A recent report by joint standing committee published on 13 May 2020 , reflected on the current scenario of Supported Independent living homes (Disability Accommodation) in Australia. It detailed the facts, observations and recommendations by the committee on the existing SIL model of supports.
As I went on reading the report, it was clearer to me that the committee was keen to bring a positive change to the existing ndis housing situation and it had made a great stand point highlighting the current issues, and pointing that the current SIL model requires a serious fix. I was impressed to find a long list of 45 recommendations made by the committee to improve the existing NDIS accommodation service scenario for people with disabilities.
The key information within the report ranged from all sorts of discussions, relating to ndis housing - from SIL approval process, all the way to the exit of the participant from a provider's home and the issues around managing the vacancy in a SIL home.
The report is an intensive 149-page document and is a lengthy document but the information is easy to grasp for those connected to NDIS in some way.
So, for those who are new to NDIS, I thought to write this little piece of document that may hopefully give some background and insights into ndis housing, bit of a background and current situation with SIL making it simple.
In doing that, I have tried to summarize some key aspects including the What, Why and How for the issues mentioned in the report.
If you wish to go deep in to this quality report, the full document is available here - https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/National_Disability_Insurance_Scheme/Independentliving/Report
Lets explore -
If you are pondering what is it all about that the joint committee is discussing in its report and what sorts of flaws in the current SIL home model needing streamlining, I must say - you have got the heat of this situation and you have an Interesting learning ahead, to begin with.
So those who are connected to NDIS and/or disability sector in Australia, they may be familiar with the terms SIL, ILO, STA & SDA and may also be aware of some of the service and funding related issues existing with these models of accommodation. However, for those who are new to these terms, let me tell you that these terms represent Disability housing models in Australia that are funded by NDIA (A Government Agency).
These are the types of dwelling which are owned or rented by Disability service providers and the supports are offered to participants within that home 24/7 based on the needs and requirement of NDIS participant. This is to enable participants to live as independently and autonomously as possible. The supports are totally funded under the National Disability Insurance Scheme, while the tenancy part of the dwelling is managed by service provider and is funded by participant from their DSP.
WHAT are the current issues with current ndis SIL housing then?
Now, its an outcry that the current SIL process is fractured due to many reasons, both at NDIA's end and at the providers end.
From NDIA's end - Slower and less transparent processes, lack of flexibility with the way funds are allocated for SIL only, so participants unable to explore any other individual living until review or rest of the plan, lack of measures to completely stop or eradicte conflict of interest issues existing by separating SIL, support coordination and tenancy management provided by same provider are few of many issues.
From Provider end - Inefficency in managing vacancy is a major factor affecting many providers financialy and leading to be persuaded for a quick intake of participants without proper capacity check of the team's expertise and the compatibility check within the members with disability within a SIL home.
Much of the issues discussed above is also resulting due to the fact that the current SIL model transitioned from the pre NDIS era model of disability housing (state funded system) and the report did acknowledge that. Hence, in order to bring serious improvements, it is important to try and see SIL from a completely new set of eyes, that when new refinements can be suggested and hence the report making 40 plus recommendations is something heading in that direction
So, If new improvements are designed in a way that it can assist providers with vacancy management in someway, creating some sort of vacancy matrix or portal; providers can rather prefer gradual introduction and a proper introduction process for participants to their SIL homes, rather than being hasty in filling vacancies which in turn may avoid the risk of misfit.
So, clearly in coming times, NDIA has a tough job to handle, it needs to introduce measures from both participant and service providers side to make a solid two-way bridge.
WHY this change?
NDIS is all about providing choice and control to people with disabilities, however it seems like when it comes to SIL home model - committee is of an opinion that NDIS principles stumbles here.
To simplify - lets look at good practices first
With more than 10 years of my experience in Disability sector, and having worked in senior administration position for a larger charities, I am very well aware of the pain points faced by SIL service providers and participants in SIL homes.
