Community Support Fund (CSF)
With this form you can request financial hardship support for up to three appointments per calendar year from approved services on the national Here’s to Strength Self Care Directory designed to improve your mental health and overall wellbeing. This service is designed to bridge the initial gap of access and provide stepping stones of support in conjunction with Medicare’s Better Access Mental Health Care Plan, Enhanced Primary Care Plans and other community service initiatives. It is not designed for long term care and has been created to bridge the initial acute phase of support.
*A waiting period may apply
Due to the recent high demand and use of this fund, your request will be added to a temporary waiting list while we work on continued fundraising efforts to support the developing needs of our community. We are working hard behind the scenes to increase the and sustain the long term capacity and endeavour to support you as soon as we can. We will respond to your request as soon as increased funding is available to cover the cost of your appointment.
Who is completing this request?
*
I am referring myself for financial assistance
I am referring a family member for support
I am a GP referring a patient
I am a Service Provider referring a client
Back
Next
Eligibility Criteria
If all four criteria has been ticked you can proceed with this request
Please select all that apply
*
The individual's current basic living expenses exceed their regular capacity for income
The individual is currently experiencing a deterioration in their mental health
The individual has not already received 3 sessions of funding from the Here's to Strength Community Support Fund within this calendar year
The individual is unlikely to be able to afford to pay privately within the next three months
Types of Financial Hardship Support
By continuing this request, I understand the individual will receive a triage assessment phone call where a worker from Here's to Strength will discuss their circumstances and what services may be of benefit to them. Each request is assessed on a case by case basis. Once approved, concession card holders may receive funding support of up to $150 per appointment. Non concession card holders may receive funding support of up to $75 per appointment. In the event of an extenuating circumstance, non concession card holders may be eligible for additional funding. If the service they want to engage in costs more than the subsidy amount, a gap fee may apply.
Tier 1 services available - Mental Health
Tier 1 - Psychology, Psychiatry, Psychotherapy, Counsellors, Activities Based Counselling, Animal Assisted, Counselling, Hypnotherapy, EFT Tapping, Breathwork, Meditation, Mental Health Occupational Therapy, Disability and Social Work Supports
Tier 2 services available - Holistic Supports to improve Mental Health
Tier 2 - Allied Health Specialist Health, Massage (Somatic Therapeutic Relief), Hair Washing (Depression Matting), Positive Body Movement Therapies, Intuitive Therapies, Home Assistance Services (for when you feel overwhelmed)
Back
Next
About you (the person referring/requesting financial support)
If you are the individual seeking financial hardship, you can skip this section by clicking next. This section is only to be completed by someone who is referring another person.
My Details
Your email
Best contact number
-
Your mailing address (we will only use this if we need to provide you an update about this referral)
Business Name (if applicable)
Street Address
Suburb
State
Postcode
If you are a GP, please record your provider number
Back
Next
About the individual who requires financial hardship support
Name
*
Best contact number
*
-
Do we have permission to leave a voicemail?
*
Yes
No
Date of Birth
-
Month
-
Day
Year
Gender
Does the individual have a concession card?
*
Yes
Not yet, waiting on approval
No I am not eligible
If yes, please record the healthcare or pension concession card number here
Card Expiry
-
Month
-
Day
Year
Which council does the individual live in? *Please note, the individual must live in one of the following councils to be approved for financial hardship support from the Aldinga branch of the Here's to Strength Community Wellness Hub
*
City of Onkaparinga
Alexandrina Council
District Council of Yankalilla
Residential Address
*
Postal Address (if different)
Back
Next
Reason for Referral
*
Details of relevant medical information, social circumstances and financial hardship providing necessary evidence of need for this funding
Back
Next
Request Acknowledgement
The Here’s to Strength Community Support Fund is a not for profit designed to help communities access self care by bridging the gap of access to existing independent service providers. I understand the Here’s to Strength Community Support Fund cannot guarantee or control outcomes and is not liable for the independent services delivered by individual providers who are listed on the Here’s to Strength Self Care Directory as they have their own service agreements, insurances and policies.
What to expect
A worker from the Here's to Strength Community Support Fund will contact the person who has been referred to receive financial hardship support so they can conduct a triage assessment by phone. If this referral has been requested by a GP, we will send a report providing a formal update after contact is made. If we are unable to make successful contact with the individual after three attempts, we will also send a report back to the referring party to advise if no triage assessment could be arranged.
Submit
Should be Empty: