“I want to stay at home with my roses.”
They’re the flowers Jean Mathew’s husband surprised her with before he died more than 25 years ago, and they’ve spread throughout her garden ever since. Her home is full of memories, but the roaming cream rose bush is part of why she wants to stay.
The 78-year-old lives alone near Adelaide and is highly independent, attending church once a week and doing her own washing and cooking. She has cerebral palsy and uses a powered wheelchair, receiving assistance from a support worker for personal care.
But, despite her capabilities, she is considering an aged care home for the first time.
The turning point came after she was recently assessed for home support by the federal government’s integrated assessment tool (IAT), an algorithm-based computer model that determines how much assistance older Australians receive.
Peter Schulz, a friend of Mathew’s from church, said “everyone involved assumed Jean’s funding would be increased”.
“She currently has to wait all day to go to the toilet, only receiving a support worker for one hour in the morning and one in the evening,” he said.
“Instead, the algorithm classified her as needing less funding than she currently has, assigning her to category 7.”
This amounts to $58,000 a year.
Mathew used to receive $163,000 a year under the Disability Support for Older Australians (DSOA) scheme, which helped cover things like a support worker, equipment and other assistance. This was terminated when she moved on to an aged care package, which had provided her with $63,000.
‘A recipe for disaster’
Schulz said even Mathew’s clinical assessors were “frustrated with this outrageous computer algorithm”, which they had no ability to override.
Mathew’s case is similar to many examples revealed to Guardian Australia of older Australians being assigned lower levels of support under the IAT than clinicians and carers say is safe or appropriate.
The Greens senator Penny Allman-Payne said she has received messages from constituents and aged care providers “who are telling me that older people are being denied critical care because of an opaque system that is systematically under-assessing their needs”.
The Department of Health, Disability and Ageing did not respond to questions about how the IAT calculates support, but a department spokesperson said clinician expertise is still important when inputting the data.
Guardian Australia understands the tool was tested on more than 200,000 completed assessments, but these evaluations have not been made public.
“Rolling out an automated tool to determine support needs for older people – many of whom have deteriorating conditions – was always going to be a recipe for disaster, and that’s clearly what’s being born out now,” Allman-Payne said.
The independent MP Monique Ryan previously described the IAT as “robo aged care” after Guardian Australia revealed even the clinical assessors using the tool are frustrated, saying it underestimates the support a person needs and bars assessors from using their experience to override the tool when it makes a mistake.
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Schulz said the “description of this farce as ‘robo aged care’ is quite apt”.
“Not just because it outsources important decisions to an unaccountable and stupid computer algorithm that creates enormous suffering, but because it is another example of government’s punching down on vulnerable Australians with impunity,” he said.
Adrian Morgan, the general manager of Flexi Care, a Brisbane-based not-for-profit that supports older people to stay at home, said the organisation had been dealing with “inappropriate decisions” since the IAT began operating in November.
“We’ve had 37% of the participant applications for an upgrade in funding level using the IAT algorithm rejected,” he said.
“Prior to 1 November, we are confident none of these requests would have been rejected.”
The ages of those affected range from 71 to 84, he said, and they typically have at least five medical conditions.
“The rejections make no sense and are leaving people and their families stressed and confused,” Morgan said. “They can’t receive funded services they should be entitled to receive.”
Morgan said most people affected or their families had lodged formal appeals against the assessment decisions, but none had been decided. The department has 90 days to respond to appeals.
According to departmental data, 414 requests for formal reviews of decisions were made between 1 November and 23 January.
Mathew says if she doesn’t receive extra support through an appeal and has to go into an aged care home, “it will be the end of me”.
“My parents always encouraged me to do as much for myself as I could, and that’s always worked to my benefit.
“I love my little place, and I don’t want to go. I won’t be able to take my roses with me.”
Do you know more? melissa.davey@theguardian.com
