The Government’s NDIS amendment legislation passed the Senate on 18 August 2026, with the Minister for Health and Ageing describing it as making the scheme “safer, clearer and more sustainable for participants”. Source. Alongside it, Thriving Kids starts on 1 October 2026, the first phase of the foundational supports that will sit outside the NDIS. Source.
For paediatric occupational therapists, speech pathologists and psychologists, that leaves roughly five weeks before the first state-commissioned services open. Nothing switches off in October, and NDIS access rules do not change until 1 January 2028. Source. What does start moving is where children are seen, who commissions the work, and which referral pathways clinics will be relying on in two years.
Key Summary
- The bill has passed. The Senate passed the NDIS amendment legislation on 18 August 2026, with Labor and the Coalition voting together and 63 government amendments tabled after consultation with the disability community. (ABC News)
- Thriving Kids is not part of the NDIS. It is a jointly funded foundational supports program, backed by $4 billion over five years, with $2 billion from the Commonwealth and the balance from states and territories. (NDIS)
- 1 October 2026 is the start, not the finish. The first state-delivered services become available to families from that date, with full national rollout by 1 January 2028. (NDIS)
- Who it is for: children aged 8 and under with developmental delay and/or autism and low to moderate support needs. A diagnosis is not required to access supports. (NDIS, Raising Children Network)
- Access changes are dated 2028. Children with permanent and significant disability, including higher support needs, remain eligible for the NDIS, and access arrangements for children change from 1 January 2028. (NDIS)
- Queensland has not signed on and is the only jurisdiction yet to do so, but the Commonwealth has confirmed the rollout is not being delayed. (ABC News)
What Passed, and What Actually Changes on 1 October
Two things are moving at once, and they are easy to conflate. The first is the legislation. The second is the program.
The legislation
The amendment package clarifies how support determinations apply and who is eligible, adds safeguards for participants who need continuous 24-hour care, improves plan management and administration, strengthens provider oversight, and expands fraud and integrity measures. Implementation is staged over several years, and the ministerial release states there are no changes to access until 1 January 2028. Source.
Reporting on the Senate vote notes new criminal and civil penalties for providers offering kickbacks, additional whistleblower protections, and expanded NDIA enforcement powers to act more quickly against unsafe providers. Source.
The program
Thriving Kids is the first phase of foundational supports agreed between the Commonwealth and the states and territories, funded at $4 billion over five years. Source. The published model has two broad levels. Universal parenting supports are open to all families and include information, advice, playgroups, peer support and short courses. Targeted supports are for children who need more, and they name allied health early intervention explicitly, including speech pathology, occupational therapy and psychology. Source and Source.
The delivery setting is the part clinics should read twice. The model is built around services delivered where children live, learn and play, in early childhood settings, schools, homes and community settings rather than clinic rooms, with a proposed Medicare Child Development Plan as a GP referral pathway into allied health and specialist services. Source.
Practical read: 1 October is when the first state-delivered services become available to families, not a cut-off for existing NDIS plans. Children currently on the scheme are expected to be assessed before 1 January 2028 and moved to Thriving Kids only if appropriate. Source.
The Transition Timeline at a Glance
| Date | What happens | What it may mean for paediatric providers |
|---|---|---|
| 1 October 2026 | First state-delivered Thriving Kids services available to families. | New commissioning channels open at state level. Referral conversations begin shifting away from the NDIA. |
| Through 2027 | Services scale up. Children already on the NDIS are assessed ahead of the 2028 date. | Caseload mix starts to move. Families will ask clinicians what happens next. |
| 1 January 2028 | Full national rollout, and NDIS access arrangements for children change. | The point at which billing mix and referral sources are most likely to look different. |
| By 2030 | Government target of about 600,000 participants, down from about 760,000. | A smaller scheme, with paediatric demand distributed across more funding sources. |
Sources for the table: NDIS Thriving Kids page for the October 2026 and January 2028 dates Source, and ABC News reporting on the Senate vote for the participant target Source.
