Despite research that indicate that group homes are overrepresented as a housing option for people with disability, are expensive, are unnecessary for large numbers of people living in them and do not represent the aspirations of many people with disability and their families, more are being built using National Disability Insurance (NDIS) Supported Disability Accommodation (SDA) funding. The question is “Why?”.
“Group homes” (also known as group houses) have been defined in this paper as providing accommodation for four or more residents (with two or three sharing referred to as “shared housing”). “Supported living” is defined as housing and support models other than group homes.
The September NDIS Quarterly Report indicates that 37% of places in newly enrolled stock were group homes. These additions meant that 65% for all SDA places enrolled to that date were group homes [i] [ii]. At the same time there is a shortage of SDA equating to approximately 12,000 places or 40% [iii].However, it is expected that this shortage will be met in the current SDA development period (which will also diversify the supply) [iv].
Group homes are common and continue to be developed at scale. A 2018 report on SDA places under development across Australia identified that 25% were for group homes [v]. This appears to be driven by a number of underlying assumptions not all of which are supported by evidence, research and contemporary practice. It is worth exploring some of the reasons offered for the demand for new group homes.
· Group homes are sought because they represent access to support with some participants and their families aspiring to group homes because, under the pre-NDIS system, support could only typically be accessed in combination with a group home. However, NDIS has now separated SDA from Supported Independent Living (SIL) bringing an end to these bundled arrangements[vi].
· Group homes are the dominant form of housing for people with disability with more than 85% of the current SDA places group homes (including both enrolled and yet to be enrolled)[vii]. However, when asked, people with a disability indicated a dislike for living with 3 or more others [viii] indicating these configurations are unlikely to have been driven by participant choice.
· Everyone living in group homes needs to live in group homes. Research would indicate that about 30% to 35% of people living in group homes have the same level of severity of disability as those living in other supported living options [ix] implying they have options other than group homes.
· Group homes facilitate lower support costs. It has been identified that many current residents in group homes have the potential to live more independently with comparable quality of life outcomes, and significantly cheaper support costs[x] [xi].
· Larger houses exist in the broader community. Five-bedroom house or larger (the typical configuration of four place SDA with an On-site Overnight Assistance [OOA] room) represents about 6% of dwellings in Australia[xii] as opposed to the 42% of enrolled SDA dwellings [xiii]. Large aggregated housing is therefore overrepresented in SDA.
· Group homes are an efficient construction model. While the construction of group homes with a standardised design can generate building efficiencies, they require larger sites and are typically restricted to single storey. This means construction saving are often offset by land cost in metropolitan areas displacing SDA to locations far from social and community networks as well as transport and services.
· Group homes represent contemporary practice. Group homes were contemporary practice during the closure of most large institutions[xiv]. However, it has been identified that the next generation will seek housing options reflecting their aspirations to be part of the mainstream society [xv]. Indeed, the National Disability Insurance Agency (NDIA) has committed to transforming the SDA, a sector of traditional group homes to buildings that are both indistinguishable from and intermingled with housing in the neighbourhood [xvi].
· Participants in group homes on “continuation of support” will lose their SDA if they move. People already in group homes who may not qualify to access SDA with the current eligibility requirements will be supported by the NDIS to move to another appropriate accommodation option not just group homes [xvii].
From this it can be concluded that new group homes, which are generally not regarded as a contemporary housing option for people with disability, are being developed because a lack of information about NDIS participant’s options and preference (who in some cases are themselves not fully informed). To avoid an overdevelopment of unwanted places in what is a rapidly growing and changing supply it would be reasonable for the market custodian, the NDIA, to intervene to support more informed decision making (which it has committed to through the SDA Innovation Plan[xviii]) and to preclude the development of new group homes. The current supply is such that, even without additions, group homes will continue to exist at scale as an option for many years to come.
