Ombudsman: Australia's aged care assessment algorithm is unreasonable and unfair
Australia's Commonwealth Ombudsman has found that the government algorithm used to determine home support for older people is unreasonable, unfair and lacks human oversight. The report calls for legal changes and a review of the algorithm's rules.
An algorithm used by the Australian federal government to decide what level of care older people are entitled to is unreasonable, unfair and lacks adequate human oversight, according to an investigation by the Commonwealth Ombudsman, Iain Anderson. The ombudsman is the official body that examines how government agencies operate. The 104-page report was discussed on Monday, 26 October, and matters because the tool affects home support for older people across the country.
The problem
The algorithm is part of the mandatory Integrated Assessment Tool (IAT) used by aged care assessors. Under the law, assessors cannot override the funding package the tool recommends, even when the decision is clinically wrong. The report found there is no public information that meaningfully explains how the algorithm turns inputs into outcomes, calling the IAT a "technological black box".
The investigation began in April after concern from media and the public, including Guardian Australia reports of older people left without adequate care after being assessed by the algorithm. Documents released under freedom of information laws indicate officials realised only hours before the November rollout that the law barred human override.
The ombudsman's findings
The report said the Department of Health and Ageing did not enforce contractual quality controls or verify that assessors held the mandatory clinical qualifications. Trials and consultations the department cited related to earlier versions of the tool and earlier legislation, so there was no meaningful consultation. The department has also not followed the robodebt royal commission's recommendations on transparency in government automated decision-making.
In July the department announced a process allowing assessors to escalate wrong decisions to it for review. Anderson said this is not adequate, because assessors themselves should be able to change clinically inappropriate decisions. The ombudsman calls for a comprehensive review of the legislation and the algorithm's rules, and for urgent action on legal issues. The department has been contacted for comment.
