Eligibility Changes, Funding Cuts & Functional Capacity: What Our Wildflower Community Needs To Know

 If your child currently has an NDIS plan, this information is important for you. 

There are significant changes occurring across the NDIS that will impact:

• how participants access the scheme

• how eligibility is determined

• how funding is allocated

• what evidence families will need to provide

• how plans may be reviewed moving forward

  
  

We know there is a lot of noise, fear, and conflicting information circulating right now. Rather than contributing to the overwhelm, we want to focus on what we do know, the practical changes we are already seeing impact families, and what we are doing right now to support our community through them.

Our goal is to help families make sense of what is changing, what the NDIS is now looking for, and how we can best support you to make informed decisions moving forward.

What Has Changed - Access, Eligibility & Funding 

The recent NDIS reforms represent one of the biggest shifts we have seen in the scheme in years.

Some of the key changes currently being discussed and implemented include:

The Shift From Diagnosis → Functional Capacity

Previously, when determining eligibility and funding supports, the NDIS placed a strong emphasis on diagnosis.

For example, a diagnosis such as Autism Spectrum Disorder often helped explain why a child required support, and reports would generally focus on how that diagnosis impacted different areas of functioning.

Now, the NDIS is shifting away from focusing primarily on diagnosis alone, and instead placing a much stronger emphasis on functional capacity.

A diagnosis itself just won’t be enough anymore.

Instead, eligibility and funding decisions are increasingly being based on: 

“Does this person experience a significant reduction in functional capacity that impacts day-to-day life?”

So rather than simply stating:

“This child has autism,”

or

“This child has an intellectual disability,”

The NDIS is now asking for much more detailed evidence around:

• how a child functions day-to-day,

• the level of support they require,

• how independently they can complete tasks,

• what barriers impact their participation across environments.

• how much prompting, supervision, or assistance is required across environments.

This means assessments and reports now need to explore things in a much more practical and detailed way.

For example, instead of only documenting:

“They have communication difficulties,”

we may now need to explain:

• Can they independently ask for help?

• Can they communicate their needs when upset?

• Can they consistently follow instructions?

• Do they require prompting, modelling, visuals, or adult support?

Or instead of saying:

‘They can count to 20,’

we might need to explore:

• Can they do this independently?

• Can they do it without prompts or songs?

• Can they apply the skill in everyday situations?

• Do they rely on routines, visual supports, or repetition?

The focus is no longer simply: “What diagnosis does this child have?”

The focus is now: “What level of support does this child require to function in everyday life?”

In many ways, this reflects something we have always prioritised in our reports at Wildflower. Our reports have consistently focused on functional impact, how a child or young person is managing at home, at school, in relationships, and across environments. What is now changing is the system’s formal alignment with this approach, and we will be strengthening this focus even further within our reporting.

It’s also important to understand why this shift is happening. Over time, there has been variability in how plans are interpreted and funded across the system. A functional model is intended to create greater consistency, fairness, and clarity around how support needs are identified and funded. It also aims to ensure that supports are more closely matched to real life needs, rather than diagnosis alone.

From a practical perspective, however, this does change what the NDIS will require from families to access, and remain on, the scheme. 

For many families, this may mean:

• it becomes harder to access the NDIS,

• plans may become smaller,

• funding rules may become stricter,

• and there may be fewer providers or support options available moving forward.

  
  

A diagnosis alone may no longer guarantee access, and some children may instead be directed toward school-based, health, or community supports rather than the NDIS, even if they are currently on the scheme.

What is Functional Capacity?

Functional capacity refers to: How a person functions in everyday life, and the level of support they require to participate in daily activities.

Functional Capacity Assessments draw together information from multiple sources, including clinical observation, parent and carer input, and where appropriate, school or external provider feedback. This allows a clear picture of how an individual is functioning across environments.

Functional Capacity Assessments are typically more comprehensive than standard review sessions. This is because they involve synthesis of multiple sources of information and the development of detailed reports aligned with funding requirements.

The reports we’ve previously written were absolutely correct and aligned with the NDIS requirements at the time. What has changed most significantly within the NDIS is the depth of evidence now being requested around day-to-day functioning, participation, independence, and support needs. While this may feel more involved, it is essential for building accurate, strong, and meaningful reports under the new framework.

Importantly, this shift also reflects the strength of our multidisciplinary model. At Wildflower, our psychologists and occupational therapists work closely together, and this collaboration is a core part of how we understand and support each individual. Our psychologists help us understand the why behind behaviour, looking at emotional, cognitive, and relational barriers that may be impacting a person’s ability to engage. Our occupational therapists then support the how, building practical strategies to support independence, participation, and daily functioning across environments.

This combined lens is exactly what the system is now moving toward. It reflects a deeper understanding that behaviour and function cannot be separated, and that meaningful support requires both insight and practical intervention. While these reforms are still unfolding, we feel confident in the model we already have in place, and we remain committed to continuing to evolve our documentation and practice in a way that meets system requirements, without losing sight of the individual behind the plan.

Because of this change, Functional Capacity Assessments are becoming much more comprehensive and detailed. These assessments often involve:

• Longer parent interviews

• Standardised assessment tools

• Detailed breakdowns of daily functioning

• Information gathering across multiple environments

• Collaboration with schools and other supports

• School, home, or community observations (where appropriate)

• Looking closely at prompting, supervision, emotional regulation, and assistance required throughout the day

So we’re now looking at functioning in a much more detailed and practical way.

In some cases, this may be billed across multiple sessions or at a higher assessment rate depending on complexity,  these assessments can take approximately 10 - 15 hours to complete.

What We Are Doing Now 

At the moment, we are proactively having these conversations with families, and you can expect your clinician to reach out to you directly so that you can make informed decisions around whether a Functional Capacity Assessment may be beneficial. 

Together, we can look at:

• when your child’s plan review is due

• current funding availability

• whether a Functional Capacity Assessment would be beneficial at this stage

• what information we already have

• what additional assessments or observations may be required

We understand this system is continuing to evolve, and with change often comes uncertainty.

Our role is to support families through these changes with transparency, advocacy, and care,  while ensuring your child’s needs are represented as clearly and accurately as possible.

We Understand These Conversations Can Feel Emotional

We deeply recognise is that these conversations can feel confronting for families.

A large part of the assessment process now involves identifying where a child still requires support, what barriers are impacting their independence, and what assistance is needed day-to-day.

Sometimes this can feel emotional, because as parents you also see your child’s strengths, growth, and progress, and we absolutely do too.

The purpose of these assessments is not to reduce your child down to their challenges.

The purpose is to clearly demonstrate the level of support your child genuinely requires in order to access appropriate funding, services, and supports through the NDIS.

Where to Find Reliable Information on NDIS Changes 

Check the NDIS news page for official updates on eligibility, planning and provider rules.