPD annually, including a minimum of five hours of interactive learning with other practitioners.

Questions remain about how supervision relates to CPD requirements. While supervision can support professional learning, reflective practice and clinical development, it should not automatically be assumed that all supervision activities qualify as CPD. The nature of the activity and how it meets the Occupational Therapy Board’s requirements need to be considered.

Professional development is most valuable when it is planned around identified learning needs rather than simply accumulating hours. Supervision can play a useful role in identifying development priorities and helping clinicians translate new knowledge into meaningful changes in practice.

Can your therapy recommendations stand up to scrutiny?

Recommending therapy under the NDIS requires more than identifying a participant’s goals and proposing a schedule of intervention. OTs need to demonstrate why the recommended frequency, intensity and duration are appropriate, what outcomes are anticipated and how the intervention will address identified functional needs.

Recent ART matters have raised questions about the strength of evidence supporting therapy recommendations. Some clinicians have also been called upon to defend their recommendations through cross-examination, highlighting the importance of being able to clearly articulate the clinical reasoning behind proposed supports.

This can be particularly challenging in paediatric practice, where research does not always provide clear guidance on intervention dosage. Rather than relying on established patterns of weekly or fortnightly therapy, recommendations need to reflect individual circumstances, available evidence and professional judgement.

Are our OT reports communicating the evidence clearly enough?

Detailed clinical descriptions do not always translate into a clear understanding of a participant’s functional capacity, particularly when reports are reviewed by people without a clinical background. Technical terminology and broad descriptions can leave important questions unanswered.

Another recent ART matter involving a participant with significant physical impairment demonstrated how photographs could have strengthened the original assessment report. While the clinical descriptions documented substantial limitations, the absence of visual evidence may have made it harder for decision-makers to appreciate the severity of the participant’s functional needs.

Clear, specific language and appropriately selected visual evidence can help communicate the practical consequences of impairment. The focus should be on making the evidence meaningful and accessible rather than increasing the volume of information included in a report.

When the NDIS safeguards don’t provide the protection you hoped for

The introduction of the NDIS Support Determination has created concerns about participants who may experience substantial funding reductions but do not qualify for the available safeguards. For participants with significant support needs, the consequences may not become apparent until their plans are reassessed.

A recent case involving a participant with a Positive Behaviour Support Plan and approximately 70 documented behavioural incidents illustrates this challenge. An attempt to have their supports recognised as intensive and complex behaviour supports was unsuccessful, with the NDIA determining that the threshold had not been met. The NDIA also advised that the requested change could not be made through a plan variation.

An agreement reached through the Administrative Review Tribunal (ART) process has allowed the participant’s existing plan to be varied without a full reassessment. While this provides some immediate protection, the potential 50% reduction to community participation funding remains a concern when the plan is eventually reassessed.

An opportunity to challenge the NDIS funding reductions

A Senate disallowance motion concerning the new NDIS funding rules presents an opportunity for the sector to raise concerns about their potential impact. However, with the reforms only recently introduced, there may not yet be enough real-world examples to demonstrate the full consequences.

The 50% reduction to social, economic and community participation funding is particularly concerning for participants who rely on substantial daily support. Meanwhile, the 10% reduction to Improved Daily Living Skills funding may be harder to identify, especially where therapy recommendations were already being funded below the amounts requested.

Advocacy remains an opportunity for OTs and other stakeholders to communicate the potential consequences of these changes. Sharing specific clinical experiences and examples of participants who may fall outside the safeguards can help demonstrate where the reforms may create unintended outcomes.

Key takeaways
• OT practices should establish clear responsibility for monitoring NDIS changes and supporting clinicians to apply them
• Supervision should not automatically be counted towards CPD without considering the requirements of the relevant professional standard
• Planning professional development throughout the year supports more meaningful learning than simply meeting registration requirements
• Therapy recommendations should clearly justify the proposed intervention frequency, intensity and expected functional outcomes
• OT reports need to communicate functional limitations in language that non-clinical decision-makers can understand
• Participants with substantial support needs may still fall outside the NDIS funding safeguards, creating concerns about future plan reductions
• The Senate disallowance process provides an opportunity to communicate concerns about the potential consequences of the new funding rules

OT Week is an opportunity to celebrate the profession, but it can also be a time to reflect on how much has changed since we first became Occupational Therapists. The expectations we had, the challenges we faced and the lessons we learnt along the way have all shaped the OTs we are today.

