LLS-LOCAL-TRAVEL-ASSISTANCE-PROGRAM.PDF

Last updated: 03/27/2018
General information
Organization The Leukemia & Lymphoma Society
Contact First name Naomi
Contact Last name Martinez
Contact e-mail naomi.martinez@lls.org
Contact phone number 6025677612
Address
Street 3877 N 7th St #300
City Phoenix
State AZ
ZIP Code 85014
From what tribe is the Fort McDowell Yavapai Nation
organization requesting the
grant?
Total grant amount request 50,000
1 / 1




Local Travel Assistance Program Proposal
Ft. McDowell Yavapai Nation
2018 Arizona benefits Fund Grant Application
Submitted By:
The Leukemia & Lymphoma Society- Arizona Chapter
Written By:
Naomi Martinez
naomi.martinez@lls.org
602.567.7612
Development Specialist
3877 North 7th Street Suite 300
Phoenix AZ 85014
March 27, 2018
The Proposed Project:

The Travel Assistance Program is a continuing program for LLS, launched originally in spring of
2014. The Arizona Chapter has begun the process of securing funding locally because money
raised in Arizona will stay in the community and help local residents. While the need within the
patient community will be continuing, the program is new for patients in Arizona as they have
not had the opportunity to apply locally for patient funding for transportation for medical needs
through this program.
Purpose & Need:
Patients often express fear and concern over the immense financial burden that comes with a
cancer diagnosis. 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 this
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. Some
patients have no transplant center in their state or surrounding area and they are faced with the
challenges of flying to a treatment center and residing far from home for an extended period of
time. Taxi fares or the cost of gas, tolls and parking fees to get to numerous appointments over
weeks, months or years is a great burden. Regardless of geography, the out-of-pocket costs
associated with traveling for care are prohibitive for many patients and reduces the funds
available for basic needs such as food, shelter and utilities. This is especially true of patients in
Arizona’s rural communities.
Oncologists and practice managers rely heavily on advocacy organizations like LLS to provide
reimbursement for treatment-related expenses like transportation to assist patients’ access to
care (2012 Kantar Health Oncologist and Practice Manager Surveys). LLS is viewed by
healthcare professionals as a crucial resource that provides education and support to patients.
Addressing the logistics of getting to and from doctors’ appointments and securing temporary
housing when appropriate for certain treatment protocols is a crucial piece of the treatment
planning process.
If transportation/lodging needs are not met, issues with compliance and adherence to treatment
regimens arise, which can affect survival outcomes for blood cancer patients. Further, travel
obstacles can have a direct impact on clinical trial enrollment. LLS has received numerous
reports from our LLS-funded investigators stating that transportation challenges prevented
appropriate candidates from enrolling in clinical trials.
Partners & Implementation Timetable:

LLS's Local 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.
This grant will be 100% restricted to LLS’s Patient 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. Ft. McDowell Yavapai Nation’s support
will help LLS break down this financial barrier and allow more patients to access the care they
need.
The proposed project would cover the area of healthcare priority funding. Within the healthcare
umbrella, this project would address direct patient care and programs assisting in improving
overall health of participants and community of Arizona. There will be an estimated 33,000 new
cases of blood cancer in Arizona this year. LLS anticipates an increase in need as the incidence
of blood cancer continues to rise. Blood cancers occur in individuals of all ages and gender.
There are very few known causes of blood cancers and no opportunities for prevention or early
detection. If funds are fully committed from Ft. McDowell Yavapai Nation, an estimated 100
patients will be served within the Arizona community.
LLS plans to reach out to the following prospective partners for the program and time frame:
Phoenix Suns Charities, SRPMIC, GRIC, Thunderbirds Charities, Subaru of America, Executive
Charities, Tohono O’odham Nation, Ak-Chin Community, White River Indian Community, and
AZ Diamondbacks
February 2018: Develop fundraising and program plan for upcoming fiscal year. Start to submit
letters of inquiry - Patient Services Director, Shayna Diamond and Executive Director, Jim
Brewer
September 2018: Begin the program- evaluate applications from patients and grant funds as
available.
October 2018: Patient services director to speak with hospitals, healthcare providers, and social
workers to evaluate the need for transportation and evaluate progress.
January 2019-May 2019 Continual application process and re-evaluate monthly end of month
June 2019 Final evaluation of entire program and assess its overall effectiveness within the
community
*dates dependent on grant funding stipulations and implementation
LLS will keep records of the number of patients served by the Local Travel Assistance Program,
including age and geographic location, and will assess its success at the end of the 2018-19 fiscal
year (June 2019) by determining how many Arizona blood cancer patients were reached through
this program. A survey at the end of the fiscal year will be taken of all recipients, asking specific
questions on how the patients/families have been helped by the funds. The success of the
program will be reflected in the survey results which undoubtedly will show that patients were
better able to afford the costs associated with travel to and from treatment.

.

The Leukemia and Lymphoma Society- AZ Chapter
Local Travel Assistance Program- Ft. McDowell Yavapai Nation
Project Budget and Project Budget Detail With Narrative
Income Sources Total Project/Program Budget Ft. McDowell Yavapai Nation Per App Total Organization Budget FY
Donation Income $300,000 50,000 (proposed) $2,743,318
Other Income 0 0 0
Total Income $300,000 50,000 2,743,318
.
Expenses
Project Administration
Staff Wages -21,000 -3,500 35 -129,720
Fundraising and Development DDB -15,000 -2500 25 -377,290
Postage -1200 -200 2 -37,375
Printing -4,200 -700 7 -17,606
Supplies and Materials -3,600 -600 6 -27,876
Miscellaneous 0 0 0 0 0
Total Expenses -45,000 -7,500 -75 -589,867
Income Projections 300,000 50,000 0 2,153,451
Income Sources Confirmed Anticipated Submitted
Phoenix Suns Charities 0 15,000 $15,000
SRPMIC 0 $50,000 $0
GRIC 0 0 $75,000
Tohono O'Odham 0 10,000 $0
Subaru of America 0 0 $30,000
Thunderbird Charities 0 10,000 $0
Other new local foundations & charitie 0 0 $0
Total Income $0.00 $85,000 $120,000
confirmed an income source already secured
prospect an income source for which a proposal has not been submitted but intended to request from LLS- in research phase
submitted an income source for which a proposal has been submitted but no feedback regarding a funding award has been received
anticipated an income source for which a proposal has been submitted but no feedback regarding a funding award has been received
Budget Narrative:
Project administration includes the following:
LLS staff to research and develop, process and submit the grant with various corporations and foundations.
LLS staff to create application, contact healthcare providers, patients and/or families
Printing applications with various supporter logos and supplies needed
Application expense is derived by the following:
$75/application Breakdown of Income and Expenses
Salary $35/application Total Number of Grant Applications for Project *Stipends of $500/ patient granted to qualif

Fundraising/Development $25/application $500 x 600 (based on total number of applications per $500 stipend)= $300,000
Postage $2/application $75 x-600= $45,000 (total expense of the entire project)
Printing $7/application 15% x 300,000= 45,000
Supplies $6/application Breakdown of Income and Expenses (Based on 100 $500 stipends from Ft. McDowell $50,000/$50
Total $75/application Total Number of Grant Applications for Project *Stipends of $500/ patient granted to qualif
$500x100= $50,000 (based on total number of applications submitted to Ft McDowell p
$75x 100=$7,500 (expense of cost submitted to Ft McDowell)

Y 18
Prospect
100,000
$100,000
fied patients

500= 100 stipends to blood cancer patients)
fied patients
per $500 stipend)