What It Means for Paediatric Caseloads, Referrals and Revenue
Paediatrics is a large share of the scheme. In August 2025, when Thriving Kids was announced, children under 9 made up around 23 per cent of NDIS participants, autism was the primary diagnosis for about 40 per cent of participants, and roughly 11 per cent of children aged 5 to 7 were on the scheme. Source. A clinic with a heavy under-8 caseload is not looking at a marginal policy change.
The commissioning shift
Under the agreed model, states and territories deliver child health checks, parenting supports, navigation and targeted supports, while the Commonwealth handles the awareness campaign, a national digital and phone information service, workforce training and evaluation. Source. For providers, that means the buyer changes. Work that has been funded through participant plans starts to be commissioned through state programs and mainstream channels instead.
The setting shift
Delivery in early childhood centres, schools, homes and community settings is a different operating model to a clinic-based one. It changes travel time, caseload density, supervision, and the kind of clinician who thrives in the role. Practices that already run mobile and in-setting services have a head start here; we covered that model in our piece on mobile allied health for NDIS participants.
The margin question
This lands on a sector already managing price pressure. Occupational therapy has held at the same hourly price limit for another year while psychology moved up, and the 2026-27 schedule split therapy claiming into six line items per discipline. We set that out in NDIS Pricing 2026-27: OT Frozen Again, Psychology Up, and the Line Items to Rebill. Add a commissioning change on top of a frozen price, and the pressure on paediatric OT margins is the thing to watch over the next 18 months.
What the professions have asked for
Occupational Therapy Australia has warned that the design of funding and commissioning is decisive. Michelle Oliver said that “if the funding and commissioning models are not set up to support children to continue to access critical supports and services, Thriving Kids will fall short”, and pointed to reform fatigue across the profession. Source. Speech Pathology Australia has argued for a new Medicare item for children under nine alongside a voucher-style system, so families can reach a broad network of qualified providers. Source.
Example scenario: a suburban paediatric practice with three OTs, two speech pathologists and a part-time psychologist, where most clients are under 8 and plan-funded. Between now and 1 January 2028, the questions worth answering are which of those clients are likely to meet continuing NDIS criteria, which sit in the low to moderate band, what proportion of revenue that band represents, and whether the practice can deliver in schools and early childhood settings if that is where the work goes. This is a hypothetical example for planning purposes, not a prediction about any particular practice.
Queensland, and the Where-to-Hire Question
Queensland is the only state or territory that has not signed on to Thriving Kids. Source. Queensland Disability Minister Amanda Camm has described the program as “a cost-shifting exercise from the federal government to the states and territories with little detail”, citing insufficient consultation and undefined criteria for autism severity and developmental delay. Source.
The Commonwealth position is that the rollout proceeds regardless. NDIS Minister Jenny McAllister has said the government is “not contemplating” a delay, and that it wants “alternative supports in place at the same time that we make access changes”. Source.
Why the map matters to workforce planning
The occupational therapy workforce is concentrated in the private sector and in the eastern states. Reporting earlier this year put 60 to 70 per cent of registered OTs in the private sector, with New South Wales at 27 per cent of the workforce, Victoria at 26 per cent and Queensland at 20 per cent, and the majority in metropolitan areas. Source. A reform that is commissioned state by state will therefore land unevenly on a workforce that is already unevenly distributed.
For multi-site providers, that argues for planning by jurisdiction rather than nationally: understanding which state programs are open to private providers, when procurement opens, and what credentialing they will require. For clinicians weighing a move, it is worth asking prospective employers how they expect their paediatric funding mix to change by 2028, and what proportion of the role will be delivered in schools and early childhood settings.
Where demand is strongest also matters. We mapped the current picture in Where the Allied Health Demand Is in Sydney.
Readiness is the open question
State and territory ministers have warned that alternative services will not be ready in time, citing consultation gaps and accelerated timelines. Source. Independent MP Dr Monique Ryan has said “there aren’t yet supports in place for vulnerable children”, and a member of the Thriving Kids advisory panel has questioned whether the state-based model matches what the panel designed. Source. Those concerns are worth tracking, because readiness is what determines whether referrals arrive in an orderly way or in a rush.
