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sdac-check-provider-eligibility

Purpose​

Determines whether a provider is eligible for Cost Pool 1 based on job title, credentials, and district enrollment.

Tool type​

Deterministic (rule-based)

Tool ID​

sdac-check-provider-eligibility

Inputs​

  • job_title (string)
  • cost_pool (string)
  • district_id (string)
  • credentials (string, optional)

Outputs​

  • Eligibility flag and provider type
  • Enrollment requirements and guidance

Example output​

{
  "success": true,
  "provider_name": "Jane Smith",
  "job_title": "School Psychologist",
  "provider_type": "SCHOOL_PSYCHOLOGIST",
  "eligible_for_cost_pool_1": false,
  "requires_enrollment_check": true,
  "required_verifications": [
    "NASP certification",
    "Missouri professional license"
  ],
  "guidance": "Cost Pool 1 eligibility cannot be confirmed from the report alone. Verify current credential status before validation."
}

Functional details​

  • Classifies provider type from job title keywords.
  • Checks district enrollment for PCA/PDN/MHD eligibility.
  • Returns guidance for missing enrollment requirements.

Implementation details​

  • Uses keyword matching for provider type (SLP/OT/PT/audiology/psych/behavioral/PCA/PDN).
  • Queries SDAC.dim_Districts for enrollment flags (PCA/PDN/MHD).
  • Returns eligible=false when required enrollment is missing.
  • Produces enrollment_requirements entries with MET | NOT_MET | UNKNOWN.

Code Location: packages/domain-sdac/src/tools/check-provider-eligibility.tool.ts