emergency assistance program
PURPOSE:
The purpose of the Emergency Assistance Program (EAP) is part of the Central California Bleeding Disorders Foundation’s continuing effort to improve the quality of life of individuals and families affected by bleeding disorders. CCBDF provides financial support, based on the availability of funding, to help pay for unforeseen requests or emergencies such as:
➢ Expenses incurred in the care, treatment, or prevention of a bleeding disorder; ➢ Health insurance premiums
➢ Transportation services to HTCs.
➢ Basic living expense emergency (rent, mortgage, utilities, etc.)
ELIGIBILITY:
Prospective applicants will need to meet the following criteria:
➢ Be a resident of the 27 counties served by CCBDF.
➢ Applicant must be an active member of CCBDF. An active member is defined as an individual who is in the CCBDF database and is an adult with a bleeding disorder or a parent or caregiver of a minor child who lives in your home and who has a diagnosis of a bleeding disorder OR an individual with a diagnosed bleeding disorder.
ADMINISTRATION:
Financial assistance depends on the availability of funds and applicant eligibility. Funding is not guaranteed. Applicants should allow at least 14 business days for CCBDF to process their request.
Assistance is limited to one grant per year per household with a maximum of $500 per year with a lifetime household cap of $3000. Any appeals of this policy will be made upon request to CCBDF’s Board of Directors. The Emergency Assistance Program (EAP) at CCBDF is not meant to be used to remedy chronic financial problems.
If the applicant is seen at an HTC, applicant’s social worker should make the referral or confirm the need. If the applicant is not seen at HTC, the request must come directly from the applicant.
CCBDF cannot provide funding directly to the individual applicant(s). Disbursements will be made directly to vendors identified in the application that has been verified by CCBDF.
CCBDF should be considered a payment of last resort, and it is requested that other payment resources be investigated including government-sponsored programs and other charitable organizations before contacting CCBDF.
CCBDF staff will review applications for completeness. If the assistance request does not provide the necessary information, a CCBDF staff member will contact the applicant for additional details. If the request cannot be completed, then it will be denied, and a new application will need to be completed and submitted.
Once CCBDF staff receives the completed assistance request, the application will be reviewed by the Client Services Committee within one week of receipt. Assistance provided will be based on the sole discretion of CCBDF Client Services Committee.
CCBDF staff will notify the applicant about the decision within two business days of the EAP committee meeting via email or phone communication. In most cases, approved applicants should expect a total of two weeks for the entire process and payment to be submitted.
Please submit all applications along with relevant bills via the website form below. If the applicant is unable to complete the form online, please download the EA form and submit to [email protected].
CONFIDENTIALITY
Applicants and information pertaining to funding requests are considered confidential to the full extent permitted by law.
Information from CCBDF’s Emergency Financial Assistance Program applications may be compiled for statistical purposes and for compliance with local, state, federal, or affiliate organization requirements. However, any publication of this data will be in aggregate form only and will not include names or any other information that could be used to identify individual applicants or recipients.
No personal information will be used or disclosed for any purposes other than that for which it was collected without the applicant’s written permission. At no time will personal information be shared with any individual, company, or organization outside the Central California Bleeding Disorders Foundation.
Download EAP Guidelines
Download EAP Application
emergency assistance application