For Supported independent living, most providers work actively to offer flexibility, choice and control - working very hard to satisfy participants. Besides offering flexibility to the roster (which every sil provider should) - I have seen scenarios, where providers have been letting the participants have their room customised and/or painted in colour of their choice. So this is all good.
Now lets look at the issues in the current model then -
So, undoubtedly, many Organisations have great processes and striving to do the best practice in this shaken ndis housing system, but there are providers who are failing in some or the other way.
What many do not understand is that SIL is not just about setting up a disability home. To achieve the choice and control and an abuse free environment, there arises a question of ethics, values and ofcourse not just having systems and processes on books but following it on a day to day basis. Surely, providers are audited against the code of conduct and the policies, but how much of it gets slipped through the cracks is a big question.
Since the start of NDIS, many new providers entered the ndis SIL market and being new, you expect these providers to be in a learning stage, and they would learn and grow from their experiences, and that is ok as long as the right ethics and values are there, following good practices but what if a provider is failing consistently to embed it in to their business operations for whatever reasons - could be the financial pressures (vacancy managemen we discussed above) or any other reasons.
If providers are proactive and are keen to nurture a culture that reduces or eliminates gaps, such issues may be less likely to occur. But if issues does occur, another important point is - how prepared a provider is to let the participant go to another provider and not wait until someone external picks it up. This even becomes worst if the conflict of interest (as discussed above) exist where support coordination and SIl provision is by the same provider. Managing vacancy is financially draining for providers.
So, this is where the committee is heading towards to increase the safeguards and also to streamline the system.
So how can this all be fixed? Pondering over the recommendations made by the committee, to me an ideal fix would not just focus on participant needs (while it is most important after all) but at the same time a good futureproof system will also give some consideration to support new and existing service providers to adapt to the SIL market and especially managing the vacancy side of things.
I am hopeful that the recommendation made by committee such as having a register of vacancy and setting up a specialist team under NDIA for vacancy management, may provide some assistance to providers in the management of SIL vacancy and an answer towards some of the financial difficulties faced by provider.
HOW – Highlights of recommendations/suggestions
To revamp the fractured system, changes will include transparent and faster processes, provisioning of additional funds in plans to give participants choice to exit SIL and co-residency arragnemnts if they prefer, more individualised funding models, strengthening choice and control by eradicating conflict of interest issues existing by separating SIL, support coordination and tenancy management provided by same provider.
If you are a SIL provider, this is the time to gear up and to develop and shape your processes or business model in a way that may give you a smoother transition in the new upcoming SIL regime. The report mentioning about provisioning additional funding for participants wanting to quit congregate living arrangements with a view to give flexibility also means an inclination towards ILO models.
Now let’s look at the ILO models for an instance, which is focussed on giving a more meaningful connection to one’s life and choice. ILO addresses and tries to strengthen six principles and is a useful starting point for assisting people explore ILO over SIL. These fundamentals are Belonging, Independent living, self-determination, flexibility, choice and trust.
So in conclusion, with changes expected and coming, a thing to ponder for SIL providers is - Will ILO model takes over SIL and is a major focus area of the agency to solve general crisis faced by SIL Disability Accommodation providers and participants in Australia? Certainly SIL will exist for participants with more complex needs as stated in the report however those who need flexibility and little care ILO opens exciting new range of possibilities than conventional SIL models. ILO provides more options and is built around individual choice Options.
We can wait, or proactively be ready and prepared for the changes coming and hope that the future of SIl under NDIS becomes only better for both participants and providers, as the scheme matures.
Written by - Shoeb Patel
A Visionary, A Founder, A Manager, with extensive experience in Disability & Aged Care and a strong academic background in Aged Care Management, Business studies and General Management.
Extremely passionate about creating a society that includes, values and amplifies the voice of people with disabilities and Frail aged
Highly Interested in developing ambitious service delivery models and sustainable organisational structures in public health sector