Information for SILS and Allied Health Professionals
Information for Support Coordinators and Allied Health Professionals
Do you have a NDIS participant that is looking for Specialist Disability Accommodation (SDA) as part of exploring housing options or do you have a NDIS participant that already has SDA approved in their plan?
Compass has SDA properties, located in various areas throughout the Hunter and New South Wales, for which applications are now open. These purpose-built houses will allow residents with either high physical support and/or robust needs to live in a safe and secure home with individual support provided by the one of our associated Supported Independent Living Providers.
If you would like to learn more about this opportunity and how we can support you, please contact us using the form below. You can also call us on 1300 333 733 and press option 5.
Partner with us
Partner with us
Compass is partnering with many Supported Living Providers (SILs) who provide the day-to-day support and care of residents in Compass-managed homes in NSW and QLD.
Some of our partnering SILs include:
Resources - For Support Coordinators and Allied Health Professionals
The Summer Foundation have produced a How to write a Housing Plan Guide and accompaning Housing Plan Template to help support coordinators write housing plans for NDIS participants who want to test their eligibility for Specialist Disability Accommodation (SDA) funding.
The guide provides information on what to include to achieve the best possible outcome for the person you’re working for.
The Summer Foundation also facilitiates workshops to build the capability of support coordinators and allied health professionals so they can write quality housing plans. Click HERE for more information.
This is an edited transcript of the presentation by Sally Coddington, Director of Disability Services Consulting, at the Compass Housing Services ' Specialist Disability Accommodation Partnering Breakfast held in Newcastle in February 2020. We thank Sally for her amazing presentation and her generosity in sharing her presentation.
Take best practice and adapt it to your situation
Today I present you with best practice. I present you with the way things should work, some of the ideas around how I have seen it work. But you have to adapt that to your own situation.
I find that the NDIS experience can be as diverse as who is running the local office you are working with.
What people with a disability want – a housing career
People with a disability want exactly the same thing as people without disability when it comes to housing. They want a home. People want what is called a 'housing career'. Which means that my housing needs will evolve as I grow and change.
So, if you are someone who is building housing, consider that people’s needs will change. And if you are someone supporting someone into finding a home, consider that they will want to move on.
I will move into a group home and maybe be here for a couple of years, but my next goal is to live with a mate down the beach. A housing career is an important concept to have in mind.
3 elements of contemporary housing
There are many elements of contemporary housing practice, as opposed to traditional housing practice but three I want to focus on three.
1. Choice and control.
Contemporary practice offers people the opportunity to choose where they live, what kind of house they live in, who they live with, who supports them. So, choice and control is essential and contemporary civility practice. If someone has no choice about who they live with and to provide support to them, there's not contemporary disability practice.
2. Separation of housing and support.
The housing element is SDA, or mainstream housing options. That refers to the physical house itself. SDA is a contribution to the costs of the bricks and mortar of the house itself.
Separate to that is the support. The support can be in the form of SIL, supported independent living, it could be in the form of ILO, individual living options, or it could be as flexible in-home supports.
But contemporary disability requires that these things are separate. The reason for that is because it comes back to choice and control. If I am living in SDA and I am not happy with my service provider, I should have options with choosing my service provider.
SDA is the property and SIL is support in the property. If housing and support are not separate, it is not contemporary practice.
3. Targeted strategies.
Targeted strategies which build and use informal support, reduce the need for 24/7 support, (eg using assistive technology), and increased relationships to ensure safeguards.
We know that people who are isolated are at higher risk of abuse and neglect. We know that people with more connections outside of their home are at lower risk of abuse and neglect. That is extremely important.
Watch this space. ILO – Individual Living Options
If you haven't heard of ILO yet, you need to do a bit of a Google search on it. Look up ISL – individual supported living. Because that is sort of precursor to ILO.
ILO is the alternative to SIL, that the NDIA will launch at some point this year. It is a 'watch this space'. It is a really important development for people living in SDA, but also people living elsewhere as well.
Some statistics for perspective
One in five Australians – about 20% – identifies living with a disability. And this doesn't include older people who live with a disability, but they are the kind of people who say that they are just old. This is people who actually identified as living with a disability.
