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Assistance to Individuals

Our Assistance to Individuals helps hospice patients and their families throughout Western Montana.

Have a last wish to fulfill? My Wishes Assistance helps hospice patients achieve final wants and needs.

Need help with utility payments, groceries, or other household items? Individual and/or Family Financial Assistance can help low-income hospice patients and their families mitigate the financial burden of a terminal diagnosis.

Explore our individual assistance opportunities below and don’t hesitate to contact us at 406-541-2255 or grants@hcfmissoula.com with any questions you may have. Please allow 2-3 business days for response.

 

All personal and health information submitted via these forms is encrypted and only viewable to authorized Hospice Care Foundation administrators.

PLEASE CLICK TO EXPLORE EACH ASSISTANCE TYPE

Individual and/or Family Financial Assistance

Assistance Description

Individual and/or Family Financial Assistance is need-based* assistance and provides financial assistance for terminally ill individuals and their families who are experiencing financial distress and are unable to be self-sufficient due to the circumstances of the terminal diagnosis. Assistance is typically provided in the range of $250.00 with maximum of $500.00 per request. Multiple requests may be made with a maximum of $1,000.00 per person/family. Assistance may be requested to pay rent and utility bills; purchase food, hygiene, and personal care items; cleaning supplies; pet care items; etc. Assistance may be requested by family members of a hospice patient for Respite or Bereavement Care.

* “Need-based” assistance is only available to those who “needy and distressed” as defined by the following statements:

  • Individuals and/or families are not defined as “needy and distressed” if monthly income exceeds (is more than) monthly expenses by $500.00 or more.
  • Individuals and/or families are not defined as “needy and distressed” if they have $500.00 or more in liquid assets (savings, checking, and investments accounts).

Eligibility

  1. The Hospice Care Foundation will consider assistance requests from any individual who has a terminal diagnosis, is receiving hospice care, and is within the last six to twelve months life, regardless of hospice care provider.
  2. In order to adhere to IRS guidelines for charitable giving, detailed financial information must be collected from the patient and/or patient’s family members, representing the entire household, applying for assistance.
    • Individual and/or Family Financial Assistance can only be awarded if the individual or family is considered “needy and distressed.”
      • Individuals and/or families are not defined as “needy and distressed” if monthly income exceeds (is more than) monthly expenses by $500.00 or more.
      • Individuals and/or families are not defined as “needy and distressed” if they have $500.00 or more in liquid assets (savings, checking, and investment accounts).
        • Specifically, the applicant must be temporarily unable to be self-sufficient as a result of the terminal diagnosis. Financial need must be related to the patient’s terminal diagnosis.
    • A Financial Assistance Worksheet is provided to assist in the collection of this information from the applicant before submitting the online application.
    • If the Worksheet shows an asset of life insurance, the cash value of the policy must be provided. If no cash value, please state this on the Worksheet.
    • This information will be used to determine the eligibility of the applicant for assistance.
    • Additional supporting documentation may be requested by HCF including but not limited to:
      • Bank Statements
      • Copies of Bills
      • Proof of Income
  3. The applicant must exhaust all other community resources prior to seeking funds from the Hospice Care Foundation.
  4. A maximum lifetime limit of up to $1,000.00 can be awarded to each applicant, with no more than $500.00 at any one time and at least 30 days between requests.

 

Emergency Assistance Application Procedures

Emergency assistance is defined as assistance that requires immediate review. In most cases, emergency assistance is related to a patient who is actively dying, where travel arrangements or items significantly affecting the patient’s quality of life are needed immediately.

Emergency requests will typically be reviewed within 48 hours.

 

Restrictions

Individual and/or Family Financial Assistance applications will be declined in the following circumstances:

  1. If a patient dies prior to application review, the application will be declined.
    • Does not apply when requests are for Bereavement Care.
  2. If the application demonstrates monthly household income that is $500.00 or more greater than monthly household expenses, the application will be declined.
  3. If the assistance application shows evidence of $500.00 or more in liquid assets, the application will be declined.

