Why did the Department change the rules, forbidding home care assessors from overriding bad decisions by the IAT ‘classification algorithm’?
The Department of Health, Disability and Ageing says it is “not aware” of AI being used to conduct aged care needs assessment, and that it “does not have any plans to implement AI software” to do so in the future.
The Department was responding to TMR‘s sister publication Health Service Daily’s reporting on Friday that home care services providers and assessors involved in the assessment process are concerned that assessors have been forbidden from over-riding IAT classification decisions even when they are egregiously incorrect or inappropriate.
The Department quibbled with HSD’s use of the term “AI” in its headline when describing the IAT, which it says is simply a “classification algorithm”. Technically, an algorithm is considered to be a set of instructions that all AI uses, but not all algorithms are AI.
The IAT “classification algorithm” ingests the responses that are captured in the participant’s aged care needs assessment. The algorithm then uses rules described in Section 81-10 of the Aged Care Rules 2025 to assign the client to one of eight classification levels for ongoing home support services.
In response to questions sent by this reporter late on Thursday, the DoHDA sent the following response at 7.03pm Sydney time on Friday night:
“The Department of Health, Disability and Ageing is not aware of AI being used to conduct aged care needs assessments.
“The Department does not have any plans to implement AI software to conduct aged care needs assessments.
“Full guidance was included in the published Aged Care Assessment Manual on 1 November and confirmed how the IAT Classification Algorithm should be used in accordance with the new legislation.
“The Department of Health, Disability and Ageing (Department) met with assessment organisations in advance of 1 November to clarify the circumstances in which the IAT outcome could be overridden.
“The Department is monitoring the IAT Classification Algorithm to ensure it is working as intended.”
Nowhere in the Department’s response is there an answer to why the guidance to assessors changed between May and November of this year, from allowing them to over-ride the IAT assessment (on page 51 of Guide for the Single Assessment System Workforce) to expressly forbidding them to (in Section 5.7.7 of the Aged Care Assessment Manual v 8.1).
We fired off follow up questions at midday Sydney time today. A spokesperson for the Department replied saying there was not enough time to formulate a response today and could we hold off on publishing until then.
We are more than happy to write another story on DoHDA’s response tomorrow.
Here are the questions we asked the Department today:
- Will the Department consider releasing the technical specifications of the IAT algorithm;
- Why was the decision made to stop human assessors over-riding the IAT’s decision?
- Can you confirm the date of the meeting between the Department and assessment providers about the change to the over-ride rules?
- Providers are very clearly saying the IAT is not working as intended. Has the Department had conversations with providers and/or assessors since 1 November?
- Why are delegates prevented from over-riding the algorithm in the case of a clearly egregious decision?
- When the Department sees inconsistent and inappropriate assessments generated by the IAT, what is the Department doing about them?
Meanwhile, today the National Aged Care Alliance – a coalition of 43 aged care peak bodies, including Ageing Australia, the Older Person Advocacy Network, COTA Australia, Catholic Health Australia, and Dementia Australia – released a discussion paper called Aged care reform: how effective so far?
Written before the 1 November implementation of the new Aged Care Act, the discussion paper has this to say about the sector’s concerns about the Support at Home program, which the IAT is an integral part of.
Related
“There are significant levels of disagreement with the program’s design. A major short-term concern is the inadequate notice of its regulatory design so close to the commencement date. Some argue it should be postponed.”
This is relevant to the IAT discussion as providers and assessors have told HSD that the change to over-ride rules was only flagged with them a few days before 1 November.
Also in the NACA discussion paper:
“The SAH assessment process and services framework is a substantial break with existing arrangements, is driven as much (or more) by financial/fiscal considerations within government than by a person-centred approach to individualised and enabling support and care.
“The new program needs to be independently and expertly monitored and evaluated.
“Much of reformed system design, especially for SAH (but not limited to it), is designed to control government expenditure, rather than focused primarily on the needs of individual people needing support and care.
“This will continue as Commonwealth central agencies now have substantial influence over aged care policy. Policy advocacy needs to respond to this like for like, not ignore it.”
