Senate Community Affairs Legislation Committee, , 6:20:44 to 6:28:41
Senator Roberts raises concerns about classification algorithms and provider overcharging, leading to a discussion on the Quality and Safety Commission's audit processes.
Topics: Social services, Artificial intelligence, Integrity
Speakers: Speaker 31, Mr Robert Day, Ms Sonja Stewart, Senator Malcolm Roberts, Senator Ellie Whiteaker
Senator Roberts, over to you.
Thank you, Chair. I'm going to continue from the previous set of questions that we got halfway through. People see the government making things harder for older Australians by limiting their access to age care packages when an algorithm can reduce or cancel vital assistance for persons in need without human understanding or input. Do you understand that?
So I understand that there is concern around the algorithms. There's two algorithms. There's one that provides an older person the classification of the classification algorithm. So it's a set of rules that is used by assessors making judgments, clinical judgments around the types of services. And then the other one is the prioritisation algorithm, which is how soon do people get the services. So I I do understand that there are concerns about systems and processes which advise people when they will get something and what they would get. These are really important parts of our system in in order to ensure equity in terms of the matter where you are in Australia, getting an assessment that the same sorts of questions are being considered and asked of you. So that would be my response. So I acknowledge the concerns, but I would also say they're key design features to ensure equity and consistency.
Is there any way the concerns can be addressed while meeting your needs?
Sorry, I didn't catch the question.
Is there any way is there any way that people's concerns can be met while you're uh addressing your own needs?
Um so uh what I how I would reply to that is that the government is um listening to concerns and has uh agreed to a review of the prioritization and the classification algorithm um to to look at how uh the system is operating with those rules.
Thank you. My office has now assisted multiple aged persons who are having problems with service providers, gouging recipients and then finding that the department when considering complaints simply take the service provider's word for it and do no actual checks, no actual checks on what was provided and at what cost. The concerns are the providers are ripping people, ripping off the taxpayer. When will there be routine situational orders done to stop ripoffs?
Yeah. So I might call upon the Commission and the complaints commissioner, and but also Mr. Day might want to make a comment. But um, we take this um very seriously uh and um particularly with uh uh piece of legislation which is uh focuses on the older person, but I'll hand over um to the public and safety commission.
I might answer quickly in terms of what we do from assurance point of view and then let the commissioner answer in terms of the regulatory response. Um so Senator, we have a rolling program of assurance in terms of support at home charging. Um of those programs looks every quarter at assuring that this the service that that provider has claimed for was delivered, that the price was the price agreed with the older person that there's evidence that that both of those things happened. Um and the second that we undertook between March and July of this year was a uh an assurance process around providers whose prices were at the top of the range for certain service.
Their prices.
That's right. So we asked them for evidence about why that was a reasonable price to charge. Um we looked at 46 providers in that process.
Out of how many in Australia?
What we what we did was we looked at the the median price for the particular service types and providers that were three standard deviations of statistical measure above the median we looked at. We found that for 43 of those 46 providers, the issue was actually the way they had recorded the charging in the system rather than the price they charge. So, for example, they charge they they entered in the system a week's worth of meals, but they entered it as one meal, so it looked like the price for one meal was ridiculously high. Um there were three providers who couldn't give us a satisfactory answer, or we couldn't satisfy ourselves it was just a record keeping issue. Um those are matters that referred to the the Quality and Safety Commission for a regulatory response. Um in addition to that role in assurance process that the Commission also has the capacity to take complaints and respond to individual complaints about pricing concerns.
Uh Liz Hef and Web Commissioner Hare Quality and Safety. Um just to the question of audits. Um we undertake rolling audits of providers or providers that are providing support at home or residential aged care on a three-year rolling cycle. So it is the case that we are assessing them against the quality standards uh regularly, just in relation to complaints. So I understand you you said um there was an allegation that we don't uh investigate the complaint or don't um provide the person with an adequate response. Is that the concern?
The concern was that and do no actual checks. Simply take the provider's word for it and do no no actual checks, but I'm learning that you do some checks.
Yes, we do checks. Um so we've um we would um routinely if a complaint is raised by an older person or their family or carers. We will go to the provider and get their perspective on the matter, and we also encourage the provider to reach out directly to the older person if the older person's interested to try and resolve the complaint uh quickly and and deal with the matter. But if the older person is not satisfied with the actions of the provider, we can investigate further. We can require them to take further steps. Um we do have um around a 62% satisfaction rating with our people feeling that the complaint was responded to well. Obviously, we'd like that to be higher, but um we do uh take very seriously our obligation to resolve complaints.
Another question we have from a constituent. When the actual labour cost is less than $30 per hour, but the charge out fee by the service provider is around 120 dollars per hour.
So Senator and the Department might want to talk about this as well. We are have the ability to assess prices against what is reasonable. When we're assessing what's reasonable, we're considering all the costs of service delivery. So obviously the wage is a component of the cost, travel is a component of the cost. On costs, and administrative overhead, superannuation, all those other elements. Um I think uh Senator Ruston said earlier that costs have gone up around 38%. That does reflect what was expected given the change in the pricing arrangements and people now having to build those on costs into the price. But I I I appreciate for older people it seems counterintuitive some of these prices, and um we do ask providers to give us evidence of how they justify their prices, and in some cases they've not been able to do that, and we have um arranged for refunds to be provided to older people where we think there's a genuine case that they've been overcharged.