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            Specify Eligibility Criteria for Programs

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            Specify Eligibility Criteria for Programs

            Create eligibility criteria that are unique to each program, and check a participant’s eligibility against their participant record on an application. Intake coordinators can see a participant’s status, which helps them make faster decisions and prevent non-compliant enrollments.

            Required Editions

            Available in: Nonprofit Cloud
            Available in: Lightning Experience
            User Permissions Needed
            To complete participant intake:

            Advanced Program Management permission set

            AND

            Track Applications permission set

            AND

            Form Framework User permission set

            AND

            Action Plan permission set

            AND

            Create access for the Action Plan object and fields and Read access for Action Plan template object and fields

            AND

            Care Plans Access permission set

            AND

            Case Referral permission set

            AND

            Is Flow user System Permission
            To update participant eligibility:

            Rule Engine Runtime permission set

            AND

            Run Decision Tables profile
            To capture client notes on the application form page:

            Interaction Summary permission set

            AND

            Omnistudio User permission set
            To complete assessments on the application form page:

            Industries Assessment permission set

            AND

            Omnistudio User permission set
            To create cases and case program records when completing an application: Care Plans Access permission set
            To set up intake and eligibility:

            Form Framework Manager permission set

            AND

            Rule Engine Designer

            AND

            Omnistudio Admin

            Use decision tables when your eligibility criteria include straightforward field values. If your programs share criteria, you can use one decision table. Or, if your programs have different criteria, you can use multiple decision tables. For example, our out-of-the-box decision table enables you to set eligibility based on the applicant’s age and country. Use expression sets when your eligibility criteria include formulas, branching logic, or extra complexity. For example, you can create an expression set that specifies income as a criteria and calculates an applicant’s income based on multiple fields.

            Before you begin, set up program participant intake tracking.

            1. From Setup, in the Quick Find box, search for and select Business Rules Engine Settings.
            2. Turn on Industries Cloud Common Decision Tables Access.
            3. In the App Launcher, enter Business Rules Engine, and select it.
            4. In the Lookup Tables page, click New.
              The New Lookup Table window appears.
            5. Select Decision Table.
            6. Click Next.
            7. Fill in the fields.
              1. In the Application Usage field, select Program.
              2. In the Decision Table Type field, select Standard.
              3. Click ProgramEligibility to select the out-of-the-box decision table template.
                The Name field is automatically populated.
              4. In the API Name field, enter Program_Eligibility.
              Note
              Note We recommend using this name and API name for the decision table because these values are referenced in the Evaluate Applicant Eligibility for Program flow. If you use different values, you must also update the references in the flow.
            8. Click Save & Next.
              The preview screen shows an empty table with the criteria included in the out-of-the-box decision table template: Country, Minimum Age, and Maximum Age. The Program ID is the required input.
            9. Click Finish.
              The Program Eligibility decision table page appears.
            10. Click Activate.
              After several minutes, the data table is activated.
            11. Add new picklist values for program recommendation rules.
              1. From the Object Manager settings for Program Recommendation Rule, go to Fields & Relationships.
              2. Click Rule Type.
              3. Create two picklist values.
                • Eligibility
                • Recommendation
            12. Add new fields to the person account page layout.
              1. From the Object Manager settings for Person Account, go to Page Layouts.
              2. Click Person Account Layout.
              3. Add two fields.
                • Birthdate
                • Mailing Address, which includes Country

                These fields are included on the layout because they correspond to the eligibility criteria to check.

              4. Add the Program Enrollments related list.
              5. Save your changes.
            13. To see the eligibility criteria for a program in the program record page, add the program recommendation rule to the program page layout in Object Manager.

            Create Eligibility Criteria for a Program

            To make sure that applicants meet the unique and complex eligibility criteria for your programs, you can specify unique eligibility rules for each program. To do so, assign the eligible values for each criteria with the Program Recommendation Rule object.

