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Eligibility Project Details
This function consists of determining programs for which funding support is available
for clients receiving services. Program eligibility may include funding for foster
care/adoption payments and determining the type of programs that will allow a client
to receive Medicaid coverage. This function is usually initiated sometime during
the Intake Function.
A. INITIAL ELIGIBILITY DETERMINATION
1. Determine title IV-E eligibility - The automated system will provide for the
exchange and referral of information necessary to determine eligibility under title
IV-E through an interface with the title IV-A system.
2. Verify eligibility for other programs - The automated system will provide for
the exchange and referral of information necessary to determine eligibility/status
under other related programs such as title XIX (Medicaid) and title IV-D.
3. Record authorization decisions - The automated system will provide for the recording
of the eligibility authorization decisions.
4. Generate documents related to eligibility determinations - The automated system
will produce the alerts, notices and reports (e.g., exception reports) needed to
provide information on and track the initial eligibility determinations.
B. CHANGES IN ELIGIBILITY
1. Redeterminations - The automated system will provide for the processing of regularly
scheduled and as needed program redeterminations and recording of redetermination
decisions.
2. Generate documents related to eligibility determinations - The automated system
will produce the alerts, notices and reports (e.g., exception reports) needed to
provide information on and track the changes in eligibility status.
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