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Practice Guide – Identifying Housing Solutions

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Contents

Practice Guide – Identifying Housing Solutions

• Purpose - 4
• To be used by - 4
• Scope - 4
  • Current position of the NDIA - 5
• Types of housing - 6
  • Public housing - 6
  • Community housing - 6
  • Home ownership - 6
  • Shared equity - 6
  • Private rental market - 7
  • Specialist Disability Accommodation - 7
• Types of support - 8
  • Capacity building – skill development - 8
  • Assistive Technology - 8
  • Home modifications - 8
  • Medium Term Accommodation - 8
  • Individualised Living Options - 9
  • Supported Independent Living - 9
• Identifying suitable home and living solutions and support needs - 9
  • Young people in voluntary out of home care arrangements - 10
  • Who is responsible for identifying suitable home and living solutions? - 10
  • Funded supports which may be required - 11
  • Compensation - 11
• Plan Implementation and Monitoring - 11
  • Task 1 – LAC or Support Coordinator - 12
  • Task 2 – Allied health practitioner - 13
  • Task 3 – Technical Advisory Branch (TAB) - 14
• Appendices - 15

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• Appendix A: Support Guide for Decision Makers – Identifying Home and Living Solutions

  • Page 15

• Appendix B – Allied health practitioners to support home and living needs

  • Page 19

• Appendix C – Specialist Disability Accommodation

  • Page 22

• Appendix D – Types of supports

  • Page 25

• Supporting material

  • Page 27

• Feedback

  • Page 28

• Process owner and approver

  • Page 28

• Version change control

  • Page 28

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Purpose

The purpose of this Practice Guide is to provide guidance to staff and Partners in the Community (Partners) when considering the inclusion of home and living supports in the participant’s plan.

To be used by

• Plan Developers – Planners and Partners in the Community (Early Childhood Partners and Local Area Co-ordinators [LACs])
• NDIA Plan Delegates
• Integrated Housing Team

Scope

Participants are encouraged to complete a Home and Living Supports Request Form (external). This is reviewed along with other supporting documentation from the participant and/or their allied health professional. The information supports plan developers, Housing Assessors or the Housing Panel to identify the appropriate home and living response for the participant to pursue their goals.

The NDIA will use the documentation to assist with determining whether a participant’s home and living support needs are reasonable and necessary.

When deciding to include any support in a participant’s plan, the NDIA must consider items in the National Disability Insurance Scheme Act 2013 (NDIS Act), including the participant’s statement of goals and aspirations. The NDIA must be satisfied that each support meets each of the reasonable and necessary criteria outlined in:

• section 34(1)(a)-(f) of the NDIS Act, and
• Part 5 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013.

For further information refer to Our Guideline – Creating your Plan.

There are different types of home and living solutions and support needs which may be considered to best meet the participant’s individual circumstances and lifestyle.

Housing solutions may include:

• social housing (public and community housing)
• home ownership
• shared equity

• private rental
• Specialist Disability Accommodation (SDA).

Support needs may include:

• Capacity building
• Assistive Technology (AT)
• Home modifications
• Short or medium term accommodation
• Individualised Living Options (ILO)
• Supported Independent Living (SIL)

The participant may be supported to identify, coordinate and ensure the required supporting documentation is completed and provided to the NDIA when requested, for reasonable and necessary decision making, by the following people:

• Participant and/or their informal support network
• LAC
• Support Coordinator.

3.1 Current position of the NDIA

The following provisions of funding for home and living support(s) need to be taken into account:

• All types of suitable and comparable home and living solutions and support needs have been considered and justification has been provided as to their suitability or unsuitability.
• The identified home and living solution and/or supports will assist to facilitate the participant’s independence, social and economic participation.
• The home and living supports are sustainable for the participant and/or their informal support network.
• Risks/impacts to the participant’s current and proposed living arrangement, informal care support, level of independence, social and economic participation have been identified.

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• The participant’s immediate and longer term home and living support needs have been considered, including opportunities for capacity building and skill development.
• Supports do not relate to day-to-day living expenses.
• When a participant resides in SDA, funding for home modifications will not be included in their plan. The provider of SDA is funded, according to the enrolled dwelling type, to meet the individual needs of each resident.

4. Types of housing

There are different types of housing solutions that must be considered when identifying a participant’s suitable home and living solution.

4.1 Public housing

Public housing is generally a long-term housing solution for people on low incomes who are most in need. Public housing is managed by state and territory governments and there are usually significant waiting periods for this type of accommodation. Applications for public housing are submitted through local state government offices. Rental contribution is approximately 25% of the household income.

