Flexibility Is Key: Innovative Disability Housing and Support Solutions Beyond the Group Home Model

The traditional group home model has proven to be deeply flawed. This model too often imposes rigid, one-size-fits-all living arrangements that strip individuals of their autonomy and dignity. Despite the NDIS's promise to transform lives, the reality is that many people with disability remain trapped in these institutionalied environments, with minimal improvement in their quality of life.?

In the latest episode of the Summer Foundation Ltd Reasonable & Necessary podcast, we explore innovative alternatives that are not only more inclusive but also more personalized and cost-effective.

This episode features two thought leaders in the field: Sam Bennett, Program Director at the Grattan Institute’s disability program, and Nicole Cox, Executive Director at My Place. Together, they share insights into how we can rethink disability housing and support under the National Disability Insurance Scheme (NDIS) to offer more effective options that? support people to be a part of the community.

Why the Group Home Model Falls Short

As Sam Bennett points out, the current group home model often limits the freedom and autonomy of people with disabilities. Many are forced to live with others they haven’t chosen, under conditions that don’t always meet their needs or preferences. Moreover, the Disability Royal Commission and the NDIS Quality and Safeguards Commission inquiry into supported accommodation uncovered alarming rates of violence, abuse, and neglect in these settings. Despite the NDIS’s promise to be transformative, a new report by the Grattan Institute has revealed that four out of five people who transitioned into the NDIS while living in group homes are still there, with little to no improvement in their quality of life.

The Promise of Individualised Living Arrangements

So, what’s the alternative? My podcast guests Sam and Nicole advocate for individualised living arrangements—a term that encompasses various housing solutions tailored to the unique needs and preferences of individuals. These arrangements offer several key advantages over traditional group homes:

1. Choice and control: People can choose where they live, who they live with, and how they are supported.
2. Cost-effective: While still requiring significant support, these models often reduce dependency on formal, paid support workers, making them more sustainable financially.
3. Community inclusion: Living in ordinary homes within the community, rather than segregated group settings, promotes greater independence and social inclusion.

Nicole Cox’s organization, My Place, has been implementing these approaches for nearly 30 years, supporting over 400 individuals in Western Australia to live independently. She shares compelling stories of how these individualized supports have transformed lives. For instance, one individual named Edward saw his behaviors of concern disappear entirely after moving from a group home to a host arrangement, where he had more control over his living environment.

The Role of Semi-Formal Support

One of the most innovative aspects of these alternative housing models is the concept of semi-formal support. Unlike the traditional model, which only allows for formal (paid) or informal (unpaid family members or carers) semi-formal support involves arrangements where people with disabilities are matched with individuals who might provide housing, companionship and help with household tasks. This model allows the person to use their funding flexibly to compensate semi-formal supporters through rental contributions and subsidies.

The Grattan report argues that semi-formal support offers cost savings and also fosters more natural, meaningful relationships between people with disabilities and our supporters. While these models are already possible under the current NDIS framework, they need greater promotion and support to become more widely adopted. “We need to stop this being something people struggle to do, as opposed to something that they have help to do,” Bennett emphasises.

Why Have Individualised Living Options (ILOs) struggled in the NDIS

In an effort to offer more tailored and dignified living arrangements, the National Disability Insurance Agency (NDIA) introduced Individualised Living Options (ILOs) in 2020. These ILOs were designed to fund personalized housing and support arrangements, providing a flexible alternative to the rigid group home model.

However, the report by the Grattan Institute revealed that uptake of ILOs has been disappointingly low. As of December 2023, only about 1,700 people had the ILO line item in their plan budgets, a stark contrast to the more than 51,500 people funded through Supported Independent Living (SIL) or similar arrangements. Moreover, the actual number of people receiving ongoing ILO support is likely even lower, as many have only been funded for the initial exploration and design of their arrangements, not for sustained service delivery.

So, why haven’t ILOs succeeded in transforming disability housing as intended?

Several factors have contributed to the limited success of ILOs:

1. Financial Disincentives: In 2020, the NDIA made the decision to stop indexing ILO payments. This means that over time, the funding available through ILOs has not kept pace with inflation and rising costs. Providers are forced to maintain housing and support services on increasingly tight margins, making ILOs less attractive to both service providers and individuals with disabilities. As a result, many people with disabilities have been dissuaded from pursuing ILOs, turning instead to more flexible funding options like SIL or Assistance with Daily Life funding.
2. Administrative Burdens: The ILO funding process involves two main phases: Exploration and Design, followed by the Support Model phase. However, only about 55% of participants who start in the Exploration and Design phase make it to the Support Model phase. This low conversion rate can be attributed to the extensive scrutiny and administrative hurdles involved in the ILO process, which adds complexity and delays for both participants and providers. These challenges further diminish the appeal of ILOs as a viable housing option.

Flexibility is essential for high-quality and less costly support options

As Australia continues to grapple with the challenges of providing quality housing and support for people with disabilities, it’s clear that we need to explore innovative individualised solutions. Semi-formal support can't replace all formal supports and it won't be suitable for everyone. However, increasing the flexibility around how NDIS supports can be used, including the use of NDIS funds to subsidise flexible arrangements will enable high quality and less expensive options to be explored. The new legislation and support lists must enable and not further restrict effective arrangements.

This podcast episode is a must-listen for anyone involved in the disability sector, from policymakers to service providers to families. It’s a call to action to rethink how we support people with disability, ensuring that we have the choice, control, and community connections that we need for a good life.

?? Tune in to the full episode of Summer Foundation’s podcast Reasonable & Necessary to learn more about these game-changing approaches to disability housing and how they can be implemented in Australia.

What changes do you think are needed to support people to develop innovative housing and support solutions? Please let me know in the comments.

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