“Support At Home” Integrated Assessment Tool (IAT)

As artificial intelligence is integrated into Support At Home aged care assessment and delivery, (IAT) the sector stands at a pivotal turning point, one where human needs and individual understanding are increasingly interpreted through data and algorithms. This shift has the potential to transform how care is accessed and funded by the Support At Home Scheme, but it also challenges long held assumptions about fairness, judgement, and the role of human insight in supporting older Australians to live safely independently or personalised care incorporating dignity.

A New Era for Home-Based Aged Care

From 1st November 2025, Australia’s long-awaited Support at Home program officially replaced the Home Care Packages (HCP) and Short Term Restorative Care programs under the new Aged Care Act 2024. These changes are meant to simplify access, deliver more tailored support, and help older Australians stay safely and independently in their own homes.

However, one of the most significant shifts, and one that is drawing intense attention from care recipients, providers, assessors, and advocates, is the introduction of an algorithm-based assessment system at the heart of how funding levels and priorities are determined.

AI Generated Algorithm Takes the Lead

At the core of the new assessment process is the Integrated Assessment Tool (IAT), which uses a classification algorithm to generate Support at Home levels based on a person’s information. This replaces much of the judgment-based decision-making previously made by experienced healthcare professional assessors.

Previously, healthcare based assessors played a central and important role not only in gathering people’s care needs but also in interpreting clinical context and adjusting funding recommendations accordingly. Under the new system, once all mandated questions are completed and entered, the algorithm produces a classification score that largely determines funding level and priority.

In some interpretations of updated guidance, assessors may nominally be able to override outcomes with justification, but in practice many providers and assessors report overrides are effectively discouraged or blocked except in rare circumstances. This has created real anxiety in the broader healthcare sector.

How the Algorithm Works.

While official documentation focuses on how the IAT gathers information about functional independence, care complexity and support needs, concerns have emerged about how the algorithm interprets this data to decide support levels. At least one independent report highlights cases where the algorithm failed to recognise obvious health needs, for example, downgrading a person with dementia and complex medical conditions to a support level too low for their current care needs, causing “considerable distress.

Aged care advocates and assessors have also described how the lack of transparency around algorithm logic means clients and providers can’t always understand how a particular classification was decided, making it difficult to appeal or explain decisions to families.

Potential Benefits the Government Highlights

• Consistency and Equity: By using a standardised tool that runs the same set of rules for everyone, the system aims to reduce regional variability and subjective discrepancies in how support is allocated. Health, Disability and Ageing Australia

• Faster Decision Making: Automation is intended to speed up parts of the assessment, helping more people get assessed and approved in a timely way. Health, Disability and Ageing Australia

• Clearer Budget Frameworks: With eight Support at Home classifications and defined funding bands rather than the four Home Care Package levels, the algorithm helps link needs to transparent budget categories. Health, Disability and Ageing Australia

• Streamlined Assessment: The IAT replaces multiple assessment steps that previously involved different assessment organisations, which could simplify the process. Aged Care Online

Obvious Concerns from Clients, Carers and Assessors

Despite the intended benefits, there are several critical concerns emerging as the system is rolled out:

1. Loss of Human Judgment

Many frontline assessors feel that removing human discretion undermines their professional responsibility to interpret subtle signs of risk, complexity, or psychosocial factors that an algorithm might misinterpret or miss entirely.

2. Incorrect Classifications

Errors in before and after testing, such as misclassifying someone with complex health needs into a lower support level — have already been reported, leaving some older people under-supported. The Weekly Source

3. Transparency and Understanding

The scoring and logic behind outcomes are not always visible to users, providers or even assessors, making it hard to explain decisions or contest them. The Australian Independent Media Network

4. Locked-In Outcomes

Once a support classification and plan are finalised, it can be difficult to correct mistakes or bring in additional context without doing a full reassessment, meaning delays in care or risk exposures for clients. The Australian Independent Media Network

5. Sector Readiness and Training

Assessors and providers have voiced that training and preparation for using the IAT and understanding algorithm outcomes has lagged in the rollout, which can contribute to assessment mistakes and frustration for those awaiting packages. The Australian Independent Media Network

What This Means for People in Home-Based Care

For many Australians already receiving aged care at home, especially those with complex needs, serious medical conditions, and cognitive impairments  the shift to algorithm-driven assessments could be both a help and a hindrance:

For Some, More Clarity

Clients may benefit from clearer funding bands and a more structured assessment that aligns services with care needs broadly.

For Others, Potential Under-Support

Those whose situations don’t fit neatly into algorithmic logic, such as people with less obvious but equally serious care challenges, risk being under classified and under-funded.

Importance of Advocacy and Oversight

With algorithm outcomes harder to challenge, strong advocacy from carers, family members and providers becomes even more critical to ensuring appropriate support is secured.

Future Ahead

The intention behind algorithmizing aged care assessments under Support at Home is clear: Modernise systems, improve consistency, and reduce unnecessary delays.

But the early experiences of providers, healthcare professionals and some clients reflect a more underlining issue, that algorithms are computer based tools, not replacements for human empathy, experienced professional judgment and ongoing client contact and needs understanding.

Conclusion

The integration of algorithm based assessments into the Support at Home program reflects a broader move toward digitisation and data-driven decision making in general public services. While this approach offers potential benefits in consistency and efficiency, it also introduces new risks if not balanced by transparency, professional judgement, and effective review mechanisms.

As Support at Home continues to be implemented, ongoing evaluation will be essential to ensure that technology supports, rather than constrains quality care. Aged care assessments must remain contact centred, responsive, and grounded in human understanding. Algorithms can inform decisions, but they should not replace the healthcare advisors judgement required to support older Australians to live safely and with dignity in their own homes.

As the system matures, it will be important for policymakers to:

• Increase transparency around how scores and classifications are derived.

• Provide clearer and accessible appeal pathways.

• Ensure ongoing training and support for assessors and providers.

• Regularly review algorithm performance and fairness with input from lived-experience representatives.

Only with these safeguards in place can the promise of Support at Home, living independently with dignity and the right level of support, be fully realised.

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ABOUT THE AUTHOR. Adaptive Clothing Australia

Adaptive Clothing Australia goes beyond providing practical aged care sector information they also provide stylish, and accessible clothing for the aging and disability community. , The company also offers medical and fall alert solutions. Including anti wandering devices and watches that provide real-time monitoring, emergency alerts, and peace of mind for both clients and their families. Through personalized consultations, on-site set-ups, and tailored modifications, Adaptive Clothing Australia ensures that every client enjoys not only comfort and style but also enhanced safety, autonomy, and confidence in their daily lives.

Disclaimer

The information presented in this blog is intended for informational and educational purposes only. While A.C.A. staff have many years of experience in the aged care and disability industry, we are not medical clinicians or healthcare professionals. The content provided should not be interpreted as professional advice. For driving concerns, medical concerns, fall safety needs, health diagnoses, or treatment, always consult a qualified general practitioner (GP) or licensed healthcare professional.