Toll Free Help Line: (888) 855-9463
Second Wind Lung Transplant Association

Financial Assistance Program

Introduction

The Second Wind Board of Directors established a Financial Assistance Fund to provide financial assistance for medical, drug, temporary housing, and emergency expenses to be incurred by a member of Second Wind which are directly related to pre or post-lung transplant care. A description of the program follows.

A Tradition of Service

The desire to be of assistance to pre and post-lung transplant patients and their families by providing support, advocacy, education, information and guidance through a spirit of service has long been the mission of Second Wind as witnessed through its slogan, “Support Through Service.” The difficulties that transplant patients experience as a result of ever-increasing costs of health care and associated expenses of transplantation clearly indicate that there may be a role for Second Wind to play with financial assistance in this area. Over the years requests have been received for financial assistance that ranged from prescriptions and air travel to temporary housing costs. Until now, the Association had never been in a financial position to help. The Association now has reached a level of membership and other supports to be able to establish a Second Wind Financial Assistance Fund with limited annual funding.

Purpose

The Second Wind Financial Assistance Fund is intended to be a charitable provider of limited financial assistance to members of Second Wind who are lung transplant patients at any accredited lung transplant center in the USA except Barnes-Jewish and St. Louis Children’s Hospitals in St. Louis, MO. (Note: St. Louis Second Wind, a chapter of Second Wind Lung Transplant Association, Inc., has a similar assistance program for patients at these centers). The program is designed to help pay for medical and other related expenses that are of an emergency or non-insured nature. There is a limit as to the level of assistance provided to each eligible applicant each year, as well as an annual limit provided to all eligible applicants each year.  Assistance will only be provided when funds are available. There are specific eligibility criteria. Once an application is received, an evaluation process will take place which will determine whether or not assistance will be provided and in what amount.

Eligibility

In order to apply for assistance an applicant must meet the following criteria:

  • Be a member of Second Wind Lung Transplant Association, Inc. (membership must be established before any grant is paid if not already a member);
  • Be a lung transplant patient at any accredited lung transplant center in the USA except St. Louis Children’s Hospital or Barnes-Jewish Hospital;
  • Be either post lung transplant, on a waiting list for lung transplant or in the lung transplant evaluation process;
  • Have a medical or other related need for financial assistance which is of an emergency or non-insured nature;
  • Complete all sections of the Second Wind Financial Assistance Fund application. The applicant or guardian cannot have a total annual household income of more than $50,000.00. Extenuating circumstances, if any, should be listed; i.e., number of family members, costs of care, unemployment etc.;
  • The application for assistance must be verified by the Social Worker, Financial Coordinator, or Nurse Coordinator of the transplant team;
  • All requested documentation must be submitted;
  • The application must be accompanied by proof of all sources of household income. This can include tax statements, pay stubs, Social Security award or denial letter, and other documents;
  • If applying for a bill to be paid, a copy of the bill or formal cost estimate must be submitted with the application.

Distribution of Funds

Any distribution of funds will be made directly to a provider, such as, a pharmacy or temporary lodging company. Amounts will be provided in specific quantities for specific purposes.

Fundraising

Donations of any nature to Second Wind Lung Transplant Association, Inc., are always welcome. With the establishment of the Assistance Fund, future donations may be designated exclusively to this Fund.

Program Funding

Funding for this program will derive from two sources:  any and all donations specifically designated to the Financial Assistance Fund; and, at the discretion of the Board of Directors, an annual contribution from the Association’s general operating funds.

The Board of Directors of Second Wind is responsible for this Policy and will:

  • Establish discretionary Program funding, if any, from general funds of the Association at the start of each calendar year;
  • Fix limits on funds to be granted as follows: as of 6/1/18 they are a maximum of $500 per single grant, a maximum of $500 to an individual in any calendar year, and a maximum of $1,000
    over the lifetime of an applicant.
  • Delegate implementation of this Policy to a Committee composed of a minimum of three (3) members of the Board of Directors.

To qualify for funding under this Policy, a Member must present valid evidence of need for legitimate related expenses as defined above. The Board of Directors of Second Wind in its sole discretion may change any aspect of this Policy or eliminate the Program entirely without prior notification.

Any distribution of funds will be in the form of a check made payable to the provider. Amounts will be for specific quantities and not general lump sums.

Funds will be distributed on a nondiscriminatory basis without regard to age, gender, race, religion, sexual orientation or ethnicity.

Application Instructions

Please read the following instructions carefully for proper completion of the attached Financial Assistance Fund Application package. Please ensure that all required sections of the application are complete. The application for assistance cannot be considered until the application and related forms are complete.

  1. The Patient or Guardian completes the appropriate sections of the application. Retain a copy of the application for your records.
  2. Patient/Guardian must sign on the last page of the application. A witness must also sign on the last page. The Patient Release Form must also be signed by the Applicant and his/her signature must be witnessed.  The Social Worker or Nurse Coordinator must complete and sign the Transplant Center Verification form.
  3. After completing the appropriate sections of the application, including the necessary signatures and witness signatures, forward the entire packet to the patient’s Social Worker, Nurse Coordinator or Financial Coordinator at the patient’s transplant center.
  4. After the designated member of your transplant team (listed in the paragraph above) has completed the Transplant Center Verification page of this packet, he/she will forward the entire package to:

Second Wind Lung Transplant Association, Inc.

Patrick Henry
2nd Wind Financial Assistance Program
75 Scattertree Ln
Orchard Park, NY 14127

By fax: 760-690-4490

Or by Email: phenry2ndwind@gmail.com

Following you will find the forms described above. All forms must be completed in order for your application to be processed.

Patient Application (3 pages)

Patient Release Form (1 page)

Transplant Center Verification Form (1 page)

Should you have any questions, please email or fax Patrick Henry at the address/fax# shown above.

FInancial Assistance Committee

Final decisions on all applicant requests are made by a vote of the Financial Assistance Committee.  Current members of the committee are:

Gary Bland

Patrick Henry

Jane Kurz

Garry Nichols

Frank Shields