Ombudsman Finds Aged Care Algorithm Unfair and Lacking Human Oversight

Older Australians receiving care funding are facing decisions that a government report calls unfair and unreasonable. The commonwealth ombudsman found that the Integrated Assessment Tool, or IAT, lacks adequate human oversight. This automated system determines which aged care entitlements individuals receive.

Iain Anderson, the commonwealth ombudsman, issued the 104-page report on Monday. He stated that legislation needs to change so that assessors can correct decisions they believe are clinically wrong. Currently, staff cannot override the algorithm's recommendations even when they identify errors.

The investigation began in April following public and media concerns. These concerns focused on assessments for home support packages. The report describes the IAT as a technological black box. It notes that public information fails to explain how the system turns assessment inputs into final decisions.

Anderson challenged the department's claim that years of trials informed the current system. The investigation found that previous consultations applied to earlier versions of the tool and older legislation. There was no meaningful consultation on the IAT in its current form.

Documents obtained via freedom of information requests revealed that developers did not know an algorithm would be added before changes took effect in November. Departmental staff raised clinical concerns and noted undisclosed IT workarounds. Officials realized only hours before implementation that the law prevented human overrides.

The report highlights failures in oversight of assessment providers. The department did not enforce contractual quality requirements. It also failed to verify whether assessors held compulsory clinical qualifications. Anderson noted that the quality of information entered by providers directly shapes the algorithm's results.

The report found that the department ignored transparency recommendations from the robodebt royal commission. In July, the health and ageing department announced a process for assessors to refer incorrect decisions for review. Anderson questioned if this route adequately handles clinically inappropriate outcomes. He said the department has not fully understood the legal framework it created.