The Shoalhaven is likely to be hit hard by the $1.6 billion NDIS under-spend in the government's federal budget, according to Flagstaff disability service CEO Roy Rodgers.
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"(People in regional areas) often cant get the service, and many service providers are withdrawing because it's not sustainable for them," he said.
"When it's prescribed to you from the NDIS what you can charge, and your labour costs exceed what you get from the NDIS, you can't keep doing that forever.
"The pricing just doesn't reflect the actual cost of providing that service. If you haven't got the workforce to provide the support it doesn't help anybody."
He said participants spending didn't always reflect their needs.
"The under-spend comes from (people with an NDIS package) not knowing where to go to get the support they need," he said.
"Just because somebody in the first year of their plan hasn't spent what's available, doesn't mean they don't need it.
"It's certainly a worry for us to think the budget has taken money out of something they know will keep on building. It may mean there's a shortfall, especially as more people come into the scheme."
He said it wasn't all bad news: "To be positive, they have said there will be some additional money for community participation programs and attendant care, but we haven't got the information about where that will go to."
Disability advocate Annette Pham echoed Mr Rodgers concerns, but said the biggest budget win for NDIS participants was certainty.
"Before the budget, there was no guarantee the NDIS would be fully funded," she said.
"Now we have assurances from both sides of politics, which is great. The pilot studies happened more than five years ago - there's no excuse why the whole country shouldn't be fully funded by now."
She was also concerned about the lack of support services, particularly in regional areas.
"People who are part of the NDIS are having difficulty sometimes spending the money they have received because the service providers aren't there," she said.
"It's concerning that some service providers may be seen to charge in excess for their services, which is why it's important the NSW Government continue to provide advocacy services for people with disabilities."
Mr Rodgers said there were systematic issues with the NDIS that, if fixed, would make the scheme more cost-effective.
"There's fundamentally a real problem with red tape and the bureaucracy of NDIS and planners and yearly plans," he said.
"The cost of servicing and advocating for participants is horrendous and takes up a lot of effort and time, which means we can't put our time, effort and money into providing services to people with a disability.
"They're forcing everyone to have a one year plan - of someone has an intellectual disability and it's been assessed, that's not going to change next year. These assessments cost a lot of money and delay everything. It's a really cumbersome way of doing things."