Looking back on our early careers can offer a different perspective on professional confidence, the importance of boundaries and the unexpected directions an OT career can take. At a time when many therapists are feeling stretched, it's also an opportunity to reconnect with what makes Occupational Therapy such a rewarding profession.

What did being a good OT look like when you graduated?

Early career expectations are often shaped by the environments we work in and the therapists we learn from. What constitutes a 'good OT' can look quite different depending on the area of practice.

In more structured areas such as occupational rehabilitation, being organised, following through on commitments and managing processes efficiently may be central to how competence is measured. In other settings, the emphasis may be on developing therapeutic relationships, being available to families or demonstrating confidence in clinical decisions.

For early career OTs, experienced colleagues can appear to manage everything effortlessly. What isn't always visible are the systems, boundaries and clinical reasoning that have developed over years of practice.

Learning that there isn’t always one right answer

Receiving feedback can feel particularly personal early in your career, especially when you're still developing confidence in your clinical skills. Even constructive suggestions can be interpreted as evidence that you're not performing well enough.

Conflicting feedback from supervisors can also be frustrating, particularly when you're looking for clear guidance on how something should be done. Over time, it becomes easier to recognise that different therapists may approach the same task differently without either approach necessarily being wrong.

Observing different therapists and learning from their individual approaches can help develop professional judgement. Rather than searching for one prescribed way of practising, OTs can draw on different perspectives to find approaches that work for them and the people they support.

You don't need to know everything

One of the biggest lessons that comes with experience is recognising the limits of your knowledge. Early career therapists can feel pressure to appear confident and capable, even when they're unsure of the answer.

As professional expertise develops, so does an appreciation of how much there is still to learn. Experience doesn't necessarily mean having every answer, but rather knowing how to approach unfamiliar situations and where to seek support.

Being comfortable acknowledging uncertainty, seeking advice and recognising when a referral is appropriate are all part of developing clinical competence. Understanding how you learn best can also make a difference when expanding into unfamiliar areas of practice.

The career you never expected to have

The career we imagine when graduating may look very different from the one we eventually build. Experience, changing interests and unexpected opportunities can take us into areas of practice we never initially considered.

Moving between occupational rehabilitation, hospital settings, disability services and paediatric practice can involve significant changes in how OTs work. Yet the clinical reasoning, communication and problem-solving skills developed in one setting often transfer into another.

Career progression doesn't always mean becoming more experienced within the same clinical area. It might involve moving into leadership, education or supporting other therapists, sometimes discovering new professional interests along the way.

What would you tell your younger OT self?

Looking back on an early career often brings a different perspective on decisions that once felt significant. Opportunities that didn't work out, difficult workplaces and unexpected career changes can all contribute to professional growth.

There's also reassurance in knowing that you don't need to have everything figured out when you graduate. Clinical confidence develops with experience, and asking questions or acknowledging gaps in knowledge doesn't make someone a less capable therapist.

Learning to establish professional boundaries is another lesson that can take time. Understanding where your responsibilities begin and end, and recognising that another person's crisis doesn't automatically become your own, can help prevent work from consuming your personal life.

When you’ve run out of spoons

Between clinical responsibilities, administrative work and personal commitments, the demands of Occupational Therapy practice can leave little energy for anything else. Even seemingly small requests can become overwhelming when you're already stretched.

Spoon theory offers a way of thinking about our limited daily energy and how different activities affect our capacity. Some tasks require considerably more energy than others, even when they appear relatively straightforward.

For OTs, recognising these limits can mean being more selective about professional commitments, setting boundaries around requests and acknowledging when there simply isn't capacity to take on more.

NDIS pricing consultation: Have your say

The NDIS pricing consultation for 2027–28 is seeking feedback from therapy providers, including questions about pricing arrangements and the financial sustainability of services. The consultation includes several questions specifically relevant to allied health professionals.

One area being explored is differentiated pricing for registered and non-registered providers, including potential reductions to the rates available to non-registered providers. Providers are being asked how different pricing scenarios could affect their ability or willingness to continue delivering services.

