Why Australia should look west on disability policy
by Sam Bennett, Hannah Orban
The NDIS could learn a thing or two from WA.
For decades, WA has led the country in innovative services for disabled people.
WA invented local area co-ordination, which was picked up (and some would say, mangled) by the NDIS.
WA introduced individualised funding before the National Disability Insurance Scheme was even a thought in Federal Parliament’s mind.
WA’s deliberate policy choices over decades has led to a reduction in group homes for severely disabled people. Instead, many people with severe disability in WA live in the broader community in ordinary homes with a range of innovative support arrangements.
And now under the NDIS, often in spite of the system rather than because of it, pioneering providers in WA continue to set the standard in innovation for the people with severe disability who often need around-the-clock support.
Not so in the rest of Australia.
Most Australians with severe disability who need housing and intensive living support have few, if any, options.
Most live in group homes where they have little choice about their daily life: who they live with and who provides them with support. Last year’s disability royal commission also heard extensive and distressing testimony that showed violence, abuse, neglect, and exploitation are common in group homes.
Four out of five people living in group homes in Australia were transferred from State-run disability services into the NDIS when it was set up more than a decade ago. Sadly, they have seen little improvement so far from a scheme that was supposed to transform their lives.
In our new Grattan Institute report, Better, safer, more sustainable: How to reform NDIS housing and support, we call on the Federal Government to follow the lead of WA and introduce more innovative approaches, so all disabled Australians can get the quality services they deserve.
Our research found that these kinds of approaches, known as individualised living arrangements, are a win-win because they mean that people with profound disabilities can live better and safer lives without costing the Government any more money.
The key is to include what we call “semi-formal support” in their NDIS packages. This can mean support from a housemate or a host family, a good neighbour or a mentor, who get a subsidy for providing support to the disabled person they take into their home, such as companionship, cooking, cleaning, and being available in emergencies.
This kind of support doesn’t replace the need for good, skilled disability support workers, but when it forms part someone’s NDIS package, there are considerable benefits — for the individual and for taxpayers.
It helps make the package cost-effective, but it also means disabled people can be more connected to their local community and have more people looking out for them, which is a natural safeguard against abuse.
Better still, when people have a mix of semi-formal support and paid support, individualised living arrangements can cost the same or less than a group home.
Group homes are popular with governments and service providers because they allow people with disability to share support. It is much more cost-effective for three people to split the cost of a support worker under one roof, than for them to live alone and pay for one support worker each.
The problem with group homes isn’t the economy of scale they offer in sharing supports; the problem is their institutional culture, which means people with disability don’t always get to decide how their home and lives are run.
We recommend practical reforms so that people with disability who want to live together and share support can do so, while getting the help they need to exercise their choice over their home life, including who they live with, who supports them, and the rhythms of their day.
Our report calls on the Federal Government to phase out big, institutional group homes over the next 15 years. It should establish a dedicated innovation fund to trial and spread individualised living arrangements and to pursue other forms of innovation, including assistive technologies, to improve the home life of disabled people.
Any government that wants to get the NDIS back on track has to get it right for people with the most severe disability. The evidence shows that WA has the blueprint for success that the whole NDIS should follow.