Almost one-fifth of older Australians who contested their Support at Home funding allocation determined by an algorithm had a higher level of support or higher priority allocated once a human reviewed the decision. The department of health and ageing would not provide the most current data on how many people have contested their funding allocation under the integrated assessment tool (IAT), introduced in November, which is used across aged care to determine eligibility and classification for services, including Support at Home. It provided data up to 31 March only, which shows there were 757 requests for a review of a Support at Home funding allocation.
Of those, 141 led to a change in outcome more favourable for the older person, resulting in eligibility for more services, a different classification or higher classification level, or a higher priority category. A further 177 cases had no change, 304 were closed, and 135 are still in progress. The IAT involves an assessor asking an older person questions about their physical, social and personal circumstances to determine how much government-funded home support they are eligible to receive.
An algorithm then uses this data to allocate a level of support. The algorithmic decision is unable to be overridden by the assessor if they believe the older person has been allocated a lower level of support than is needed. It is a system that has left many people without adequate care, potentially forcing them into aged care homes sooner.
It prompted the commonwealth ombudsman to launch an investigation in April into the tool, which has been described by assessors and older people as “cruel” and “inhumane”. That investigation is ongoing. The Greens senator Penny Allman-Payne is one of several politicians who has been calling for the government to reinstate human oversight to the tool.
She said the department’s data does not show the complete picture of how many people are being left without adequate support, since many people do not know how to contest a decision. The way the tool is set up makes it systematically incapable of accurately determining need for those with cognitive issues, mental health conditions, and frailty.” Mark Aitken is nurse who has worked in aged care, and in February he blew the whistle on the lack of human oversight in home support decisions. He has since established Mascotte Aged Care Solutions, which provides independent guidance and advocacy for older adults and their families navigating the aged care system.
Aitken said he has been supporting people to challenge their Support at Home funding allocations but said “many older people don’t have the luxury of time”. Aitken said the government needs to explain how decisions are reviewed and what criteria is used, and what the data on the number of closed cases means. The shadow health and aged care minister, Anne Ruston, told Guardian Australia that the number of review requests had “exploded” since the government “put their faceless algorithm in charge of deciding who gets care, and who gets left behind”.
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