Domain Atlas / Public benefits & eligibility
Arkansas ARChoices / ARIA
A large share of Arkansas home-care recipients had care hours cut when algorithmic assessment replaced nurse judgment, and courts found due-process violations centered on the inability to understand or contest determinations.[7]
What happened
Arkansas replaced nurse judgment with an algorithmic assessment (and later the ARIA successor) to allocate Medicaid home- and community-based care hours. Documented accounts describe a large share of recipients — people with disabilities depending on attendant care — having hours cut when the algorithm took over, without an explanation recipients or even assessors could reconstruct. Courts found due-process violations centered on the inability to understand or meaningfully contest the determinations.
The sociotechnical reading
ARChoices is the explainability case with teeth: the legal defect was not the formula's statistics but the impossibility of contesting what cannot be explained. In map terms, the appeal pathway — the system's designed correction loop — was structurally broken because the information needed to appeal did not flow to the people holding the right. A correction channel that cannot be exercised is not a control. The pattern library's provenance and explanation requirements trace straight back to failures of this shape.
The concepts used in this reading are defined in the Field Guide; the governance responses live in the Practice Library.