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Where to find help
- Newly Diagnosed
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- Familial ALS
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Support Our Services
- Help Fight ALS
**MUST BE A RESIDENT OF NORTH CAROLINA IN ORDER TO QUALIFY FOR THIS GRANT**
The North Carolina Chapter Grant Program assists North Carolina families with expenses that are not traditionally covered by insurance such as private insurance, Medicare, Medicaid and other assistance programs. It will cover, but is not limited to, home care assistance (respite), travel costs related to ALS clinics or research, home modifications, auto modifications, communication devices, environmental controls and generators for invasive or non-invasive breathing assistance.
Grants made possible in part by BAYADA Home Health Care.
Steps for applying for a Chapter Grant
***Please read instructions before applying***
Step 1: Please apply for grant below OR you may download the grant application (below) and complete, then send to us by mail, fax or email. Applications must be received (postmarked) by the "Application Deadline" date for that quarter (see dates below to determine quarter for which you are applying).
Step 2: Once we receive your application, you will receive verification either by email (or postal mail if we do not have your email address).
Step 3: Now you wait and save your receipts. DO NOT MAIL IN ANY RECEIPTS UNTIL AFTER YOU RECEIVE AN APPROVAL LETTER.
*Cancelled checks/copies of checks or credit card statement/bank statements are not acceptable as receipts.
*Receipts must be NO older then six months before the "End of Quarter Date" (Your approval letter will state this date and matches the table below).
Step 4: You will receive the approval letter along with necessary forms two weeks after the "Grant Application Deadline" date (see table below).
Step 5: NOW, send in completed paperwork and receipts following the "Guidelines for Receipts" section on your "Reimbursement Request Form" that comes with your approval letter.
*Approval of all grants will be based on available funds*
|QUARTER||APPLICATION DEADLINE||END OF QUARTER DATE|
|1st||January 20||April 20|
|2nd||April 20||July 20|
|4th||October 20||January 20|
Extra forms you may need after grant approval (Existing Grant Recipients Only)
THESE FORMS ARE TO BE USED ONLY IF EXTRA FORMS ARE NEEDED FOR A “CURRENT APPROVED” GRANT APPLICATION!
Download Reimbursement Request Form : This form MUST be completed, attached to an invoice/receipt and submitted for any reimbursements to be processed for a current approved grant.
Download the Service Provider Receipt: This form can be used by service providers who do not have their own receipt for services that they have provided. It must be completed by the Service Provider and sent in with a completed Reimbusement Request Form.
Download the Mileage Log: This form is used to submit reimbursements for mileage expenses (to and from clinic, clinical trials, feeding tube or diaphragm pacer appointments ONLY).
For questions regarding the grant application process or reimbursement process, please contact Claudia Winkler, our care services programs manager, at email@example.com.