NDIS provider sustainability: quality, leadership and service continuity

In a sector under real pressure, how do organisations make hard decisions without losing sight of quality, culture and purpose? DSC's Charmaine Fraser put that to two organisations doing it well: Mel Kubisa, CEO of South Australia's Community Living Options (CLO), and Kate Fulton and Lynsey McDonnell, CEO and CFO of Western Australia's Avivo. It was one of the most quietly inspiring sessions of the conference, and its central claim was that quality and sustainability are not rivals.

Asked how she recognises quality before she even opens an audit report, Mel Kubisa started with the organisational model: good governance and leadership that build high-performing teams who measure their impact, outcomes and implementation. But her real emphasis was evidence-based practice, everywhere. At CLO that begins with active support, which they have committed to seriously, including taking part in La Trobe University's active support trials (a nod to Christine Bigby's team in the room) to actually measure how well they were implementing it, rather than assuming. They have applied active support to psychosocial disability and a good lives model to forensic disability. And she brought it back to earth: quality, walking the floor, looks like participants living a life in their home, showing you how they shop, cook and get to their basketball group, what she called "ordinary magic" brought to life every day.

Kate Fulton and Lynsey McDonnell told a harder story. Avivo supports around 3,000 participants and employs over 1,000 staff, and endured years of losses under the NDIS. For a long time they poured energy into advocacy and case studies to argue for better pricing, effort aimed at an outcome they could not control. The 2024 pricing review was, in Lynsey's words, a kick in the guts and a wake-up call. They decided to stop working that way and invest in what they could control. That meant a thorough review of their structure and operating model and some fast, difficult decisions, communicated transparently and implemented quickly: a significant reduction in business-support roles, ceasing legacy programs, closing unviable services, centralising functions.

What made it land was how they did it. Kate noted their colleagues are largely middle-aged women who, as she put it, get stuff done, people who know how to build a budget, cut their cloth and make hard decisions. So they went in with respect and nothing to hide, involved people in the decisions and the implementation, and when services closed, most colleagues chose to stay to the end to ensure people had a good transition. They did not, Kate said, lose trust or their values; the work they do is something they are proud of and want to still be doing in 50 years.

Charmaine noted CLO had achieved an exceptional audit result, 26 elements of best practice, while staying financially viable, and asked why Mel sees quality and sustainability as inseparable. Her answer became the session's thesis: quality is sustainability and sustainability is quality. CLO never set out to be compliant; they set out to implement evidence-based practice and deliver outcomes, measuring implementation and impact daily, and the audit result followed. She called the connective tissue "implementation discipline," with two structures: finance at the table at every organisational meeting (so you truly understand your cost model, your bottom line, and where role and efficiency drift creep in) and an operating model that fits evidence-based practice into that reality. Tellingly, CLO's strategic direction is written to focus on quality evidence-based practice, not growth, and they grew anyway. And she made a deliberate choice to bring back joy and magic amid the discipline, right down to dress-up AGM parties, because grinding through efficiency structures alone was "losing the will to live."

Asked where providers waste energy waiting for government, the panel was pointed. Lynsey said the waiting itself is the problem; Avivo should have made its hard decisions sooner, lulled by one good price-review year into a false sense of security. Her test: if you were starting a new organisation in today's context, how would you structure it, and what are you carrying that no longer fits? Be honest, and act.

Kate framed it as a leadership paradox. You are constantly scanning a grim horizon of risks, and it had skewed everything toward survival, with no room for innovation. The job of a leader, she argued, is to balance that realism with joy, purpose and impact, not as Pollyanna denial (many people with disability are genuinely frightened), but because balance is where innovation and real listening return. Avivo's leadership team wrote a manifesto and now call themselves "Joy Hunters," a reminder that leaders get to decide how they show up and what they celebrate.

Mel agreed you cannot lead through fear, and gave a concrete example: a year ago CLO started building a practice framework in anticipation of new SIL practice standards, mapping their practice rather than dreading the standards, because they wanted them, to lift quality across the sector. Their PBS lead partnered with a university on a supported decision-making framework. That, she said, is leading without fear.

Mel wanted two. First, change the narrative about good providers: the whole market has been defined by its worst examples, when good providers are disability experts holding complexity, risk and relationships, and it is government's job to lift the bar on market entry and deal with the poor-quality "pop-ups" she refuses to call providers. Second, organisational kindness: a trauma-informed system that is kind, not soft, with proportionate, fair regulation that understands frontline complexity.

Kate's answer was that the sector has a far greater social impact than an hour of support, the volunteering, the effect on colleagues' families and communities, that never shows up in a billable hour. She thinks of Avivo as a community organisation, not a supplier, and pointed to their "Support Project," a public installation across Perth demonstrating the reciprocal value of this work. Her closing insight, echoed by Lynsey: a participant's or colleague's experience on any given day is shaped far more by leaders and the conditions they create than by government context or funding, and there is freedom in accepting that you have agency there.

The unifying message: stop waiting for the perfect pricing, legislation or conditions, and lead on what you control. Put finance at the table alongside practice, treat quality and sustainability as one thing, make hard structural decisions early and transparently, and deliberately protect joy and culture, because that, more than the funding context, shapes the experience of the people you support and employ.

Both organisations modelled respect for staff as capable adults: involved in hard decisions, trusted with the truth, and central to quality. The message to workers is that your expertise and your wellbeing are treated as core to sustainability, not a cost to be trimmed.

Behind the business language is a participant-centred claim: quality, measured as real outcomes in real homes, is what keeps good providers viable enough to keep supporting you. And both leaders were determined to hold hope alongside honesty, walking alongside people who are frightened about the future rather than pretending the fear away.

Mel Kubisa, CEO, Community Living Options Mel started in the sector as a support worker nearly 30 years ago and has led Community Living Options (CLO) in South Australia as CEO for the past seven years, with a deep commitment to evidence-based practice.

Kate Fulton, CEO, Avivo Kate leads Avivo, a Western Australian provider supporting around 3,000 participants with over 1,000 staff, and champions leading from balance rather than fear.

Lynsey McDonnell, CFO, Avivo Lynsey brings financial and commercial expertise "with pragmatism and heart" to Avivo's leadership.

Charmaine Fraser, DSC (host) Charmaine is DSC's "link queen" and a senior manager in quality, risk and compliance at Thrive.

Read the full 2027 NDIS changes summary from the reforms reshaping the NDIS to who's expected to stay or go and the crackdown on unscrupulous providers, we've pulled every hot topic and its likely outcome into one quick overview, then gone deeper on each with its own explainer written for both providers and participants, Q&A included. Get the lot in the DSC NDIS Conference 2026 wrap-up.