Support models describe how you receive assistance to live your life in a way that is meaningful to you. For some with lower support needs, they may require drop-in supports during the week, either from unpaid or paid sources. For others with high support needs, they may need 24/7 paid support, either alone or in a shared environment.
Good support is the main indicator of quality of life and we know extraordinary lives can happen in ordinary buildings. Taking time to deeply consider who will support you and how they will do it is key to good outcomes in accommodation. A good support team can assist you to access new places, introduce you to new things, teach you new skills and provide a sense of security and stability in your life.
Natural Supports are unpaid supports that are provided to people in an organic way. Natural supports are varied in their nature and who provides them, but the most common type of natural supports are those provided by family members to those who have a disability. Natural supports more broadly can include support from friends, neighbours, members of a circle of support or from voluntary support organisations or workplaces.
What does “Natural Supports” really mean? To answer this question, it may be easier to look at yourself and think about all the people in your life—friends, family, co-workers. Relationships with these people are your natural supports. Who has been instrumental in pivotal points of your life, or whom can you count on for help? What did you do to establish those relationships? These are questions that some people give little thought to, because our natural supports are taken for granted.
We assume most people want to live happy and comfortable lives. To achieve the lifestyle they prefer, people rely on some kind of support system or network. This is where “natural supports” enter. Natural supports by definition are just that …”natural.” They are a phenomenon of personal and community support that touch many facets of life.
For those with lower support needs, checking in with natural supports and some limited hands on support might be all you need to have your support needs met. Legacy planning is a must for those who only receive natural supports, and your Support Coordinator or LAC may be able to help in linking you to people who can set up a framework for ongoing natural supports into the future.
Supported Independent Living (SIL)
Supported Independent Living is the model of support that most people think of when considering disability supports outside of the family home. Supported Independent Living is the model of support that is usually delivered in Group Homes (Community Residential Units). SIL is the biggest ticket support item on the NDIS, costing on average $340,000 per Participant as of 2020
SIL is for those who require a 24 hour support in their day to day lives. SIL supports typically can be described as one support provider (although this is not always the case) working in a home to deliver all in home supports, including personal care, support with meals and organising a person’s day to day life, communication with other providers and in some cases, transport. SIL providers have duty of care for people who live in their homes, and for this reason, some families and participants preference this model of support, as the model has a lot of built in safeguards for vulnerable people.
SIL works on what is called a Roster of Care (ROC). This roster sets out all supports that are to be delivered within a given property and at what ratio (eg 1:1, 1:2), how many hours of support are required outside of the home (Community Participation hours) and how many incidental hours (unplanned hours for days at home etc) are required.
Be aware that SIL to live alone is very hard to get in an NDIS plan and requires very specific evidence as to why living alone is Reasonable and Necessary. You will need an experienced Allied Health team behind you to make a case for living alone. It is not uncommon to have to go to review and potentially to the Administrative Appeals Tribunal (AAT) to have SIL to live alone funded in your NDIS plan. If you want to live alone, you will need to make sure you have presented evidece to suggest to the NDIA that living alone is Reasonable and Necessary.
This model of supports needs to be considered carefully, as in some instances it can limit choice and control. It is also important to ensure that there is a separation of housing and support i.e. the landlord is not also the provider of Supported Independent Living. Separation of housing and support is extremely important for people who are considering their support options in the community. This is so that if there is an issue with either the landlord or support provider there is no conflict of interest.
People living in SIL will have taken time to carefully select and employ a Supported Independent Living provider who is responsible for the duty of care. It is recommended that people who employ a SIL provider have clear expectations of the service they would like to receive, which is set out in an agreement signed by all parties. The provider of SIL can be the biggest determinant of a good life for many people with this level of needs requirement. Remember that Participants hold the funding in these arrangements and therefore the power. It is important that you have an agreement that states how you want to be supported that is agreed upon by your provider.
It’s important to look for a provider that clearly wants to work with you towards your individual goals, and is prepared to take time and invest in knowing who you are and how you want to be supported.
For more info on SIL, check this link: SIL for Participants – NDIS
Individualised Living Options (ILO)
ILOs are a package of supports that are developed with your support needs and preferences in mind. If you have moderate to high support needs, ILOs might be for you. An ILO can take many forms and have a high degree of flexibility built in. These models of support are designed to consider people’s unique circumstances and promote an ordinary life in the community.
A common example of an ILO is what we call a Housemate arrangement. Housemate arrangements are typically where a person who does not have a disability lives with a person or people who has a disability and an NDIS plan funded with ILO. The Housemate provides an agreed upon level of guidance, prompting, companionship and support to the participant(s) and in return the NDIS will provide what we call a sustainability payment (rent stipend) to cover some or all of their rental costs. Alongside the Housemate will be a budget for direct support workers, and funding for facilitation of the arrangement to ensure consistency and quality.
ILOs are broken down into two stages:
Stage One – Exploration and Design.
An NDIS Participant can ask for this funding in their NDIS plan by submitting a Supporting Evidence – Home and Living form to the NDIA. Once this funding is in a person’s NDIS plan, they can work with an ILO provider to explore their options and to develop what is called a “Service Proposal”. This proposal will include important detail about the proposed arrangement and will contain evidence from allied health providers about why the arrangement is reasonable and necessary.
Stage Two – ILO Supports.
If the Service Proposal is considered Reasonable and Necessary by the NDIA, they will fund ILO Supports in your NDIS plan. Please note, this is defined as a “decision” by the NDIS and will generate a new NDIS plan. This funding should mirror the funding set out in the Service Proposal developed in stage one. You can use this funding to work with an ILO provider to deliver the supports set out in the Service Proposal – including Support Workers, facilitation of the arrangement and supplementary supports.
See more about ILOs here.
Assistance with Daily Living (ADL)
This is the model of in-home support that most NDIS participants will be familiar with. This support is also known as “drop-in supports”. These supports can be provided by multiple organisations or by independent support workers.
A support worker will come into the home and work with you on activities of daily living, including meal preparation, domestic duties and personal care. This support is usually provided to those who have lower support needs, who might just need someone from time to time to check in and make sure that things are running smoothly and to assist with planning and preparing for weekly activities.
This support comes from the Core budget of your NDIS plan, and can be used to purchase supports in a shared or 1:1 setting as part of a roster or “as required” support.
To get this model of support in your NDIS plan, you will need to let the NDIS know what your are asking for in a very specific way. This will mean working with your Support Coordinator or another trusted person to develop a vision for your Home and Living supports. You will need to have evidence from an Allied Health professional to support any request that you make, including how you want to be supported, when you need support each day, and when you want to take holidays or spend time with natural supports (family, etc).
This information needs to be put into a Home and Living Supporting Evidence form and the submitted to the NDIA alongside full reports. You need to remember that anything you ask for needs to be considered to be Reasonable and Necessary.