The consultation also asks providers to estimate how much non-face-to-face time is required to deliver therapy services. For OTs and therapy businesses, these questions provide an opportunity to communicate the practical costs of delivering services and the potential consequences of changes to pricing arrangements.

A message to the OT community

To celebrate OT Week, Occupational Therapists from across Australia contributed messages of encouragement, appreciation and support. Their reflections acknowledge the challenges of working within changing systems and the emotional demands that can accompany clinical practice.

Many recognised the creativity, adaptability and advocacy that OTs bring to their work. They also spoke about the difference seemingly small achievements can make to the lives of the people and families they support.

The messages encourage therapists to recognise their achievements, protect their wellbeing and remember the value of the relationships they build. At a time when many OTs are feeling exhausted, hearing encouragement from colleagues across the profession offers a different perspective on the work they do every day.

Key takeaways

• Early career expectations are often shaped by the workplaces, supervisors and therapists we learn from
• Different clinical approaches can be equally valid, and professional judgement develops through experience
• Knowing when to seek support or acknowledge the limits of your expertise is a professional strength
• Occupational Therapy skills are transferable across different areas of practice and career pathways
• Difficult experiences and unexpected opportunities can shape professional growth and future career decisions
• Establishing boundaries and recognising your energy limits can help manage the demands of Occupational Therapy practice
• The NDIS pricing consultation provides an opportunity for therapy providers to communicate the costs and challenges of delivering services

Link

The NDIS consultation opened on 17 September 2026 and closes on Sunday 1 November 2026: https://www.ndis.gov.au/news/11696-consultation-begins-2027-28-ndis-pricing

The review will consider whether current pricing arrangements are providing access to quality supports and services and if any changes are needed for the 2027-28 financial year.

A billable target only tells part of the story. The time needed to complete a report, the travel involved in a caseload and the support available to an early career OT all affect whether expectations are realistic.

Fair billing and practical time management sit alongside broader questions about growing a practice beyond its owner. Examples from Freedom Solutions and Freedom Wheels also explore how tailored equipment can help people return to activities they love.

Report-writing expectations need to reflect the work

A practice owner’s usual report-writing time may not be a fair benchmark for every therapist or assessment. Fixed limits based on how quickly the owner believes they could complete the work can overlook the participant’s circumstances and the complexity of the assessment.

Experience also affects efficiency. An early career OT may need considerably longer to complete a report, but there is a distinction between time reasonably charged to the participant and additional time spent learning.

Clear expectations need practical support behind them. Showing therapists how to structure reports, use templates thoughtfully and streamline their work gives them a way to improve, rather than simply being told to write faster.

What actually counts towards a billable target?

An example of an early career OT being asked to achieve 25 billable hours each week, with billable travel excluded from that target, raises questions about how performance expectations are calculated.

Some practices count travel at a reduced rate because it generates less income. However, this can create additional workload when therapists need to find more billable activity to meet their target, particularly in regional areas with long distances between appointments.

Understanding how a practice earns income is part of working in the private sector, but targets need clear explanations and realistic workload planning. Clustering appointments and reviewing the mix of travel, therapy and report writing can help identify where expectations become difficult to meet.

Accurate time recording starts with managing interruptions

Time spent on client work can be difficult to reconstruct when reports are interrupted by phone calls, emails and other tasks. Relying on memory makes it harder to distinguish the work completed for each participant.

Timekeeping sheets, tracking software or a simple kitchen timer can help record actual work accurately. Pausing when attention shifts elsewhere also prevents unrelated activity from becoming mixed into the time recorded for a report.

Protecting concentration matters too. An inbox-hiding browser extension provides one example of how to search for an email without being distracted by new messages and leaving the original task unfinished.

Growing a practice means growing the team

A service built around one therapist’s reputation can become difficult to expand. If clients expect the owner’s particular approach, bringing in another OT involves more than handing over appointments.

Nikki reflects on Action OT’s tenth anniversary, recalling a first referral that involved a Saturday home visit and a report for a man with a brain injury who could not afford an out-of-pocket payment. Only a small Medicare rebate covered the work.

Moving from those beginnings to a team-based service requires confidence in the skills of other therapists. Developing staff and communicating the value of the whole practice helps the service become less dependent on one person.

