Senior health officials were deeply concerned in the run‑up to the launch of a funding algorithm for older Australians, after finding that the accompanying legislation was so strict that aged‑care assessors had no legal power to overturn its decisions.
Freedom‑of‑information disclosures from the Department of Health, Disability and Ageing reveal that, despite long‑standing promises to assessors that they could correct erroneous algorithmic decisions, senior officials only belatedly realised that doing so would breach the proposed regulations.
This discovery triggered an emergency briefing for aged‑care minister Sam Rae and health minister Mark Butler just three days before the algorithm went live. In a briefing email, senior departmental officials warned that eliminating the human override for the Support at Home (SaH) assessment tool would carry significant risk.
Sent on 29 October, three days before the algorithm’s 1 November launch, the email warned the ministers that “the late shift in messaging to assessment organisations might not reach assessors in time.”
Publicly, the department has consistently maintained – including in media statements – that assessors could override the algorithm’s classification recommendation, and that such an override function was already embedded in the system.
However, the ministers were advised that the Aged Care Rules 2025 legislation had been drafted so that “assessors and assessment delegates have no legal discretion to override the algorithm’s SaH classification recommendation.”
Consequently, the Integrated Assessment Tool (IAT) user manual had to be revised before the launch to explicitly inform assessors that outcomes could not be overridden.
The email noted that “assessment organisations – including state and territory governments – or individual assessors might criticise the stance as inconsistent with earlier government statements.”
Under the IAT, an assessor interviews an older person on physical, social and personal factors, after which the algorithm uses that data to calculate the level of government‑funded home support and funding the person qualifies for.
Assessor’s clinical judgment cannot overturn the algorithm’s decision, even when they believe the allocated support level is insufficient for the older person’s needs.
On 24 October, assistant secretary Rachel Blackwood wrote to deputy secretary Greg Pugh flagging the legal complications that had emerged concerning assessors’ ability to override the algorithm.
The Aged Care Rules 2025 “have been drafted to give assessors and assessment delegates no discretion other than to accept the SaH algorithm’s recommendation,” her email stated.
Blackwood noted that the department had “consistently indicated that assessment delegates would have the discretion to use their clinical judgment to override the SaH algorithm’s recommendation.”
Many staff regarded the inclusion of an override as a settled position, she observed.
She presented a list of possible solutions and associated risks, all of which were redacted in the FOI release. On 26 October, deputy secretary Greg Pugh replied that the approach he had selected “… may not be your preferred approach.”
He continued, “Nevertheless, I am comfortable that this decision represents the best option given the timing, the proximity to the 1 November launch, and the need for a clear and workable pathway forward. Thank you for working through this tricky issue and for providing your frank and open advice.”
On 27 October, Blackwood wrote to Pugh: “We have been working hard to build credibility with assessment organisations and other stakeholders, and we want to avoid actions that would undermine our working relationship at this critical time.”
She added, “We have a responsibility to provide guidance to delegates to exercise their powers with integrity, accuracy and honesty.”
It remains unclear why the department opted to remove the override from the instruction manual instead of amending the legislation to permit it. The Department of Health has not responded to requests for comment.
Within days of the algorithm’s launch, Blackwood was emailing senior officials to report that distressed assessors were filing complaints that the algorithm was consistently under‑assessing vulnerable older Australians, leaving them without adequate support.
In an email dated 20 November, Blackwood told senior department staff that “the majority of Aged Care Needs Assessment Organisations – including State and Territory Governments – have raised concerns about the inability to override the IAT classification algorithm.”
She continued, “Assessment organisations have supplied details of cases where assessors believe the algorithm’s outcome does not align with client needs.”
Separate FOI‑released documents show that state health officials were maintaining logs of hundreds of underassessment cases, forwarding these to federal counterparts.
One email from 14 November noted that “approving classifications and assessment outcomes that they [aged care assessors] do not agree with does not align with their professional ethics and could have legal ramifications.”
Guardian Australia previously reported that individuals already receiving support packages who needed reassessment because their needs had increased were routinely being recommended for lower support levels by the algorithm.
FOI documents also reveal that, after discovering the tool was under‑assessing people despite the government’s public pledge that older Australians would be “no worse off” under the reforms, a workaround was put in place.
When an aged‑care assessor clicked “accept” on the algorithm’s downgraded recommendation, the portal temporarily retained the client’s previous funding amount while silently recording a lower clinical classification in their permanent file, the documents show.
Shadow aged‑care minister Anne Ruston said the Coalition had introduced legislation to restore human decision‑making in the assessment process, accusing Labor of blocking it.
She described the bill as “a practical, overdue fix that has passed the Senate but remains blocked by Labor from even being debated in the House.”
Ruston said that while reinstating the override was necessary, it was far from sufficient to fix an aged‑care system she described as “broken.”
Do you know more? melissa.davey@theguardian.com
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