Specific Eligibility Rules For Insurance Needs

Submitted By shawnasue01
Words: 1688
Pages: 7

Just about every healthcare agency relies on specific eligibility rules, which are set forth to formulate business and help clients. Not every agency has the same rules; however, such rules are critical for agencies in order to provide fair services to each eligible client. These rules set a foundation for the agency, which helps avoid circumstances of favoritism or stigmatization. By establishing specific eligibility rules for all clients, it is easier to identify the qualifying individuals. This paper will evaluate and discuss the eligibility rules used by AIDS when determining who qualifies for services and under what conditions they qualify.
The AIDS organization is partnered with several federal agencies which provide a broad range of services to millions of clients. Consequently, this researcher will discuss the eligibility rules for housing assistance. “Housing Opportunities for Persons with AIDS Program (HOPWA)” is managed by the “Department of Housing and Urban Development (HUD)”. “HOPWA is the only program available committed to addressing the shelter needs of low-income people living with HIV-AIDS” (HUD, 2008, Para 1).
The “Department of Housing and Urban Development” along with other federal programs provides millions of dollars towards the HOPWA program to grant rental assistance to people who qualify. The HUD-HOPWA program combines short or long-term housing assistance for persons living with HIV-AIDS along with clinical services and confidential case management as a basis for stabilization and increased comprehensive healthcare participation (HUD, 2006).
The type of eligibility rule used by the HUD-HOPWA program is the eligibility by administrative rule and regulation. This rule is set forth to clarify in detail the laws of HUD and any housing agency. The use of this rule is an advantage for individuals currently living with HIV-AIDS. This rule provides the means “by which to administer the benefit or service program evenhandedly and reliably, so that people similarly situated are given similar benefits” (Chambers & Wedel, 2005, p. 112).
The rule used by the HOPWA program is slightly different from the rule used by the regular HUD program. The essential component of HOPWA is to provide housing assistance strictly for the low-income AIDS population. Their rental assistance program is carefully coordinated with the delivery of additional supportive services. Hence, the eligibility rules that govern this program in order for a person to qualify for the service is that income must be below 80% of the area’s median income (HUD 2006, Para 1). The second and most important factor, which is set forth under their eligibility rules, is the specific circumstances for which the person will qualify for the HOPWA Program. Because this is program is strictly enforced for the specific disability of AIDS-HIV, in order to qualify the person must have “documented HIV-AIDS status” (HUD 2006, Para 1).
Although there are many programs with clear stigmatization and off-targeted benefits, the HOPWA program appears to be a straightforward program. The benefits provided by this program are specific to people living with HIV-AIDS. As long as the income requirements are met and the persons status is documented there is no room for personal judgment or discretion. Because of its use of the eligibility by administrative rule and regulation, there is no stigmatization in this program.
The HOPWA program was created as a universal program which is backed up by “Title VIII of the Civil Rights Act of 1968 (Fair Housing Act)”, “Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act of 1990” (HUD, 2008, Para 8). This program ensures that the targeted population is able to receive assistance and supportive services by proving eligibility through set standards. In doing so, HUD has eliminated stigmatization and off-targeted benefits from this program.
In determining trade-offs, there are