Grant Guidelines - Minnesota AIDS Project

2012-2013 Greater MN Guidelines (outside 11 County Metro) forEvery Penny Counts Emergency Assistance (EPC)PO Box 582943Minneapolis MN 55458612-331-7733 (Metro) OR 1-800-565-9028 (Toll-free)612-341-3804 – faxEvery Penny Counts Emergency Assistance is available for low-income (see income guidelines), HIV-positiveMinnesotans. Please read these guidelines carefully. Failure to complete the application or provide correctdocumentation will result in a delay in meeting your emergency need.1. Eligible individuals may receive up to $390 per program year (April 1 – March 31) for any of the following:Rent, application fees: provide copy of current lease or rental agreement letter, application fee (nodamage deposits, storage fees, mortgages, or foster care/nursing home fees) To be eligible to submit arent request, you must first be submitted to the Gr. MN Housing Assistance (HOPWA) lottery and if notdrawn in that lottery you can request to use your available Gr. MN EPC funds for rent. Or if you havealready used all of your Gr. MN Housing (HOPWA) funds and need additional rental assistance you canrequest to use Gr. MN EPC funds if available. If you are on a rent subsidy of any sort, you are not eligiblefor Gr. MN Housing (HOPWA) funds, but are eligible for rent assistance out of Gr. MN EPC funds.Utilities: fuel oil, propane, gas, electric, water, (no garbage fees) To be eligible to submit a utility billrequest, you must first be submitted to the Gr. MN Housing Assistance (HOPWA) lottery and if notdrawn in that lottery you can request to use your available Gr. MN EPC funds, or if you have already usedall of your Gr. MN Housing (HOPWA) funds and need additional utility assistance you can request to usethe Gr. MN EPC funds if available. Must provide copy of bill/s prior to lottery for submission.Moving fees: Professional movers or U-haul rental only. Must provide an invoice.Phone: Phone and cell phone bills, limited to $200 annually (cannot pay for cable, internet bills, prepaidphone cards or prepaid phone plans). For bundled phones services, you must submit a copy of the entirebill. Must provide copy of bill/s prior to lottery for submission.Food: Cub Foods, Super One Foods, HyVee , etc gift certificates, comes out of the $390 allotment.Individuals can get up to $40 in certificates once per month if selected in lottery. You may call to requesta food certificate for a particular month’s lottery or you can call and request that you automatically besubmitted for each monthly food certificate lottery. Counties served by EPC for food are: Blue Earth,Brown, Cottonwood, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Jackson, LeSueur,Lincoln, Lyon, Martin, McLeod, Meeker, Mower, Murray, Nicollet, Nobles, Olmsted, Pipestone,Redwood, Renville, Rice, Rock, Sibley, Steele, St. Louis, Wabasha, Waseca, Watonwan, Winona &Yellow Medicine. If you live in a Gr. MN county not listed here you need to access Rural AIDS ActionNetwork (RAAN) for food assistance by calling: 800-966-9735.Medical care: doctor, hospital, and clinic visits, mental health visits, home health care, substance abusecare, dental care, chiropractic care, vision care including glasses, prescription co-pays, durable medicalequipment, and medical transportation (ambulance, special transportation services) that is not paid fromhealth insurance or other sources.2. Complete the attached application (both sides). A new application must be completed each program year (April 1,2012 – March 31, 2013). If you request assistance more than once during the program year and have a current applicationon file, you do not need to complete another application for each additional request for assistance.3. If this is the first time you are applying for assistance, please provide written verification of HIV-positive or AIDSstatus signed by a licensed health care professional.4. Attach proof of the income that you report on the application such as a copy of: most recent paystub (within the last30 days), 2011 tax return, benefit statement such as Social Security award letter, MFIP award letter, bank statement,certification of zero income form or affidavit, or a MN-ITS printout or a copy of your Medical Assistance card indicatingthat you are on Medical Assistance (MA, QMB, SLMB, or QI). If you have a spend down or any unusual situations with

MA, we may need to collect additional income verification. Enrollment in Program HH,or a copy of your MN HealthCare Programs card do not qualify as income verification for EPC. Without income documentation we will be unable toprovide assistance. Please note that we need to collect updated income verification from clients every 6 months.5a. Submit a copy of the bill you want paid, and/or a copy of current lease or letter from landlord. Rent requests mustinclude a signed Hennepin County Human Services & Public Health Department/DHS Housing Related Assistance Form(Exhibit L). A copy of this form is available from HIV case managers, by contacting Every Penny Counts, ordownloading it from the MAP website. You must also submit an invoice for moving fee charges.5b. Requests for assistance must be for $20.00 or more, requests that are less than $20.00 will not be processed(exception is for prescription co-pays, medical insurance premiums, medical co-pays)6. Monthly lottery: Funds for emergency financial assistance will be divided evenly by month so that the same amountof funding is available each month. Once the lottery of allotted monthly funding has been spent for individual requests, nofurther assistance will be available until the following month. Requests containing all the required paperwork (lease, rentletter, bill) will be included in the lottery. On the first business day of the month a lottery will be conducted, requeststhat are to be submitted into the lottery must be submitted by Noon of the prior business day of the upcominglottery. Requests for assistance will not automatically be carried over to the next month (except for monthly food lotteryrequests). If your request is not selected, you must resubmit your request to be considered for the following month’slottery. If your request was not selected and you request to have it resubmitted to the following month’s lottery, thatrequest will go to the top of the following month’s lottery.7. Every Penny Counts will pay the bill directly to the vendor and contact you by mail if the bill/request will not bepaid/honored as requested.8.To qualify for assistance, applicants must meet all eligibility requirements and have first used any other availablefunding resources. This service is funded by the federal Ryan White HIV/AIDS Treatment Modernization Act, Part BPLEASE NOTE:Please call our voicemail and leave a detailed message if you have questions. We will usually return your call within one(1) working business day. Also, it may take up to 5 business days to process your request if selected in the lottery.The Every Penny Counts voice mail greeting is updated after ever lottery to reflect the status of the lottery, the availabilityof funding, and when the next lottery will occur.Every Penny Counts Emergency Assistance has a grievance policy, contact the MAP AIDSLine for further information.During the grant period/year, program guidelines and the amount of funding allowed individuals is subject to changebased on needs and/or the availability of funding. A notice will be sent to providers and a message will be recorded onthe Every Penny Counts voicemail of any changes that occur.Housing (rent and/or mortgage) and Utility Assistance is available to HIV positive individuals living in Greater Minnesotathrough the Greater Minnesota Housing Assistance program. Please contact your case manager or Every Penny Countsfor an application and details on eligibility.INCOME GUIDELINES FOR EVERY PENNY COUNTS EMERGENCY ASSISTANCE2012 Federal Poverty Guidelines(175%)Family Size Gross Annual Income Gross Monthly1 $19,548 $1,6292 $26,478 $2,2063 $33,408 $2,7844 $40,338 $3,3615 $47,268 $3,9396 $54,198 $4,5167 $61,128 $5,0948 $68,058 $5,671For family units with more than eight members, add $6,930 for each additional member to annual income. “Family Unit”is defined as all people living together that are legally dependent on the income. Income for all members of the “familyunit” will be considered for these guidelines.