SaH: Serious Assessment Wobbles

Opinion

25 Nov

3 minute read

Big government reforms rarely move into crisis in one dramatic moment. They start with small wobbles, quiet signs that something underneath isn’t holding steady.

Right now, those early wobbles are coming from the Integrated Assessment Tool (IAT) and the Independent Funding Assessment algorithm, the new engine behind Support at Home.

This is the part that was supposed to fix inconsistency, duplication and postcode lotteries in aged care outcomes. The government promised it would be fair, consistent and predictable. On paper, it’s smart: one assessment, one tool, one algorithm delivering eight new funding levels.

And then this brand-new system tells a woman with vascular dementia, diabetes and anxiety that she has “no impairment” and that the assessment can’t be corrected.

The rollout wobbles

This rollout has been showing strain for a long time, well before anyone saw the first algorithm output. The wobble started with so many years of delays and carried straight into the launch of the new assessment system.

Planning has been poor, deadlines have slipped repeatedly and the build wasn’t ready when it needed to be.

Assessors have now been pushed into a system that hasn’t stabilised with rules still shifting under their feet. Training is inadequate and guidance arrives far too late. What was pitched as a streamlined, person‑centred process has hit the real world on very shaky foundations.

What’s happening right now

The IAT was designed to solve the long-standing mess: duplicated assessments, repeated questioning, inconsistent decisions. It was meant to deliver smarter questions, built‑in risk detection and a single gateway into care.

The algorithm would turn the assessment into one of eight funding levels and be more precise than the old HCP tiers, better aligned to need with less room for bias. In theory it’s a clean and predictable system. Like all government IT rollouts, it looked much cleaner on the slide deck than it does in the wild.

Providers and assessors are already reporting:

Assessments ‘locking’ permanently on submission
A black‑box algorithm with no transparency
Similar clients receiving different outcomes
Cognitive and safety risks underweighted
Domestic tasks skewing results

Older people are being assigned lower priorities than their risk suggests. Families are blindsided and providers can’t onboard safely. Carers are stretched while applications sit in the wrong queue. Experienced assessors are baffled by the outputs yet we hear overrides are being discouraged as “against the Aged Care Rules”.

When someone with clear red flags is labelled “standard priority” the risk is obvious. If they fall while waiting, nobody cares that the algorithm didn’t.

These aren’t minor teething issues, they’re early system wobbles with real human consequences. When the assessment and funding engine shakes, older people wait longer, risks grow, carers absorb the pressure and providers are left carrying decisions they didn’t make.

Providers don’t have months to compensate for errors. Older people don’t have months to sit in limbo.

What providers can do now

Until the Department acknowledges the scope of the issue (don’t hold your breath), providers can:

Ask clients about their assessment experience and flag anomalies early
Support families to request reconsideration (within 28 days)
Document everything, evidence matters
Build processes for clients arriving with mismatched levels
Track wait times; priority categories may not reflect genuine need
Share your concerns on QANDA and with your peaks

Support at Home was pitched as the fix: one pathway, one assessment, one fair system. But the early signals make it clear these aren’t temporary stumbles, they’re baked-in design failures.

Adding insult to injury, the government has begun allocating new Support at Home packages as “interim packages,” funded at just 60% of their assessed classification, with no clarity on how long this interim status will last. It’s a decision that forces older people to wait longer for adequate support and leaves providers carrying the gap.

The human cost of this poor planning is already real. Older people are going without essential care, providers are absorbing the fallout. Without a major course correction, it’s hard to see how this system will ever stabilise.

Ultimately the government will wear the political price, even if it tries to shift the blame.

Let’s tell the Minister what’s really happening

Let’s not wait for the crisis. Minister Rae has asked for feedback on the reform progress. Let’s give him the real story.

We’ve created a dedicated QANDA channel where providers can share their concerns about the SaH roll-out (and big thanks to Adrian Morgan for raising the IAT problems). We’ll compile and share the key issues as they arise and make sure the Minister receives the feedback he has requested.

* Invox QANDA

Invox QANDA is a free hub where 1,300+ people are getting real-time answers to emerging SaH questions - https://www.invox.com.au/invox-qanda

Featured

Roland Naufal

Roland has built (and at times threatened) his career by being outspoken about things that matter. He has over three decades of experience – from aged care CEO and Age Friendly Cities expert to the founder of DSC, Australia’s best known NDIS educators. This led him to ask the question: if radical honesty worked for Australia’s disability sector, then why not aged care, too? And here we are, folks.

Paul Sadler

Few people have as much experience in the aged care sector as Paul. 35 years, to be exact. He’s been a national and state CEO of aged care industry associations, CEO of a major aged care provider, and influencer of ageing policy, disability and community care programs for both national and state governments. He actually enjoys staying on top of the detail and is always ready to share his wisdom and insights (which comes in kind of handy).