The NDIA Consultation Paper, An Ordinary Life at Home, revealed many insights into the transformation proposed by broad ILO uptake. Curiously, several scenarios were provided that allow us to form a view on how the model might be priced and what the implications may be for customers, providers and ILO teams.

The scenario of Tori in the consultation paper gives us a clear view on how much time is spent inside and outside of placement. Using scenario analysis we can make assumptions about what the equivalent SIL funding might have been. At the 1 on 1 rate, Tori’s support would cost around $410,000 a year, including public holidays and sleepover costs. The scenario suggests that the NDIS prices these supports at $115,000. If we consider the time in placement, the SIL model provides an effective hourly rate of $73.01 (including some assumptions about sleep over disturbance) and the ILO model provides an effective hourly rate of $20.41 – a 72% discount.

This raises several key questions about how an ILO setting might differ from the current SIL model. Is the NDIS expecting far less support in ILO settings? Or is there a view that ILO support is fundamentally different, and less cost intensive? If we assume the NDIS price the support in the same fashion, then an ILO setting would provide, on average, 30 hours of support a week, or about 28% of the support of a regular SIL placement. This presents us with a fundamental question about ILO – Does ILO provide considerably less support than SIL, or is ILO paid at a drastically lower hourly rate?

Regardless of the above, it is our view that ILO may still be in the best interest of the person being supported. They are able to live in a way that is as close to regular life as possible, with support only being provided as needed.

Indeed, this aligns nicely with both the concepts of active support and person-centredness. Of course, we are staunch advocates for such an approach, however the implications for support professionals and organisations need to be considered.

Firstly, Empathia Group are strong advocates for the professionalising of support work. It is a valuable and complex profession that makes a genuine difference in people’s lives. However, the ILO model implies that either the support provided under SIL is cheap to replicate, or that SIL supports are far too intensive. We are unable to reconcile either perspective.

For organisations there are serious repercussions regarding how work is recognised and rewarded. The funding model proposes a radical rate reduction from SIL, which implies that support must be far less intensive. However, the implied hours are far too low for people to receive support in a fashion remotely similar to SIL. Indeed, if people are funded for only reasonable and necessary supports, then someone is going to foot the bill for the support gap. I suspect this will take the form of voluntary support from ILO host teams, who are likely more than happy to do it.

If we take the view that ILO supports are fundamentally different, and are truly “informal” then the consequences are considerable. For participants who access ILO, the supports they receive will undeniably replace those which would have previously been provided by paid support workers under the SIL model. The NFP sector has learned that volunteer work must not replace work which can be performed by professionals, as demonstrated by a number of precedents within the FairWork Commission.

At any rate, the ILO proposal is a “de-formalising” of support work, with implications in both directions. As we saw in the early days of SIL with weekly “block funding”, the true cost of support tends to benefit one party. Unfortunately, informal systems tend to incentivise intense customer selection, where providers only seek to support customers who can be assisted within the constraints of the informal price model.

ILO represents a radical departure from formalised SIL funding and will create a support surplus, or support gaps that will need to be accommodated by someone.

We would love to keep this dialogue going, feel free to contact us to discuss.