            1. In the App Launcher, enter Program Recommendation Rule, and select it.
            2. Click New.
            3. Fill in the fields.
              Program Select the program that you’re creating eligibility criteria for.
              Name Enter a name, for example, Program Name Eligibility Criteria.
              Minimum Age Enter the minimum age that an applicant must be to enter the program. The out-of-the-box decision table compares this value to the value of the Birthdate field on the account.
              Maximum Age Enter the maximum age that a applicant must be to enter the program. The out- of- the- box decision table compares this value to the value of the Birthdate field on the account.
              Country Select the country that the applicant must be in to enter the program. The out-of-the-box decision table compares this value to the value of the Mailing Country field on account.
              Rule Type Select Eligibility.
            4. Save your changes.
            5. Repeat the previous steps for all of your programs that use the eligibility criteria in this decision table.
            6. In the App Launcher, enter Business Rules Engine, and select it.
            7. In the Lookup Tables page, click Program Eligibility.
            8. Click Refresh.

            Modify the Eligibility Criteria in the Decision Table

            The out-of-the-box ProgramEligibility decision table template includes age and country as eligibility criteria. To adjust the criteria to meet your organization’s needs, you can modify the template, create a decision table, or add an expression set to customize eligibility checking for your programs.

            Add Criteria to the Decision Table

            1. Add the new criteria to the program recommendation rule.
              1. From the Object Manager settings for Program Recommendation Rule, go to Fields & Relationships.
              2. Click New.
              3. Add a new field to specify the criteria.
                For example, if your program eligibility is based on ZIP code instead of country, you can add a text field with the label Zip Code and a length of 5 to represent the ZIP code.
              4. Add the field to your page layout.
            2. Create a decision table from the template.
              1. In the App Launcher, enter Business Rules Engine, and select it.
              2. In the Lookup Tables page, click New.
              3. Select Decision Table, and then click Next.
              4. In the Application Usage dropdown, select Program.
              5. Select the Program Eligibility template.
              6. Enter a name, for example, Program Eligibility with Zip Code.
              7. Click Save & Next.
              8. Click Finish.
            3. Edit the decision table.
              1. From the lookup table detail page, click Edit.
              2. Click Save & Next.
                The Conditions & Results page appears.
              3. Click Add Condition.
              4. In the Source Object Field field, select the field that you previously added to the program recommendation rule.

                For example, to add ZIP code as a criteria, select the Zip Code field that you created in the Program Recommendation Rule object.

              5. If needed, remove conditions.
                For example, if your program eligibility is based on ZIP code instead of country, you can remove the condition with country as the source object field.
              6. Click Save & Next.
              7. Click Save & Next again.
              8. Click Finish.
              9. Click Activate.
            4. Update the Evaluate Applicant Eligibility for Program flow to include the new criteria.
              1. Open the Evaluate Applicant Eligibility for Program flow.
              2. Open the Have Required Information decision element.
              3. Update the element to check for the conditions that you specified in the decision table.
                For example, add a condition that checks the applicant’s mailing ZIP code, and remove the condition that checks for mailing country.
              4. After the Check Program Eligibility element, add a new action element for the new decision table.
                For example, search for the Program Eligibility with Zip Code action.

                You can use the input values in the Check Program Eligibility element as examples. For example, you can map the ZIP code to the mailing ZIP code or postal code field on the account associated with the application.

              5. Update the Eligibility Status formula to reference the outcome of the decision table that you previously created.
              6. For example, change the value of the EligibilityStatusFormula to BLANKVALUE({!EligibilityStatus}, IF(ISBLANK({!Check_Program_Eligibility_with_Zip_Code.singleOutcome.Name}}), "Not Eligible", "Eligible")).
              7. Delete the Check Program Eligibility action.
              8. Save and activate your flow.
            5. Create a program recommendation rule or update the existing rule for programs that use this new criteria.
            6. In the App Launcher, enter Business Rules Engine, and select it.
            7. In the Lookup Tables page, click the decision table you created, for example, Program Eligibility with Zip Code.
            8. Click Refresh.

