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Create Benefits and Eligibility Rules

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Create Benefits and Eligibility Rules

Set up benefit program such as the LIHEAP and SNAP, and the rules that determine who qualifies for them.

Required Editions

View supported product editions.
User Permissions Needed
To create decision matrices and expression sets: Rule Engine Designer

Create each benefit in the Program Management app. Then build the decision tables and expression sets that evaluate applicant income and household data against program standards. Attach each expression set to its benefit so eligibility is determined automatically during intake.

Create Benefits

Create benefits such as Low Income Home Energy Assistance Program (LIHEAP) and Supplemental Nutrition Assistance Program (SNAP) in the Program Management app.

  1. From the App Launcher, find and open Benefits.
  2. Click New.
  3. Enter a name for the benefit. For example, LIHEAP.
  4. Search for and select a benefit type. For example, LIHEAP.
  5. Select Active.
  6. Save your changes.

Automate Benefit Eligibility Determination with Expression Sets

Give constituents an accurate, automated eligibility check instead of a manual review for every program.

Set up the decision tables and expression sets that power benefit eligibility. Create and activate decision tables for program standards, such as LIHEAP and SNAP, upload their lookup data, generate and activate the matching eligibility determination expression sets, then attach each one to its benefit for the application to automatically evaluate eligibility during intake.

Set Up Decision Table

Store each program's income and household eligibility rules in one place so admins can apply them consistently.

  1. From the App Launcher, find and open Lookup Tables.
  2. Click New.
  3. Select Decision Table.
  4. Specify the decision table details. Here are the sample values for LIHEAP Program Standards.
    • Name: LIHEAP_Program_Standards
    • API Name: LIHEAP_Program_Standards
    • Application Usage: Default
    • Decision Table Type: Advanced
  5. Select the applicable template. For example, LIHEAP_Program_Standards template.
  6. Click Save & Next.
  7. Click Finish.
  8. In the Version tab, open the V1 version of the decision table.
  9. Click Upload CSV and then upload the CSV file for the LIHEAP lookup table.
  10. Click Add Data.
  11. After the CSV Upload Status changes to Uploaded, activate the decision table.
  12. Repeat the steps for other decision tables. For example, LIHEAP_Eligibility_Amount_Standards.

Set Up Expression Set Templates

Use expression set templates to enable eligibility logic from the decision tables to run automatically against each applicant's data, instead of being evaluated case by case.

  1. From the App Launcher, find and open Expression Set Templates.
  2. Click the applicable program template. For example, LIHEAP Eligibility Determination.
  3. Click Save as New Expression Set.
  4. Enter 1 in Rank and select Active.
  5. Save your changes.
  6. Repeat the steps to create the decision table and the expression sets for other programs. For example, these details apply for Supplemental Nutrition Assistance Program (SNAP).
    • Decision Table
      • Name: SNAP_Program_Standards
      • API Name: SNAP_Program_Standards
    • Expression Set
      • Template: SNAP Eligibility Determination
  7. From the App Launcher, find and open Benefits.
    1. Click a benefit. For example, LIHEAP.
    2. Edit the Benefit Eligibility Expression Set field and attach the LIHEAP Eligibility Determination expression set.
    3. Repeat the steps to attach the SNAP Eligibility Determination expression set to SNAP.
 
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