Before the NDIS’s big changes, regional care was already difficult for families to access. The numbers show that up to $24.5 million in approved NDIS funding is completely undelivered every six months because there are no providers. Add to that, 38% of NDIS plans for children aged 9 to 14 go unused because families face waitlists ranging from 6 to 12 months for services like occupational therapy or speech pathology. Out in rural Australia, there’s been a care crisis for years.
The NDIS’s big changes in 2026 are hitting the industry hard; we can all appreciate that. Industry changes are always planned for city environments, but out in the bush, they don’t roll out the same, and their impact is different.
Every change has a compounding effect in a regional area because we have fewer caseworkers, transport is difficult for families, and most parents are already stretched to breaking point working long hours for lower pay.
The NDIS’s changes may be uniform across the country, but they’re not equitable and make access to care even harder where access was already sparse. As a regional therapeutic centre, we’re shedding light on the top four changes that affect our families out in Dubbo.
Change 1: “Functional Capacity” Needs Assessments
The government is removing the automatic access lists that allowed entry based on a specific diagnosis. Instead, the law introduces a standardised “Needs Assessment” to measure a person’s abilities “in isolation.” This means the test judges what a child can do on paper in a quiet room, completely ignoring their actual school environment, family support, or the geographic challenges of living far from a major city
This is a tough hurdle for kids with “invisible” learning or behavioural struggles. A child might seem to function just fine in a quiet, sterile clinic room during an assessment. But drop that same kid back into a noisy, chaotic regional junior high classroom, and their system overloads. Because the new test rules ignore real-world environments, more country kids risk missing out on support.
Parents also can’t secure NDIS support with a referral letter from their doctor anymore; they’ll have to navigate a complex, evidence-heavy assessment process. There is an extra burden for rural-based families who live hours away from major medical panels and earn lower salaries working 9-5 jobs.
Our team will spend much more time up front sitting with families, helping them map out and document every single specific, isolated daily struggle to move past these stricter hurdles.
Change 2: Banning Plan Rollovers (The New “Use It or Lose It” Rules)
Previously, if your family couldn’t spend your allocated budget within the year, often because you were waiting on services, the unspent money would roll over into the next plan so you didn’t lose it. Under the new laws, plan rollovers are banned. If funding isn’t spent within the strict plan timeframe, it’s returned straight to the government.
Out here, service shortages are a harsh reality. For example, in the Dubbo region, 38% of NDIS plans for kids aged 9 to 14 sit completely unused simply because families are stuck on 6-to-12-month waitlists for occupational therapy or speech pathology. Under the new rules, the clock is ticking while your child waits. By the time you finally get an appointment, the money could be stripped away, penalising your kid for a market shortage they didn’t cause.
This constant pressure and panic forces country parents to either watch their child’s funding vanish, or take unpaid leave, lose a day’s wages, and drive hours to a city clinic just to spend the budget. Teams like Spear & Arrow can onboard a child immediately and cut report turnaround times down to 2.2 weeks, which maximises the value a child can get from their plan’s budget.
Change 3: Ministerial Powers for Funding Adjustments & Restricted Plan Reassessments
Under the updated Act, the Minister now has the power to make broad, percentage-based adjustments to funding across entire categories of NDIS support without needing to pass new laws through Parliament. On top of that, the rules for requesting an “unscheduled plan reassessment” (emergency reviews) are severely tightened.
The main targets for these sudden cuts are “capacity-building” budgets, the funds used to teach kids how to regulate their emotions and navigate social spaces. For a teenager heading into high school (where 71% of school suspensions happen), losing therapy means losing the tools that keep them calm in class. If they experience a major crisis at school, they can no longer get a quick emergency funding increase to adapt.
For the Parents, the safety net is effectively gone. In the past, if your family hit a major crisis or breaking point, you could ask the NDIA for an urgent review. Now, you’re locked into your budget framework. When things get tough and local care is cut, the emotional weight and the guilt land right back on the shoulders of parents and their kids. With funding categories shrinking or shifting without warning, local care teams have to be incredibly adaptable.
Change 4: Mandatory Provider Registration & Centralised Electronic Claims Tracking
Over a rolling transition period, the government is expanding mandatory provider registration and moving to automated, electronic tracking for all NDIS claims. Plan management is being restructured into a centralised, commissioned panel model.
As the pool of local workers shrinks, kids who thrive on consistency will be forced to adapt to a revolving door of larger, city-based corporate providers who treat them like a case number rather than a name. The “barefoot” flexibility of choosing small, trusted local workers from your own community is being compromised. Parents will have less direct control over who they bring into their homes and classrooms, forced instead to use registered, bureaucratic agencies that lack a personal, country touch.
This is a massive headache for regional health workers, who already have an average job lifespan of just 3 years in the bush before burning out. The extra compliance load will cause many solo practitioners to quit the sector entirely, widening our region’s $24.5 million service gap.
That said, while solo practitioners might struggle with the new registration rules, established, fully connected regional teams have the structural backbone to absorb the new compliance load. Because the business handles the digital portal and the legal paperwork behind the scenes, homegrown workers can stay focused on the child in front of them.
Reinventing Rural Care
At Spear & Arrow Therapeutic, we’re not running a corporate and streamlined operation. This is a cup of tea, round the table, with the family kind of operation. We’re wiping tears, explaining paperwork, engaging with little children, taking calls after hours and measuring our success by milestones, not by actions we can tick off on a to-do list.
Our support workers provide core services including behaviour support and Early Childhood Early Intervention (ECEI). We’re also in the early stages of developing a new, trademarked framework, drawing on evidence-based practices from experts such as Dan Seigal, Dr Ross Greene, Dr Bruce Perry, Kim Bartel, Gabor Maté, Brene Brown, Andrew McDonnell, Kelly Mahler, Greg Santucci, and Greenspan.
The NDIS provides a critical service that Australia’s most vulnerable citizens depend on. Creating instability really does pull the rug out from under people’s feet. To us, someone’s need is not necessarily something that can be measured and plotted against a plan that’s compliant or not. Building an independent service that doesn’t rely solely on NDIS is our next move; we want to help people on the merit of help being needed. We’ll be sharing the details of our new business model soon!
Learn more about Spear & Arrow Therapeutic’s regional support services and approach to care at https://spearandarrow.com.au/