Of them, 11% are eligible for the NDIS. So, it is just a very small proportion of Australians that identify as living with a disability who are eligible for the NDIS.
And of them, around 6% will be eligible for SDA. So it is important to put that in context, for a couple of reasons. Firstly, there is something called the 'other 94%', which is the other 94% of NDIS participants who will be looking for a home that would be SDA eligible.
So, housing providers and support providers have to consider that, if you are going to develop a specialisation in housing, you have to consider that other 94%.
But say we're talking about the 6%. And it's important we talk about the SDA 6%, because it is a complex process. It is complex for testing eligibility; it is complex for matching people with homes.
It is also important for you because it means you have to manage expectations. You have to manage the expectations of people who are considering testing their eligibility. I have met many, many people and families who were so excited about the SDA when it was originally launched, not realising that the likelihood of being eligible was slim. So, to be fair to people, we have to manage their expectations.
Testing eligibility - the pre-work that needs to happen
The first thing is developing a housing goal.
Section 34 is one of the most important parts of the NDIS Act. The reason it's so important is because it is what we call 'reasonable and necessary'. It is a list of six criteria that a planner, or the NDIA, needs to have met for a support to be included in a plan, for a support to be considered reasonable and necessary.
The first criteria is that the support is aligned with the goals and the plan. So, if somebody is interested in exploring SDA, they have to have a goal in the plan around housing.
The first thing is to have a housing goal included in the plan. The second is to request funding to help the person reach that goal.
Generally, when you request funding to explore housing, you will get a combination of support coordination and a combination of allied health. That will be Improved Daily Living. Often what will happen, is the person's plan will say – SDA quote required.
What is important to understand is that doesn't mean the person is eligible. Even though SDA may be listed in their plan as quote required, it doesn't mean they have tested their eligibility yet. Again, another opportunity to manage expectations.
The next stage is most frequently forgotten. And that is to start by supporting a person to develop a vision for the life they want to live. To explore, in 10 years’ time, where do they want to be? What does their life look like? Who is involved in their life? What are they doing, what is their job?
The reason this is important is because the wrong home can be a barrier to the life you want to live, but the right home should support the life you want to live. Often what we do when we explore housing with people is think of it as a housing problem. But actually, it is a whole of life opportunity. So, particularly if you are a support coordinator, support people to think big, beyond the house to the life they want to live and what sort of home would support the life they are aiming for.
The next stage, after we have supported someone to develop a vision for their life, the life they want to live, is to start drilling down into their housing preferences. It is helpful to have templates to record this kind of stuff, things like – is it important for you to have a backyard? Yes, because I want to have a dog.
Is it important for you to have neighbours who live so far away you can't see their house? Yes, because I want to have my music loud or run around naked.
WA Individualised Services has a sample templates, questions and cards you might like to use to guide people in thinking about their housing preferences.
The next thing you will need to do is support someone to map their support network. You need to tell the Agency who the person has in their lives and the role those people play in their lives. (I find this is a great tool for support coordinators anyway, just as an aside. I think of it as a quasi-risk assessment. We know that the problem is a lack of support during times of crisis. Mapping who is involved in a person's life upfront helps you determine if the shit hits the fan, is there someone who can step in?)
Assessing SDA eligibility
It's important to understand, in submitting evidence for testing SDA eligibility, that you understand that we are asking the Agency to answer a million-dollar question. This is a huge investment.
It is generally said that once a person is found eligible for SDA, that is more or less guaranteed for the rest of their life. It is not an absolute. But most people who get SDA will be eligible for the rest of their life.
So we have to understand the importance and the gravity of the decision the Agency is making when we are pulling together this evidence.
In order to test SDA eligibility, we need to provide information that shows how the person is eligible against the eligibility criteria listed in the SDA rules. Here is a link to some of the legislation you will need to check out in order to understand the rules and the eligibility requirements.
The evidence you will submit will need to outline the most appropriate design category for that person, building type and location.
You need to be able to communicate how the SDA response will assist the person to meet the goals and improve their life stage outcomes. I imagine it as telling a story when you are pulling together evidence.
The story is like this. Here is Sally, here is who she is, this is what she likes and this is her goal for her life. This is where she wants to live. This is where she has lived in the past, this is what has worked, this is what hasn't.
