SAMPLE POLICY WORK

• The intellectual disability is indicated (IQ ≤70 or similar). • All required documentation is authentic, recent, and complete. • There are no inconsistencies or unresolved queries in the submitted records.

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Initial Approval:

– Once confirmed, the eligibility specialist flags the file as “Initial Approval” in the agency’s electronic record system. – Any necessary notes on follow-up or points requiring clarification are documented in detail in the applicant’s file.

Step 5: Managerial Review and Final Confirmation • Management Oversight:

– The file, marked “Initial Approval,” is forwarded to a senior supervisor or director in the Care Services team for a final review. – The supervisor verifies that all internal controls and documentation standards have been met by comparing the file against regulatory reference standards and internal checklists.

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Final Determination:

– Upon satisfactory review, the supervisor confirms the individual’s eligibility by updating the digital record with a “Final Confirmation” status. – A formal notification is prepared for both the individual or their legal representative, explaining the eligibility status, next steps in the service delivery process, and any additional documentation required in the future.

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Documentation of Decision:

– A detailed log entry is created in the individual’s file, documenting the dates of both the initial and final determinations, responsible staff signatures, and any corrective actions taken during the evaluation process.

Step 6: Continuous Monitoring and Feedback Loop • Internal Audit and Quality Assurance:

– Regular audits (at least quarterly) are performed by the Compliance and Regulatory Affairs Team to verify that eligibility determinations are consistent and compliant with CAC Waiver requirements. – Audit findings are documented, and any discrepancies are immediately addressed through corrective action protocols. • Feedback and Improvement:

– Staff are encouraged to provide feedback on the eligibility process through structured digital forms and periodic review meetings.