1. Use Case Specification: Determine and Redetermine IV-E Eligibility Use Case Name
1.1 Brief Description
The purpose of this Use Case is for the system to determine whether the applicant is eligible for IV-E funding based on the data provided by the SW to the EW during the creation of the IV-E referral (UC3). The user will do an initial determination within 45 days of receipt of the application/referral. The flow for UC4 begins after the EW has determined whether they have enough information in AES that was entered during the application referral process (UC 3). The EW and/or the EW Supervisor may execute the eligibility determination for cases assigned within their locality/district. The results of the eligibility determination will determine whether the user can go on to the next use case (UC5-determine reimbursability) or return to UC3-Create initial IV-E referral. If found ineligible because of missing information the user must return to UC3. If found eligible, the user can go on to UC5. After initial determination is made users will have to periodically run the eligibility determination after changes to the FC Child’s case or when the time rules require a redetermination.
2. Flow of Events
Actors: EW and/or EW Supervisor. Only the EW or the EW Supervisor at the locality who owns the Foster Care case can run the Eligibility Determination function of the system.
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Go to UC 5.
2.1 Basic Flow –EW Logs on to AES.
2.2 EW searches for and opens the applicable case referral.
2.3
EW navigates to the eligibility determination
screen. EW reviews referral for
completeness. (The EW can create a
missing information report at this time or let the system create the report if
the system finds that required information is missing during the eligibility
determination phase.) If missing information is displayed, system shall create
missing information report to send to SW.
(See UC 8)
2.4
EW selects type of eligibility determination
(initial, redetermination)
2.5 System evaluates the following on each Foster Care Child (there could be multiple FC children in a removal home and each child must be evaluated separately):
a. The system shall determine if the foster care child meets the Age/School requirements to be IV-E eligible. (for initial and redetermination)
b. The system shall determine if
the foster care child meets the Citizenship/Alienage requirements to be IV-E
eligible. (for initial only)
c.
The system shall determine if the foster care child meets the Virginia
Residency requirements to be IV-E eligible. (for initial only)
d. The system shall determine if
the foster care child meets the Period of Ineligibility criteria to be IV-E
eligible. (for initial only)
e.
The system shall determine if the foster care child meets the Commitment
requirements (Legal status/Judicial language criteria) to be IV-E eligible.
(for initial only)
f.
The system shall determine if the foster care child meets the Specified
Relative/Removal criteria to be IV-E eligible. (for initial only)
g. The system shall determine if
the foster care child meets the Deprivation requirements to be IV-E eligible.
– (for initial only) (for
redetermination the deprivation criteria relates to reimbursability but not
continued eligibility)
2.6 For initial eligibility-System evaluates the following to determine members of the Assistance Unit (AU):
Only time this would
be required for redetermination is if for initial eligibility, deprivation is
based on absent parent and the parents are reunited in the removal home.
a. The system shall identify the composition of the Assistance Unit for the foster care child.
b. The system shall identify the income and resource source which includes the AU members and few excluded individuals.
c. The system shall calculate all the countable income and resources for the Assistance Unit and excluded individuals, as specified by the business rules.
d. The system shall identify the Maximum Income based on AFDC standard.
2.7 For initial eligibility-System calculates Income and Resources totals for members of the AU.
2.8 For initial eligibility-System
compares AU resources/income to 185% chart to determine need in foster care. If they don’t meet the 185% standard, they are ineligible. Stop processing. If they do meet the 185% standard, then check
against the 100% standard.
2.9
For initial eligibility-System compares AU resources/income to 100%
chart to determine need in foster care.
If they don’t meet the 100% they are ineligible. Stop processing.
2.10 System makes eligibility determination.
2.11 System displays results (eligible, ineligible, missing information)
2.12 If ineligible for cause, system creates a notification (which includes the reason for ineligibility) to tell the SW the applicant is ineligible for IV-E funding.
2.13
If ineligible due to missing required
information on the referral, system creates a Missing Information Report to
send to the SW. (See UC8)
2.14 If eligible, system creates a notification to tell the SW the applicant is eligible for IV-E funding. EW continues on to UC 5, Determine Reimbursability.
2.15
System stores disposition and creates historical
record of the entire referral application and the disposition.
3. Preconditions
3.1 A Foster Care case must exist in OASIS with the following minimum data: Open Date, Case Type (Foster Care or Dual: CPS & Foster Care), Case Name, Locality (default to SW’s locality), Case Number, DSS Case Number (editable workers in assigned locality), Primary SW (LDAP ID).(ref BR122)
4. Post Conditions
4.1 System displays results (eligible, ineligible, missing information)
4.2 If applicant is found ineligible because required data is missing, the system shall create the missing information report and send it to the SW.
4.3 If the result is ineligible, the system shall display (report) to the SW and EW the first rule which caused the applicant to be determined as ineligible.
5. Extension Points
UC 5-Determine Reimbursability will occur after the
completion of UC4 and a determination of “eligible” is found.
UC-2 The user may
return to the caseload screen after completion of UC4.
UC3-Create Initial Referral-the user may return to the referral to enter missing data.