Ndis

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GUEST OBSERVATION
For the National Disability Insurance Scheme to be successful, our cities will need to change.
Our new research explores the impacts that the NDIS is having on Australia’s cities.
A major goal of the NDIS is to improve participation in mainstream services by people with disability. The success of the scheme will depend on how well it achieves this.
But the responsibility for change should be shared far more broadly – mainstream services must actively transform themselves to become more inclusive.
Functioning cities rely on a variety of health, education, welfare, sports and community services. These services are essential to the wellbeing and social inclusion of diverse people in our cities.
But despite being called “mainstream”, these services are never equally open to all members of society. Relentless privatisation of previously public programs and facilities has arguably undermined their capacity to provide services to users with “challenging” or “costly” needs.
The chair of the National People with Disabilities and Carer Council, Rhonda Galbally, has observed: 
"For many years people with disabilities found themselves shut in — hidden away in large institutions. Now many people with disabilities find themselves shut out — shut out of buildings, homes, schools, businesses, sports and community groups. They find themselves shut out of our way of life."
To ensure people with disability are included in our way of life, mainstream services and the wider community, along with the NDIS, will need to contribute to reshaping our cities.
When accessibility fails, people are shut out
People with disability face particular barriers to participating in mainstream services. Under Australian law, newly built or upgraded public spaces and premises must meet national accessible design standards. But even facilities designed to be accessible will fail in this if they are not well managed.
Frequently closed accessible checkout lanes at the supermarket and accessible toilets that are kept locked or used for storage are common examples of poor management.
Matters of accessibility are often discussed in relation to wheelchair users. However, people with disability are a diverse population and experience many forms of exclusion.
For example, communication barriers arise when information needed to use a service is not presented in comprehensible ways. The pace of activity in mainstream spaces is another potential barrier that can make people with disability feel unwelcome and excluded.
Staff in mainstream services are often unskilled in providing service to people with disability. This can prevent people with disability from using a service, leading to poor and even harmful outcomes. One recent example is the evidence of overprescription of antipsychotic drugs to people with intellectual disability in mainstream health services.
Can the NDIS alone deliver on the promise of participation?
The NDIS will fund a wide range of specialist disability services, but “wherever possible” will help participants access mainstream systems. This includes training and personal assistance to build participants’ capacity to use these services. The majority of NDIS participants’ plans include funding assistance for access to mainstream services.
In addition, the NDIS will seek to “encourage mainstream services and community organisations to become more inclusive”.
The NDIS thus has a critical role to play in enhancing mainstream participation. It will be important to collect evidence about the effectiveness of its interventions. However, meaningful change will only occur if mainstream services themselves take action to become more inclusive.
It is not enough for services to avoid direct and intentional discrimination. It is also not enough to passively “accept” people with disability as service users. Mainstream services providers need to initiate internal changes to become more inclusive of people with disability.
Services will have to ensure staff are skilled up, redesign spaces and revise approaches to communication. Service users without disability will also need to adjust the ways they participate in services.
The most meaningful participation will be achieved when people with disability and those close to them are actively engaged in planning these changes and exerting their “right to the city”. In addition, a body of research evidence on inclusive adjustments in mainstream services will need to be built.
Most of these changes and challenges will occur in Australia’s cities. But the task will be no less challenging in regional areas where services are often undersupplied and geographically distant. Local and state governments have a critical role to play as funders, providers and regulators of mainstream services, to lead and drive these adjustments.
Many mainstream services are already badly underfunded and under pressure from competing demands from diverse users. Rather than compete with each other for scarce resources, alliances of users with and without disability must campaign together to revive the public services sector and make it more inclusive for all Australians.
Legislation will also need to be reviewed. Current law requires services to make minimal “reasonable” adjustments in order to avoid discrimination based on a person’s disability. More progressive legislation would require mainstream services to make exceptional adjustments so that people with disability are treated as equals while their differences are recognised and accommodated.
If the NDIS, governments, services and the wider community all play their parts, people with disability will experience greater participation in their community. This will enrich not only their lives but those of others. Australian cities and regions would benefit from the contributions of people with disability to their social, cultural and economic vitality.