4.2 Community housing

Community housing offers secure long-term, affordable housing options to individuals who may be disadvantaged in the private rental market. It is managed by not-for-profit organisations, known as community housing organisations. Examples of community housing are The Salvation Army Australia or Community Housing Ltd. Generally, tenants pay similar rent to public housing tenants, which is equivalent to approximately 25% of the household’s assessable income, or the market rent for the property (whichever is lower). In some community housing settings, there may be group share options, where tenants can have their own bedroom but share facilities such as the bathroom, kitchen and laundry areas.

4.3 Home ownership

Home ownership applies to participants currently living in their own/family owned home or looking to purchase their own home. The NDIA may consider funding for home modifications, AT, capacity building supports and/or SIL supports which are deemed reasonable and necessary to enable the participant to live in their own home.

4.4 Shared equity

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A barrier to home ownership is the inability to save a deposit for a home loan on a low-medium wage or income payment. Shared equity can best be described as a ‘shared home-ownership financial model’. This is where the cost of the dwelling purchase price is contributed through a range of partnerships (for example, families/participants purchasing together, developers, land and homeowners and cooperatives) in conjunction with the participant. As with a home loan, there are eligibility requirements and criteria that need to be considered.

Most state, territory and local governments are currently supporting various housing initiative(s) that assist singles, couples or families with the costs associated with becoming a home owner, or when considering the purchase of a home with other investors.

Private rental market

The private rental market may include opportunities listed in the newspaper, online, through real-estate agents and websites. This may include sharing a home with others to reduce costs. Rent and utilities are paid by the participant at the market rate.

Specialist Disability Accommodation

SDA is specialised housing designed to support people with extreme functional impairment or very high support needs. It is not a solution designed to deal with homelessness or other similar matters. SDA does not refer to the support services but the homes in which these are delivered. SDA may include specialist designs for people with very high needs or may have a location or features that make it suitable for providing complex supports for independent living.

The three different types of SDA are:

• new
• in-kind
• existing.

Participants that can be suitable for SDA are those with:

• very high mobility needs
• intellectual or cognitive disability who have very high person-to-person support needs.

The two occasions when SDA may be included in a plan are:

• when there is a new SDA decision
• when the participant was already residing in disability related supported accommodation at the time of transition to the NDIS.

For further information about SDA, and which participants are eligible for SDA, refer to Appendix C – Specialist Disability Accommodation.

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Types of support

There are different types of supports which must be considered when identifying a participant’s suitable home and living solution(s) and support needs.

Capacity building – skill development

Capacity building supports enable a person to increase their ability to manage their day-to-day activities independently and can be beneficial to support participants in their transition to an alternate home and living solution. These supports are designed to deliver an improved measurable outcome for the participant while reducing the need for funded supports in the future.

Refer to Appendix D – Types of support Capacity Building - Skill Development.

Assistive Technology

AT is defined by the World Health Organisation as ‘any device or system that allows individuals to perform tasks they would otherwise be unable to do or increases the ease and safety with which tasks can be performed’.

Refer to Our Guidelines – Assistive technology on the NDIS website and Assistive Technology guidance on the Planning resources Intranet page.

Home modifications

Different types of home modifications may be funded by the NDIS. The NDIA defines standard (simple) home modifications as those that are non-structural and do not require local authority or other permits and classifies them at Complexity Level 3.

Complex Home Modifications (CHMs) require structural alteration to the building, may also require permits and are classified at Complexity Level 4.

Refer to Appendix D – Types of supports – Home Modifications.

Medium Term Accommodation

The participant may require temporary accommodation support as a result of their disability-related needs, whilst they transition to their desired long term accommodation arrangements. In these situations, Medium Term Accommodation (MTA) support can be added to plans to facilitate medium term transitional accommodation.

MTA needs to be considered reasonable and necessary to assist the participant to meet their longer term accommodation goals. Accommodation is considered transitional if it is temporary and assists the participant to transition to their permanent accommodation solution. MTA would generally be considered for periods of up to 3 months and can be reviewed for longer periods of time if required. Refer to the Our Guideline – Medium Term Accommodation for further information.

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Individualised Living Options

ILO is a home and living support that lets the participant choose the home they live in and set up supports in the way that best suits them. ILO is the package of supports that can help the participant live in the way they want in the home environment they have chosen. It’s not the home itself.

ILO supports help the participant to work out how they want to live, where they want to live and who they would like to live with. The participant can share their home with friends, housemates, live in the home of a host family or on their own with a variety of individualised supports.