Why this matters for clinics and practices:
- Know your caseload mix. Work out what share of revenue sits with children aged 8 and under at low to moderate support need, because that is the cohort the model targets.
- Diversify referral sources now. GP, early childhood and school pathways are central to the model, and they take time to build.
- Watch state procurement, not just federal announcements. States are commissioning the targeted supports, so the practical detail will surface at that level.
- Hire for setting, not only for discipline. Clinicians comfortable working in schools, homes and community settings are the ones this model needs.
Conclusion
The legislation is done and the start date is fixed. For paediatric allied health, the next five weeks are not about reacting to a cut, because access changes are dated 1 January 2028 and children with permanent and significant disability remain eligible for the scheme. Source. They are about understanding a shift in who commissions paediatric therapy and where it is delivered.
The practical work is unglamorous and useful: measure the caseload exposure, build the referral pathways, follow state procurement, and hire for the settings the model favours. Providers that do that quietly over the next 18 months will be in a better position than those waiting for full clarity, which, on the evidence so far, may arrive late.
Disclaimer: This blog is a general overview and should not be construed as professional legal, financial or medical advice.
FAQs
- What is Thriving Kids?
Thriving Kids is the first phase of foundational supports agreed between the Australian Government and the states and territories, sitting outside the NDIS. It is backed by $4 billion over five years, with $2 billion from the Commonwealth, and is aimed at children aged 8 and under with developmental delay and/or autism who have low to moderate support needs.
- What actually starts on 1 October 2026?
The first state-delivered Thriving Kids services become available to families from 1 October 2026. Full national rollout is scheduled for 1 January 2028. October is the start of new services, not a change to existing NDIS plans.
- Will children lose their NDIS plans in October?
No. The ministerial release states there are no changes to access until 1 January 2028, and children with permanent and significant disability, including those with high support needs, continue to be eligible for the NDIS. Children currently on the scheme are expected to be assessed before 1 January 2028 and moved to Thriving Kids only if appropriate.
- Who delivers Thriving Kids supports?
States and territories deliver child health checks, parenting supports, navigation and targeted supports, while the Commonwealth runs the national information service, awareness campaign, workforce training and evaluation. Targeted supports include allied health early intervention, with speech pathology, occupational therapy and psychology named in the model.
- What happens in Queensland?
Queensland is the only jurisdiction that has not signed on, and its Disability Minister has described the program as cost shifting with little detail. The Commonwealth has confirmed the rollout is not being delayed. The practical arrangements for Queensland families and providers after 1 January 2028 have not been published.
- What should paediatric clinics do in the next five weeks?
Useful steps include measuring what share of revenue sits with children aged 8 and under at low to moderate support need, building GP, early childhood and school referral pathways, monitoring state procurement for targeted supports, and considering whether the team can deliver in schools, homes and community settings.
Information Sources
- Minister for Health and Ageing, Legislation to secure the future of the NDIS passed by the Senate, 18 August 2026
- Minister for Health and Ageing, media releases
- NDIS, Thriving Kids
- ABC News, Federal government to pass NDIS overhaul, 18 August 2026
- ABC News, NDIS minister says government not contemplating delay, 16 August 2026
- ABC News, Parents nervous as Thriving Kids program in Queensland still unconfirmed, 4 August 2026
- ABC News, Thriving Kids program not intended to be state-based, advisory panel member claims, 26 June 2026
- ABC News, Months out from Thriving Kids, workforce questions remain unanswered, 28 March 2026
- ABC News, Model revealed for Thriving Kids, 3 February 2026
- ABC News, The new $2b plan to divert kids with autism, developmental delay off the NDIS, 20 August 2025
- Raising Children Network, Thriving Kids support: your questions answered, 17 April 2026
- DSC, Unpacking the Thriving Kids model, February 2026
- Insight PBS, Thriving Kids: what has been confirmed, 8 April 2026
- Australian Psychological Society, What you need to know about the Government’s Thriving Kids program
- Speech Pathology Australia, Stronger funding, better access, workforce support