Ilan Wiesel, Lecturer in Urban Geography, University of Melbourne
Brendan Gleeson, Director, Melbourne Sustainable Society Institute, University of Melbourne
Carolyn Whitzman, Professor of Urban Planning, University of Melbourne
Ellen van Holstein, Research Fellow in Urban Geography, University of Melbourne
Christine Bigby, Director, Living with Disability Research Centre, La Trobe University
This article was originally published on <a href="http://theconversation.com" target="_blank">The Conversation</a>. Read the <a href="https://theconversation.com/we-cant-just-leave-it-to-the-ndis-to-create-cities-that-work-to-include-people-with-disability-93419" target="_blank">original article</a>.
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j.ballantyne1990-6AQqhLzZaK

We can't just leave it to the NDIS to create cities that work

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GUEST OBSERVER
Funding for Specialist Disability Accommodation (SDA) under the National Disability Insurance Scheme (NDIS) is expected to support 28,000 people, 6% of all NDIS participants. However, the NDIS has provided limited information about the demand for this specialist housing. Now a newly published study has found the existing supply of SDA needs to grow by 60% to house the 28,000 people the NDIS expects to fund.
The report identified another 33,200 people with very high support needs who “may require SDA on top of the 17,500 already in this form of housing. Of these 33,200 people, 6,200 people are under 64 residing in aged care.”
These are among the insights revealed in the government-funded report by the Summer Foundation, the Australian Housing and Urban Research Institute (AHURI) and SGS Economics &amp; Planning.
It is important to understand the nature and scale of demand, given that SDA is expected to account for NDIS spending of A$700 million a year when the scheme is fully implemented. The transformation from grants-based funding to a market-based system in which people with disabilities control their own funding is predicted to create a A$5 billion disability housing market over the next five years.
What is SDA?
Specialist Disability Accommodation ensures the housing requirements of people with extreme functional impairment or very high support needs are delivered.
SDA payments cover a wide range of housing options, depending on the individual’s needs. By including the payment in the individual’s support plan, the person with disability should have choice and control over where they live and who they live with.
Of course, this depends on a fully functioning, mature and competitive market in which providers compete to provide housing to NDIS participants. SDA payment rates have been set to cover the cost of capital and to incentivise a new market.
What are the key findings?
Comparing existing SDA places with the NDIS’s current projected demand across the country, the study found the supply of such housing needs to grow by 60%. The largest required rate of increase, 120%, is in the ACT. New South Wales requires the most new SDA places (3,290).
The study found the greatest demand in locations with the highest population growth. As an illustration, in southwestern Sydney, the NDIS is expected to increase the current 137 SDA places to 492. That’s 360% growth in disability housing in the area.
The results highlight the differences in people living in current SDA (mainly government-funded group homes) and the population representing the potential demand for SDA.
People in the potential demand group have a far younger age profile. More than two-thirds are under 45 years and half of them are under 34. People now living in SDA have a median age of 42.
The potential demand group also has a very different disability profile. Those living in SDA are predominantly people with intellectual disability. The potential demand group still has a significant proportion of people with intellectual disability, but physical and neurological disabilities become more prevalent. This profile suggests the future SDA cohort will need much more highly accessible housing.
The qualitative component of the study highlights that people who are eligible for SDA have aspirations for housing that is very different from where they live now. Their housing preferences are unlikely to be met by the dominant group home model – most want to live on their own or with friends in a share-house arrangement.
This highlights the need for apartment-style living where people can live independently in their own home with easy access to on-site support.
NDIS pricing encourages these developments. It will provide more than A$107,000 a year for a two-bedroom apartment in addition to the NDIS participant’s rent contribution.
What do the findings mean for policy?
This study provides much-needed insights into the SDA market, which will help potential providers better understand future demand.
However, the study’s predictions of the amount of new SDA housing to be constructed are likely to be underestimates. The study’s underlying assumption is that the current stock will continue to provide housing. In practice, much of the existing SDA stock will need to be redeveloped or replaced to be competitive in a market-based system.