ILOs are funded in two stages:

• Stage 1 Exploration and design - the first part is all about the participant exploring and designing the ILO support model that suits them.
• Stage 2 Support Model - the second part is funding to put those supports in place and monitor and adjust the supports as the participant’s needs change.

There are examples of ILO arrangements in the ILO participant scenarios. There is also information available for participants and service providers on the NDIS website.

For information about making an ILO decision refer to Our Guideline – Individualised Living Options.

For information about how to include ILO supports in the participant’s plan, refer to Appendix D – Types of Support – Individualised Living Options.

Supported Independent Living

SIL is assistance with and/or supervising tasks of daily life to develop the skills of individuals to live as independently as possible.

For further information refer to Providing Supported Independent Living (external) or Appendix D – Types of supports – Supported Independent Living (SIL).

Identifying suitable home and living solutions and support needs

Suitable home and living solutions can increase a person’s quality of life and independence whilst reducing the need for funded supports.

The participant may identify a goal of finding suitable home and living solutions for a variety of reasons, which may include but are not limited to:

• identified risks (for example risk to self and/or others, homelessness)

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• current housing is no longer suitable or sustainable, for example, the participant is at an age where it is more appropriate to live independently or they have ageing parents
• dissatisfaction with current housing, for example, residing in a nursing home, limited support network due to location
• current housing is unable to be modified to address functional limitations or to enable the provision of supports in a value for money manner
• current public housing residence is unable to be modified beyond the level of responsibility of the state housing authority.

6.1 Young people in voluntary out of home care arrangements

An assessment for SDA and SIL can be included in the plan for a 16-17 year old living under a voluntary out of home care arrangement. In exceptional circumstances an assessment may be included for children 15 and under with General Manager approval. Refer to Practice Guide – Children living in a formal voluntary arrangement outside their family home.

6.2 Who is responsible for identifying suitable home and living solutions?

The following people may be involved to identify suitable home and living solutions and gather required supporting evidence:

• The participant and/or their informal support network – where participants or their informal supports have the capacity and desire to coordinate any or all of Task 1 LAC or Support Coordinator or Task 2 Allied health practitioner below.
• LACs – if the participant is supported by an LAC, the LAC may provide assistance with identifying and coordinating of one or more of the tasks. Refer Task 1 – LAC or Support Coordinator.
• Support Coordinators – where the participant receives funding for a support coordinator, the support coordinator may provide assistance with identifying and coordinating required supporting evidence and justification. Refer Task 1 – LAC or Support Coordinator. The NDIA requires sufficient supporting evidence and justification from suitably qualified AHPs. Refer to Task 2 – Allied health practitioner.

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Funded supports which may be required

Funding for individual assessments and support coordination may be required when determining a participant’s home and living support needs (refer to the table below).

Funding will be informed by the typical support package (TSP) and reasonable and necessary decision making.

The plan developer will need to include sufficient funding in the participant’s plan to complete the relevant assessments. The Integrated Housing Team can provide advice about the assessments needed.

For information about how to include ILO supports in the participant’s plan, refer to Appendix D – Types of Support – Individualised Living Options.

Support Type	Description
Coordination of Supports (07_002_0106_8_3)	To assist the participant with identifying and coordinating the required supporting evidence and justification as described in Task 1 – LAC or Support Coordinator and Task 2 – Allied health practitioner. Refer to Standard Operating Procedure – Include Support Coordination in a Plan
Assessment, recommendation, therapy and/or training (includes Assistive Technology) (15_056_0128_1_3)	To assist with obtaining relevant allied health practitioner assessments and reports. This includes justification for the identified home and living solutions and supports as described in the requirements of Task 2 – Allied health practitioner.

Compensation

Compensation, for NDIS purposes, is either a lump sum or periodic payment.

If you identify the participant is, or has been, entitled to compensation, update the responses in the risk assessment task in the system. Refer to the Compensation Recoveries intranet page for guidance on how to proceed. For further information refer to Our Guideline – Creating your Plan.

Plan Implementation and Monitoring

When the participant has a goal to explore and identify an appropriate home and living solution in their NDIS plan, the plan implementer must support the participant to achieve this goal by completing the following tasks/s when required:

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Task 1 – LAC or Support Coordinator

If the participant identifies a goal of finding suitable home and living supports, the LAC or support coordinator is required to understand the NDIS legislation, reasonable and necessary decision making, NDIS Operational Guidelines, Pricing Arrangements and Price Limits and funding flexibility, as it applies to suitable home and living options.

