What is the purpose of this AI system?
Risk Assessment & Triage
Eligibility & Public Benefits
Who is accountable for this AI system?
Department of Social Services (DSS) Deployer
Gainwell / Health Management Systems Vendor
What is the AI system doing?
Deciding (Analytical AI) Human decides
What are the risks and how are they mitigated?
Reputational harm
Financial & business harm
What are your rights?
Right to a Human Review
Right to Algorithmic Transparency
What input data does this AI system process?
Sensitive personal information Identifiable data
Sensitive personal information Identifiable data
What algorithm or model processes the data?
Classification & Prediction
What does this AI system produce?
A decision about you Identifiable data
Who has access to the data?
Available to the accountable organization
Not available to me
How long is the data kept?
Retained Not specified in available disclosure