HACA Family Assist Program

Purpose

To improve the quality of life for individuals/families with bleeding disorders by providing financial support, based on availability of funding, to help pay for:
  1. uncovered medical bills associated with the diagnosis and treatment of a bleeding disorder and any complications thereof, and
  2. basic living expense emergencies.

Eligibility

Successful applicants will meet the following criteria:
  1. Resident of Northern Virginia, Montgomery County, Prince Georges County, or Washington DC or receive treatment for bleeding disorders at Children’s National Medical Center or Georgetown University Hospital in Washington DC.
  2. Parent or caregiver of an individual living in your home or an individual with a diagnosis of: A bleeding disorder, the treatment and care of which is within the mission and purpose of the Hemophilia Association of the Capital Area as determined by the Executive Director in his/her sole discretion.
  3. Complete all sections of the application thoroughly and accurately in order for HACA to review the request. If a question does not apply, it should be marked not applicable (n/a). Failure to provide complete and truthful information insures denial of your request.
  4. Coordinate request with Social Worker/Nurse Coordinator at a hemophilia treatment center or other healthcare provider treating bleeding disorders.

Administration

  1. Funding Assistance is not guaranteed and is dependent upon availability of funds.
  2. Disbursements will be monitored and reported to the Board of Directors.
  3. Assistance is limited to once per calendar year unless special circumstances are presented.
  4. If grant application is for a dollar amount less than $150, the Executive Director, in consultation with the President, will approve the amount of assistance.
  5. If grant application is for a dollar amount more than $150, the Executive Committee must approve the amount of assistance.

Confidentiality

  1. All applications and information pertaining to funding requests are considered confidential to the extent permitted by applicable law.
  2. Aggregate data on the Family Assistance Fund will be available, but will not include the names or any other information that will identify individual recipients.

Contact the HACA Office at 703-352-7641 for an application.