You will need to complete the following tasks, which can include, but are not limited to:

• Ensure the participant understands what is contained in their NDIS plan and how they will be supported to explore and identify an appropriate home and living solution.
• Provide guidance on where the participant can access further information about the National Disability Insurance Scheme (Specialist Disability Accommodation) Rules 2020 (SDA Rules) and Our Guideline – SDA. With this information, the participant can learn what criteria are assessed when determining their eligibility for SDA. The information can also build the participant’s understanding of reasonable and necessary decision making.
• Ensure the participant has adequate support whilst identifying a suitable home and living solution.
• Assess the adequacy of the supports that will assist the participant to remain living in their current accommodation.
• Where risk has been identified in a participant’s current living situation, ensure the participant is linked with relevant allied health practitioners. Adequate supports must also be in place to sustain informal care until a home and living solution is identified.
• Collate the supporting information and assist the participant to complete the Home and Living Supports Request Form (external).
• Collate the Home and Living Supports Request form and any allied health professional assessments/documents and refer to the Integrated Housing Team so they can identify the appropriate home and living response for the participant to pursue their goals.
• Help the participant with home and living applications (for example private rental, mainstream and public housing). If there is no immediately available accommodation, support the participant to manage their flexible budget and identify skill development and life transition planning strategies to prepare for future accommodation or home and living options.

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Task 2 – Allied health practitioner

Assessments are required to inform reasonable and necessary decision making and must be undertaken by suitably qualified practitioners, including Occupational Therapists (OT), Psychologists, Physiotherapists and Speech Therapists.

The plan developer may send a request for service form (for example the Request for Service – Specialist Assessment and Program) to the AHP. The form will help the AHP understand the requirements when supporting the participant to identify their home and living solutions. AHPs are required to perform the following tasks:

• Complete a comprehensive assessment of independent living skills, physical, sensory, neurological, cognitive and communicative needs, functional abilities and support needs.

Note: not all of these assessments are required for every participant.

• Identify any potential risks to the participant’s current living arrangement, informal care support, level of independence, social and economic participation. Provide recommendations to mitigate any potential risks, including how the recommended home and living solution will mitigate these identified risks.
• Identify suitable interventions, programs, strategies or skill development/capacity building opportunities that will help the participant maintain their current living arrangement and support them until a suitable home or dwelling becomes available.
• Monitor capacity building and skill development programs for the proposed home and living solution and provide a report in relation to the participant’s progress/measurable outcomes.
• Identify the participant’s informal support network and their ability to sustain their caring role, where applicable. Identify support needs, AT and/or home modifications, skill building and training needs to sustain informal supports and support the participant to remain in their current living arrangement, if this is appropriate.
• Identify the participant’s home and living support needs, considering their capacity to live with others. Provide details of behaviours of concern, physical, cognitive and

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sensory support needs, proposed and previously funded home modification and aides/equipment.

• Consider all types of suitable and comparable home and living options. For example, private rental, community housing, private residence and public housing.

• Consider any risks or additional support that may be required as a result of the participant moving to the recommended home and living solution. For example, choice of location may result in social isolation from community, informal support network, and local services and supports.

Refer to Appendix B – Allied health practitioner.

Task 3 – Technical Advisory Branch (TAB)

Not all assessments and recommendations need to be forwarded to TAB for advice.

Participants identified as being suitable for private rental or social housing will continue to work with their LAC or support coordinator to identify appropriate home and living solutions, including the support required to live as independently as possible.

Check if the support requires referral to TAB for advice before including the support in the participant’s plan. To check if TAB advice is mandatory and how to request advice refer to the TAB Requesting Advice intranet page.

The TAB will perform the following tasks:

• Review all assessments and supporting documents received by the regional site and submitted to TAB.
• Complete the Advice Request Process.

If a request for Home Modifications or AT requires TAB advice, a decision is made after receiving the TAB advice.

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Appendices

Appendix A: Support Guide for Decision Makers – Identifying Home and Living Solutions

Type of Support	Supports generally funded by NDIS	Supports generally funded by OTHER PARTIES
Housing costs: Rent and utilities Whitegoods Moving house expenses	Moving house expenses May include support to pack personal belongings and domestic cleaning assistance, when the participant is unable to do this due to functional limitation (assessed on an individual case-by-case basis). Does not include removalist charges.	Rent and utilities (including bond and property damage) Considered day-to-day living costs normally met through disposable income (income support which is provided to assist participants with the cost of housing, including government pensions and allowances such as Rent Assistance).
Explore general insurance options, however, this will be considered a ‘deliberate act’ and excluded in most policies.
Explore general insurance options relating to accidental damage. Whitegoods Related to day-to-day living costs normally met through disposable income. Moving house expenses Including removalist costs which is an everyday cost normally met through disposable income.

