Retired public servant Helen Parkinson wants to keep living in her north Canberra home for as long as possible.
But, after four hospital admissions this year and a fall that left her with bleeding on the brain, Mrs Parkinson fears she will have to go into residential aged care after an algorithm decided her approved level of home care funding was not urgent.
"I've always been independent," the 85-year-old, who worked for the Department of Prime Minister and Cabinet under Bob Hawke and Paul Keating, tells The Canberra Times.
"I've always been able to manage things on my own. But I'm not as agile or as capable as I've been."
In March, Mrs Parkinson was approved for a level four support at home package, enough to pay for about 15 hours a week of care - up from the five or so hours she gets on level two.
But when she called to ask when she would get the extra funding, she was told that her case had not been categorised as urgent by the controversial Integrated Assessment Tool that has replaced human decision-making in Commonwealth-funded aged care.
Mrs Parkinson, whose husband died a month ago after three years in a nursing home, says her level four package was approved by an assessor who visited her at home.
"They said I needed [a level four package] because I'm living on my own," Mrs Parkinson says.
"I needed supervision, just someone there to sort of make sure I wasn't going to fall on the bathroom floor again ... because having a shower on your own can be dangerous. You can slip."
After her latest hospitalisation, she says, "I wasn't allowed to do a lot of things that I had been normally doing, and it's affected me quite considerably."
Unable to drive, Mrs Parkinson has relied on ACT government taxi vouchers to get to medical appointments.
While she has been able to get some cleaning, gardening and meals funded, her quarterly funding has run out and she is not able to get the personal care help she now needs.
Under current wait times, older people deemed urgent priority receive their assessed level of home care in less than a month, high priority within a month and medium priority in five to six months. Those deemed to be a standard priority wait seven to eight months.
Aged Care Minister Sam Rae said it was "always concerning to hear of stories where the system has not served older Australians well, and my thoughts are with this family".
Mr Rae promised to "legislate a new assessment escalation pathway to ensure decisions can be reviewed and changed when necessary," as a "safety net [to support] the older people whose circumstances don't fit neatly into a tool".
And the department has been ordered to undertake "a rapid review of the support at home prioritisation mechanism to make sure that the right people are being fast-tracked for the care that is desperately needed".
But the Coalition, the Greens and crossbenchers including ACT independent senator David Pocock say this is not enough, and on Tuesday united in the Senate to pass a motion demanding that the Integrated Assessment Tool be abolished, after last week passing a bill to restore human override (a symbolic move, with the government holding the numbers in the lower house).
During parliamentary question time on Tuesday, Mr Rae was asked if he would "establish a mandatory automated decision-making framework, including human oversight, as recommended by the Robodebt Royal Commission, to improve public confidence and trust?"
He replied that the algorithm aimed to deliver a standardised assessment system, as recommended by the Aged Care Royal Commission, that was "efficient, accurate, and fair, so that no matter where in Australia someone lives or who does their assessment, they are always treated equitably".
Opposition health and aged care spokeswoman Anne Ruston said the algorithm was imposing arbitrary decisions on the people least able to fight them.
"This is not a sophisticated clinical tool making careful, evidence-based decisions about older Australians' care," Senator Ruston said.
"It is an untested system producing wildly unfair outcomes."
Senator Pocock said the minister "is failing older Australians and families who deserve a much higher standard of care".
ACT Liberal Senate candidate Nick Tyrrell said Canberrans wanted to know why Finance Minister and ACT Labor Senator Katy Gallagher had voted against the human override bill.
"Even the department has admitted there is a rationing of aged care packages, and bizarrely Labor put an algorithm in charge of prioritising them," Mr Tyrrell said.
Health Department Secretary Blair Comley told Senate estimates in June that "in a rationed system", the algorithm was put in place with the aim to ensure that funding went "to the highest need at the right time" and that previously, there had not been "enough consistency".
Greens spokesperson for older people Penny Allman-Payne said on Tuesday that the "friendless system" was "systematically under-assessing need and priority, denying care to thousands and leaving people with degenerative conditions desperately short of even the bare minimum funding they need."
Health Minister Mark Butler said, when asked why the government would not just "cancel the algorithm", that he was "still a very strong supporter of the idea of a single assessment framework".