[i] Table O.5 National Disability Insurance Agency (NDIA) (2019b). COAG Disability Reform Council NDIS Quarterly Report 30 September 2019. [online] NDIA. Available at: https://www.ndis.gov.au/media/1998/download [Accessed 15 Nov. 2019]. [ii] Noting that the reported figure will be a combination of both new stock and existing stock that has been enrolled. [iii] Page 760. Productivity Commission Inquiry Report Volume 2 Disability Care and Support. (2011). [online] Available at: https://www.pc.gov.au/inquiries/completed/disability-support/report/disability-support-volume2.pdf [Accessed 4 Oct. 2019]. [iv] FIGURE 2 - ASSUMED SUPPLY OF SDA (NEW BULDINGS), National Disability Insurance Agency (NDIA). “SDA Position Paper on Draft Pricing and Payments.” Ndis.Gov.Au, 2016, www.ndis.gov.au/media/1037/download. Accessed 18 Nov. 2019. [v] Page 6, SGS Economics & Planning. Specialist Disability Accommodation: Market Insights. Summer Foundation, 2018 [vi] Ndis.gov.au (2018). Supported Independent Living | NDIS. [online] Ndis.gov.au. Available at: https://www.ndis.gov.au/providers/housing-and-living-supports-and-services/housing/supported-independent-living. [vii] Page 6, SGS Economics & Planning. Specialist Disability Accommodation: Market Insights. Summer Foundation, 2018. [viii] Table 6, Taleporos, G., Craig, D., Brown, M., McNamara, C. and Forbes, S. (2013). HOUSING AND SUPPORT FOR YOUNGER PEOPLE WITH DISABILITIES TRANSITIONING TO INDEPENDENT LIVING: ELEMENTS FOR SUCCESS IN THE DESIGN AND IMPLEMENTATION OF DISABILITYCARE AUSTRALIA, A NATIONAL DISABILITY INSURANCE SCHEME. [online] Available at: https://mgb.id.au/YDAS_PDF_Project.pdf [Accessed 1 Oct. 2019]. [ix] Bigby, C., Bould, E. and Beadle-Brown, J. (2017). Comparing costs and outcomes of supported living with group homes in Australia. Journal of Intellectual & Developmental Disability, 43(3), pp.295–307. [x] Mansell, J., Beadle-Brown, J. and Bigby, C. (2013). Implementation of active support in Victoria, Australia: An exploratory study. Journal of Intellectual & Developmental Disability, 38(1), pp.48–58. [xi] Stancliffe, R.J. and Keane, S. (2000). Outcomes and costs of community living: A matched comparison of group homes and semi-independent living. Journal of Intellectual & Developmental Disability, 25(4), pp.281–305. [xii] https://profile.id.com.au/australia/bedrooms?BMID=50 [xiii] Table O.5 National Disability Insurance Agency (NDIA) (2019b). COAG Disability Reform Council NDIS Quarterly Report 30 September 2019. [online] NDIA. Available at: https://www.ndis.gov.au/media/1998/download [Accessed 15 Nov. 2019]. [xiv] Page 7, Wiesel, I., Laragy, C., Gendera, S., Fisher, K., Jenkinson, S., Hill, T., Finch, K., Shaw, W. and Bridge, C. (2015). Moving to my home: housing aspirations, transitions and outcomes of people with disability authored by. [online] Available at: https://www.ahuri.edu.au/__data/assets/pdf_file/0014/2165/AHURI_Final_Report_No246_Moving-to-my-home-housing-aspirations,-transitions-and-outcomes-of-people-with-disability.pdf [Accessed 1 Oct. 2019]. [xv] Page 8, Zakharov, R. and Minnery, J. (2007). Disability Delphi study report National Research Venture 2: 21st century housing careers and Australia’s housing future Research Report authored by ACKNOWLEDGEMENTS. [online] Available at: https://www.ahuri.edu.au/__data/assets/pdf_file/0025/2698/Disability_Delphi_study_report.pdf [Accessed 2 Oct. 2019]. [xvi] Page 5, National Disability Insurance Agency (NDIA) (2019a). A Home for Living Specialist Disability Accommodation Innovation Plan. [online] Available at: https://www.ndis.gov.au/media/1867/download. [xvii] https://www.ndis.gov.au/applying-access-ndis/people-receiving-supports-other-governments/continuity-support [xviii] National Disability Insurance Agency (NDIA) (2019a). A Home for Living Specialist Disability Accommodation Innovation Plan. [online] Available at: https://www.ndis.gov.au/media/1867/download.