LEUKEMIA AND LYMPHOMA SOCIETY_SRPMIC_APPLICATION.PDF

SALT RIVER PIMA-MARICOPA
INDIAN COMMUNITY
10005 E. Osborn Road, Scottsdale, Arizona 85256 / Phone 480-362-7520 / Fax 480-362-7593
12% Gaming Grant Program Application
Calendar Year 2020
About the Grant Program Application:
The Salt River Pima-Maricopa Indian Community 12% Gaming Grant Program (“Program”) application
will serve to provide a comprehensive review of the programming requests for Arizona cities, towns,
counties, non-municipal public service organizations, and non-profit organizations selected to apply for
grant funding. It is not the intent of the Program to award grants that would benefit individuals, be used
as sponsorships, be used for religious activities, primarily fund the indirect or administrative costs of a
program/organization, or be used for the direct benefit of the Salt River Pima Maricopa Indian
Community.
Date of Application:
08/29/2019
Organization Name:
Leukemia & Lymphoma Society
Organization/Municipal Government Mailing Address:
3877 N 7th ST #300 Phoenix AZ 85014
Organization History:
(Provide a brief summary of the origins of the organizations and any notable milestones and/or
significant audit findings)
The Leukemia & Lymphoma Society (LLS) was born out of a family's grief following the death of their
son, who was 16 when he succumbed to leukemia in 1944. Frustrated by the lack of effective treatments
for what was then a hopeless disease, parents Rudolph and Antoinette de Villiers started a fundraising
and education organization. Driven by the de Villiers' nearly boundless belief that leukemia was indeed
curable, the foundation grew steadily, opening its first chapters in the New York City area.
Today, LLS, a 501(c)(3) organization, is the largest not-for-profit health agency dedicated to finding cures
and better treatments for people with blood cancer, funding cutting-edge research worldwide to
advance breakthrough therapies and bring them to more patients faster. With the size and scope to
fund research on a scale that makes progress happen, LLS funds more blood cancer research than all
other blood cancer organizations combined. Advised by leading biomedical research and clinical experts,
LLS identifies and funds the most promising blood cancer research found anywhere and has invested
more than $1.3 billion in research to advance therapies and save lives. Unlike corporations that invest in
drugs offering the best profit potential, LLS funds research based on unmet medical needs of blood
cancer patients, without restriction by commercial return, market size or geography.
LLS recognizes that finding cures is not enough; we need to ensure that patients have access to the
treatments they need. Through diverse and extensive outreach initiatives we advocate, educate, assist

and support patients, and fight for them on the national and state levels. The LLS community – including
patients and their families, donors, volunteers and our research and clinical partners – rely on us to be
financially stable, transparent and a responsible steward of the funds we raise and invest in our mission.
Last year, we invested more than 81 percent of our operating expenses into research and programs to
find cures, ensure access to treatments and improve the quality of life for people with leukemia,
lymphoma, Hodgkin lymphoma and myeloma.
Organization Structure:
(Provide a list of current board members and key staff members)
LLS Executive Director
Jim Brewer
Board of Trustees
Fiscal Year 2020
EXECUTIVE COMMITTEE
Wes Gullett, Chair
Tony Lee, M.D., Vice Chair
M. Preston Clarke, Treasurer
MEMBERS
Jonathan Abbas, M.D. Hamilton Baiden
Kris Costa Justin Field, M.D.
Adrian Gastelum John Gray
Alison Handel Katherine Hurd
Joe Larkin Jenny Lewis
Autumn Mitchell Matthew Pruitt
Carissa Rose Liz Scott
Josh Schimmels Vershalee Shukla, M.D.
Jennifer Swanton
Do any conflicts of interest exist within the organization structure?
(I.e. family, professional or personal conflicts, SRPMIC representatives on board, etc.)
There are no conflicts of interested at this time that exist within the organization structure
Contact Person and Project Manager if different from Contact Person:
Naomi Martinez
Title:
Advancement Specialist
Address:
3877 N 7th ST #300 Phoenix AZ 85014
Phone:
602.567.7612
Fax:
n/a
Email Address:
naomi.martinez@lls.org

