2016 GRIC LEUKEMIA & LYMPHOMA SOCIETY.PDF

Created: 01/19/2016
Last updated: 02/29/2016
Page 1
General information
Organization 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 Ste 300
City phoenix
State Arizona
ZIP Code 85014
From what tribe is the organization requesting the grant?
Gila River Indian Community
Total grant amount request
50000
The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this
project or program from the Gila River Indian Community, enter the amount to be requested each year.
Amount
Year 1 (Gila River Indian Community Grants Only)
Year 2 (Gila River Indian Community Grants Only)
Year 3 (Gila River Indian Community Grants Only)
Year 4 (Gila River Indian Community Grants Only)
Year 5 (Gila River Indian Community Grants Only)
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Gila River Indian Community Grant Application
Grant Cycle 2016
Cover Sheet
Municipality Information
1. Date of Application: 2/29/2016 (NOTE: Click or use up/down arrow keys to move among
fields)
2. Name of City, Town or County: Maricopa County
3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Clint Hickman, Board of
Supervisiors Chairman
4. Mailing Address: 301 W. Jefferson , 10th Floor
5. City: Phoenix State: Arizona Zip Code: 85003
6. Acknowledgement of Submission by Authorized Municipality Representative:
Typed Name: Amanda Nash Signature:
Applicant Information
7. Department/Organization Name: Leukemia & Lymphoma Society
8. Is this a non-profit 501c(3) Organization? No Yes If yes, attach IRS Determination
Letter
9. Application Contact Person: Naomi Martinez Title: Development Assistant
10. Phone Number: 602-567-7612
11. Mailing Address: 3877 N 7th St., Suite 300
12. City: Phoenix State: Arizona Zip Code: 85014
13. Email Address: naomi.martinez@lls.org Website Address: lls.org/az
Project Information
14. Project Name: Improving the Quality of Life and Access to Care for Arizona Blood Cancer Patients and
Their Families
15. Purpose of Grant: Grant funds will assist The Leukemia & Lymphoma Arizona Chapter in providing
resources, programs and support for Arizona blood cancer patients, their caregivers and family members.
16. Priority Funding Area Healthcare
17. Annual amount requested $50,000
18. Number of years that funding is requested 1
For Office Use Only:
Data Entry
Receipt
Evaluation

Gila River Indian Community Grant Application
Grant Cycle 2016
19. Total amount requested (annual amount x # $50,000
of years)
20. Has your organization received past funding 2015- $25,000
from GRIC? If yes, list each year and amount
21. Geographic area served Maricopa County

Gila River Indian Community Grant Application
Grant Cycle 2016
Narrative
Please structure your proposal to provide the following information in the order indicated. Provide the narrative
in paragraph form in the text field provided. Please be thorough but strive for brevity.
1. Briefly describe the organization’s mission, history and goals.
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. Five years later, frustrated by the lack of
effective treatments for what was then considered a hopeless disease, parents Rudolph and Antoinette
de Villiers started a fundraising and education organization in their son's name. The task was daunting.
Most leukemia patients, especially children, died within three months. 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 a blood cancer. We have a 66-year history of supporting
groundbreaking and lifesaving research for all blood cancers, including leukemia, lymphoma, Hodgkin
lymphoma and multiple myeloma, where LLS has invested over $1 billion in research to advance
therapies and save lives. The mission of LLS is very clear: cure leukemia, lymphoma, Hodgkin’s
disease and myeloma, and improve the quality of life of patients and their families. We fulfill our mission
in three ways – research, patient access and advocacy and policy. LLS drives research in areas of
unmet medical need and helps bridge the gap between academic discovery and drug development.
LLS also supports patients, survivors, families and healthcare professionals through our 61 chapters
across the United States and Canada and our centralized Information Resource Center. We advocate
on behalf of patients to ensure they have access to treatments, services and providers they need to live
longer, better, healthier lives.
The Arizona Chapter was founded in 1963 to raise awareness for The Leukemia & Lymphoma Society
as well as work with blood cancer patients in the state. For over 50 years, this chapter has grown and
evolved to serve the diverse needs of the Arizona blood cancer population, offering a human touch to
patients and families with services that are personal, immediate and tailored to need.

Gila River Indian Community Grant Application
Grant Cycle 2016
2. If the organization is a non-profit 501c(3), please describe your relationship with the municipality
including past and present support, whether it be through partnerships, collaborations, in-kind
contributions, grants, tax-based funding or other. If the organization is a municipality governmental
sub-division please enter the text “Not applicable.”
Click here to enter text.
3. Describe the proposed project and planned goals and activities.
The overall goal of this project is to improve the quality of life and access to care for Arizona blood
cancer patients and their families, and the LLS Arizona Chapter will achieve the the following objectives
in order to reach this goal:
a) Deliver personal, peer-to-peer support for newly diagnosed blood cancer patients through the Patti
Robinson Kaufmann First Connection Program where trained volunteers who have recovered from
a similar diagnosis provide a unique kind of support, offering guidance, coping strategies, resource
information and hope when it is needed most.
b) Connect Arizona patients, survivors, family members and caregivers with Information Specialists at
the centralized LLS Information Resource Center (IRC) who provide assistance through cancer
treatment, financial and social challenges and give accurate, up-to-date disease, treatment and
support information.
c) Network with Arizona healthcare professionals, hospitals, cancer centers and community-based
organizations to provide local Patient Travel Assistance and Co-Pay Assistance funding to blood
cancer patients who meet the programs’ criteria.
Through the work outlined in this proposal, LLS will meet the informational, supportive and financial
needs of blood cancer patients in Arizona. LLS will connect more patients to services, introducing them
to a network of supporters and educating them about their disease. All of these efforts will empower
people to take action to help themselves and help others. We have found that the patients and
caregivers with whom LLS has helped tend to have improved confidence accessing the healthcare
system, an important by-product of our interaction with them.
4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the
Gila River Indian Community.

Gila River Indian Community Grant Application
Grant Cycle 2016
Our proposed project aligns well with the Healthcare funding area where LLS will assist in improving
the overall health of blood cancer patients and their family members in Arizona. We are living in an
exciting time for blood cancer research, but the promise of life-saving new therapies cannot be realized
if not all cancer patients can access available treatments. By offering support services and arming
patients with information and educational opportunities, we will reduce the disparities in cancer
outcomes and improve the quality of life of patients. In addition, patients who become empowered can
further affect change by participating in legislative advocacy, which can lead to the development and
support for more health policies benefiting blood cancer patients in Arizona and the United States.
5. Identify the needs/problems to be addressed, target population and number of people to be served by
the project.
More than 1.18 million Americans are currently living with, or in remission from, a blood cancer (1).
Every 3 minutes, someone new is diagnosed with a blood cancer, with more than 155,000 new cases
expected this year. Blood cancers are the number three cancer killer, behind cancers of the respiratory
and digestive systems, including lung and colon. Every 10 minutes, another child or adult dies from a
blood cancer – that’s more than 55,000 deaths this year.
In Arizona, non-Hodgkin lymphoma is among the top ten most common types of cancer afflicting males
and females, and leukemia and non-hodgkin lymphoma contribute to some of the highest death rates
for individuals with cancer (2). Though prevalence data (that is, the number of persons who have a
history of a particular diagnosis) for blood cancers in Arizona is not available, the U.S. data for
leukemia, myeloma and non-Hodgkin lymphoma are helpful in understanding survivorship as well as
the target population this project aims to serve. In the U.S., 761,659 people are living with or in
remission from lymphoma, 327,520 people from leukemia and 95,874 people from myeloma (1).
The estimated number of new cases and deaths for leukemia, myeloma and non-Hodgkin lymphoma
are 2,680 and 1,160, respectively for the state (3). Of the estimated cases for all cancers in Arizona,
these blood cancers represent 8% of estimated new cases and 10% of estimated deaths. Maricopa
County reports the highest number of myeloma and lymphoma cases each year, but this is expected
because this county is where most of the Arizona population lives (4,5). Blood cancers affect individuals