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Type of Support	Supports generally funded by NDIS	Supports generally funded by OTHER PARTIES
Accommodation	Long-term SDA accommodation where deemed reasonable and necessary by the Housing Assessor or Housing Panel. Note: transitional arrangements are in place for existing and in-kind SDA. Refer to Appendix C – Specialist Disability Accommodation.	Reasonable rent contributions by participants living in social housing or SDA in the form of 25% of Disability Support Pension. Government rent assistance. Affordable or social housing schemes.
Supports for child participants (under 18 years)	Disability related supports Supports specific to a child’s disability additional to the needs of children of similar ages. Includes assistance with daily personal activities, AT, capacity building, community participation and home modifications. Disability specific parenting training programs Specifically designed for the participant’s needs and are not available as a mainstream service. This can include intensive training such as one-on-one or in-home training for parents, specific to a participant’s disability. Disability related transitional supports for 17 year old participants to prepare for transition to living independently as an adult.	Parental responsibility The Agency does not replace what is considered parental responsibility, when considering the support needs of children of similar ages. SIL and SDA related supports The NDIS generally only provides SDA or SIL for participants aged 18 years and over. Parents are responsible for providing daily care, support and supervision for children under 18 years of age. For young people in voluntary out-of-home care arrangements please refer to 6.1 Young people in voluntary out-of-home care arrangements. For children in statutory out-of-home care (Child Protection), the relevant state authority holds parental responsibility and is responsible for providing daily care, support and supervision.

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Type of Support	Supports generally funded by NDIS	Supports generally funded by OTHER PARTIES
Holidays/overnight stays
No additional funding is included for supports during holidays/overnight stays. Participants are required to use their SIL budget and negotiate inclusions with their provider.

Stand-up shifts and sleepovers No additional funding is included for stand up-shifts and sleepovers. Participants are required to use their SIL budget and negotiate inclusions with their provider.

If there has been a significant change to the participant’s circumstances/needs, then a plan review should be initiated to consider the participant’s SIL support needs.

Non-participant residents as such, is responsible for providing daily care, support and supervision for children under 18 years of age.

Housing and accommodation for children The NDIS generally only provide SIL and SDA for participants aged 18 years and over. Parental responsibility includes the provision of housing and accommodation for children under 18 years of age.

Vacancies within the property The Agency does not fund vacancies. Funding is based on number of bedrooms and shared support. It would not be appropriate to approve a change of circumstances (s48) plan review to change the ratio of the SIL to accommodate the provider’s vacancy. It is the provider’s responsibility to fill any vacancy.

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Type of Support	Supports generally funded by NDIS	Supports generally funded by OTHER PARTIES
	Funding is based on bedrooms and shared supports. For example, where a person who does not receive NDIS supports shares a house with NDIS participants and shares the core roster of supports, we fund a ratio which includes the non-participant. The support needs of the non-participant are not funded, but their care needs are considered when determining the ratio.

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Appendix B – Allied health practitioners to support home and living needs

Participants may require various assessments to determine their functional abilities and the support they may require to assist transition to alternate accommodation, once a home and living solution is identified. It should also be recognised that a participant may have current information from previous assessments that may be suitable to use to determine support needs.

The assessments will determine the participant’s current capacity and support needs and will inform the support required to remain in their existing home or to transition to a new home. Assessments will report on any risks to the participant or others and will identify skill development and capacity building opportunities.

The different types of AHPs who may be engaged to support the participant with determining suitable home and living support needs has been described in more detail below.

8.2.1 Occupational therapist

An OT undertakes an assessment showing the functional capacity of an individual and recommends interventions to support the participant to achieve goals and promote independence. These interventions can relate to:

• changes to the environment (for example, home, work or community)
• to the way the task is undertaken (for example, the use of AT or alternative methods)
• capacity building for the individual (for example, skills, knowledge).

An OT can design and coordinate individual programs to support a participant’s independence in everyday activities and provide strategies to maintain a safe home, work and social environment to suit the needs of the individual. For a participant an OT can:

• develop coping strategies to help overcome mental health issues
• improve confidence and self-esteem in social situations
• monitor function and progress, prescribing AT for individuals when required.