The decommissioning of old stock will also help Australia to meet its obligations under Article 19 of the UN Convention on the Rights of Disabled Persons. This states: 
"Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement."
Group home living arrangements are inconsistent with this because they force people with disabilities to live with others who, in most cases, they have not chosen.
Recent government inquiries have also shown that group homes are rife with abuse and neglect. Last year over 100 academics wrote an open letter to the prime minister in support of a royal commission into the abuse, with some calling for group homes to be phased out.
When the NDIS is fully rolled out and participants have the freedom to move out of outdated and segregated group homes, they will be seeking a very different type of housing arrangement than they were forced to endure before the NDIS.
This report shows that developers have a significant opportunity to capitalise on the unmet demand. They can achieve sizeable returns while also having a positive impact on the lives of people with disabilities.
How was the study conducted?
In the absence of official NDIS data, the Summer Foundation study analysed data from state-funded disability service systems. The Australian Institute of Health and Welfare (AIHW) compiled this data in the Disability Services National Minimum Data Set. The analysis used data from before the transition of most areas to the NDIS, providing a comprehensive snapshot of people using state-funded disability services.
Likely shortfalls in SDA supply were modelled by distributing the expected supply of 28,000 NDIS-funded accommodation places and comparing that to current populations. In addition to identifying areas with major shortfalls, the analysis modelled potential demand from existing service users with very high support needs who were living in other settings, mainly the family home with ageing parents. This included young people living in nursing homes.
George Taleporos, Adjunct Senior Research Fellow, Living with Disability Research Centre, La Trobe University
<img src="https://counter.theconversation.com/content/93479/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1">The author wishes to acknowledge the contribution of Robin Zakharov, senior policy adviser at the Summer Foundation.
This article was originally published on <a href="http://theconversation.com" target="_blank">The Conversation</a>. Read the <a href="https://theconversation.com/ndis-needs-the-market-to-help-make-up-at-least-60-shortfall-in-specialist-disability-housing-93479" target="_blank">original article</a>.
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NDIS needs the market to help make up at least 60% shortfall in specialist disability housing: George Taleporos

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<img src="https://counter.theconversation.com/content/83144/count.gif?distributor=republish-lightbox-advanced" alt="The Conversation" width="1" height="1">
GUEST OBSERVER
Housing for people with disability is being transformed from grants-based funding to a market-based system where people with disabilities control their own funding.
This market has the potential to grow in size by around A$5 billion over the next five years in the National Disability Insurance Scheme (NDIS).
PwC and the Summer Foundation recently released a paper called NDIS Specialist Disability Accommodation: Pathway to a mature market. The paper provides a vision of a mature, properly functioning disability housing market and outlines the pathway to reach it. 
<h2>The importance of getting this market to work</h2>
Creating housing is one of the most important tasks for the NDIS. It’s especially important for the young people living in aged care and the adults with disability living with ageing parents. 
More than 6,200 young people are living in aged care, with 2,000 young people entering aged care annually. In some parts of the country, young people occupy more than 20% of all aged care places. 
The NDIS has the resources and mandate to fix this problem through the Specialist Disability Accommodation (SDA) payment policy. The NDIS has an annual recurrent budget of $700 million for SDA. This housing funding is designed only for people under 65 with very high disability support needs. This equates to around 6% of NDIS participants – 28,000 people.  
<a href="https://www.propertyobserver.com.au/images/2017/09/15/Screen%20Shot%202017-09-15%20at%209.41.12%20AM.png" target="_blank">Click to enlarge</a>
<img src="https://www.urban.com.au/images/2017/09/15/Screen%20Shot%202017-09-15%20at%209.41.12%20AM.png" alt="">
The SDA policy is ambitious. The value of all SDA properties across Australia is expected to total around $11.5 billion. The breakdown would be:
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$2.5 billion to create housing for the 6,000 young people in aged care;
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$2.5 billion to create housing for others with unmet needs for SDA; and
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$6.5 billion to replace, refurbish and manage disability housing stock that existed prior to the NDIS. 
