SNJREIC Special Needs Fund

Please Read Before You Get Started
We recognize that every family’s needs, circumstances, and access to resources are unique. We encourage you to reach out to your county Service Coordinator first, they can help explore different resources that may be available to you, such as community and state programs. In some cases, these resources may provide more sustainable, long-term support. For this reason, we encourage families to look into those options before applying to the Special Needs Fund. Our goal is to ensure each family is connected with the resources that best meet their situation and provide lasting benefit.
- Family Success Centers : These community-based centers provide families with access to free support services, resources (often including baby supplies - diapers, wipes, formula and more), and activities designed to strengthen and empower them within their communities.
- Women, Infants, and Children (WIC) : The WIC program offers nutritional support, education, and resources to low-income pregnant, postpartum, and breastfeeding women, as well as infants and children up to age five.
- Special Child Health and Early Intervention (SCHEIS) : SCHEIS is within New Jersey's Division of Family Health Services and encompasses several key programs dedicated to supporting children with special health needs and their families.
- Catastrophic Illness in Children Relief Fund : This fund provides financial assistance to families facing substantial medical expenses due to a child's illness, helping to alleviate the financial burden of uncovered costs.
- From We Can't to We Can : Resource Recycler group that recycles used and unused medical equipment to families who are in need. Refurbish and transport equipment to local families who have been denied by insurance or can't afford the necessary equipment.
- Goodwill Home Medical Equipment : Provide sanitized and refurbished affordable durable medical equipment and supplies to all individuals in need without a prescription.
- FindHelp.org : Free online resource where families can search for local supports such as food assistance, housing, childcare, healthcare, financial help and other community services.
- NJ 2-1-1 : Free confidential service that helps families quickly connect with local resources such as food, housing, utility assistance, childcare, and health services.
- Social Media - Search on Facebook Marketplace, local Mommy Groups & local "Buy Nothing" Groups to explore others giving away for free or selling at little to no cost gently used items, including diapers, clothing, strollers, cribs, car seats, toys and more.
Please refer to the www.thefamilymatterswebsite.org for additional information and resources
If you have already explored other resources but still need support, please provide a brief explanation of what you have tried.*

Introduction
Dear Family,

Thank you for your interest in the Special Needs Fund of the Southern New Jersey Regional Early Intervention Collaborative (SNJREIC). The purpose of this fund is to provide assistance to families of infants and toddlers with disabilities under the age of three who are impacted by the high costs of supports/services not covered by the New Jersey Early Intervention System, medical insurance, Medicaid or other funding sources.

Assistance will not exceed $500 per family, per 12-month consecutive period, and will be based on the availability of financial resources within the SNJREIC Special Needs Fund, and child/family needs. The Special Needs Fund is supported solely by private donations and is not funded by the State of New Jersey's Early Intervention Program. The Board of Trustees meets six times a year to review all requests and has the full discretion to deny, grant or partially award assistance for each request. Notification may not include a reason for denial.

Please review the following eligibility criteria, examine the list of all eligible services and equipment, and complete the application in its entirety. All information provided will remain confidential and will solely be used for the purpose of determining need and financial award. If you have any questions, please contact me at AudreySB@snjreic.org

Sincerely,

Audrey Searles-Bogdan, M.Ed.

Executive Director

Eligibility
Eligible Services and Equipment

Limited to the following:

1. Community Activities/Programs:
- For example, swimming classes, recreation programs, social skills classes, and therapeutic horseback riding programs that are related to or will assist in furthering the goals outlined in the current IFSP.
2. Adaptive/Assistive Devices/Orthopedic Equipment/Therapeutic Toys:
- For example, any item, piece of equipment or toy that is used to increase, maintain or improve the functional capabilities of children with developmental delays. Please include a statement of need signed by the child's physician. If the request is for therapeutic toys, please include a letter of support from the child's Early Intervention provider(s) and a description of what has been used in the home to meet the child's needs.
3. Conferences or Workshops:
- Conference or workshop registration for the applicant related to the child's special need/diagnosis.
Services and Equipment NOT Eligible for Assistance from the SNJREIC Special Needs Fund:
- Early Intervention Family Cost Share payments
- Medical services/bills (diagnostic evaluations)
- Clothing (unless adaptive in nature)
- Insurance co-payments
- Diapers, formula and/or nutritional supplements
- Furniture, heating/cooling units
- Rent or mortgage payments
- Utilities
- Exterminating services
- Strollers
- Walkers
- Jumpers
- Home Modifications (unless medically necessary or adaptive in nature)
- Membership fees for organizations
- Services/devices not listed on the current IFSP or related to the stated outcomes of the current IFSP
All criteria eligibility must be checked:*

