The NDIS is failing tens of thousands of profoundly disabled Australians, according to a new Grattan Institute report.
Instead of having genuine choice over where they live, who they live with, and who provides their support, people with profound disability are often left with only one option - group homes - where they are at high risk of violence, abuse, and neglect.
The report, Better, safer, more sustainable: How to reform NDIS housing and support, finds that about 43,500 people who need intensive support are getting little benefit from a scheme that was supposed to give them a better life.
Yet the costs are eye-watering: at least $15 billion per year, or an average of more than $350,000 per resident for intensive support. That's 37 per cent of the total costs of the NDIS for only 7 per cent of its users.
'The government needs, and disabled people deserve, far better services for this price tag,' says report lead author and Grattan Institute Disability Program Director Sam Bennett.
Big, institutional-style group homes should be phased out within the next 15 years.
There are better and cheaper alternatives to group homes, but they are not widely available because National Disability Insurance Scheme (NDIS) policies are too rigid and its funding too inflexible.
Other countries - notably the UK and Canada - have successfully reformed disability housing and introduced new living arrangements which offer people greater choice, safer accommodation, and stronger links to their local community.
The Grattan report calls for a four-pronged national strategy to improve housing and support for profoundly disabled Australians.
First, the National Disability Insurance Agency should give more support to alternative options, such as those that are working well in Western Australia and overseas, and help more disabled people into housing in the community.
Second, the current group-home arrangement should be reformed so people can control the rhythms of their day: who they live with and how services are provided in their home.
Third, the funding process needs to be overhauled so people who need intensive support at home get more help to understand their options and navigate the system.
And fourth, the NDIS regulator should develop practice standards for share homes and individualised living, with mandatory inspections to make sure the standards are being met and the residents are safe.
'Giving disabled people more options and more say about how they live is a win-win,' Dr Bennett says. 'It will transform the lives of some of Australia's most disadvantaged citizens, and taxpayers will be better off because it will help make the NDIS more sustainable for future generations.
'Getting this right should be a litmus test for any government seeking to get the NDIS back on track.'