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<h2>How this market works</h2>
The PwC and Summer Foundation paper provides a vision for how this market will operate once it is mature. 
The report shows how funding for housing provided directly to people with disability creates a user-driven market. People with disability will be empowered to decide where they live and who they live with. 
NDIS participants with high support needs will receive annual funding to pay for the cost of their housing. The SDA payment is calculated based on the dwelling’s location, size and level of accessibility. The housing payments are designed to cover the costs incurred in providing the bricks and mortar and offer a return on investment at market rates (5-12%).
Critically, the provider bears the vacancy risk should they fail to find a tenant – only when the dwelling is occupied are SDA payments made. In this competitive SDA market, housing providers will compete to deliver the best outcomes for tenants, which include being close to shops and transport.
<h2>Progress over the past year</h2>
The government and the National Disability Insurance Agency (NDIA), which oversees the NDIS, have done a tremendous job in setting up this new funding stream. The new SDA rules under the NDIS Act took effect in March 2017. We are moving from policy design to implementation. 
We now need to make sure that this well-funded and well-designed SDA payment delivers new housing on the ground. 
The market is responding, with NDIS housing being built in cities across Australia. Large retail banks and superannuation funds are reviewing SDA transactions. Large developers are including SDA builds in some new developments. 
Summer Housing (Summer Foundation’s sister entity) opened ten new SDA apartments in the Hunter Region of New South Wales in mid-2016. Contracts were recently signed for another ten apartments designed for people with disability throughout a 77-apartment development built by Grocon in Fairfield, Melbourne. 
Summer Housing aims to build 300 apartments through SDA – meeting the needs of less than 5% of all young people in aged care. 
<h2>What will it take to meet the need more quickly?</h2>
Over the next five years, 16,000 new or refurbished SDA places are needed. Around 650-700 new SDA places were created or commissioned in the past 12 months. Only 250-300 of these are for unmet demand. The remaining 400 are to rebuild existing, outdated government disability housing stock. 
The market needs to reach scale more quickly. The NDIA and government need to listen to and actively steward this fledgling market. 
The government sector can do three things to accelerate progress toward a mature market: 
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The federal government can provide certainty to the market about how long these prices are guaranteed for and how any price reviews occur. 
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The NDIA can provide regular and good-quality information on demand for SDA. 
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Local and state governments can mandate targets for SDA in major developments.
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Beyond these actions, there is the potential to link SDA with the federal government’s commitment to support a strong Social Impact Investing market in Australia. Social impact investments generate measurable social outcomes, while delivering a financial return to the investor. 
Robust evaluation and evidence-based decision-making are integral to social impact investing. The NDIS approach will provide solid evidence that well-located housing with accessible design and technology will increase the quality of life and independence of NDIS participants, thereby reducing the NDIS’s lifetime care costs and liability. 
The SDA market has the potential to demonstrate how government can leverage large amounts of capital from superannuation to fund other forms of affordable housing.
<h2>Laying the foundation for a revolution</h2>
For people with the highest levels of disability, the NDIS housing payment will bridge the gap between what people with disability can reasonably afford and the cost of building highly accessible housing. 
This policy lays the foundation for developing the range and scale of housing needed to resolve the issue of young people in nursing homes in Australia. 
The next step is for government to work with stakeholders in the market — including investors and the housing sector — to create the revolution in housing that Australians with a disability and their families have been waiting for.
<a href="https://theconversation.com/profiles/di-winkler-8828" target="_blank">Di Winkler</a> is Adjunct Associate Professor, La Trobe University.
<a href="https://theconversation.com/profiles/george-taleporos-287224" target="_blank">George Taleporos</a> is Adjunct Senior Research Fellow, Living with Disability Research Centre, La Trobe University.
<a href="https://theconversation.com/profiles/luke-bosher-255941" target="_blank">Luke Bo'sher</a> is Fulbright Scholar, New York University.
All are authors for <a href="https://theconversation.com/au" target="_blank">The Conversation</a>.
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