This is the house we are recommending for Sally, the SDA housing type we are recommending for Sally, and this is how that house will support her to reach the goals for the life she wants to live. It's a bit like bringing them on the journey.
There are a few times when we test eligibility.
Moving out of the family home is one. Living with ageing parents, living in a group home and wanting to leave and wanting to live with a mate. If someone is living in hospital because there is no alternative for them or living in a residential aged care facility.
It's important to note though that a person can test their SDA eligibility prior to having a place to move out to. A caveat to that is, I was having a conversation with one of my DSC colleagues in Victoria and she was saying her local office will not allow them to put in a test for eligibility until the person has a house. Different things happen in different places in the country. But as a policy, people are able to test eligibility prior to having a house.
Test SDA eligibility early
I suggest that if someone is likely to be eligible, you test that as soon as possible. Have that done. One of the barriers to moving into a house can be that you haven't yet tested your eligibility. Let's remove that barrier earlier on and leave someone with the freedom to explore the actual homes they might want to live in.
Allied Health reports
Allied Health reports are critical in the process.
The reports need to answer a few questions, including “how significant is a person's disability on their mobility, self-care or self-management, or a combination of those?”
What other supports other than specialised housing could be implemented to help the person reach their housing goals? It could be in-home assistive technology. And what type of housing does the person need in order to meet their goals?
Reports have to use recognised assessments.
One of the criteria for reasonable and necessary is that it is evidence-based practice. To be able to show that the SDA property is evidence-based practice, you need to use assessments that are evidence-based.
Allied Health practitioners need to use templates or tools that the Agency recognises. Some elements of a high-quality SDA Allied health report include highlighting your professional qualifications and experience, introducing each assessment tool in terms of standing and validity.
Summer Foundation has defined housing pathways for us, including a list of assessments that Allied Health practitioners should use, that are considered to be valid from the Agency's perspective.
Number the paragraphs and avoid using tables and text boxes. Support Coordinators often refer to Allied Health reports in their summary or cut and paste information and it makes it easier for you to work together if your reports meet these requirements.
And then interpret all findings in reference to the rules and legislation. Anyone who works in SDA – there is no way you can avoid reading the rules and aspects of the legislation.
Especially Allied Health practitioners, your reports have to refer to the legislation, reasonable and necessary.
Two streams to test SDA eligibility
I won't go into too much detail because it is complex to test eligibility. But I want to highlight that there are two streams through which SDA eligibility can be tested. The first is, extreme functional impairment.
And the second is, very high support needs. Sometimes I have a quick rule I use for myself when I am trying to determine if I think someone is likely to be eligible. And I usually use this when managing expectations.
I ask myself, "Is the person's impairment or support needs likely to need a build environment response?" And usually you will get a pretty good sense up front whether or not that person's disability or support needs require a built environment response.
For example, some people might need a high level of support needs but they actually could live very easily in a mainstream house. They may not be eligible for SDA.
So, this is a reasonable and necessary test for the SDA. It is similar to Section 34 of the Act, which refers to other NDIS funded supports. But it kind of has its own lean, or its own focus.
The first, of course, is that in order for the SDA to be reasonable and necessary, it has to be linked to the goals or objectives in a person's plan. So, going back to the idea of the first thing we have to do is to include a goal around housing in a person's claim.
It needs to be aligned with current best practice. So, the Agency has two broad ways of measuring current good practice. The first is that it is evidenced-based. Which means that if I went into the university database and did a search, that the majority of research would come back and say, yes, it is good practice. Or if you are a room full of OTs, and I asked if it was good practice for this person, the majority of you would put your hands up and say, yes. That is evidence-based.
The second measure of good practice is that in the particular person's case, it has been formed to be good practice. This is why it is important in your storytelling to talk about, where I have lived before, what worked, what didn't work? And how that might impact on my need for a built environment response.
And then we have value for money. And the criteria that is a bit unique to SDA is, would it promote stability and continuity of the supports? That is a bit different from the other reasonable and necessary test.
For those of you who are unfamiliar with the operational guidelines, they are the NDIA's interpretation and operationalisation of the legislation. Which means, it is the interpretation of legislation in the Agency's own words. And it is really helpful.
