Set Up Single-Program Benefit Management

Caseworkers determine eligibility, review applications, process changes and recertifications, and assign and disburse benefits, all within guided flows built for one program at a time, as opposed to the unified multi-program intake experience described in the following note.

Note

This setup applies to the single-program Benefit Management experience, where constituents apply for and track one benefit program per application. For a unified intake experience where constituents apply for multiple benefit programs, such as SNAP and LIHEAP, in a single application, see Unified Intake for Multiple Benefit Programs.

Setup at a Glance

Set up single-program Benefit Management in this order.

1. Complete the prerequisites, such as enabling the required org features and permissions.
2. Set up the eligibility assessment flow so constituents can screen for likely eligibility before applying.
3. Configure automated eligibility determinations using decision matrices, expression sets, and Decision Explainer, so eligibility is calculated consistently and transparently.
4. Deploy the Benefit Management Discovery Framework template to get a starting set of assessment questions and configuration.
5. Set up the benefit application intake flow, so constituents can apply for the benefit program with prefilled and validated data.
6. Set up the change of circumstances flow so constituents can report life changes that affect their benefits.
7. Set up the benefit recertification flow so constituents can renew their benefits before they lapse.
8. Set up the benefit application review flow, so caseworkers can review, determine eligibility for, and act on submitted applications.
9. Configure a flow to alert applicants when their application status changes, so constituents stay informed without having to call in for updates.
10. Build the Benefit Assistance Experience Cloud site where constituents apply, recertify, report changes, and file complaints.
11. Enable caseworkers to process benefit applications, changes of circumstance, benefit assignment adjustments, and recertification applications using guided flows.
12. Configure how caseworkers assign and disburse benefits to eligible applicants, either automatically on a schedule or manually.

Note

Customer is solely responsible for any use of sample, example, or template benefit eligibility criteria, formulae, or similar schema provided with Benefit Management. Customer must ensure that any benefit eligibility decision-making by Customer using such sample, example, or template benefit eligibility determination tools are used: (i) only by authorized personnel of Customer; and (ii) in compliance with applicable laws and regulations to which Customer is subject.

• Benefit Management Prerequisites
  Before you set up benefit management in Public Sector (formerly Public Sector Solutions), complete the prerequisites.
• Set Up the Eligibility Assessment Flow for Your Benefit Assistance Site
  To specify eligibility criteria and set up the assessment, customize the Omniscript, create a decision matrix, build an expression set, and activate the Omniscript.
• Automate Eligibility Determinations
  Use Business Rules Engine to determine benefit eligibility and the benefit amounts for qualified applicants. First, create a decision matrix that defines the income threshold based on the income and household size. Then build an expression set that uses the matrix to find benefit eligibility and calculate eligible benefit amounts. Use Decision Explainer to share the reasoning behind application decisions, eligibility determinations, and benefit amount calculations with constituents.
• Deploy the Benefit Management Discovery Framework Template
  Deploy version 5 or later of the Discovery Framework sample template for benefit management in Public Sector (formerly Public Sector Solutions).
• Set Up Benefit Application Intake
  Use Discovery Framework assessment questions and Omniscripts to capture information from constituents who apply for a benefit. Store assessment questions responses in Salesforce objects using Omnistudio Integration Procedures and Omnistudio Data Mappers. Capture effective start and end dates when you store income and expense data. Use Business Rules Engine to automate benefit eligibility determination.
• Set Up the Change of Circumstances Application Flow
  Set up a guided flow on your Experience Cloud site that constituents can use to report changes of circumstance that affect benefit or service eligibility. Review the changes in an individual application record, and adjust the services or benefits assigned to constituents as necessary.
• Set Up the Benefit Recertification Flow
  Enable constituents to recertify for benefits on your Experience Cloud site. Show them benefits that are pending recertification and give them a guided flow to review the information that they previously provided, confirm or update details, upload supporting documents, and submit their recertification application.
• Set Up the Benefit Application Review Flow
  Configure a guided flow for caseworkers to use to check whether benefit, change of circumstances, and benefit recertification applications are complete and accurate, to determine eligibility, and to assign and adjust benefits and services.
• Alert Applicants When Their Benefit Application Status Changes
  Keep applicants informed of the progress of their benefit applications by using a flow to automatically send a desktop notification and an email to applicants when the status of their benefit application changes.
• Build a Benefit Assistance Experience Cloud Site in Public Sector
  Create an Experience Cloud site where constituents can apply and recertify for benefits, report a change of circumstances, and file complaints.
• Process Benefit Applications by Using a Guided Flow
  Check whether an application in review is complete and accurate. Correct details based on evidence and, if necessary, return the application for additional information. When the application is complete, if the applicants are eligible, assign them a benefit amount.
• Process Change of Circumstance Applications by Using a Guided Flow
  Check whether a change of circumstances application is complete and accurate. Correct details based on supporting documentation and, if necessary, return the application for additional information. When the application is complete and you have confirmed the details, accept or deny the application.
• Process Benefit Assignment Adjustment Applications by Using a Guided Flow
  Check the changes reported. View benefit assignment details and adjust the benefit amount to match the change in circumstances.
• Process Benefit Recertification Applications by Using a Guided Flow
  Check whether a recertification application is complete and accurate. Correct details based on supporting documentation and, if necessary, return the application for additional information. When the application is complete and you’ve confirmed the details, accept or deny the application. Renew or adjust the amount of benefits that constituents receive to match their benefit eligibility.
• Assign and Disburse Benefits to Eligible Applicants
  Assign benefits to eligible applicants and disburse the benefits by using flows in Public Sector (formerly Public Sector Solutions).