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Response to the Supported Independent Living Commissioning Consultation
The fundamental principle should remain simple.
Support should be organised around the person. The person should never be organised around the support system.
That is the standard against which SIL commissioning should be judged.
Abstract:
This submission responds to the Australian Government’s consultation on a possible commissioning approach for Supported Independent Living (SIL). It argues that the central issue is not simply whether commissioning could improve the quality, safety or sustainability of SIL, but whether transferring greater control over the organisation and delivery of support to government and commissioned providers is compatible with the NDIS principles of individualisation, choice and control and with the right to independent living.
The submission examines commissioning through the framework of Article 19 of the United Nations Convention on the Rights of Persons with Disabilities and General Comment No. 5. It argues that institutionalisation is not defined by the size or location of a building, but by relationships of power. Obligatory sharing of support, limited choice over workers or housemates, provider-controlled routines, restricted control over everyday decisions and dependence upon organisational systems can reproduce institutional characteristics even within ordinary homes in the community. SIL reform must therefore be assessed according to whether it transfers power towards or away from the person with disability.
The submission responds to the consultation questions concerning participants, quality, safeguards, innovation, participant choice and provider sustainability. It rejects any presumption that people requiring 24/7 support should constitute a commissioning cohort or that shared staffing ratios provide an appropriate starting point for determining support. Support arrangements should instead arise from individual need, circumstances, preferences and evidence, with Government bearing responsibility for demonstrating that any proposed shared arrangement is safe, appropriate and rights-compatible.
Particular attention is given to how quality is defined. The submission distinguishes organisational performance from personal quality of life and proposes person-defined approaches such as Personal Outcome Measures as a more appropriate basis for evaluating outcomes. A service may satisfy regulatory, staffing and administrative requirements while the person receiving it exercises little meaningful control over their home or everyday life. Quality should therefore be assessed through outcomes such as autonomy, safety, relationships, community inclusion, rights, choice, personal authority and the achievement of goals that matter to the individual.
The submission similarly argues that autonomy, relationships, community inclusion, independent advocacy, control over workers and the ability to change providers without losing one’s home are themselves important safeguards. Innovation should encompass self-direction, direct employment, Service for One arrangements, participant-governed teams, micro-providers and other alternatives developed by disabled people and families, rather than being understood primarily as innovation by commissioned providers. Provider sustainability is recognised as necessary, but it must remain a means of supporting participants rather than an outcome to which participant rights are subordinated.
The submission does not defend the existing SIL system. It argues for substantial reform, but cautions against responding to the failures of provider-controlled and congregate models by constructing a more efficiently commissioned version of the same underlying system. Instead, reform should strengthen individualised funding, self-direction, participant governance, separation of housing and support, direct employment, Service for One arrangements, independent advocacy, relational safeguarding and targeted intervention where genuine market failure can be demonstrated.
Before proceeding with commissioning, Government should demonstrate the problem it is seeking to solve, publish the evidence and modelling supporting its proposed intervention, examine less restrictive alternatives, undertake a human rights impact assessment against Article 19 and General Comment No. 5, protect the right to refuse inappropriate shared support, and guarantee the continuing availability of genuinely individualised support arrangements. If the consultation is genuine, not proceeding with commissioning must remain a possible outcome.
The submission's central proposition is simple. Support should be organised around the person; the person should never be organised around the support system. SIL reform should ultimately be judged by that standard.
Key Themes
This essay develops a consistent argument that the SIL commissioning debate is ultimately not about procurement or market management, but about power. Who controls the home, support and everyday life of a person with disability. That theme runs through the submission's responses on participants, quality, safeguards, innovation, choice and provider sustainability.
The key themes are:
Commissioning represents a potential transfer of power. The essay argues that commissioning is more than a technical funding reform. By allowing government to take a stronger role in determining providers, funding, service structures and delivery expectations, it potentially transfers decisions that were intended to belong to participants to government and commissioned providers. The central question is therefore whether supports will continue to be built around individual people or whether people will increasingly be fitted into predetermined service structures. This concern is particularly relevant because the Government itself describes commissioning as taking a more active role in how SIL is planned, funded, delivered and monitored.
Article 19 and independent living provide the human-rights benchmark. Drawing on the UNCRPD and General Comment No. 5, the essay argues that independent living cannot be defined merely by living in an ordinary house in the community. Institutionalisation can exist in small group homes and even individual dwellings where people experience obligatory sharing of support, limited choice of workers or housemates, provider-controlled routines, paternalism or lack of control over everyday decisions. The essential issue is therefore the distribution of power.
