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In this regard, the concept of the “prudent worker” is helpful. The term refers to the reasonableness of the judgments made by an individual eligibility staff member in a given situation. In a court case, a person charged with negligence will try to show that his actions were the actions that any reasonable or “prudent” person would take in the same circumstances. When finalizing an eligibility decision, eligibility staff should be conscientious about making a decision that is reasonable, based on his or her knowledge of and experience with the Medicaid programs. If the eligibility staff member encounters a problem in a specific case that is felt to be outside the ordinary policy and procedure, the problem should be referred first to their supervisor/field operations manager, and then to the Service Desk. If the problem applies to only a specific case or to a limited number of cases and is generally covered by existing policy, the eligibility staff member makes a judgment that is defined as reasonable and prudent. Case notes are documented with the actions taken. Effective Date: July 01, 2016