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The Home and Living Section of the NDIS Review is the equivalent of the Supporting Actor and Actress Oscar winners. Hear me out. Those Oscar winners may be on screen for a fraction of the time, but their impact is significant and memorable, and movie-goers and Oscar watchers like me will never forget them.
The Home and Living Section of the Review is just eight pages long, has three major principal recommendations, and has 28 actions required of the federal government. These statistics could indicate that the section took a minor supporting role, but its substance and potential impact, if implemented, affects the entire Scheme. Home and Living supports are designed for the participants with the highest level of need, so any conversations about the future of the Scheme and its financial viability must address Home and Living policy.
The Panel believes this aim can be achieved by:
- providing more consistent funding for people who require 24/7 support
- conducting a review of the SDA design categories
- the mandatory separation of SDA and Support
- nationwide compliance with the National Construction Code
- a more significant role for the Quality and Safeguards Commission in maintaining high standards of service delivery.
These are all only recommendations at this point. We are waiting for the government’s response, which we can probably expect in coming months. And if recommendations are accepted, there will still be a lot of work and consultation to be done before they can be implemented.
Many of the Review’s suggested changes in these areas have been on the horizon for a while, with much of this Section of the NDIS Review echoing the development of a new Home and Living policy by the NDIA. The general principles outlined in the Consultation Paper for the policy, and the Review’s recommendations echo one another.
Both documents identify the same critical flaw in the Home and Living market. If you have skin in the Home and Living game, it’s essential to take the time to examine all of the recommendations and actions. Let’s look at the main policy challenge in this area and two significant changes that the Independent Review Panel proposes to fix.
The Core Problem
The most telling sentence summarising what the Review sees as the core problem in the home and living space, is on Page 146 of the NDIS Review Report. It states:
“Providers have incomplete and inadequate information on best practice housing and living support, and there is a limited understanding and knowledge translation of the alternative contemporary housing and living support models.”
The Panel concludes that providers and participants have yet to understand the full potential of how Home and Living works. Often, the concepts of Home and Living are siloed from one another, and when they are combined, there is confusion for all involved.
So, what’s the solution?
The Panel’s vision articulates that greater choice and control in Home and Living should be exercised by participants so that they can have more say as to how they can spend their Home and Living Budget to suit their needs.
The solution articulated by the Panel is a two-tiered approach. The priority is to ensure a better user experience for the participant, but another goal, as in other areas of the Scheme, is to reduce costs. Such changes could allow the Agency and the government to control the cost of daily living support, which has been a concern for many years. However, despite the need for clearer rules on how budgets are set, the flexibility to amend them when required is still a feature of the proposed pathway. Budgets can change if there is a discussion with the participant and the Home and Living Navigator (Navigators are a new role that the Review proposes eventually replace Support Coordinators, Psychosocial Recovery Coaches, Plan Managers and Local Are Coordinators).
A New Budget Pathway
The centrepiece of the proposed reforms is a specialised Home and Living planning process, which is framed as a ‘…new budget setting pathway for those who require 24/7 living support needs’.
The proposed ‘budget setting pathway’ is a four-step process:
1. Pre-Budget Setting: a person is delegated to a Home and Living specialised pathway. If a person desires to explore or change living arrangements, a Navigator would refer them to a Home and Living Navigator. The Home and Living Navigator takes the responsibility of guiding the person through the planning process.
2. Needs Assessment and Budget Setting: including a specialised assessment by trained professionals specialising in home and living to ascertain customisable support options. These can include options for Specialist Disability Accommodation (SDA), Short and Medium Term Accommodation (STA & MTA), Individual Living Options (ILO), Supported Independent Living (SIL), and assistive technology. These items would be considered when developing a plan and reflected in an entire home and living budget.
3. Exploring and Securing Supports: Setting a budget that the participant has to work within. Home and living would be one of the three budget categories in a plan, along with flexible budget and one-off capital. The participant nominates their preferred living arrangement. This could include shared support options, likely to be deployed where support is required overnight, and where multiple participants live in a shared or co-located dwelling. The panel recommends a default setting of a 1:3 support ratio for people who require 24/7 support. But the Report also says that living arrangements should be determined based on comprehensive assessment processes.
4. Maintaining Supports: participants would be regularly checked in with by their Home and Living Navigator, with the participant and the Navigator evaluating the success of the support and negotiating any changes.
With this suggested planning process, the Independent Review Panel and the NDIA are on the same page. The Consultation Paper for a new Home and Living Policy proposed similar changes, even deploying the same ‘Navigator’ term. The Consultation Paper and the NDIS Review Report agree that the funding process needs to change and become more transparent.
Although changes to planning processes for Home and Living have been slow, the messaging and signposting have been consistent. Implementation of these processes will, however, become the next challenge.
Changes to SDA
The other main area of concern for the Independent Review Panel is the performance of the SDA market. While the mainstream property market’s challenges are widely known, their impact on the SDA market has been amplified. The Independent Review is blunt in suggesting, that, in their opinion, the SDA market does not function as intended.
They suggest a significant change to the SDA Design Categories by removing ‘Improved Liveability’, one of the four Design Categories currently in use. The Panel believe that the Fully Accessible design category already achieves the outcomes intended by the Improved Liveability category. In its place is a new ‘low cost’ category with minimal speciality features designed to curb the presence of ‘…close system SIL Homes operated by providers.’ These changes would represent a significant paradigm shift in how investors, providers and participants approach the SDA market, if implemented.
SDA investors and property developers typically need long lead times over multiple years to determine what Design Category new builds will fall under, and then to build those properties. Different Design Categories use different cost models, and must be built based on the access needs of people eligible to live in those properties. Consequently, investors and providers who have already decided to build under Improved Liveability specifications several years ago, may be implicated by this change, depending on how/if it is implemented and over what timeframe.
The Report also calls for more flexible pricing of SDA to help support more accommodation being developed in locations where participants want to live, in order to maintain community connections, and access to informal support networks. It is worth noting that the SDA Pricing Review, released at the end of last year (after the NDIS Review consultation had closed), has already begun this process. Most of the recommendations in the NDIS Review would continue the work already started by the NDIA to encourage additional investment in properties.
Conclusion
One way or the other, changes are coming to Home and Living. Should the NDIS Review recommendations be implemented, it will supercharge processes that the NDIA had flagged previously. The long-promised Home and Living Policy was already heading in the direction of the NDIS Review. Their suggested changes to SDA are bolder, but propose solutions to problems the NDIA have already identified.
Home and Living may not be taking the lead role in the NDIS Review, but it’s destined to play a flashy supporting role the disability sector won’t forget.
Artwork by Melissa Pym: Melissa’s linktr.ee