Project Name:
AZ LLS Local Travel Assistance for Patients
Provide a brief description of the project being submitted to the 12% SRPMIC Grant program. In the
description provide a summary of the relevant experience, administrative activity, and program
development related to the grant request.
The Leukemia & Lymphoma Society’s mission is to cure leukemia, lymphoma, Hodgkin's disease and
myeloma, and improve the quality of life of patients and their families. We have one goal: a world
without blood cancers.
LLS is the leading provider of free information, education and support services to blood cancer patients
and their families, touching patients in local communities through our chapters across the U.S. and
Canada. LLS is dedicated to removing barriers to care. We are the voice for blood cancer patients,
working with regulatory bodies (i.e., FDA) and state and federal legislatures to drive policies that
accelerate the development and approval of innovative treatments and ensure that patients have access
to quality, affordable, coordinated care.
LLS has invested more than $1.3 billion in research to advance therapies and save lives since its
founding. Advised by leading biomedical research and clinical experts, LLS identifies and funds the most
promising blood cancer research found anywhere. Last year alone, LLS invested $49.3 million in blood
cancer research, funding 268 cutting-edge projects at prestigious academic research institutions
worldwide. LLS also supported 22 projects through its Therapy Acceleration Program, a strategic
initiative through which we build business alliances and collaborations with biotechnology companies
and academic researchers in order to speed the development of new therapies and diagnostics. Since
1999, LLS has locally invested nearly $6.8 million in 17 Arizona based research projects. In addition, in
the last fiscal year, LLS distributed nearly $2 million in direct financial assistance to Arizona families
battling blood cancers. This includes direct financial aid and our Co-Pay Assistance Program, which helps
patients meet their co-payment obligations related to treatment.
The program detailed in this proposal will aim to connect more blood cancer patients and their families,
particularly those from underserved populations in Arizona with patient services and community
resources to address their informational, practical and supportive needs from the time of their cancer
diagnosis, through treatment and, hopefully, survivorship. LLS will mobilize community-based partners,
medical professionals and representatives from underserved populations toward meaningful action that
will result in increased access to cancer care and support.
LLS is the only volunteer health organization with comprehensive support services for blood cancer
patients in the Arizona area. We are also one of the few with services for pediatric blood cancer
patients. Oncologists and practice managers rely heavily on patient advocacy organizations like LLS to
provide reimbursement for treatment-related expenses such as transportation to assist patients’ access
to care, and LLS is viewed by healthcare professionals as a crucial resource that provides education and
support to patients.
Goals and Objectives
The program detailed in this proposal will broadly address the AZ-LLS Local Travel Assistance for blood
cancer patients, as well as other support, particularly for vulnerable populations, and ultimately improve

the quality of life of patients and their families. The LLS Arizona Chapter will achieve the following
objectives in order to reach this goal:
a) Engage and connect blood cancer patients and their families with LLS resources and local travel
assistance services
Local Travel Assistance Program for Patients
LLS' Patient Travel Assistance Program provides financial assistance to people diagnosed with a blood
cancer who struggle to pay for treatment-related transportation and/or lodging costs (e.g., parking,
tolls, gasoline, plane or train tickets, temporary housing). Qualified patients receive an annual stipend of
$500 to help cover these expenses. Applicants to the program must meet the following eligibility
criteria:
• Applicants (patients) must be US citizens or permanent residents; and
• Applicants must have a confirmed blood cancer diagnosis; and
• Applicants must meet financial eligibility criteria defined as an annual household income at or below
500% of the Federal Poverty Level*
*The 2019 poverty guidelines are in effect as of January 26, 2019. Income can also be impacted by the
Cost of Living Index (COI) in your area. To be eligible for the Travel Assistance
Program, your household income must be at or below 500% of the Federal Poverty Level as adjusted by
the COI
*2019 Federal Poverty Guidelines The Department of Health and Human Services
publishes this information and it is updated each
January for the current year. The numbers are based
on data collected by the U.S. Census Bureau
Persons in Household 500% Annual
1 $62,450
2 $84,550
3 $106,650
4 $128,750
5 $$150,850
6 $172,960
7 $195,050
8 $217,150
**Add $4,320 for each person over 8 Source: https://aspe.hhs.gov/poverty-guidelines,
Adapted by The Leukemia and Lymphoma Society’s
Travel Assistance Program.
This grant will be restricted to the AZ-LLS Local Travel Assistance Program and will aid blood cancer
patients with financial need in the state of Arizona by helping to cover treatment-related travel and
lodging expenses. LLS has recognized this as an area of unmet patient need and a significant barrier to
access for many patients. Funds will serve blood cancer patients residing within the 15 counties in the
state of Arizona. We have initiated the program because patient feedback consistently identified