 

The Fine Print

  1. The hospice benefit covers all care related to the terminal diagnosis. The Hospice Care Foundation cannot pay for expenses that the hospice agency is legally responsible to cover under the benefit reimbursement.
  2. The Hospice Care Foundation cannot pay for medical bills that an applicant has accumulated with any health care company. In these cases, if the patient or family meets the criteria of financial distress, an assistance request can be submitted for assistance with other living expenses to help alleviate the financial distress.
  3. Assistance payments will not be made to the patient or family but to the appropriate vendor as applicable. Assistance for groceries and other daily living expenses will be awarded in the form of gift cards to the appropriate store type.
  4. Individual and/or Family Financial Assistance checks cannot be made to a power of attorney (POA) unless complete financial information is provided by the POA, and he/she is determined to be financially needy.
  5. Individual and/or Family Financial Assistance will cannot be awarded to pay for the following:
    • Home Loans, Property Taxes, or Insurances
    • Automotive/Motor Vehicle Loans or Insurances
    • Personal Loans
    • Educational Loans
    • Income Taxes
    • Credit Card Payments and/or Fees
    • Legal Fees
    • Medical Expenses (including hospital stays and/or nursing home fees, except for eligible respite care fees)
    • Burial/Cremation Expenses
    • Income Replacement
    • Home Improvements/Renovations/Remodels
    • Reimbursements: The Hospice Care Foundation will not support assistance requests to cover costs that were paid prior to the application submission.

 

How to Apply
The online application is to be filled out by either the patient themselves, a family member requesting the assistance, or the hospice/palliative care provider.

After reviewing the guidelines above, if you have any questions about the appropriateness of your request, contact our office at (406) 541-2255 or grants@hcfmissoula.com to discuss your potential application.

 

Application Process

Step 1: Read the Application Guidelines outlined above

Step 2: Complete the Eligibility Quiz below

Step 3: Complete the Financial Assistance Worksheet

Step 4: Complete the Online Application

Step 5: Attach additional forms, letters, etc. to the application as applicable

 

Incomplete Applications Cannot Be Processed

 

Review & Award Process

  1. The application is received by the Hospice Care Foundation. Complete applications include supporting documents and required signatures from the person recommending this request.
  2. The information is reviewed by the HCF to ensure its completeness.
    • The attachments are reviewed to ensure all required documents are included.
    • HCF will call the applicant if more information is needed.
  3. Applications are graded on a “black & white” points system to eliminate applications that do not meet basic criteria (i.e. outside funding area, request inappropriate, financial need not demonstrated, patient not receiving hospice care, etc.).
  4. A decision is made after the complete application is received to award none, some or all of the requested amount.
    • Requests may be reviewed by the Board President before a decision is reached.
  5. The person who submitted the application is contacted with the decision.
  6. Payment
    • If applicable, the check is mailed along with a cover letter to the vendor with all of the pertinent information as soon as possible.
    • Otherwise, tangible goods will be purchased by HCF for delivery to hospice patient and their family.

 

WORKSHEET: TO BE DONE PRIOR TO ASSISTANCE APPLICATION

This worksheet is designed as a tool for the applicant to collect the required information from the individual/family who is applying for Financial Assistance. The information collected on this worksheet can then be used to submit the online grant application.

Financial Assistance Worksheet

 

HCF complies with all HIPAA regulations regarding confidentiality as well as all federal and state regulations regarding record retention.

ELIGIBILITY QUIZ

If you are eligible to apply, a link will appear for you to fill out the assistance application online after completion of the quiz below.

My Wishes Assistance

Assistance Description

This assistance allows individuals with a terminal diagnosis who are receiving hospice care to seek peace and closure through the realization of a final wish, but are unable realize that wish due to the financial distress related to the terminal diagnosis. My Wishes Assistance is limited to $1,000.00 per Wish with a lifetime maximum amount of $1,000.00 per individual. There are no income restrictions when applying for My Wishes Assistance.

Some examples of Wishes include (list is not all inclusive, contact HCF for more information):

  • Entertainment (concerts, movies, plays, sporting events)
  • Gift Baskets (containing favorite foods, snacks, candles, crosswords, books, gift cards to favorite restaurants, store gift cards)
  • iPod, Kindle, audio books w/player or large print books
  • Domestic travel, including travel for family (cab fare, bus fare, limo cost, gas card, hotel, etc.)
  • Personal treatments (spa day, lotions, candles, massage, music thanatology, hair treatments, pedicure, manicure)
  • Other small things that matter (warming blankets, a night out, etc.)

