Lynda Henderson, a key member of the expert advisory group that developed Australia's Integrated Assessment Tool (IAT) for aged care, has revealed she is now too terrified to use the very system she helped create. Henderson, who sat on the working group from late 2020, expressed fury upon learning that the federal government had introduced an algorithm to score responses and categorise individuals' care needs, a move she claims undermines the tool's original intent.
Algorithm Introduced Without Warning
Henderson stated that neither she nor the health consultancy company overseeing the development knew the government planned to apply an algorithm to the assessment questions. "We in the working group didn't know the government were going to be using an algorithm to score each question and assign categories," she said. The tool was initially designed to assist clinical judgments, with room for nuance and notes, but Henderson described the scoring algorithm as "ridiculously simplistic."
Impact on Funding and Care
The algorithm-based classification is used to determine funding packages for home support, but aged care workers and clients report it frequently under-assesses needs. Some individuals with deteriorating health have been reclassified at lower levels, resulting in reduced funding and support despite greater requirements. Since November, assessors have been unable to override these outcomes, a change documented in government papers.
Henderson, whose partner died with dementia two years ago, now faces her own health decline and needs more home support. However, she fears applying for a reassessment, saying, "I am so terrified about applying for a reassessment and having all my support cut if it under-assesses me." She added that the government's decision to disallow overrides is the "worst thing" they did.
Political and Public Backlash
Greens senator Penny Allman-Payne has written to Aged Care Minister Sam Rae, urging immediate reinstatement of human oversight and the ability for assessors to override under-assessments. She cited a surge in complaints, noting that older Australians are being denied urgent at-home supports, leading to hospital stays and increased strain on families. The senator also called for transparency regarding the algorithm's development and testing.
The Department of Health has not responded to questions about when the algorithm was introduced or who developed it, though it is understood the rationale was to ensure a consistent national approach. Critics argue this has come at the cost of personalised care, with Henderson's experience highlighting the human toll of automated decision-making in critical sectors like aged care.