financial assistance as an area of unmet need. Often times a lack of financial resources represent a
significant barrier to access of proper necessary care. Patients often express fear and concern over the
immense financial burden that comes with a cancer diagnosis.
LLS regularly fields calls from patients who cannot move forward with their treatments because they
cannot afford the transportation to get to their providers. While LLS does offer co-pay assistance to help
with insurance co-pay obligations and premiums, the expenses of traveling to and from treatments can
be quite substantial and these expenses are not covered under the co-pay program. LLS will target the
assistance to those who need it most by requiring an attestation of financial need. LLS regularly receives
calls from patients in crisis who cannot move forward with potentially life-saving treatments because
they cannot afford to pay for transportation to get to their providers, e.g., doctors, hospitals, transplant
centers, and research or clinical trial centers. As patients increasingly need to travel to see a specialist
for treatment, follow-up, or special tests to make the most of their chance to fight for life, these costs
and burdens are only increasing. SRPMIC support will help LLS break down this financial barrier and
allow more patients to access the care they need.
By offering this support service we will reduce the disparities in cancer outcomes and improve the
quality of life of our patients. The program will also benefit our patients and families in Arizona as they
have little opportunity to apply locally for patient funding for transportation for medical needs. SRPMIC
has given LLS the opportunity to further develop its relationship not only with its patients and families,
but also its partnerships with other healthcare community leaders and organizations. The Leukemia &
Lymphoma Society would be honored to receive a grant from Salt River Pima-Maricopa Indian
Community (SRPMIC) to support this important mission program and appreciates the relationship with
The Salt River Pima-Maricopa Indian Community and hopes to continue to build our collaboration in the
upcoming years.
What percentage of the grant request are Direct Costs of the programming and Indirect Costs,
respectively?
The percentage of the grant request that cover direct and indirect costs of the program will encompass
approximately 15% and the remaining 85% will directly cover the program.
Define the Project Category and/or relevant sub-category:
(i.e. Education, Public Safety, Transportation, Economic Development, Health Care, Social Services, or
Cultural and Environment)
The project category fall under health care
Beginning Date of Project: November 2019 End Date of Project: June 30, 2020
Geographic Area to be served: The geographic area to be served will be the state of Arizona
** Attach Detailed Budget**
Amount of Total Project: $ 300,000 Amount of 12% Request: $125,000
(No Multi-Year Request will be accepted)
If the amount of funding received is less than the amount needed for the project, do you have other
funds to complete the project? (Please Explain):

LLS will seek additional funding to underwrite these efforts. Sources may be internal (grants and/or
allocations from the society’s home office) or external (support from corporate donors, pharmaceutical
partners, foundations and individual contributors).
If you receive SRPMIC 12 % funding, will it be spent (Check One):
 Monthly
 Quarterly
X Lump Sum
List any SRPMIC 12% funds you have received in the past. If the organization has received funding
through the SRPMIC 12% Gaming Grant Program for five consecutive years, they will be required to
submit a comprehensive report of grant funding toward the stated program objectives and mission of
the organization. In addition, you will be asked to provide a formal presentation to the 12% Gaming
Grant Committee prior to the awarding of any additional funding.
2018 $50,000 2017 $50,000
2015 $20,000 2014 $50,000
2013 $50,000 2012 $50,000
2011 $100,000 2010 $100,000
2009 $100,000 2008 $100,000
List any other 12 % grant funds your organization may be seeking from other Tribal Governments in
2019-2020.
Tohono O’odham (submitted)
Gila River Indian Community (declined)
Ak-Chin (submitted)
Pascua Yaqui (approved)
List any other funds you have received from the Salt River Pima-Maricopa Indian Community
(Enterprises Included) and identify the amount and the source:
$50,000 2017 Man/Woman of the Year $30,000 2015 Man/Woman of the Year
$25,000 2013 Man/Woman of the Year $25,000 2012 Man/Woman of the Year
$25,000 2011 Hope Ball $25,000 2010 Hope Ball
Has your organization ever applied for and received any local, state or federal grants? If so, please
detail.
Leukemia & Lymphoma Society has not applied or received any local, state or federal grants.
Funding for project/programs may be based on available funding. As such, if funding were not
available for the full the amount of request how would you prioritize funding.
1. Local Travel Assistance Program will be the main priority regardless of the amount funded to the
program
Which municipal governmental entity will serve as your pass through agency to accept 12% gaming
grant on your behalf?

LLS intends to use Maricopa County as our pass through entity to accept the 12% gaming grant on our
behalf
By execution of the 12% Gaming Contribution Grant Application the undersigned agrees that the
information contained in the Application is true to the best of the Applicants knowledge. The
Applicant shall notify the SRPMIC if any information in this Application changes.
08/29/2019
Signature for the Applicant Date
Jim Brewer, Executive Director
Name and Title
The Application shall be signed by the senior elected official of the local government, or in the case of
a non-profit entity, the Chief Executive Officer authorizes to commit the non-profit entity to apply for,
accept, and implement an award from the SRPMIC utilizing 12% Gaming Contributions.