HFUNY Assistance Program Guidelines

Financial assistance is meant to assist individuals during a temporary financial emergency or crisis. Assistance will be targeted towards individuals whose bleeding disorder directly impacts their income and/or their immediate well-being and their independence.

Eligibility:

1. Any individual with a bleeding disorder who resides within the counties listed below may apply.
   
   • Allegany
   • Chemung
   • Genesee
   • Livingston
   • Monroe
   • Ontario
   • Orleans
   • Seneca
   • Schuyler
   • Steuben
   • Wayne
   • Wyoming
   • Yates
2. Applicant must meet the following criteria for financial assistance: income below 200% of NYS poverty line. HFUNY board may make exceptions based upon individual circumstances, including extenuating situations or to avoid crises.
3. Applicant must explore other available resources prior to seeking assistance from HFUNY whenever possible (i.e. Department of Social Services, other charitable organizations).

Application Process:

1. Applicant must be referred by an HTC social worker. The referring professional should assist the applicant with the application process and provide confirmation to HFUNY of the applicants bleeding disorder.
2. Applicant and/or the “referring professional” should submit a completed application along with clear documentation of income, such as employment pay stubs, community assistance records and/or (recent) income tax records.
3. Typically, applications will be reviewed and processed rapidly – no longer than 5 or fewer business days after receipt of request.

Requests that will be priority:

• Financial assistance that targets basic life needs including: rent/housing, utilities, food, or clothing;
• Assistance to address barriers to medical care including: prescription costs, provider co-pays, insurance deductibles, insurance premiums, other health related expenses or transportation to/from sites of medical care;

Limits:

1. Financial assistance is limited to up to $5,000 per 12 month period, per applicant. The HFUNY Board may provide additional financial assistance above the maximum on a case-by-case basis to account for extenuating circumstances. Financial assistance is not intended to be an ongoing source of income.
2. Applicants may request assistance multiple times in any 12 month period.
3. Payments will not be made directly to the applicant and should be paid directly to the vendor. HFUNY payments will be directed as appropriate to address an applicant’s financial hardship (i.e. utility provider, landlord, health provider or health insurer, grocery card, gas cards, etc).

Documentation:

HFUNY will make a determination about an individual’s financial need after the referring provider has determined such need using a reasonable set of financial need guidelines based on objective criteria (at a minimum, HFUNY shall use source documentation submitted with the application by the referring provider – HFUNY may at its discretion, require additional documentation).

HFUNY will review and consider financial information submitted with or pertaining to the application. It may also review and take into account other relevant variables, including cost of living, individual/family circumstances, income/expenses/assets, number of dependents / family size, and the cost of medical bills. In cases where documentation of financial need is unavailable, HFUNY may take into account other reasonable methods of determining financial need, including documented patient interviews or questionnaires.

200% of Federal Poverty Guidelines, 2024-2025

Family Size	Monthly Income Limit for PAP Financial Assistance (200% of poverty line)	Annual Income Limit for PAP Financial Assistance (200% of poverty line)
1	$2,510	$30,120
2	$3,407	$40,880
3	$4,303	$51,640
4	$5,200	$62,400
5	$6,097	$73,160
6	$6,993	$83,920
7	$7,890	$94,680
8	$8,787	$105,440