OTs with appropriate skills and experience (eligible for registration in the NDIA Specialist Behaviour Support registration group) can also provide sensory assessments for participants. Sensory assessments may be required for participants with a primary disability of autism with identified positive behaviour support needs and where intellectual disability, complex communication requirements (participant communicates indirectly or unintentionally) or major mental illness is present.

A sensory assessment provides an enhanced understanding of the way the participant with these characteristics experiences the world, such as:

• heightened reactivity to sound, touch or movement

• difficulty accepting changes in routines or transitioning between tasks
• poor sleeping patterns
• distractibility
• poor motor skills or preference for increased amounts of input to sensory systems - auditory, tactile or movement. These characteristics may underlie observed behaviour. A behavioural assessment from a psychologist and a communication assessment from a speech pathologist, may assist in the development of appropriate management strategies including capacity building for the person and their support network. Assessments and capacity building strategy recommendations could include, but are not limited to:
• Activities of Daily Living (ADL) assessment (all participants requesting support with SDA)
• General Living Skills or Functional Capacity Assessment (all participants requesting support with SDA)
• balance and mobility assessment (as part of the Functional Capacity Assessment)
• AT and home modifications assessment, including current and proposed needs as they relate to new home and living options, where a participant has a functional impairment or mobility support need
• sensory assessment (autism and intellectual disability)
• Behaviour Support Assessment (in conjunction with a psychologist). Focus on environmental modifications related to positive behaviour support.

Psychologist

A psychologist will undertake a functional behavioural assessment for a participant who has behaviours of concern (BoC), and will consider everyone involved in the participant’s life. The assessment will inform the behavioural intervention supports required and will support the development of a Behaviour Support Plan (BSP). The BSP will provide strategies and detail supports required to develop the skills of the participant and the people around them. The aim is to promote a supportive and positive environment to reduce the frequency and intensity of BoC. The development of a BSP requires specialised skills that can only be provided by qualified behavioural professionals, therefore funding in the participant’s plan must be entered into the V22.0 2021-04-28 Practice Guide – Identifying Housing Solutions Page 20 of 29 OFFICIAL This document is uncontrolled when printed.

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System as a ‘Stated Support’. A copy of the BSP and any other assessments completed need to be attached to the participant’s record in the System.

If a participant has a current BSP, a review request to a psychologist should be made to ensure all identified BoC have strategies and recommendations to support the participant and carers in their new and existing environments.

8.2.3 Speech therapist (also known as a speech pathologist)

A speech therapist is able to assess the development and disorders of communication and swallowing. A communication assessment will provide a comprehensive assessment of a participant’s communication skills and explore receptive, expressive and pragmatic language, articulation, literacy and fluency of speech. The assessment supports participants who have difficulty expressing themselves and would benefit from capacity building support to assist their communication and learning development.

Participants who have complex communication needs (those who do not appear to communicate directly in a conventional manner) can also benefit from a communication assessment. For these participants, assessments provide support with communication in daily life (including AT where appropriate), provide information to psychologists involved in the development of behavioural management strategies and can result in improved relationships and quality of life.

For participants who have a swallowing disorder, a speech therapist may recommend specific swallowing treatments and exercises to improve muscle movement to support the participant to swallow more effectively. A speech therapist may also consider specific foods and liquids that may be easier to swallow.

Note: The assessment and diagnosis of a swallowing disorder is not an NDIS funded support.

A speech therapist will also provide guidance to support workers or informal supports to assist in implementing and maintaining the treatment plan.

If there are concerns about the nutrition and related health of the participant who needs a modified diet related to their disability for swallowing, then a certified practicing dietitian may be asked to provide an assessment.

8.2.4 Physiotherapist

A physiotherapist provides an assessment which supports the mobility, transfer and equipment needs, recommending suitable self-managed exercise programs to maintain functional mobility. The focus is on the participant’s general functional ability to move about over different types of ground and environments, with an emphasis on the community. A physiotherapist normally:

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• considers features such as stairs, ramps, uneven ground, transfers in and out of
• furniture or vehicles
• identifies suitable mobility AT to support maximal function in different environments
• advises safety precautions.

The assessment report should provide information about factors including balance, strength, enurance, range of movement, stability, coordination, reaction time and whether functional capacity fluctuates over the day or in certain circumstances. A physiotherapist will also consider the influence of coexisting issues such as vision, hearing and cognitive problems, for example, decreased concentration, difficulties with planning and problem-solving and inattention to left or right. This information, together with an assessment by an OT to consider the requirements for a suitable home and living solution, should be taken into account.

