Back
Politics

Aged Care Assessment Algorithm Under Scrutiny Amid Reports of Under-Assessment and Lack of Human Override

Generated on: Last updated: 4 sources
View source

Algorithm-Driven Aged Care Tool Under Fire for Under-Assessment

The Australian government's new algorithm-assisted assessment tool for home-based aged care, the Integrated Assessment Tool (IAT) , has become the subject of ongoing debate following reports that it frequently under-assesses individuals' needs.

The tool, introduced in November as part of the Support at Home reforms, uses an algorithm to determine funding levels and priority for services. A central point of contention is that assessors have been prohibited from overriding the tool's outcomes for home support assessments, even when errors are identified.

System Function and Government Rationale

The IAT is designed to evaluate eligibility and assign funding levels for aged care services. Minister for Aged Care Sam Rae has stated that the tool provides a standardized and objective application of rules, describing it as a significant improvement over the previous system. He cited over 130,000 assessments conducted in the March quarter, with median wait times under a month.

"The tool provides a standardized and objective application of rules." — Minister for Aged Care Sam Rae

The Department of Health, Disability and Ageing has indicated that the rationale for introducing the algorithm was to create a consistent, national approach to assessing care needs and to reduce variation in outcomes. Robert Day, the department’s first assistant secretary, stated during a Senate inquiry that the lack of an override function stems from the IAT's design to provide an "objective outcome" with "no discretionary element" based on assessment scores.

Reports of Under-Assessment and Impact on Individuals

Reports from multiple sources indicate that the algorithm has frequently classified individuals at lower support levels than they previously received or were expected to need, even in cases where health has deteriorated.

  • The Older Person’s Advocacy Network (Opan) reported a 50% increase in requests for information and advocacy related to home support between October and December, totaling 7,500 requests. Opan stated that numerous concerns are related to the IAT, including individuals with dementia not being classified as a high priority.

  • Specific cases have been cited in media reports and parliamentary inquiries, including an 83-year-old largely immobile man who was denied home support, and a visually impaired man who received a lower-level package because he could find the toilet in his home.

  • Developer Concerns: Lynda Henderson, a member of the federal government's advisory group involved in developing the IAT assessment questions, stated that she was unaware an algorithm would be applied to score questions and assign categories. She has expressed concern about the current implementation and is hesitant to use the tool.

Legal and Regulatory Questions

A Senate inquiry heard that there appears to be no legal barrier to overriding the algorithm. Department staff confirmed the government has sought advice on reinstating the override function.

  • The IAT user manual details an override function but does not explicitly link a ban on its use to a specific provision of the Aged Care Act or the Aged Care Rules.
  • Liberal senator Paul Scarr and Greens senator Penny Allman-Payne have raised questions about the legality and regulation of preventing assessors from correcting algorithmic errors.

Algorithm Testing and Review Process

Department staff confirmed that the algorithm was tested in 2024 and 2025 with human override capabilities still active. It was not tested after the override function was removed.

As the only recourse for disputing an assessment, the department has received 834 requests for internal review of IAT outcomes since November. These reviews take over two months on average. Of the over 1,000 individuals who initially requested a review, 132 out of 606 finalized cases required reassessment.

Political Responses

  • Independent Senator David Pocock questioned the rationale of not allowing experienced assessors to correct errors, raising a specific case of a visually impaired man.

  • Shadow Minister for Health and Aged Care Anne Ruston reported increasing concerns from frontline professionals and has requested clarity on the tool's operation and the number of complaints.

  • Greens Senator Penny Allman-Payne has written to Minister Rae urging the immediate reinstatement of human oversight and public disclosure of the algorithm's details.