Aged care algorithm found to operate as a black box, ombudsman says

Australia’s commonwealth ombudsman has determined that an algorithm used to assign aged care funds operates unfairly and unreasonably. The 104-page report identifies serious flaws in the system and a lack of adequate human oversight. It also finds that the government did not follow transparency recommendations from the robodebt royal commission.

The investigation focused on the Integrated Assessment Tool, or IAT. This tool recommends funding packages for older people. Assessors currently cannot override its recommendations, even when they believe the decision is clinically wrong. Ombudsman Iain Anderson said on Monday that legislation must change to allow assessors to correct these decisions themselves.

The probe began in April following public and media concerns about home support packages. Earlier reporting noted that older people were experiencing distress and receiving inadequate care due to algorithmic assessments. The report found that public information did not clearly explain how the system translated inputs into decisions. Anderson described the IAT as a technological black box.

The ombudsman also challenged the department’s claim that years of trials and consultation informed the current system. The investigation found that those activities related to earlier versions and older legislation. There was no meaningful consultation on the IAT in its current form. People involved in developing the tool did not know the government would add an algorithm before changes launched in November.

Documents obtained through freedom of information requests showed departmental alarm and clinical concerns among frontline staff. Officials discovered only hours before implementation that the legislation prevented human overrides. Senior staff had warned that review procedures could only confirm algorithmic outcomes rather than fix them. The department had also failed to enforce contractual quality requirements or verify that assessors held compulsory clinical qualifications.

Anderson stated that the quality of information entered by providers is crucial because it shapes the algorithm’s results. The report calls for a comprehensive examination of the legislation governing needs assessments. It found the department had not complied with the robodebt royal commission’s recommendations on transparency in automated government decisions. Anderson questioned how people could challenge outcomes without understanding how they were reached.

In July, the department of health and ageing announced a process allowing assessors to refer incorrect decisions for review. Anderson questioned whether this route adequately addresses clinically inappropriate outcomes. He said significant legal problems require urgent attention. The department has been approached for comment.