Assessments are aimed at those who use mobility aids and where assistance may be required due to progressive deterioration of balance and mobility.

A physiotherapist is able to review and monitor prescribed exercise programs (including hydrotherapy) and will develop support worker training to support the participant to maintain their functional mobility.

Note: The participant will require ongoing reviews with the physiotherapist to monitor their outcomes against their individual goals and the physiotherapist will implement changes to any programs or treatment needed.

8.3 Appendix C – Specialist Disability Accommodation

SDA can only be determined as a reasonable and necessary support for participants with extreme functional impairment or very high support needs. Other home and living options should be considered and explored as part of determining the reasonable and necessary supports for a participant. The combination of SDA and other supports must provide greater benefit in pursuing a participant’s goals and outcomes, and represent value for money compared to other options.

SDA is intended for participants where their accommodation needs and the supports within the home cannot be met by the types of housing available in the general market.

The SDA Rules and Our Guideline – SDA provide further guidance on how participants, providers and their dwelling are considered and managed by the NDIS.

SDA is capital funding the participant will receive in their NDIS plan for the SDA dwelling in which they live. Any other NDIS funded supports that may be provided within the dwelling are funded separately to the SDA and through a separate service agreement to the SDA.

SDA is only expected to be funded for a very small portion of participants, around 6% (or 28,000 at full NDIS capacity) is the current estimate.

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If SDA funding is included in the participant’s plan, it is expected this will assist in meeting the long-term outcomes for the participant and not be used as a transitional support. SDA payments to providers are made at the equivalent rate related to the type of SDA as shown in the participant plan. It is not made based on the current accommodation price for the dwelling, unless the two are equal, (that is, where there is a difference between the participant is found eligible for and the rate the dwelling is enrolled for, the lower price is paid).

There are a range of SDA building types and design categories specified in the SDA Rules and SDA Pricing and Payments. The building types range from a single resident apartment to a group home for five residents. The SDA design categories are: Improved Liveability, Fully Accessible, Robust or High Physical Support.

The NDIS will consider the participant’s current living arrangements, their goals and aspirations in determining if SDA is appropriate. Therapeutic assessments will provide the evidence to further support the planning decision.

When it is identified that SDA is the most suitable home and living solution, the planner must complete a Home and Living Application to be considered by the Integrated Housing Team.

Participants with SDA in their plan may be requested to make reasonable rent contributions to their SDA providers. This is capped at 25% of the base rate of the Disability Support Pension, plus any other government rent assistance payments received. SDA payments are paid to SDA providers through the plan and are separate to the participant rent contribution.

A new SDA decision

When the participant wishes to move in to SDA for the first time or wishes to move to a different SDA dwelling, from an existing or in-kind SDA dwelling, this is considered to be new SDA.

For new SDA, the SDA support funding must not be included in the participant’s plan without referral for a home and living application decision.

The Integrated Housing Team representative or the Housing Panel will review the participant’s SDA eligibility and provide a decision for the participant’s Home and Living request. If the participant is eligible for SDA the home and living application decision will include information on the eligible SDA type and level for the participant. This information is recorded in the Housing and Accommodation section of the participant’s record.

Refer to the Standard Operating Procedure – Create a Home and Living Application.

Existing or In-Kind SDA

When the participant is already residing in an SDA dwelling when they transition to the NDIS they are considered to be in existing or in-kind SDA. SDA funding needs to be included in the participant’s NDIS Plan. Refer to:

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• Standard Operating Procedure – Include Specialist Disability Accommodation (SDA) supports
• Standard Operating Procedure – Adding In-Kind Supports in a Plan.

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Participants transitioning to the NDIS

During transition, all participants already in disability related supported accommodation which has been funded by either State, Territory or Australian Governments will be considered to meet the eligibility criteria for including SDA in their plan. The level of SDA funding approved will be at the same level required to match the enrolled SDA dwelling they already live in. Many existing dwellings are considered Basic. According to SDA rules, basic cannot be considered to be a participant’s appropriate SDA. As a result, many participants will be found to require a different (higher cost) SDA if they are assessed with the intention to move.

Note: It is not expected that the participant once found eligible for SDA, would lose that eligibility. Participants are eligible for SDA if they cannot live in mainstream housing because of:

• an extreme functional impairment
• very high support needs
• their needs are most appropriately met by SDA.

Appendix D – Types of supports

8.4.1 Assistive Technology

AT is defined by the World Health Organisation as ‘any device or system that allows individuals to perform tasks they would otherwise be unable to do or increases the ease and safety with which tasks can be performed’.

