Case #1: Request financial assistance for four months’ rent.
The patient is a four-month-old who was born 13 weeks premature and has been in the NICU at ACH since he was born. He was diagnosed with severe pulmonary hypertension and a significant PDA, patent ductus arteriorus, which is an opening between two blood vessels leading from the heart. He was placed on a ventilator and inhaled nitric oxide in critical condition for several weeks. When he was one month old, he had a procedure to close the opening on his heart. He was eventually weaned off the ventilator but remained on CPAP at this time. Over the past four months, he’s been diagnosed with additional conditions that include brain bleeds, hydrocephalus, anemia, blood clots, and an underactive thyroid. He will have surgery to have a shunt placed to drain fluid off of his brain in the next two weeks. He’s also been found to have septo-optic dysplasia, a rare disorder characterized by abnormal development of the brain, optic nerve, and/or pituitary gland (some patients have abnormalities in all three areas).
Mother and father have remained at the patient’s bedside during his four months in the hospital. The father has returned to work but takes off when the patient has needed surgery or during very critical periods. Typically, the family lives within their means, but the father’s income is impacted when he has to take off work since he does not receive paid leave. They have been struggling to pay their bills, and assistance with their rent would greatly relieve the stress on this family, allowing them to focus on their son and his needs. The amount requested should cover rent for the remainder of the patient’s hospitalization.
Total asked: $1,600 APPROVED
Case #2: Request financial assistance for the outstanding balance on the electric bill.
The patient is a 16-year-old male with several medical issues, including seizures, immune deficiency disorder, dysphagia, and poor weight gain. He also has a diagnosis of ataxia telangiectasia, a rare childhood neurological condition that causes degeneration in the part of the brain that controls motor movements and speech.
The patient is from a large family that is typically able to cover their monthly expenses. However, the patient’s father was in a car accident two years ago (not at fault) and sustained injuries that impacted his ability to work as he did before. His salary has decreased by approximately half due to this, and the family has begun to struggle to pay their bills. They recently received a disconnect notice from their electric company after falling behind on their payments. They’ve negotiated a payment plan, but their account total is over $ 2,000. The family uses electricity for their air conditioning and heat, and we would like to assist them to avoid being disconnected.
Total asked: $2,309.89 APPROVED
Case #3: Request financial assistance for two months’ rent.
The patient is a 12-year-old female with developmental delay and cerebral palsy. She also has right spastic hemiparesis, which is a weakness in one half of the body caused by brain damage that occurs in the womb or during or shortly after birth. This patient is a long-time patient of ACH, typically followed by the neurological team on an outpatient basis. The mother is the sole caregiver for the patient and her sister; they do not have any social support.
The patient’s mom is in the process of applying for Medicaid gas reimbursement to alleviate travel costs to the clinic. She’s also applied for food stamps and other resources to lower her monthly expenses. However, she has fallen behind on rent and is facing eviction. She owes over $2000 but we are requesting assistance with two months’ rent in the amount of $1400 to relieve stress and the financial burden of this outstanding balance.
Total asked: $1,400 APPROVED
Case #4: Request financial assistance for help with utilities.
The patient is a three-month-old female who was born five weeks premature. She had several genetic abnormalities and was born with an incomplete AV canal, a heart defect that causes blood to flow where it shouldn’t or carry less oxygen than normal. The condition causes the heart and lungs to work harder than they should and may lead to congestive heart failure. The patient receives all of her nutrition through a G-tube and has been in the NICU or CVICU for most of her life.
Since the patient is unable to attend daycare and they have multiple medical appointments, the patient’s mother is unable to work. She is currently looking for a job that will allow her to work from home. She’s also applied for SSI for patients and receives food stamps and WIC. She has fallen behind on utilities (water, electricity, and gas) and is struggling to make ends meet since the patient’s birth and subsequent lengthy hospital admission.
Total asked: $1,311.94 APPROVED
Case #5: Request financial assistance for one- or two months' rent.
The patient is almost four months old and has been in the NICU or PICU since her birth. She was born six weeks premature and sustained an injury to her kidneys at birth. She is on dialysis and will be discharged home on daily, continuous dialysis. She is currently on methadone and will not be able to discharge until she is weaned off narcotics, which will likely be one to two more months. She is followed by several specialists, including nephrology, hematology, neonatology, and endocrinology.
The patient lives with her parents and three siblings. Mother and father both work full time and are only able to visit on the weekends due to the need to work and care for their other children. Mom was fired from her job during the patient’s hospitalization due to missing so much work. She was able to find another job, but the family has started to fall behind on bills. They are just above the financial cut-off for state assistance but have to pay out of pocket for private insurance and TEFRA for patients. They also live three hours away from ACH, and the travel expenses to/from the hospital are costly. Their current rent is $1300 monthly—they would be appreciative of any financial support.
Total asked: $2,600 APPROVED
Case #6: Request financial assistance for vehicle sales tax.
The patient is a 15-year-old male with end-stage renal disease. He is currently receiving dialysis treatments three times per week at Arkansas Children's Hospital.
The family relies on one vehicle to get them to and from appointments and to mom's job. Currently, the family is unable to use the family car as they have not been able to pay their state sales tax to get tags for the car. When they purchased, they believed the taxes were included in the financing, but this was not the case. They have managed to pay a portion of the $2635 owed but still need $1100 to make the payment in full. They are relying on Medicaid transportation to get to dialysis appointments, but mom is unable to work since she doesn’t want to risk driving on expired temporary tags. They are a resourceful family and should be able to manage their finances once this transportation barrier is resolved.
Total asked: $1,100 APPROVED