Applicant must be a resident of and currently receiving Early Intervention services in one of the following New Jersey Counties: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester or Salem.Applicant must be the primary legal caregiver/guardian for the infant or toddler.Applicant must have a signed, current Individualized Family Service Plan (IFSP) in which the requested service(s) or device(s) are: a. related to the stated outcomes of the IFSP; or b. identified on the IFSP service pages.The application must be submitted at least three months prior to the child’s third birthday. If it is submitted less than three months prior to the child’s third birthday, it will require special consideration.

Application Information
Child's Full Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Diagnosis or area of Developmental Delay*
Service Coordinator's Name*
Name
Service Coordinator's Email Address*
example@example.com
Upload most recent IFSP below*

Browse Files
(Please reach out to your Service Coordinator if you need assistance with this) Cancelof
What is the request for?*
please be specific on the equipment, activity/program, etc. that is being requested
Amount of Request*
$ amount
Have you previously submitted an application to the Special Needs Fund?*

YesNo
If "Yes," was it approved?*

YesNo
Date Approved*

MonthDayYear
Amount Approved*

Applicant (Primary Legal Guardian/Caretaker) and Family Information
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
County of Residency*
Primary Language*
E-mail*
Phone Number 1*

Area CodePhone Number
Mobile Number 2

Area CodePhone Number
Family Size*
(Enter number of total family members living in the home)

Supporting Documentation
A letter written by the applicant that states why he/she requests assistance from the Special Needs Fund. If the funds requested will only partially support the purchase of the device or equipment, etc., please include an explanation of how the remaining balance will be paid (payment plan, personal loan, community fundraising, etc.).*

Browse Files
(Applicant Statement of Need letter) Cancelof
For Durable Medical Equipment only: (Orthotics, Modified Stroller, Walker, etc.) Please provide written documentation, if applicable, that shows denial of assistance from other agencies or charities for the expense. This may be shown by providing dated copies of bills, invoices or receipts, along with statements of partial payment/rejection of benefits from insurance and/or other funding sources.

Browse Files
multiple items can be uploaded if needed Cancelof
If the request is for Durable Medical/Orthotic equipment, include a statement of need signed by the child’s physician.

Browse Files
multiple items can be uploaded if needed Cancelof
Dated copies of bills, invoices, receipts or itemized order forms. Reimbursement for items purchased previously would need to have been purchased during the child’s current IFSP period.

Browse Files
multiple items can be uploaded if needed Cancelof
For items that have not been purchased, please include detailed order information along with the website where the item can be purchased. If approved, all items will be purchased by the SNJREIC and shipped directly to the applicant.
If the request is for community activities/programs, a detailed description and price breakdown directly from the organization's website. This can include a brochure, printout from the company’s website, official invoice, etc.

Browse Files
multiple items can be uploaded if needed Cancelof
If the request is for adaptive/assistive devices or therapeutic toys a letter of support from the child’s Early Intervention provider and a description of what has been used in the home to meet the child’s needs.

Browse Files
Letter of Support Cancelof
If the request is for conferences or workshops, include a detailed description and price breakdown directly from the organization running the conference or workshop. This can include a brochure, printout from the organization’s website, official invoice, etc.

Browse Files
multiple items can be uploaded if needed Cancelof

Application Review
If you need any additional assistance, resources, or support please contact your Service Coordinator.
By signing below, I certify that:
1. These expenses are related to the needs of my child as identified on their current IFSP.
2. The funds requested were not paid by any other source.
3. The financial assistance will be used for the approved purposes.
4. All of the information contained in this application is true/accurate.
5. I understand that financial determination will be made at the sole discretion of the SNJREIC Board of Trustees.
6. I understand that my submission, along with all attached documents, will be shared with the Board of Trustees for review.
Print Name*
Date*

MonthDayYear
Date
Signature*
Please verify that you are human*
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