Gila River Indian Community Grant Application
Grant Cycle 2016
of all races, age and socioeconomic background. Therefore, the work defined in this proposal will serve
as many blood cancer patients as possible residing across the 15 counties of Arizona.
LLS has found that coping with a cancer diagnosis can be easier when patients have access to
information about their illness and treatment options; someone who has been through a cancer
experience can offer support and guidance; support is available for the emotional needs of family,
spouses and caregivers; and assistance is available for insurance premiums, co-pays obligations and
travel expenses. LLS will help patients individually and collectively to access needed care as we
connect newly diagnosed patients to resources and clinical trials information, reduce financial barriers
to insurance coverage and treatment-related expenses and recuit and train volunteer advocates who
collectively influence legislators and regulators. Through this project, LLS will be able to help Arizona
blood cancer patients gain access to quality, affordable and coordinated care throughout their cancer
experience.
In fiscal year 2015, LLS assisted 741 individuals in Arizona who were seeking information, services or
local support. LLS provided over $1.25 million in Co-Pay Assistance funding to 584 patients in the state.
An additional 25 patients were provided national Travel Assistance stipends for a total of $12,500.
These baseline numbers represent the minimum number of individuals LLS expects to serve through
this project. Because the Arizona Chapter has secured funding for a local Travel Assistance program for
the state, we anticipate the number of patients served through that program will be much higher than
25.
6. Define the project as a new or continuing program.
This project is considered a continuing program; LLS established our resources and services in Arizona
prior to 2015.
7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible.

Gila River Indian Community Grant Application
Grant Cycle 2016
Typically, LLS uses our fiscal year cycle, which runs from July 1 – June 30, to determine start and finish
dates of continuing projects. However, we are flexible with the timeline and can measure and evaluate
project results within a 12-month period immediately following receipt of grant funds.
8. Identify other organizations, partners or funders participating in the project and their roles.
The LLS Arizona Chapter works with health organizations and nonprofits throughout the state to serve
blood cancer patients and their families. The chapter has developed a number of working relationships
with social workers, nurses, physicians and other healthcare professionals at these organizations, and
we anticipate that our current collaborators will refer blood cancer patients to our local and national
Patient Travel Assistance Program as well as the Co-Pay Assistance Program when they come across
patients requesting financial assistance in their own work. LLS works with the following organizations
and nonprofits: Arizona Center for Cancer Care, Arizona Childhood Cancer Coalition, Arizona
Department of Health Services, Arizona Myeloma Network, Arizona Oncology, Banner Health, Be the
Match, Cancer Support Community Arizona, Cancer Treatment Centers of America Western Regional
Medical Center, Cardon Children’s Medical Center, Dignity Health, HonorHealth, Ironwood Cancer &
Research Centers, Latino Cancer Coalition, Mayo Clinic, Phoenix Children’s Hospital, Susan G. Komen
Arizona, University of Arizona and Yuma Regional Medical Center.
9. Would you be able to implement the proposed plan if your organization received partial funding for this
project?
We would be able to implement this project with partial funding. However, reduced funding would mean
we will have limited reach within the Arizona blood cancer population and thus less impact on the
overall quality of life and access to care for these individuals. We recognize that the needs of our
constituents continue to outweigh our resources. Therefore, LLS is dedicated to securing funds to keep
this project moving forward in order to provide vital resources to the increasing numbers of blood
cancer patients in the state.
10. Describe your plan for project sustainability beyond the grant period. If this is a program/project
previously funded by the Gila River Indian Community describe efforts made towards the previously
described sustainability plan.

Gila River Indian Community Grant Application
Grant Cycle 2016
The LLS Arizona Chapter plans to continue seeking donor, local foundation and corporate funds to
support the efforts in Improving Quality of Life and Access to Care for Arizona Blood Cancer Patients
and Their Families. Each year, LLS must raise funds from partners in the community to support these
vital programs, and more funds are needed to reach the increasing number of blood cancer patients in
the state. Through maintaining good relationships with our current donors and developing connections
with local individuals, corporations and foundations, LLS will sustain our vital patient services and
mission programs. The Gila River Indian Community graciously awarded funds to the LLS Arizona
Chapter in October 2015 to support our Patient Travel Assistance Program. While the efforts outlined in
this proposal describe the broader reach and impact on blood cancer patients and their families, the
Patient Travel Assistance Program is one of many key components that will propel LLS forward in our
overall project goal and thus our mission.
11. Describe your plan to document progress and results.
LLS is currently tracking our interactions with patients, family members and caregivers on a new
platform called Salesforce. We capture various data elements for each individual with whom the
organization communicates or assists through our programs, if in the Arizona Chapter, the IRC or with
national staff members directly. We capture this information to characterize our constituents, their
needs and the types of assistance LLS provides. The LLS Arizona Chapter will be able to run reports
regularly from Salesforce to track our progress on this project and report results as they pertain to
Arizona blood cancer patients, caregivers, family members and healthcare professionals.
12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community
for state shared revenues for this and any other project. If this information is included in a separate
attachment, please indicate that here.
The Leukemia & Lymphoma Society- AZ Chapter has received the following awards since 2008 from
the Salt River –Pima Maricopa Indian Community:
SRPMIC Funding:
2015 $25,000
2014 $50,000

