Why aged care’s IAT human override could become the next bottleneck

The Integrated Assessment Tool (IAT) has been under fire for a while now, systematically eroding trust and burning out assessors. With three adjustments in a matter of weeks, the recent proposed changes might not be faster than the process they’re replacing. So does this point to a system fault, does the IAT need to be rebuilt, or is there another solution yet to be uncovered? 

We spoke to Older Persons Advocacy Network (OPAN) CEO Craig Gear to unpack what happened, where the focus should go, and what boards and aged care leaders need to know.

The IAT timeline 

To understand the scope of what’s happening now, let’s take a look at the history of the IAT and how it came to be:

• 1 July 2024: The Integrated Assessment Tool (IAT) goes live nationally, replacing the National Screening and Assessment Form (NSAF), as the first part of the new Single Assessment System. 
• 9 December 2024: The three separate aged care assessment workforces (ACAT, RAS, and the NSAF workforce) are merged into a single Single Assessment System workforce. 
• August 2025: Aboriginal and Torres Strait Islander assessment organisations begin a phased rollout, to provide culturally safe assessments.
• 1 November 2025: The Support at Home program commences and IAT-generated classifications become determinative for funding under the new pricing model. Human override of IAT-generated decisions is removed from assessors at this point, without prior consultation – assessors lose the ability to correct algorithm-generated outcomes.
• 28 November 2025: An independent review finds My Aged Care “in serious need of an overhaul” (per OPAN media release summarising the review’s release) — the first major official signal that the post-reform system isn’t functioning as intended.
• 14–17 April 2026: The Commonwealth Ombudsman opens a formal investigation into the IAT algorithm’s operation, in response to complaints.
• 5–11 June 2026: Health Minister Mark Butler and Minister for Aged Care and Seniors Sam Rae announce a rapid review of the IAT’s prioritisation mechanism.
• 23 June 2026: Coalition Senator Anne Ruston introduces the Aged Care Amendment (Restoring Human Override for Aged Care Needs Assessments) Bill 2026 in the Senate.

A pivotal day was 2 July 2026 when two things happened within the space of hours:

1. The Aged Care Minister announces a new escalation pathway allowing clinical/human input into contested assessments — described in coverage as “the most significant concession yet” but explicitly not full human override, and
2. The government loses a Senate vote on the Restoring Human Override Bill, signalling the bill has crossbench support to pass.

And on 10 July 2026, the Senate formally passed the Aged Care Amendment (Restoring Human Override for Aged Care Needs Assessments) Bill 2026, with crossbench support. It includes a pathway for reassessment of anyone assessed since November 2025. It’s currently sitting with the House of Representatives for discussion and a vote. 

This timeline highlights a glaring gap in the tool’s design and its reality, which is something OPAN are actively speaking out about – with ideas for how to fix it. 

What’s actually breaking in the IAT

OPAN were involved in the initial consultation and design of the IAT and, at first, it hit the brief. “In the design phase, the theory was right,” Gear explains. “We wanted to see consistency in approach – clinically validated tools, the right level of assessment for the right level of complexity. We were quite pleased with that.”

But as with any tool, once it reached the hands of the public, kinks in the system came to light – and fast. 

“Older people and families – people coming to our advocacy services – are saying, ‘I got assessed and it doesn’t seem to meet my needs’,” laments Gear. This points to a break in the IAT that’s bringing assessments to a shuddering halt, placing even more strain on the system that’s already buckling at the knees.

The tool’s ability to capture the nuance of individual needs isn’t reflected in its design, particularly the ‘free text’ section of the IAT. 

“There are extenuating circumstances that sit in the free text [section of the IAT],” Gear points out. “A good example: this person has a carer, but the carer is 84 and about to go in for a hip replacement – they’ll be out of action for a while. Is the tool picking up that individual circumstance?”

It’s a similar story for other specific needs, like dementia. “Someone living with dementia in a metro area will actually never get to the high-urgent level [in the IAT], because of the way the scoring system works,” he explains. 

OPAN’s advocates, aged care providers, assessors, and the community are all aligned in their experience and feedback of the IAT. The Minister is listening but the gap between acknowledgement and action needs to be shortened to prevent waitlists from continuing to blow out.  

What needs to change in the IAT

While the steps taken on July 2 have been welcomed, the details are yet to be finalised. In a recent ABC Radio National interview, Melissa Clarke asked Minister Rae about a number of unresolved IAT design questions – trigger criteria, timeframes, retrospective application – and Rae could not answer. 

But Gear points to the human override mechanism as one place where significant improvements can be made – but only if the right person can trigger a reassessment and the right person is available to action it.

“It needs to be someone with clinical knowledge, and it needs to be someone that can respond quickly,” Gear advises. “The current internal reconsideration process (90 days) is way too long. We’d like to see a decision within five business days.” 

If authority sits solely with a departmental delegate with no committed SLA, providers have no fast internal lever to correct a wrong assessment. That exposure (complaints, duty-of-care questions) will continue to land on providers, not the department. So if you’re not already capturing this data, it’s worth tracking now as a live design question to feed back into the reviews currently underway.

Avoid this operational risk 

What’s happening with the IAT is a live case study in what happens when a system-level control failure (an unvalidated algorithm with no override) gets fixed reactively, under floor pressure, with implementation details still undefined. 

For aged care leaders, bear in mind there’s four review streams running at once at the moment: rapid review of the priority system, a committed-but-undated algorithm review, a forms review, and the Senate inquiry into Support at Home. 

Planning any fixed operating assumptions around current IAT settings is a risk – it’s wise to expect further change, and on a timeline nobody has committed to yet.