So, just a broader recommendation to anyone working in the NDIS space – check out the operational guideline on planning. It is beautiful because it provides so much clarity around how the Agency understands reasonable and necessary.
There is actually an operational guideline on SDA.
Support Co-ordinator toolkit for Allied Health practitioners
So, for those support coordinators who have decided to develop a specialisation in housing, I would suggest that in your toolkit, you have a mini toolkit that is especially for Allied Health practitioners.
There is a real lack of OTs who have the experience and understanding to support a smooth SDA eligibility testing process.
These are the resources I would suggest you make sure an OT become familiar with before you work with them.
- A copy of NDIS Act Section 34 reasonable and necessary
- A link to the SDA Rules 2016
- The Summer Foundation’s Housing Plan Tool
- The Summer Foundation’s SDA Payments Guide
- With the consent of the participant, information about their:
- Goals and long-term aspirations
- Housing goals and preferred housing arrangement
- Access to informal supports
- Current funded supports.
Submitting your SDA summary and evidence
This is speaking specifically to support coordinators now, because support coordinators will usually be the ones working with a person and their family to pull together the evidence to test SDA eligibility.
Feedback I have received suggests you no longer have to complete an entire SDA housing template per the Summer Foundation example, but instead you can create your own synopsis of what is attached. And what will be attached will mostly be Allied Health reports, so they have to be good and they have to be in the right language.
So, for the summary you will have to pull together information from the visioning work you did, the relationship map, Allied Health reports, carer statements, behaviour support plans, incident reports, etc.
I imagine the summary should be just like the report I told you about before. This is Sally, this is who she is, this is a life she wants to lead, this is where she has lived in the past, this is what has and hasn't worked, this is what the OT reports tell us about the SDA support Sally needs, and this is how it will support Sally to live her life.
SDA eligibility decision is made
We have submitted the evidence and we have attached our summary, and an SDA eligibility summary is made by the Agency.
Of course, occasionally, the decision made isn't the decision we were hoping for. And you may need to ask for a review of a reviewable decision. The reason it is called that is because it starts with a reviewable decision. And so, there is a finite list of reviewable decisions. And you can find them on the NDIA's website.
And one of their decisions which is reviewable is SDA eligibility. And so, if we are not happy with that decision, we can ask for a review of a review of a decision.
Moving in – transition plan and skill development plan
There are couple of other plans that may be required in order to support someone to actually move into the home. That is a skill development plan and a life transition plan. Summer Foundation has templates.
The transition plan is basically an outline of what needs to happen for there to be a smooth transition. It includes timeframes, roles and responsibilities, so that everybody is on the same page about what we need to do to support this person into their new home.
A skill development plan may be part of a transition plan. A skill development plan is kind of like a plan about – what are the skills that Sally needs to develop between now and when she moves into her home to be ready? And that could be things like budgeting skills, learning to use the microwave, it could be finding assistive technology to give reminders about taking medication. It could be a variety of things but it's part of the transition plan.
The next step is implement the life transition plan. This might include things like making sure that there are support workers who are ready to go on day one. It won't be helpful if they are not helpful until two weeks in.
It might be things like making sure that those support workers have been trained and are ready to go. It might be things like connecting the person with local services, making sure there is a GP locally that they can visit, those kinds of things.
The next step might be supporting the person to understand how they will get around. Are they going to take public transport? Will they have transport pick them up from home? In which case, will the car come into the driveway or meet them out the front? This is the nitty-gritty stuff, right? Supporting the person to make sure they have everything they need to move in.
Do they have furniture? Do they have crockery? Do they have bedding? And if person doesn't have the resources to purchase furniture for themselves, then knowing what other supports are in the community to help the person get those things.
Using technology, or utilities, I don't think anyone lives without Wi-Fi these days, making sure those things are ready to go. And move in day, the things you want to consider, again, nitty-gritty – is there milk in the fridge? I'd be angry if I couldn't have my coffee in the morning. Who is bringing the boxes?
I had a conversation with a support coordinator, who said that once it all went perfectly but nobody brought the sticky tape so there was no way of closing boxes. You have to get into this detailed stuff.
At that point, someone has moved in and that is our SDA process.