Gila River Indian Community Grant Application
Grant Cycle 2016
2013 $50,000
2012 $50,000
2011 $100,000
2010 $100,000
2009 $100,000
2008 $100,000
References:
1. The Leukemia & Lymphoma Society (2015). Facts 2014-2015. White Plains, NY: The Leukemia &
Lymphoma Society.
2. U.S. Cancer Statistics Working Group (2015). United States Cancer Statistics: 1999-2012 Incidence
and Mortality Web-based Report. Atlanta, GA: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention and National Cancer Institute.
3. Arizona Cancer Registry (2014). Profile of Myeloma in Arizona. Phoenix, AZ: Arizona Department of
Health Services.
4. Arizona Cancer Registry (2015). Lymphoma in Arizona. Phoenix, AZ: Arizona Department of Health
Services.

Gila River Indian Community Grant Application
Grant Cycle 2016
Project Budget
Budget Period: 2016-2017
For each budget item listed here please provide a narrative description on the following Project Budget Detail
page.
Proposed Budget Expense Amount Amount In Kind Total Budget
requested from requested or contributions
(list each budget item) GRIC secured from
other funders
1. Project Administration $50,000 $20,000 $0 $0
2. Co-Pay Assistance $0 $1,250,000 $0 $0
3. Patient Travel Assistance $0 $200,000 $0 $0
4. Click here to enter text. $0 $0 $0 $0
5. Click here to enter text. $0 $0 $0 $0
6. Click here to enter text. $0 $0 $0 $0
7. Click here to enter text. $0 $0 $0 $0
8. Click here to enter text. $0 $0 $0 $0
9. Click here to enter text. $0 $0 $0 $0
10. Click here to enter text. $0 $0 $0 $0
11. Click here to enter text. $0 $0 $0 $0
12. Click here to enter text. $0 $0 $0 $0
13. Click here to enter text. $0 $0 $0 $0
14. Click here to enter text. $0 $0 $0 $0
15. Click here to enter text. $0 $0 $0 $0
16. Click here to enter text. $0 $0 $0 $0
17. Click here to enter text. $0 $0 $0 $0
Total Budget $50,000 $1,470,000 $0 $1,520,000

Gila River Indian Community Grant Application
Grant Cycle 2016
Project Budget Detail
Please provide a narrative description for each of the project budget items listed on the previous page. Include
the dollar figure and how it was derived.
1. Project Administration – The Gila River Indian Community funding is requested for this line item, which funds
the overall project described in this proposal, including time and effort to connect with blood cancer patients,
caregivers, family members and healthcare professionals and to implement the First Connection, Patient
Travel Assistance Program and the Co-Pay Assistance Program for Arizona.
2. Co-Pay Assistance Program – This program provides $1,000 - $10,000 annually to Arizona blood cancer
patients who qualify. The amount awarded per person depends on the patient’s diagnosis, and financial need is
a requirement for eligibility (at or below 500% of the Federal Poverty Limit). We estimate that $1.25 million will
be distributed to Arizona blood cancer patients through this program.
3. Travel Assistance Program – This program will provide a $500 stipend to 400 Arizona blood cancer patients
who demonstrate financial need (at or below 500% of Federal Poverty Level) in order to help them offset
treatment-related travel and lodging expenses. Stipends are available on a first come first serve basis until
funds are depleted.
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Gila River Indian Community Grant Application
Grant Cycle 2016
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