Planning an exit starts before you need to leave

A busy practice does not necessarily operate independently of its owner. Whether the business can keep running when the owner takes time off is a useful question, particularly when decisions and referrals still depend on them.

Selling can also have implications for templates and resources an owner hopes to use in future work. Alyce’s reflection on closing her practice and moving into The OT Coach illustrates how plans for the next stage of a career can influence which exit option makes sense.

Assuming a sale will be available when personal circumstances suddenly change can leave owners with limited options. Considering an exit earlier creates more time to review staffing stability, dependence on the owner and what would be included in a potential sale.

When standard equipment cannot support a meaningful activity

Freedom Solutions’ fiftieth anniversary provides an opportunity to reflect on the collaboration between OTs and volunteer engineers. One example discussed involved developing a tray table when commercially available options would not fit a client’s power wheelchair.

Another involved a man who could no longer strum his guitar after a stroke. An adapted device allowed him to return to playing, with further modifications expanding how he could use it.

The OT’s contribution is to identify the functional requirements and understand what the person wants to do. Working with an engineer can then help turn those requirements into a tailored solution when standard products are unsuitable.

Adaptive bike trials involve more than learning to ride

Freedom Wheels clinics support children and adults who have never ridden, outgrown suitable equipment or experienced changes in their function. A young girl riding for the first time and saying, “I doing it”, captures what access to suitable equipment can mean.

Different equipment can address different barriers. Examples include wider stabilising outriggers and a pedal-assist trike trialled by a man with multiple sclerosis who wanted to ride with his wife but experienced fatigue. A new folding trike also prompted discussion about transport, given the difficulty of moving larger trikes without a van or trailer.

These assistive technology trials have a different purpose from bike skills sessions. In the clinic model described, the participant’s own therapist remains involved in the assessment and recommendation, while the clinic provides equipment knowledge and facilitates trials.

Key takeaways
• Report-writing expectations should account for assessment complexity and therapist experience, with practical support to build efficiency
• Participants should not be expected to fund the additional time an early career OT needs for learning
• Clarify how travel contributes to billable targets and consider its effect on the therapist’s actual workload
• Record client work as it happens and pause time tracking when interruptions shift attention elsewhere
• Growing a practice requires developing the team and reducing dependence on the owner
• Consider exit options early, including how a sale could affect resources intended for future work
• Tailored equipment and adaptive bike trials can support participation in activities that standard products cannot accommodate

Links
ARATA Australia Assistive Technology Conference. Register here: https://aatc2026.com

Requests for essential equipment are becoming more complicated when a plan variation is redirected towards a full NDIS reassessment. For some participants, accessing the support they need now may also expose their existing funding to further changes.

Understanding these pathways affects how OTs plan assessments, identify future support needs and prepare evidence. Questions around high-intensity supports, the High Support Needs safeguard and the Thriving Kids rollout add further complexity to decisions about funding and service access.

Why are equipment requests triggering plan reassessments?

Requests for assistive technology (AT) and home modifications are receiving inconsistent responses. Some are progressing as plan variations, while others are being redirected towards full reassessments, including requests for minor modifications such as grab rails.

Whether the relevant support category already appears in the plan may be influencing these decisions. A recent example involved an approximately $18,000 manual wheelchair being funded through a variation where the existing plan included an AT category with a zero-dollar allocation. However, the distinction between these pathways remains unclear in practice.

A reassessment can have consequences beyond the equipment request, potentially exposing other budgets to funding changes. FCA recommendations should identify foreseeable AT needs, including repairs, maintenance and replacement or hire, and explain the functional and safety implications if equipment cannot be accessed when required.

Does seizure management qualify for high-intensity support funding?

As participants face funding changes, understanding which exclusions apply becomes particularly relevant. Epilepsy and seizure management appears in the high-intensity support skills descriptor document, but its inclusion does not mean it independently qualifies for the high-intensity support rate.

It needs to accompany one of the eight recognised high-intensity descriptors, such as severe dysphagia management or tracheostomy care. Although seizure management can require substantial worker knowledge and skill, that requirement alone does not establish eligibility for the high-intensity rate.

When considering exclusions from the funding reset, check the participant’s existing funded line item and the descriptor that applies. Reporting should clearly identify the relevant high-intensity support needs rather than relying on seizure management alone.

