Automated aged care algorithm needs a human override, ombudsman finds

Aged care funding algorithm neither fair or consistent, ombudsman finds In short: Use of automation in Australia's aged care system lacks safeguards and has led to unfair outcomes for elderly patients, the Commonwealth Ombudsman has found. The ombudsman released his findings after an investigation into the Department of Health, Disability and Ageing's automated funding algorithm. What's next? Of the 10 recommendations made, six were accepted by the government and a further two, including instating a human override, were noted. The Commonwealth Ombudsman Iain Anderson has issued a damning report on the aged care algorithm, saying the government should amend the law to allow senior assessors to override its decisions when it gets it wrong. In a scathing report of more than 100 pages, the ombudsman says the actions of the Department of Health, Disability and Ageing, in its administration of the assessment scheme and the algorithm, "have been unreasonable". The report says the department put the classification algorithm in place "without any meaningful risk assessment, evaluation or analysis, despite the obvious risks that would arise with deterministic automated decision-making". The classification algorithm was launched on November 1 last year as part of the government's "once in a generation" reforms to aged care and is used to assign people a level of funding to stay at home with support rather than go into a nursing home. But it has been mired in controversy since its introduction, with hundreds of people appealing its decisions, a more than five fold increase on appeals in the previous year. In his report released today, Mr Anderson said: "A reasonable person would, in my view, lack confidence that the system is in fact fair and consistent." In a response to the draft report, the department said it "does not accept this characterisation" that it didn't test the algorithm or validate it. However, as revealed by Four Corners and by the ombudsman, tests were conducted on an original version of the algorithm created by a consultancy. The algorithm in place today was modified by the department and there was no external validation. Audit recommended Mr Anderson also recommends the Australian National Audit Office consider doing an audit of the implementation of the Single Assessment System and the Independent Assessment tool, which is the questionnaire which drives the algorithm, "and in doing so, assesses whether the Department's use of public resources was efficient, economical and ethical". The ombudsman made a total of 10 recommendations, with six being accepted by the government. The first two recommendations, that legislation be introduced to allow override by a human and amending the aged care rules, have not been accepted by the department, and have only been noted. However, the department has accepted the recommendation for a comprehensive review of the Aged Care Act in relation to the assessment process and algorithm to "identify legal defects, inconsistencies, ambiguities or unintended consequences" and address these issues in a timely way. It has also accepted the recommendation that any amendment to the act be "preceded by and informed by meaningful consultation with the public". Department 'incorrectly advising' assessors Mr Anderson said the department had been wrongly telling assessors that the algorithm outcomes could be changed right up until the new legislation took effect. This is despite the fact that there was no mechanism in the act or the rules to change outcomes. "The Department did not, and may still not, understand key components of the legal framework it created, nor did it understand what legal framework it was meant to create,"Mr Anderson said. The government has resisted calls to give blanket permission for delegates for assessment agencies to override the classification algorithm. It instead passed legislation last week to allow an "escalation pathway" for appeals in exceptional circumstances. In return for the Coalition's support in passing the legislation, it has commissioned a review into the assessment system and algorithm, with a report due in the first half of next year. In a statement, Minister for Health and Ageing, Mark Butler, and Minister for Aged Care, Sam Rae, said: "The Government will consider the Ombudsman's report carefully as we continue to improve our aged care system, including the assessments system." "We're already acting on many of the recommendations to ensure our aged care system is transparent and reliable, and we'll examine what further action we can take to give every Australian confidence in the system." Over a million people, or 85 per cent of those using aged care, receive services through the home support system. [Image text:] OMBUDSMAN COMMACMMEACE ACT Ombudsmon