‘Everybody’s a person’ Sonja Stewart was told as she tried to minimise the number of people affected by the Support at Home integrated assessment tool. More than 2200 reviews of IAT decisions have been lodged.
Senator Anne Ruston has slapped down a Department of Health, Disability and Ageing’s senior official for attempting to put thousands of reviews of Integrated Assessment Tool decisions into “proportional” context, telling her, “Everybody’s a person; they’re not a statistic or a number”.
DoHDA officials told the Senate inquiry into the Support at Home program late yesterday afternoon that 2208 review-of-decision requests relating to the IAT had been lodged.
Of those, 1564 had been finalised and 644 remained in progress.
Senator Ruston, the opposition’s health and aged care spokesperson, asked DoHDA to provide the outcomes of the finalised reviews and the average time taken to assess review requests.
When deputy secretary for the department’s aged care group, Sonja Stewart attempted to point to the “record number of assessments” undertaken, Senator Ruston interrupted.
“Look, that’s fine. You don’t have to contextualise everything,” she said.
“I just asked a question. I’m happy just to get the answer.”
Ms Stewart replied: “Proportionality is quite important.”
“Proportionality is fine, apart from when you’re one of those people that’s had an assessment that has appeared to be clinically wrong,” Senator Ruston retorted.
“Everybody’s a person; they’re not a statistic or a number.
“So I really think it would be maybe well advised for the department to stop talking about things being statistically relevant or otherwise, [and] actually think about the people that are being impacted by those decisions.”
Ministers briefed on IAT ‘misalignment’
Officials also faced sustained questioning over how assessors came to lose the discretion to override the IAT algorithm when determining Support at Home funding.
Assistant secretary Rachel Blackwood confirmed reporting based on FOI documents that she had emailed first assistant secretary Greg Pugh on 24 October 2025 raising the fact that the rules did not give assessors legal discretion to override the algorithm.
Ms Blackwood said the issue emerged during final checking ahead of the 1 November aged care reforms and after the department sought internal legal advice.
“In the course of undertaking those processes and seeking various pieces of internal legal advice, we reached the conclusion that … there was no discretion under the rules as they’d been agreed,” she said.
Ms Stewart described what had occurred as a “misalignment” between the rules and guidance provided to assessors.
“There was a misalignment in this stage,” she said. “Unfortunately, that misalignment was considered and found late in the piece.”
Mr Pugh said the consultation draft of the rules had been published on 15 April while the department was simultaneously finalising implementation of the IAT.
“We had system legislation rules and policy design happening in parallel,” he said.
“Then when we got to the final point of checking to make sure everything was lined up, that was when the misalignment was identified.”
He took on notice whether drafters had been directed not to include discretion to override the algorithm and whether the mismatch resulted from drafting instructions or a subsequent policy decision.
Ms Stewart confirmed advice had been provided about the misalignment, but could not say whether aged care minister Sam Rae, health minister Mark Butler or both had been briefed.
“I’ll have to just take that on notice in terms of … who was in the actual brief,” she said.
The department also took on notice who decided to address the problem by changing guidance for assessors rather than the rules, when the legal advice was obtained, whether subsequent legal advice was sought and whether amending the rules before 1 November was considered and rejected or not considered at all.
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Death data still not available
DoHDA was also unable to tell the inquiry how many older Australians had died while waiting for aged care funding in 2025-26.
Acting first assistant secretary Josh Maldon said the mortality data was “not yet available”.
“We’re still validating the methodology to reliably identify deaths and determine the mortality rate under the Support at Home care program,” he said.
The new methodology links information from the Support at Home priority and allocation systems with deceased-event notifications recorded through the aged care gateway and Services Australia.
Mr Maldon said the department hoped to have the information available “shortly and in line with the next quarterly release of data”.
He said the department was aiming for an October release but would not commit to a date or guarantee the data would be available before Senate estimates, which begins in the week of 26 October.
Ms Stewart said the department understood there was significant interest in the figures.
“We want to make sure it’s accurate. We want to make sure that we can compare it, and we are going to be transparent,” she said.
Senator Ruston contrasted the delay with the reporting demanded during the pandemic.
“During covid, there was an expectation for the minister for aged care to know on a day-by-day basis how many older Australians had died in residential aged care,” she said.
“We are now talking about providing data four months after potentially the last person has passed away.
“You’ll excuse me for being a little sceptical about this obfuscation that we’re getting at the moment.”
Three-month target is to ‘some funding’
The hearing also clarified that the government’s commitment to reduce the average Support at Home wait time to three months by 1 November 2027 does not mean participants will receive their full assessed funding within three months.
Mr Pugh said current estimated waits had fallen to within one month for urgent and high-priority participants, five to six months for medium priority and seven to eight months for standard priority.
The standard wait was down from 10-11 months when Support at Home commenced, he said.
But officials confirmed the current published wait-time figures included participants who initially received interim funding at 60% of their full allocation.
Asked whether the figures included people funded at the 60% level, acting assistant secretary David Creelman said:
“Yes, it would include people with a funded place, and some of those are funded at a 60% level.”
Senator Ruston then asked whether the government’s promised three-month average wait in November 2027 meant the wait to an interim minimum service offer or to full funding.
Mr Pugh said it was an “average of three months wait time to some funding”.
“So yes, it includes – or any funding. So yes, it includes interim service arrangements.”
Officials were unable during the hearing to confirm whether the methodology used to calculate waiting times under the former Home Care Packages program was directly comparable with the Support at Home measure and took the question on notice.