Aged Care Algorithm Under Fire After Family's Support Reduced

A new algorithm-based system used to assess eligibility for aged care support in Australia is facing criticism after a family reported a significant reduction in their care package. This follows a reassessment under the new system for Graham Crossan, 80, who has advanced Motor Neurone Disease (MND).

Graham Crossan, 80, who has advanced Motor Neurone Disease (MND) and requires 24-hour care, was denied additional home support and had his weekly care hours reduced following a reassessment under the new system.

Background: A Life-Limiting Condition and Reduced Support

Graham Crossan, ineligible for the National Disability Insurance Scheme (NDIS) due to his age, receives essential support through My Aged Care. His condition requires constant care, including assistance with mobility, feeding, and breathing via a ventilator. His wife, Gaynor, 79, provides primary care and relies on a dedicated carer for assistance with demanding daily tasks, such as safely moving Graham.

Prior to the reassessment, the Crossans received 14 hours of carer support per week; this has since been reduced to nine-and-a-half hours due to increased costs and the new assessment outcome. This significant reduction has placed additional strain on Gaynor and their family.

The New Algorithmic Assessment Tool

The federal government implemented changes to aged care support assessments in November as part of reforms aimed at system sustainability and equity. Graham's re-assessment was conducted using the Integrated Assessment Tool (IAT), an algorithm specifically designed to determine a person's level of need. A critical feature of this new system is that decisions made by the IAT cannot be overridden by human assessors.

Growing Concerns and Advocacy Efforts

Geoff Rowe from Aged and Disability Advocacy Australia reported an increase in similar cases, comparing the situation to the 'robodebt experience.'

Rowe highlighted a significant flaw, stating that the algorithm is not adequately identifying the urgency or complexity of individuals' situations. He noted a worrying trend where some individuals seeking increased care packages have instead experienced reductions, profoundly impacting their ability to live independently and safely at home.

The process for challenging an IAT assessment is stringent: it requires sending a postal letter to the System Governor at the Department of Health, Disability and Ageing within 28 days of the decision. A response is then aimed for within a lengthy 90-day period.

Jo Whitehouse from MND Victoria has voiced strong objections to this timeline. She stated that a 90-day waiting period for a response is too long, particularly for individuals with progressive neurological conditions like MND. Whitehouse has called for the immediate removal of the algorithm and for all MND cases to be fast-tracked through a more humane assessment process.

Government's Stance

A spokesperson for the Federal Minister for Aged Care, Sam Rae, stated that the assessment process is based on assessor input and clinical advice to achieve accurate and consistent outcomes. The government maintains it is actively monitoring the assessment and pricing processes and intends to refine them as the system develops.

Wider Implications and Calls for Change

Geoff Rowe highlighted that inadequate home support is leading to increased hospital admissions or accelerated transitions to residential aged care, which are often not preferred outcomes for individuals and represent more expensive options for taxpayers.

These outcomes pose a dual challenge, impacting both the well-being of individuals and the financial burden on the public purse. Gaynor Crossan described the system as unfair and inhumane, noting that her request for a review of the decision was merely acknowledged, not confirmed for reconsideration. This lack of clear recourse leaves families feeling powerless and desperate as they navigate a complex system designed to support their loved ones.