Reassessing Case Eligibility and Entitlement

Real world information about a client is constantly changing and those changes can impact that client's eligibility and entitlement. Case reassessment updates client eligibility and entitlement as their circumstances change. Reassessment occurs automatically when evidence is added or modified that changes the result of previously created decisions. For example, when a client submits new income information, since that income has been used to determine eligibility for income support, reassessment will occur automatically, resulting in a new determination and decisions based on that income.

Reassessment can also result in the creation of a new determination when changes to evidence only impact decision details or key decision factors. For example, a child in a foster home may be moved to a new facility. This may not impact the child's eligibility and entitlement for care and protection, but is still a key factor in meeting the needs of that child and thus should be kept up-to-date in the overall representation of the explanation of the child's eligibility and entitlement.

The result of case reassessment is a new determination which includes any new decisions, new decision details information, and/or new key decision factors.

An agency can configure whether or not automatic reassessment should occur within a closed case as part of the application administration. For more information, see section 3.2.2, Eligibility Determination and Decisions in the Cúram Integrated Case Management Configuration Guide.

An agency may also choose to prevent reassessment and the creation of a new determination from occurring within a case under certain conditions. For example, this may not be desired in cases created to manage once-off payments once a payment has been issued. Note that development effort is required in order to do this. For more information, see the Inside Cúram Eligibility and Entitlement Using Cúram Express Rules developers guide.