Commissioning carries a risk of reinstitutionalisation. The essay does not suggest that Government intends to recreate large institutions. Rather, it warns that commissioning could reproduce the characteristics of institutionalisation through shared staffing, provider-controlled arrangements, standardised service models and organisational control. A smaller house in the community does not necessarily represent deinstitutionalisation if the underlying relationships of power remain unchanged.
24/7 support should not automatically define a commissioning cohort. The response rejects the assumption that people requiring continuous or complex support are inherently appropriate for commissioning. For many such people, individualisation, worker continuity, communication knowledge, environmental predictability and carefully designed relationships are essential elements of safe support. Complexity should therefore be a reason for greater attention to individual need, not a reason to standardise support.
Quality should be measured through people's lives, not provider compliance. One of the strongest themes is the distinction between organisational quality and personal quality. A provider can pass audits, maintain rosters and comply with standards while a participant exercises little meaningful control over their own life. The essay therefore proposes Personal Outcome Measures (POM) as a more appropriate framework because it asks whether people actually experience safety, relationships, rights, choice, community inclusion and progress towards personally meaningful goals.
Autonomy and inclusion are themselves safeguards. Safeguarding is presented as much more than regulation, registration, audits and incident reporting. The ability to choose and dismiss workers, change providers without losing one's home, maintain relationships outside the service system, access independent advocacy and exercise authority over one's life are themselves powerful safeguards. Conversely, concentrating housing, support, complaints and everyday decision-making within one organisation can increase dependency and vulnerability.
Innovation should not be defined as provider innovation. The essay argues that some of the most important innovations in disability support have come from disabled people and families rather than traditional providers. Self-direction, direct employment, Service for One, participant-governed teams, micro-providers and separating housing from support are examples. Commissioning could suppress rather than encourage such innovation if it favours large providers, standard contracts and organisations with the administrative capacity to participate in procurement processes.
Choice must be substantive rather than managed choice. Being allowed to select from a small number of government-commissioned providers is not equivalent to the NDIS conception of choice and control. Genuine choice includes deciding where and with whom to live, who provides support, who enters one's home, whether support is shared and whether to use a conventional SIL provider at all. The essay therefore makes voluntary participation central: freely choosing to share support is fundamentally different from having shared support imposed through funding rules or provider economics.
Provider sustainability must remain subordinate to participant rights. The essay accepts that viable providers and a sustainable workforce are necessary, but rejects provider sustainability as an end in itself. Occupancy, predictable revenue, workforce utilisation and shared staffing may improve organisational viability while simultaneously diminishing a participant's autonomy or safety. The appropriate policy objective should therefore be making individualised, rights-based arrangements sustainable, rather than making people conform to arrangements that sustain providers. The tension is particularly relevant because Government reform material expressly identifies addressing “provider viability challenges” as one rationale for exploring SIL commissioning for people requiring 24/7 support.
The economic logic of shared support must not replace individual assessment. The essay directly challenges generalised shared-support assumptions. One worker supporting several participants may be less expensive, but economic arithmetic does not establish that the arrangement is safe, effective or appropriate for a particular person. The submission argues that Government should establish why sharing is appropriate rather than requiring a participant to demonstrate why they are incapable of sharing.
Commissioning should be tested against institutional characteristics, not appearances. The proposed human-rights test is particularly important. Rather than asking whether people continue to live in community houses, Government should examine whether commissioning produces obligatory sharing, reduces control over workers or housemates, increases provider control, limits the ability to change providers or makes individualised alternatives practically unavailable. The central question becomes whether the reform reproduces the power relationshipscharacteristic of institutionalisation.
There is an alternative reform direction. The essay is deliberately not a defence of existing SIL. It proposes reform based on individualised funding, self-direction, Service for One, direct employment, participant governance, separation of housing and support, independent advocacy, relational safeguarding and targeted intervention where genuine market failure exists. The objective should ultimately be to develop alternatives to traditional SIL rather than simply improve the administration of traditional SIL.
The themes ultimately converge on one proposition. The success of SIL reform should be measured by whether it transfers power towards or away from the person with disability. The essay accepts the need for reform but rejects the proposition that the solution to problems created by provider-controlled and congregate systems is necessarily to construct a more efficiently commissioned version of those systems. Its central message is captured by the statement already placed on the cover:
“Support should be organised around the person. The person should never be organised around the support system.”
That is really the organising principle connecting every section of the submission.
Click on this link to read the complete submission:
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