Home Choice: An Interview with Hannah Orban, Co-Author of The Grattan Institute Report “Better, Safer, More Sustainable. How to reform NDIS housing and support.”
In the Spring 2024 Edition of the Canberra Disability Review, Editor Rob Donnelly sat down with Hannah Orban to discuss the Grattan Institute’s (@GrattanInst) recent report “Better, Safer, More Sustainable. How To Reform NDIS Housing and support”. Today’s blog piece shares key parts of their interview, highlighting issues with the current NDIS housing system and opportunities for improvement. You can read the original interview here.
Rob: Hannah, you recently co-authored the report “Better, Safer, More Sustainable. How to reform NDIS housing and support.” It's concerned with the current reality of Australians with disability who are living in group homes. What can you tell us about the quality of life, particularly that sense of home life, that is currently being experienced by many of those people currently living in group homes in Australia?
Hannah: The Disability Royal Commission heard from people with disability in Australia, and their families, that group homes can really inhibit people's quality of life through limiting choice and control over where people live, who they live with, and who provides their support and even about the rhythms of their day - such as when and what they eat, when they go to bed or wake up.
Evidence from the Disability Royal Commission indicates that institutional practices persist in many group homes. And this is really the unfinished business of de-institutionalization, which started in the 1960s as Australia moved away from really large, segregated institutions.
However, changing the number of people who live in one place isn't enough. What it's like to live in a home really matters. The NDIS Quality and Safeguard Commission's Own Motion Inquiry into Aspects of Supported Accommodation found high incidences of violence, abuse, and neglect in a sample of supportive accommodation settings.
If people aren't feeling safe in their home, they aren't experiencing a good quality of life. So, our report lays out how government can make housing and living supports better, safer, and more sustainable for people who have intensive housing and living support needs, including people who are currently living in group homes.
Rob: …The report mentions pockets of innovation… Maybe we can dig down a little bit more into these alternate models to group home settings, that you've come across, particularly over in the West?
Hannah: A big focus of our research and recommendations is to create more options for people in housing and living support. So, we looked at innovation in Australia, particularly WA…, where these alternative approaches have really taken off. And we also looked at the UK and British Columbia, Canada. And in British Columbia home share arrangements, which are a kind of alternative to group homes, are the main type of residential support for people with intellectual and developmental disability, overtaking group homes now.
We recommend a new approach to living support that we're calling individualized living arrangements where people live in the community. For example, with a host or a flatmate. And instead of relying only on formal paid-by-the-hour support workers, people with disability draw on a mix of supports from support workers, family and friends which is also known as informal support. And then what we call semi-formal support, which is, for example when a host or a flatmate provides you with support such as cooking, cleaning, taking care of the garden. And they receive a subsidy for the costs associated with that support and normally that semi-formal support is integrated into the household life and the life of the person providing the support.
So, it's not paid by the hour, and it isn't someone earning a salary, but for example in a host arrangement, a person with a disability lives full time with a host who isn't related to them in the home of the host. Or there's the housemate model, which we focus on as well, where the person with disability lives in their own home or in a shared rental property, for example with another person, or with people who aren't related to them, who are providing support.
And these forms of semi-formal support can't entirely substitute formal supports all the time, but when they are part of a person's package, they do reduce that dependence on paid staff. So they're more cost effective and they have benefits in being more community oriented and more inclusive essentially. These arrangements have worked really well in the UK, in Canada, and in WA, and you know it's good news because it means that people can have a cost-effective way of setting up their housing and living supports without needing to share supports all the time.
We also recommend, in our report, a housing payment that people with disability can use the private rental market if they need intensive support and they aren't eligible for the current specialist disability accommodation categories or if they want to move away from their group home. And that's great because it means people don't have to live in specialist accommodation or in specific locations. They have more options and hopefully they can find a better fit in the private rental market where there's just a greater variety of options available to them.
So, by creating more options for people beyond group homes, and using a more flexible approach of supports, mixing formal, semi-formal and informal, we argue that people will have greater choice about where they live and who they live with and who provides their support and that people with disability are more likely to find a better fit for their particular situation.
Rob: The report not only looks at alternate models of accommodation, but also tackles the pressing issue of reforming and improving current group home environments… Can you tell us some key points around these reform ideas about how group homes can be improved, particularly, I guess in relation to the vulnerabilities related to violence and those issues of safety?
Hannah: …To be brief, because we do go into this in quite a lot of detail in the report, our report lays out a series of recommendations to ensure the transition from group homes to share houses. Such as support for resident-led decision making, training and high-quality care such as active support for support workers, enforceable service agreements, and separating housing and living support providers in most cases.
The rental payment we propose will also allow people who want to establish a share house to do so in the private rental market, if that's the best option for them, which means they don't have to rely on special disability accommodation if they don't need it.
As a safeguarding measure, we also recommend that the Quality and Safeguards Commission should be able to inspect properties, where there's shared supports, so that they can check-in on people's well-being and talk to them and make sure they're hearing from them that they're happy with the arrangement.
About the Contributors
Rob Donnelly is the Editor of the Canberra Disability Review, a unique and powerful platform that aims to ignite change-making conversations and challenge disabling social structures and attitudes.
Hannah Orban (@HannahOrban7) is an Associate in Grattan’s Disability Program. Hannah advocates for the equality of people with disability through evidence-based public policy that is led by the disability community. She brings her experience as a sibling to people with disabilities to her work, as well as her professional experience in the government and non-profit sectors.
In Washington D.C., Hannah worked alongside leaders in disability policy in the U.S. as the Eileen Sweeney Graduate Intern in Disability Policy with the National Academy of Social Insurance, and the Century Foundation’s Disability Economic Justice Team. Previously, Hannah worked as a research assistant in economics at the University of Michigan, and in public and disability policy in the NSW Department of Education.
Hannah has a Master of Public Policy from the Gerald R. Ford School of Public Policy, the University of Michigan, where she studied as a Fulbright scholar. She holds a Bachelor of Arts (First Class Honours) in Philosophy from the University of Sydney.
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