The safeguard pathway still has practical gaps

The High Support Needs safeguard is separate from the high-intensity support descriptors. It provides a pathway for eligible participants to seek additional daily living funding when the funding reset creates a gap in their existing 24-hour support arrangements.

The practical application process remains unclear. There does not appear to be a dedicated safeguard form, and conflicting advice about variation and reassessment pathways is making it difficult to establish how requests should be submitted.

The wording of the rule points towards a plan variation because it refers specifically to varying the participant’s plan. However, clearer guidance is needed to connect the safeguard requirements with the forms and processes participants are expected to use.

An FCA needs a clear purpose before it begins

These different funding pathways make it even more necessary to establish what an assessment is intended to achieve. Completing a functional capacity assessment “just in case” can use valuable participant funding, and evidence prepared too early may need updating before it is required.

Unscheduled reassessments create a different challenge. A recent CEO-initiated reassessment gave a participant around three weeks to gather evidence, leaving little preparation time. The balance between preparing ahead and preserving funding requires consideration of the participant’s circumstances, likely timing and existing evidence.

For a participant-requested early reassessment, the report needs to explain why reassessment is warranted as well as justify the recommended supports. Where functional capacity or informal support arrangements have changed, identify what has changed and why the current plan can no longer meet the participant’s needs.

Every part of the report should earn its place

Once the assessment’s purpose is clear, the report should stay focused on the evidence needed for that decision. More complex NDIS processes do not automatically require longer reports.

A medication list illustrates the difference. Listing every medication and supplement may add little, while explaining that medication-related fatigue increases the assistance required for afternoon tasks provides relevant functional evidence. Historical information should be considered in the same way.

Standardised assessment results also need interpretation. Explain what the findings mean, whether they align with observation and reported function and how they inform recommendations. An FCA is a point-in-time functional assessment, so information gathering should remain focused on its purpose rather than expanding into every possible area of therapeutic assessment.

Thriving Kids: what support is actually available?

For families of children with disability, uncertainty extends beyond changes to existing NDIS plans. The initial Thriving Kids developments include an autism information helpline delivered by Amaze and an online resource hub, but these do not resolve the question of where families can access targeted therapy and support.

Details about the wider rollout remain limited, particularly around local providers and service pathways. Practices are also reporting different experiences of NDIS access and funding changes, with substantial caseload impacts in some services and little apparent change in others.

While alternative pathways remain unclear, families seeking NDIS access still need support to navigate the early childhood partner process. For children already receiving NDIS supports, decisions about assessment and therapy should consider the purpose of each service and how it will use the funding available.

Making space to recognise the profession

Professional awards provide an opportunity to recognise OT work and learn about achievements across allied health. They also make visible work that may otherwise remain largely within individual practices or local communities.

Rural and remote services are one area where valuable OT contributions deserve broader recognition. Sharing this work can help others understand the practical challenges, service innovations and outcomes being achieved outside larger professional networks.

OT Week offers another opportunity to connect, particularly for sole practitioners who may not have a workplace celebration to attend. Organising a local gathering or joining other OTs creates space to recognise the profession and the people doing the work.

The safeguard pathway still has practical gaps

The High Support Needs safeguard is separate from the high-intensity support descriptors. It provides a pathway for eligible participants to seek additional daily living funding when the funding reset creates a gap in their existing 24-hour support arrangements.

The practical application process remains unclear. There does not appear to be a dedicated safeguard form, and conflicting advice about variation and reassessment pathways is making it difficult to establish how requests should be submitted.

The wording of the rule points towards a plan variation because it refers specifically to varying the participant’s plan. However, clearer guidance is needed to connect the safeguard requirements with the forms and processes participants are expected to use.

Key takeaways

• Inconsistent variation and reassessment responses can complicate access to essential AT and home modifications
• Identify foreseeable equipment needs and explain the risks if equipment is unavailable
• Epilepsy and seizure management alone does not qualify for the high-intensity support rate
• Clearer application guidance is needed for the High Support Needs safeguard
• Clarify the purpose, timing and available funding before commencing an FCA
• Keep reports focused on functional evidence and clearly explain the reasoning behind recommendations
• Thriving Kids information services leave ongoing questions about access to targeted supports and local service pathways

The NDIS funding reset is here, and for OTs the implications go well beyond understanding the percentage reductions. There are questions about who will be affected, what happens when funding is reduced and what evidence may now need to be captured.

