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Supported Independent Living: Broke or Broken?

SIL participants and providers have been pushed to the brink over recent years. Our resident home & living experts explore the pressure cooked escalation and consequences.

By Rebecca Brissett and Brent Woolgar

Updated 15 Apr 202414 Apr 2022

The concept behind Supported Independent Living (SIL) didn’t originate with the NDIS. For many years, providers have been delivering the support within complex systems that are often poorly funded and with a structure determined by funding bodies. When the NDIS came along and categorised supports in the home, SIL was the category most closely aligned with the block-funded model. The NDIA used “SIL” and its quoting tools primarily to enable the transfer of state- and territory-supported accommodation residents into the national Scheme. 

Over time, SIL has evolved from being a service strictly for people who shared their 24/7 support in a group environment into a tool focusing more on how support in that environment is reimbursed. But with its original intent in mind and pressure applied in the right places, SIL was full of endless dreams and potential for people who had been disadvantaged for far too long.

Today, SIL has evolved into an unwieldy beast that the NDIS prefers would just go away. At least, that is the sentiment of a growing number of service providers and participants who are weathering the constant barrage of changes and reductions imposed on SIL to tame it.

Unless you have been living off the grid or have made a conscious decision not to alarm yourself by reading the plethora of reviews, inquiries, consultations, and reports on SIL, you will already know that there have been many such exercises in recent times. The highlights include:

  • Joint Standing Inquiry into Supported Independent Living, May 2020
  • Restructure of SIL funding and prices, July 2020 
  • Review of Supported Independent Living (SIL) Price Controls Issues Paper, August 2020
  • NDIS Provider Consultation: Improving Outcomes for Participants Who Require Supported Independent Living (SIL), September 2020
  • NDIA Participant Family and Carer Consultation: An Ordinary Life at Home, June 2021
  • SIL Operational Guideline and Provider Guidance, November 2021 

Given the above list, it is evident that SIL is very much front of mind for the NDIA. The reasons for this are outlined in some of the Council of Australian Governments (COAG)  NDIS Quarterly Reports from 2020 and 2021. 

The Quarterly Reports show that the average annualised SIL payment climbed exponentially until Q4 19-20, when the changes to SIL funding announced in July 2020 (but implemented much earlier) appear to have taken effect. Still, the most recent Quarterly Report notes a total committed SIL spend of $8.992B, or 26% of the total NDIS committed spend – and that’s for only 5% (25,954) of the total NDIS cohort (see Tables P.1 and P.2).

It’s clear that SIL funding was left to grow out of control for several years, and we must highlight that this was not entirely the NDIA’s fault. A minority of providers noticed that nobody was minding the store and took advantage of the out-of-control growth. They enjoyed solid returns while having to do very little, if anything, to adjust their services to the new consumer-led model. It looked and felt like nothing had changed from the old block-funded models apart from a few additional spreadsheets and – despite all the fear-mongering – returns were stronger than ever.

However, the ballooning figures cannot be solely attributed to overspending and the failure of the expected transformation of SIL providers to materialise. On the ground, there were too many stories of reduced capacity building and community participation budgets, with expectations that SIL should pick up the slack. The Roster of Care tool was also too closely aligned with the block-funded model to stray beyond it, particular if the planner or support coordinator had history in the sector and assumptions about what was reasonably included in an SIL support. 

Is it surprising that we now find SIL in the crosshairs after such a pressure cooker escalation? The NDIA is now well into the process of controlling the issues with what can only be described as a slash and burn approach. DSC is hearing of widespread, unpromoted, unplanned, and unexpected reviews of participants’ SIL funding across most regions of Australia. In some cases, these reviews are not just fine-tuning the funding – we are talking about reductions in funding of 50% or more, with no notice and no consultation. There is now also no recourse for many participants as the NDIA has closed the door on providers communicating with them regarding SIL. DSC is fielding new requests for assistance every day, many of which centre on issues of participant and support personnel welfare rather than provider viability and Scheme sustainability.

It would be wonderful to assume that the forthcoming Home and Living Policy will provide the answer to this madness, but it can be assumed that the next few years will only offer more of the same. The proposed Home and Living funding process will see participants approach providers with predetermined support budgets after undergoing what is frighteningly similar to an independent assessment. And from what we have witnessed over the last six months, these budgets will be grossly unaligned with the participant’s current situation, let alone having any consideration for the viability of the support model. 

What does this mean for the future of SIL?

Recently, the Minister for the NDIS announced the “Making SIL Better” campaign. Many providers were counting on this announcement to end or at least explain the ongoing chaos.  The provider briefings have outlined the first round of material changes as being:

  • A weekly claiming option will be available to curb the administrative burdens. However, this option will not be the default and will need to be a part of the negotiation process with participants. The maximum weekly claim amount will also be stated in the NDIS plan.
  • The Roster of Care will still be used for communicating material changes in support needs or as part of a participant's first plan with SIL.
  • In limited circumstances where a participant has an unplanned exit from a home, the provider may claim for up to 4 weeks' payment.
  • If a participant's support ratios have decreased or their support intensity has reduced, the NDIA will provide a minimum of 12 weeks at the previous level of funding to assist with the transition

Further details will be announced on the 19th of April, and additional provider briefings will be scheduled covering each of these main changes. While some of these changes will indeed reduce some pressure, they do not promise an end to the current funding reductions or a real shift in the way SIL is working at an operational level. 

There is no doubt that supports in the home need to be restructured to align with NDIS principles and become financially viable and accessible for the sake of participants, providers, and the overall sustainability of the Scheme. The introduction of Individualised Living Options (ILOs) and even the pandemic have driven innovation light years from where we were three years ago. Excitement is building in the sector that advancements in technology may provide an alternative to the heavy reliance on person-to-person support and its inherent invasiveness. We have already seen the brands of Home and Living supports falling away, with people living in “SIL” homes who are no longer eligible for SIL but have flexible core budgets that meet their needs and are more portable to facilitate changes through life stages and development. This individualised, flexible support budget approach will undoubtedly open countless opportunities for innovation and enable outcomes that have previously been blocked by rigid ideas of service boundaries and petty squabbles about whose job it is to absorb risk.

DSC has been privileged to be included in the transformations of many providers seeking to restructure their operations. If adopted en masse, these changes will benefit the sector and the sustainability of the NDIS well into the future. Disappointingly, however, 2022 has seen this progress stall as it becomes harder and harder to sustain the motivation and momentum to change when such dangerous practices are diverting attention from the need to fight a system that appears to have retreated behind closed doors.

 The questions that remain for us right now are as follows:

  • Will it be left to the sector to continue to highlight the risks of significant participant funding changes via appeals and emails?
  • Will the Quality and Safeguards Commission finally see the alignment between funding and the standard of support and step into the conversation? 
  • Or will we be left with a sector in ruins and people with a disability the victims of a Scheme that may have strayed too far from its principles to return to them without a significant shakeup?

Authors

Rebecca Brissett
Brent Woolgar

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