Guidelines for Direct Family Support

PURPOSE

The purpose of “direct family support” is to provide a source of financial assistance to families of pediatric patients, ages 0-21, suffering from liver disease who are unable to afford necessary services. It is intended as a source of funds after all other avenues have been exhausted.

BACKGROUND

During the course of a patient’s illness, families sometimes incur expenses for services for which they are unable to pay, and for which they are ineligible for coverage under insurance or government coverage. Many times expenses are necessary but unusual. C.L.A.S.S. may be able to provide assistance when alternate sources of funds have been exhausted.

APPROVED SERVICES FOR FUNDING BY C.L.A.S.S.

	Travel expenses for medical services related to liver ailment.
	Telephone installation and service charges while waiting for a transplant.
	Travel expenses to reunite family members during a patient’s extended hospitalization.
	Temporary housing for an out-of-town patient who is released from the hospital, but who requires frequent monitoring.
	Assistance with funeral and burial expenses.
	Hospital parking fees.
	Food allowance while staying with a hospitalized patient.
	Gasoline allowance to allow family members hospital visits.

ASSISTANCE LIMITS

	Maximum of $750 lifetime total assistance per family, excluding funeral and burial expenses.
	Maximum of $500 total assistance per family for funeral and burial expenses.
	Maximum of $20 per family per day for food and this allotment is within the boundaries of the $500 lifetime total assistance limit.
	Limits for unique or unusual situations will be set by the Board of Directors on a case-by-case basis.

HOW TO INITIATE A REQUEST FOR ASSISTANCE

As C.L.A.S.S. does not have the ability to evaluate a family’s financial assets, request for assistance must be directed to C.L.A.S.S. through a social worker, or other appropriate person at a hospital, clinic or other medical institution who has access to the patient’s financial information. A hospital social worker or other qualified medical practitioner can initiate a request when other sources of funds have been exhausted.

GRANT APPROVAL

The Board of Directors shall evaluate each grant request by email. Requests will be typically considered within three days of request.

Reviewed on 03/31/2008

Children’s Liver Association for Support Services
27023 McBean Parkway #126 Valencia, CA 91355
Toll-free: 1-877-679-8256 Local phone/fax: (661) 263-9099
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