The new Support Determination, High Support Needs safeguard and exclusions for certain supports have practical implications for OT assessment, reporting and service delivery. There is also the challenge of supporting participants and families through changes that may significantly affect their everyday supports.

What does the funding reset mean in practice?

From 1 October 2026, the funding reset applies to relevant new or reassessed plans, with a 50% reduction in accessible Social, Economic and Community Participation funding and a 10% reduction in Improved Daily Living.

This could mean substantially less funding available for community participation and reduced therapy budgets. The changes are relevant across both adult and paediatric practice, including participants accessing Allied Health and community supports.

The changes will be introduced progressively, with plan renewals also affected from 1 February 2027 and the reset intended to apply across participant plans by September 2027.

What happens when the reduction creates a support gap?

The High Support Needs safeguard provides a potential plan variation pathway where the funding reset creates a gap in a participant’s ability to safely receive 24-hour disability supports.

Eligibility requires NDIS-funded disability supports across 24 hours and the relevant annual funding threshold to be met. The previously referenced 1:3 support ratio is not a separate eligibility criterion.

The pathway does not simply reinstate the Social, Economic and Community Participation funding that has been reduced. Instead, a variation may provide additional Assistance with Daily Life or Home and Living funding to address the resulting gap in 24-hour supports.

A significant concern remains for participants who require support across 24 hours but do not currently receive NDIS-funded disability supports across the full 24-hour period. This may include participants whose family members provide substantial support during currently unfunded hours.

Which supports are protected from the 50% reset?

Not all Social, Economic and Community Participation supports are subject to the 50% reduction. Excluded support subgroups include specialised supported employment, eligible high intensity supports and intensive and complex behaviour supports.

For OTs, this makes accurately identifying and evidencing the type of support a participant requires particularly relevant. A participant may have needs consistent with high intensity supports while their existing plan has been built using standard support line items.

High intensity support needs may include areas such as epilepsy and seizure support, complex bowel care, dysphagia support, diabetes management, enteral feeding and tracheostomy care. Appropriate evidence of the support required, including relevant management plans, may need to accompany these recommendations.

Similarly, having a behaviour support plan does not automatically establish a need for intensive and complex behaviour supports. Functional evidence should clearly demonstrate the behaviours of concern, their impact on safety and wellbeing and the level of support required.

Working differently with reduced funding

For therapy, a 10% reduction does not necessarily mean simply reducing every service by 10%. Looking at the available funding across the full year may create more flexibility in how intervention is delivered.

This could include changing session frequency or length, using blocks of intervention, incorporating telehealth or coaching where appropriate or prioritising particular aspects of a participant’s goals. Any changes still need to reflect the participant’s assessed needs and the potential impact of reduced intervention.

There may also be efficiencies to find within OT practice. Streamlining assessment processes, reducing duplication in reports and improving templates may help make better use of available funding without compromising clinical reasoning or the evidence required.

When you can’t change the outcome

There is also a significant emotional impact for OTs navigating these reforms alongside participants and families. One client example involved achieving a positive outcome through the ART, only for the prospect of the new plan being affected by the funding reset to create another major challenge.

This raises the issue of moral injury, particularly when clinicians can see the potential consequences of a system decision but have limited ability to change the outcome.

Supervision, psychosocial safety and appropriate support for clinicians become increasingly relevant when OTs are having difficult conversations with participants and families while also managing their own response to changes outside their control.

Key takeaways

• The funding reset affects both community participation and therapy funding, with changes being introduced progressively

• The High Support Needs safeguard may provide a plan variation pathway where the reduction creates a gap in safe 24-hour disability supports

• Participants who need 24-hour support but do not receive NDIS-funded disability supports across the full 24 hours remain a significant concern

• Some eligible high intensity and intensive and complex behaviour supports are excluded from the 50% reduction

• OTs may need to strengthen how high intensity and complex support needs are identified and evidenced within Functional Capacity Assessments

• Reduced therapy funding may require different approaches to service delivery and greater efficiency within OT practice

• Supervision and psychosocial safety are increasingly relevant as OTs navigate the professional and emotional impact of these changes