            Add an Expression Set to Calculate Eligibility

            Managing multiple programs with different eligibility criteria can become increasingly complex. Eligibility criteria can require formulas to calculate values such as household income. They can also require branching logic. For example, a program can specify that if an applicant’s income is less than $20,000, the applicant is eligible, but if it’s greater than or equal to $20,000, the applicant isn’t eligible. In these complex situations, we recommend including expression sets in your program eligibility strategy. For more information, see Expression Sets.

            Salesforce includes the Program Eligibility expression set template, which demonstrates how to calculate age and use a decision table within an expression set. To view this example, go to the Expression Set Templates tab in the Business Rules Engine Lightning app.

            Set Up the Eligibility Check on the Application Form

            Enable staff to check an applicant's eligibility status in real time with the Evaluate Applicant Eligibility for Program and Get Program Eligibility flows. The Evaluate Applicant Eligibility for Program flow automates the process of checking an applicant’s information against the eligibility criteria for each program they’re applying to. The flow stores the eligibility status for each program in the Status field of the Application Form Evaluation record for that program. Update this flow to enable Salesforce to check an applicant’s eligibility when a user creates an application form or as they gather more information from the applicant.

            The Get Program Eligibility screen flow shows an applicant’s eligibility status for each program on an application form, making it easier to see eligibility in the flow of work. Update this flow to add a button to the application form that enables users to recheck an applicant’s eligibility status throughout the intake process.

            1. Test the eligibility flow.
              1. From Setup, in the Quick Find box, enter Flows, and select it.
              2. In the All Flows list, click Evaluate Applicant Eligibility for Program.
              3. In the flow, expand the Errors and Warnings pane, and check whether the flow contains any errors.
                If the flow contains errors, correct them before proceeding.
            2. Automate eligibility evaluations.
              This step enables Salesforce to check an applicant’s eligibility while the application form is created so that a user can see the eligibility status when they open a new application.
              1. From Setup, in the Quick Find box, enter Flows, and select it.
              2. In the All Flows list, click Create Application and Action Plans.
              3. Add a Subflow element after the Create Action Plans element.
                Create Action Plans is the last element in the flow.
              4. In the Search Flows pane, select Evaluate Applicant Eligibility for Program.
              5. In the Properties pane for the subflow, provide a label and API name.
              6. In the Set Input Values area, include recordID.
              7. Set the recordId to the Application Form ID field from the ApplicationForm record variable, for example, {!ApplicationForm.Id}.
              8. Click Save As New Flow.
              9. Provide a flow label and API Name, and then click Save.
              10. Activate the flow.
                The new flow overrides the original flow.
            3. Add a Refresh Eligibility button to the Application Form.
              The button allows the user to refresh the applicant’s eligibility status throughout the intake.
              1. From Setup, in the Quick Find box, enter Flows, and select it.
              2. In the All Flows list, click Get Program Eligibility.
              3. Click the Display Program Evaluations screen element.
              4. In the Screen Properties pane, click Configure Footer.
              5. Select Show Footer.
              6. In the Next or Finish Button field, make sure that Use a custom label is selected.
              7. In the Next of Finish Button Label field, enter the label for the new button, for example, Refresh Eligibility.
              8. Click Done.
              9. After the Display Program Evaluations screen element, add a Subflow element.
              10. In the Search Flows field, enter Evaluate Applicant Eligibility for Program, and select it.
              11. Provide a label and API name for the element.
              12. In the Set Input Values area, include the recordId input, and set the value of the input to the recordId variable.
              13. After the new Subflow element, click the Add Element icon, and then click Connect to element.
              14. Select the Get Application Form Evaluations element.
              15. Click Save as New Flow.
              16. Provide a label and API name for the flow, and then click Save.
              17. Click Activate.
             
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