Pawnee Tribe of Oklahoma
Elders | Disability | Emergency Assistance Application
Other Members of Household
Source of Income For All Adult Members of Household 18 Years of Age or Older
PROGRAM REQUIREMENTS(Must be enrolled Pawnee Tribal Member)
Elders:Applicant must be at least 60 years old at the time of the application for assistance. Proof of age will be determined by a Certified Degree of Indian Blood (CDIB) or Tribal Membership Identification Card. Applicant must provide copy of CDIB.
Proof of guardianship/power of attorney must be provided if applying on behalf of an elder applicant.
Disability:Applicant must provide proof of such disabled condition via a disability award letter from the Social Security Administration or Veteran’s Affairs. Doctor’s notes will NOT be accepted. Proof of age will be determined by aCertified Degree of Indian Blood (CDIB), Tribal Membership Identification card, or a copy of a birth certificate.
Proof of guardianship/power of attorney must be provided if applying on behalf of disabled applicant. Birth certificate required for all minor disabled applicants.
Emergency:Applicant must be at least (18) years of age at the time of application for assistance and in a *crisis to apply. Documentation of *crisis may be required. Proof of age will be determined by a Certified Degree of Indian Blood (CDIB) or Tribal Membership Card. The maximum number of emergency assistance checks is one (1) per household.
*A crisis is defined as a decisive or critical moment in regards to a client’s health and/or life. The following constitutes as a crisis: loss of clothes and/or shelter due to natural disasters, becoming disabled due to illness or accident, and life-threatening sickness to immediate client or family members.
Income:Applicant must meet poverty guidelines set forth by Department of Health & Human Services (DHHS). Household incomes must not exceed over 150% of poverty level. This applies to all three assistance programs. Please providethe last 30 days income verification (i.e. check stub, social security, bank statement, unemployment statement, TANF, etc.). Tribal members age 85 and older do not have to provide proof of income.
Types of Assistances:Medical—covers medical exams and prescribed treatmentDental—covers dental exams and treatment, partials, and denturesOptometry—covers eye exams and treatment and eyeglassesAudiology--covers hearing exams and hearing aidsPrescriptions—medications prescribed by a medical doctor and not covered by insurance or Indian Health ServiceHousehold—includes utilities/housing payments, utility/housing deposits, and minor home repairs (plumbing, roofing, handicap accessibility, hot water heater, stove, refrigerator, installation fees) that affect elder home health and safety.
*Bills must be from original vendors (i.e.; no collection agencies)
*Household expenses do not include property tax or home insurance.
*Utilities are specific for electric, natural gas, propane, water. This does not include cable, telephone, internet, and cell phone bills.
*Utility bill(s) must be in the tribal member’s and/or living relative’s name (if in relative’s name, that individual must reside at the current residence.
*Household assistance is provided for applicant’s current residence only; no payments for former residences.