Compliance Requirements - Eligibility (E)

Eligibility (E)

The main objective of this compliance requirement is that only eligible individuals or organizations participate in Federal assistance programs. While the criterion for determining eligibility may vary from program to program, the objective that only eligible individuals or organizations participate is consistent across all Federal programs, which forms the basis of this compliance requirement. To comply with this objective, recipients must first assure that proper eligibility determinations are made, which means that the recipient must determine the parameters and limitations to define eligibility for a specific program in accordance with the program’s purpose. Many Federal programs already contain eligibility requirements based on laws, agency regulations, grant agreements, etc., and recipients must assure that their eligibility determination complies with such requirements. An example includes Federal programs which offer HIV/Aids treatment and require that the participants be victims of such diseases. It is usually the recipient’s responsibility to determine how to determine such eligibility, such as establishing policy that requires an in-house doctor or laboratory to diagnose each prospective participant, accepting diagnoses from third-party doctors or laboratories, etc. However, certain agencies have included specific parameters for which the recipient should follow, as in the case of the Department of Housing and Urban Development (HUD) which states in the Code of Federal Regulations (CFR) that recipients of certain HUD housing subsidy programs must obtain specific income verification documents in order to prove the eligibility of a participant, such as W-2 payroll forms, a Federal income tax return, etc.

After determining which eligibility requirements are needed for participation in a program, the recipient must also assure that individual program participants or groups were correctly determined to be eligible by obtaining evidence of such compliance, such as maintaining documentation in participant files (e.g., copies of HIV/Aids diagnosis, copied of Federal income tax returns, etc.). Furthermore, the recipient must assure that only eligible individuals or groups participated in the program by establishing strict controls of program funds to avoid non-eligible persons from receiving the specific assistance.