Key facts
- Legislation drafted for the Aged Care Rules 2025 provided no legal discretion for assessors to override the SaH algorithm's recommendations.
- Senior department officials had previously indicated to assessors that they would have powers to change incorrect algorithm decisions.
- An email on October 29 warned ministers that removing the human override function carried risks.
- The Integrated Assessment Tool (IAT) uses an algorithm to determine government-funded home support and funding eligibility.
- Complaints from aged care needs assessment organizations indicated the algorithm was routinely under-assessing clients.
- State health officials were keeping logs of hundreds of underassessment cases.
Senior officials within Australia's Department of Health were reportedly in a state of turmoil shortly before the planned rollout of a new algorithm designed to determine funding packages for aged care recipients. Emails obtained through freedom of information requests reveal that legislation governing the rollout was drafted so rigidly that it legally prevented aged care assessors from overriding the algorithm's decisions, despite prior assurances that such powers would exist.
This discovery prompted an urgent briefing for the federal Minister for Health, Mark Butler, and the Aged Care Minister, Sam Rae, just three days before the algorithm was set to go live on November 1. Senior department staff warned in an email that the late change in messaging regarding the override function could lead to confusion and criticism from assessment organizations, potentially undermining relationships with stakeholders.
The Integrated Assessment Tool (IAT), which incorporates the algorithm, asks older individuals questions about their circumstances to determine their eligibility for government-funded home support. However, the Aged Care Rules 2025 stipulated that assessors could not deviate from the algorithm's recommendation, even if they believed a lower level of support was allocated than needed.
Concerns about the lack of override functionality were raised by an assistant secretary, Rachel Blackwood, on October 24, who noted that the department had consistently indicated assessors would have discretion. Despite this, a chosen solution, detailed by deputy secretary Greg Pugh on October 26, prioritized proximity to the rollout date over the preferred approach of allowing overrides.
Following the algorithm's implementation, complaints began to surface from assessors who felt the algorithm was routinely under-assessing vulnerable older Australians. Emails from November 20 indicated that the majority of Aged Care Needs Assessment Organizations, including state and territory governments, had raised concerns about the inability to override the IAT classification. Separate documents revealed that state health officials were compiling logs of hundreds of underassessment cases.
Guardian Australia had previously reported instances where individuals needing reassessment due to increased needs were recommended for less support by the algorithm. A workaround was reportedly implemented where the system logged a lower clinical classification while temporarily maintaining the client's previous funding level. The shadow aged care minister, Anne Ruston, criticized the government, stating that the Coalition had proposed legislation to restore human decision-making, which Labor had blocked from debate.