What changed for participants in the final NDIS bill: permanence, 24-hour care and safeguards explained

When the NDIS Amendment (Securing the NDIS for Future Generations) Bill 2026 received Royal Assent on 20 August, it wasn't quite the bill first introduced - the government moved a further round of amendments in the Senate on 18 August, two days earlier. Our full rundown of the final changes covers all of them; this is the closer look at the two that matter most if you're a participant - what "appropriate treatment" actually means for access, and the new pathway for people who need continuous 24-hour care.

What "all appropriate treatment" actually means

Access to the NDIS is granted once all appropriate treatment to remedy or alleviate an impairment has been undertaken, no other treatment is likely to materially improve it, and the impairment is likely to be lifelong. That was one of the most contested pieces of the original bill, and the government has since published a Supplementary Explanatory Memorandum spelling out exactly what it does and doesn't mean.

It does not mean trying every possible treatment, and it does not force anyone into treatment - people keep the right to make their own healthcare decisions. "Appropriate treatment" specifically means treatment that's regularly undertaken in Australia with public funding available for it; restrictive practices don't count as appropriate treatment at all. A treatment generally only counts as appropriate if it's expected to significantly improve, reduce or manage the impact of the impairment - small or short-term improvements aren't enough. And nobody is expected to undertake treatment that's unsuitable for them, carries significant risk, could cause serious long-term side effects, or could alter their fertility or have other major lifelong impacts. Separately, earlier House of Representatives amendments (agreed 1 July 2026) already clarified there's no requirement to keep undertaking additional treatment once all appropriate treatment has genuinely been exhausted.

A dedicated pathway for 24-hour care

Support determinations - the mechanism used to reset funding for community participation and capacity-building supports - now come with explicit safeguards for participants with high support needs who require continuous 24-hour care. Critical care (help with eating, drinking, dressing, toileting, laundry, cleaning, nursing care and medication), home and vehicle modifications, personal mobility equipment, continence and menstrual products and Specialist Disability Accommodation are all protected from being reduced this way - as are high intensity supports, complex behaviour supports, and customised or wearable technology and hearing supports.

On top of those exclusions, participants needing continuous 24-hour care get a brand-new plan variation pathway: they can apply within 90 days of a support determination applying to them (after their plan is reassessed or renewed), and the NDIA can increase their funding specifically to make sure that 24-hour care is maintained. This is a group advocates repeatedly flagged as being at particular risk under the earlier drafting - our coverage of what disability advocates were saying about the bill goes into why. Participants can still request an unscheduled reassessment at any time if there's been a significant, ongoing change in functional capacity or circumstances, regardless of this pathway.

What this means in practice

Neither change is retroactive in a way that immediately reopens existing plans, but both will shape how access requests, reassessments and support determinations are handled from here. If you have a reassessment or access decision coming up, get independent advice before the meeting rather than after - the rules it's assessed against have just moved, and if you rely on continuous 24-hour care, it's worth knowing the new 90-day variation window exists before you need it.

This article is general information dated 10 September 2026, not legal advice, and reflects the Department of Health, Disability and Ageing's own fact sheet. Verify current requirements at health.gov.au and ndis.gov.au, or speak to your planner or an independent advocate.