For information on including AT supports in the participant’s plan refer to Our Guidelines – Assistive technology on the NDIS website and Assistive Technology guidance on the Planning resources Intranet page.

8.4.2 Home Modifications

For all Home Modifications, the participant must involve a therapist who is suitably experienced and qualified to complete these assessments.

Complex Home Modifications are changes to the structure, layout or fittings of the participant’s home and are required to enable the participant to safely access and move around their home. All Complex Home Modifications need to be referred to the TAB for reasonable and necessary advice prior to progressing the quoted modification. Refer to the TAB Home Modifications intranet page.

It is expected a home modification would only be considered where the home to be modified is the participant’s primary residence and the participant intends to remain living at the residence.

8.4.2.1 Public and community housing home modifications

Remain the responsibility of the relevant state/territory and are not funded by the NDIS.

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Home ownership home modifications

Participants and families who own their own home may have home modifications funded through the NDIS if deemed reasonable and necessary.

Shared equity home modifications

Where allowable under the agreement, home modifications may be funded through the NDIS if deemed reasonable and necessary.

Private rental home modifications

If home modifications are required in a rental property, written agreement from the owner of the property is required before the NDIS would consider funding reasonable and necessary home modifications.

SDA home modifications

The NDIS generally does not fund home modifications in properties owned or leased by SDA providers. The reason for this is that the SDA provider is responsible to provide a suitable physical environment for their clients. Refer to Standard Operating Procedure – Include Home Modification Supports in Plans or Complex Home Modifications Assessment Template.

Capacity Building – Skill Development

If the TSP has generated funding for Capacity building – daily life supports (e.g. individual therapy assessments), this funding should not be removed from the budget and can be used to complement identifying home and living solutions if required. For example, funding generated by the TSP may be used to support the participant in developing their skills for self-care tasks as they await suitable housing.

Individualised Living Options (ILO)

ILO supports are included for the participant in two stages. Generally, you will only include what is reasonable and necessary for the support model once Stage 1 is complete.

Stage 1: Exploration and Design

The first stage is all about the participant exploring and designing their ILO. During this time the participant works with their family, friends and/or chosen provider to:

• work out where they want to live
• what support they will need
• who they want to provide the support
• complete a Service Proposal form. To work out what Exploration and Design supports are reasonable and necessary refer to Our Guidelines – Individualised Living Options.

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To include ILO Stage 1 supports in the participant’s plan, refer to Standard Operating Procedure – include ILO Stage 1: Exploration and Design.

8.4.4.2 Stage 2: Support Model

The second stage is putting the ILO supports in place. Stage 2 Support Model includes funding for:

• Primary supports

• Supplementary supports, and

• Monitoring and adjusting supports if the participant’s needs change.

To work out what Support Model funding is reasonable and necessary refer to Our Guidelines – Individualised Living Options. To include ILO supports in the participant’s plan, refer to Standard Operating Procedure – include ILO Stage 2: Support Model.

8.4.5 Supported Independent Living

SIL is assistance with and/or supervising tasks of daily life to develop the skills of participants to live as independently as possible.

The NDIS generally only provides SIL for participants aged 18 years and over. Funding SIL for children under the age of 18 years would only be considered in exceptional circumstances. All providers will be required to use the new SIL pack and quoting tool when submitting quotes for these services.

The SIL pack and quoting tool and template will ensure a more efficient and nationally consistent process and is intended to result in provider quotes being assessed in a timely and responsive manner.

Refer to the Provider SIL pack and Standard Operating Procedure – Include Supported Independent Living (SIL) in plans.

Supporting material

• NDIS Act 2013

• NDIS Rules

• Planning Operational Guideline

• Our Guideline – Specialist Disability Accommodation (SDA)

• Our Guideline – Medium Term Accommodation

• Our Guideline - Individualised Living Options (ILO)

• Our Guide – Supported Independent Living

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Feedback

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Process owner and approver

General Manager Participant Experience Design.

Version change control

Version No	Amended by	Brief Description of Change	Status	Date
18.0	CW0032	Class 1 approved. Updated links to assistive technology guidance.	APPROVED	2020-12-10
19.0	BIB217	Updated information for Specialist Disability Accommodation (SDA). Includes Housing Applications created in the ACE Business System, the role of the Operational Housing team and Housing Panel process. Update Assistive Technology link to external Our Guidelines. Content endorsed by Operational Housing Branch Manager Performance Management and Quality. Class 3 approval	APPROVED	2020-12-27

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