 

Eligibility

  1. The Hospice Care Foundation will consider assistance requests from any hospice patient, family member, or hospice worker on behalf of a patient who has a terminal diagnosis and is receiving hospice care regardless of care provider.
  2. Recipient Must Be:
    • A Legal Resident or Citizen of the United States of America
    • Capable of experiencing the Wish and be willing to sign the liability release form
    • Able to obtain approval from their physician to engage in the Wish (if necessary)

Restrictions

  • Assistance is not given as cash but in form of an item (concert ticket, bus fare, iPad, etc.) or experience (travel, visit from family)
  • More than one My Wishes application can be submitted per hospice patient but the total amount awarded is limited to $1,000.00/person (lifetime limit) with at least 30 days between requests.
  • Assistance requests seeking travel arrangements must include the following information under the “Describe the Wish” field located on the assistance application:
    • Name of Traveler(s) as listed on photo ID
    • Date of birth for each Traveler
    • Address & phone number for each Traveler
    • Departure and arrival airports (if applicable)
    • Dates/times available to travel (departure and arrivals)
    • Email address for Traveler(s)

NOTE: Regarding commercial travel, Hospice Care Foundation reserves the right to evaluate ticketing options and to purchase tickets directly.

 

We regret that we are unable to fund the following types of My Wishes requests:

  • Requests for individuals with chronic illnesses, unless they have received a terminal diagnosis and are receiving hospice care
  • Requests from individuals living outside the United States
  • Requests for cash
  • Requests for legal assistance
  • Requests for automobile, lift, and RV rentals or repairs
  • Requests for hunting excursions
  • Requests for property and/or home improvements or repairs (including accessibility modifications)
  • Requests for funeral arrangements or posthumous requests
  • Requests for travel outside of the United States and/or cruises
  • Requests for medical treatment/supplies/equipment/transportation or dental extractions

 

How to Apply
The online application is to be filled out by either the patient themselves, a family member, or a hospice/palliative care provider requesting the assistance on behalf of the patient.

After reviewing the guidelines above, if you have any questions about the appropriateness of your request, contact our office at (406) 541-2255 or grants@hcfmissoula.com to discuss your potential application.

 

Application Process

Step 1: Read the Application Guidelines outlined above

Step 2: Complete the Eligibility Quiz below

Step 3: Fill out Online Application

Step 4: Attach additional forms, letters, etc. to the online application

 

Incomplete Applications Cannot Be Processed

 

Review & Award Process

  1. Complete application is received by the Hospice Care Foundation. Complete applications include supporting documents and required signatures as needed.
  2. The information is reviewed by HCF to ensure its completeness.
    • The attachments are reviewed to ensure all required documents are included.
    • HCF will call the applicant if more information is needed.
  3. Applications are graded on a “black & white” points system to eliminate applications that do not meet basic criteria (i.e. outside funding area, request inappropriate, patient not receiving hospice care, etc.).
  4. A decision is made after the complete application is received to award none, some, or all of the requested amount.
    • Requests may be reviewed by the Board President before a decision is reached.
  5. The person who submitted the application is contacted with the decision.
  6. If the request is for commercial travel, HCF will either coordinate with the requesting person/agency and/or make the necessary arrangements on behalf of the applicant. The following information is needed:
    • Name of traveler(s)
    • Current, unexpired photo identification
    • Departure and arrival locations
    • Dates of travel
  7. Payment Upon Approval
    • If applicable, the check is mailed along with a cover letter to the vendor with all of the pertinent information as soon as possible.
    • A “Wish Basket” containing the requested items or gift cards may be given directly to the applicant for requests of food, clothes, fuel, etc.

 

HCF complies with all HIPAA regulations regarding confidentiality as well as all federal and state regulations regarding record retention.

ELIGIBILITY QUIZ

If you are eligible to apply, a link will appear for you to fill out the assistance application online after completion of the quiz below.