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A more diverse and innovative range of inclusive housing and living supports

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Too few housing and living arrangements are fostering more inclusive and connected lives

There has been little innovation in housing and living supports, and increases in supply of Specialist Disability Accommodation (SDA) have been slow and have not always met the needs of participants.

Outdated group homes still dominate the system and, despite pockets of innovation, service models appear relatively unchanged - leaving participants with little choice. At the end of June 2023, over half (55 per cent) of SDA enrolled places were in either group homes with four to five residents or legacy stock (dwellings designed for six or more long-term residents).168

A decade into the scheme, many participants who transitioned from previous disability service systems have not been given the same opportunities for more contemporary housing and living support arrangements as new participants. Close to four out of five participants receiving 24/7 living supports transitioned into the scheme from previous disability systems. These transitioned participants were almost twice as likely to have funding amounts equivalent to sharing support with more than two others (22 per cent compared to 13 per cent). For participants funded for 24/7 living supports residing in SDA, indicatively, more than two in five (44 per cent) transitioned participants lived in ageing SDA, compared with fewer than one in five (17 per cent) new participants.169

While there are pockets of innovative dwelling design, we have found there are barriers to greater diversity and innovation in the delivery of housing and living supports.

Providers have incomplete and inadequate information on best practice housing and living supports, and there is limited understanding and knowledge translation of alternative, contemporary housing and living support models. Constant reforms over the last decade have diverted providers from investing time and focus in improving their service models.

We have heard individualised funding and payment approaches do not always align with the shared nature of delivery of housing and living supports, or give incentives for providers that align with good outcomes for participants and a sustainable scheme.

The NDIS’ individualised pricing structure works poorly in shared living arrangements. It prevents providers from investing in shared costs to support safety, as spending must be tied to an individual’s plan. It makes funding for supported living unpredictable, as one participant’s withdrawal from a provider can undermine the viability of supports of other residents they live with. It leads to unstable rosters that impact the ability to recruit and retain staff, and as a result, staff vacancy rates have never been higher.

- Health Services Union170

We have also found current rules and procedures have led to unintended consequences. For example, we have heard about the challenges with getting home modifications for private rentals. In determining value for money for home modifications, the National Disability Insurance Agency (NDIA) takes into account whether tenure is secure and there is written approval from their landlord. We have heard that even when landlords are amenable to a tenant making modifications, obtaining support for modifications through the NDIS can be difficult.

Members have consistently reported struggles with lengthy wait times, overpriced quotes on housing modifications as well as modifications not being approved to stay where they are, which again, leads to a lack of choice and control in their living situations, not to mention safety issues and difficulty with completing everyday essential tasks. It creates housing insecurity, without a long-term view of modifications that can change over time as people’s needs change.

- Queenslanders with Disability Network171

We have also heard about unintended consequences of current rules within Supported Independent Living (SIL) arrangements. Currently, a participant can voluntarily exit a shared SIL arrangement with 14 days’ notice. But SIL providers cannot claim vacancy payment. This can lead to an overall reduction in the amount of support offered to the remaining participants for the duration of the vacancy and create perverse incentives for providers to fill the vacancy quickly, without regard to the preferences of the existing residents.

Filling a vacancy successfully can take some time and organisations work through a carefully considered framework which can often take months.

- Anonymous 172

The SDA market is still maturing, but has achieved much to date, attracting a large amount of private investment and increasing the supply of specialist accommodation. Nevertheless, there is a mismatch in demand and supply. Utilisation of SDA funding is also low, and at the same time, many SDA dwellings sit vacant. As a result, the SDA market is not yet delivering the right homes in the right locations.

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Participants not eligible for SDA face difficulties accessing accommodation

Access to suitable and affordable accommodation is particularly difficult for participants sharing living supports and who do not have access to SDA.173 They get little support to locate accommodation appropriate for sharing supports.174 Despite recommendations from numerous reviews and inquiries, there remains concern about ‘client capture’ where housing and support continue to be provided by one provider.175 Closed system ‘SIL homes’ have emerged leading to more, rather than less, integration of housing providers and living support providers.176

In our region new unregistered providers are starting up businesses, renting private homes that are not modified or fit a person's needs and taking in SIL participants with high plan funds. What happens when the rental agreement finishes, where are these people to live in this housing crisis? These providers will cease supports and they will have nowhere to live.

- Parent 177

More broadly outside the NDIS, there is a lack of accessible and affordable housing in Australia. This has a disproportionate impact on people with disability, particularly those with high support needs, who are more likely to have fixed or low incomes.

Most general and social housing stock is not fit-for-purpose for people with accessibility needs. There are inconsistent residential tenancy rights for participants across different dwelling types. Widespread adoption of the Livable Housing Design Standard in the National Construction Code would improve accessibility of the general housing stock. But roll-out will take time and not all states have signed up.

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