2024 LADN Grant Application
The LADN Grant Program was created to help ease the financial burdens of dysautonomia patients living in LA and California. Our grants help cover dysautonomia-related healthcare expenses (not covered by insurance) for dysautonomia patients in California who demonstrate financial need.
We anticipate awarding a total of 10 individuals with grants of $1,000 in 2024. Applications open at 12:00am PST on Tuesday, September 3rd, 2024 and close at 11:59pm on Monday, October 14th, 2024 PST.
ELIGIBILITY:
Any individual who meets the following eligibility criteria may apply:
- Has a dysautonomia diagnosis by a licensed healthcare professional.
- Resides in California (with at least 50% of grants awarded to residents of Los Angeles County).
- Demonstrates financial need, as defined as annual household income at or below 350% of the Federal Poverty Level (FPL). (This number can be found on line 11 of Form 1040 on your 2023 tax return. A FPL calculator can be found here. Ex: 350% of FPL for a household of 1 = $52,710; 2 = $71,540; and 3 = $90,370 etc.) Note: If the applicant is a dependent, then these income requirements apply to the individual(s) claiming them as a dependent. If you are an adult disabled dependent and do not meet the eligibility criteria based on the tax information of the individual(s) claiming you, we encourage you to apply and ask that you explain your circumstance in the optional essay.
- Has a social security number.
- Has documentation of dysautonomia care-related expense(s).
- Participation in the LADN community is not a requirement, but preference may be given to those that are active LADN community members.
- Previous applicants are welcome to apply again. Previous grant winners are also welcome to reapply, however, priority may be given to those who have not received funding previously.
Don’t meet the eligibility criteria but feel like you should be considered? Please email us at LADN@la-dn.org!
CONFIDENTIALITY:
LADN takes your privacy very seriously. This application is stored on Jotform's HIPPA compliant servers. LADN staff are the only people with access to the full applications and will redact identifying information before sharing applications with grant selection committee members. Your name will not be shared as a winner unless you choose to make such information public.
LADN will take reasonable steps to protect your personal information but shall not be held responsible for unintended disclosures outside of LADN’s reasonable control.
GRANT SELECTION CRITERIA:
Applicants that meet the eligibility criteria and fully complete their application will have their applications evaluated by LADN's Grant Selection Committee. Personal information will be redacted for the grant selection committee's review process (with the excpetion of LADN staff members). Recipients of the 2024 LADN grants will be chosen through a process using this rubric and that evaluates the following areas:
- Dysautonomia Impact: Applicant articulates their experience with dysautonomia and the impact dysautonomia has had on their life.
- Need for Support: Applicant demonstrates an exceptionally compelling need for support.
- Dysautonomia Care Plan: Applicant identifies how the grant award will directly support their dysautonomia care.
- Spending Plan: Applicant provides clear and detailed explanation for how the grant award will be spent (including documentation).
For final selections of grant recipients, preference may be given to those that are active members of the LADN community. Additionally, at least 50% of grant funds will go to residents of Los Angeles county with the remainder going to residents across the state of California.
LADN is committed to inclusivity and diversity and will not discriminate on the basis of race, color, religion, sex, gender identity or expression, age, disability, sexual orientation, national origin, comorbid illnesses, political affiliation, or intersectionalities of identity.
ELIGIBLE HEALTHCARE EXPENSES:
Grants can be used toward any dysautonomia healthcare related expenses that are not covered by insurance including but not limited to:
- acupuncture
- copays
- health insurance premiums
- infusion expenses
- inpatient/outpatient medical treatment
- laboratory facility expenses
- mobility aids or other assistive devices
- naturopathy
- nutrition
- prescription costs
- psychotherapy
- PT / OT / cardiac rehab
Ineligible expenses: General food expenses (excluding supplements, electrolytes, medically-directed nutrition, etc.), rent, general automobile expenses (excluding direct travel costs to/from medical appointments), and other expenses not directly related to medical treatment are not eligible. Please email us at LADN@LA-DN.org to inquire if a specific expense is eligible.
APPLICATION DEADLINE:
All application materials must be submitted by 11:59pm on Monday, October 14th, 2024 PST. Applications may close early if we reach our limit of 100 applicants.
NOTIFICATION OF GRANT AWARDS:
All 2024 LADN grant applicants will be notified whether they are a recipient by December 6th, 2024.
QUESTIONS??
Join us for a workshop on how to apply on Monday, September 16th at 5pm PST. This workshop is available to view here.
Have last minute questions? Get help during our closing office hours on Sunday, October 13th from 12-1pm PST.
Please email us at LADN@la-dn.org with any further questions.
HELPFUL REMINDERS:
1.) Please ensure that you complete the entire application.
2.) You may have someone submit an application on your behalf if your illness/disability prevents you from being able to submit an application yourself.
3.) You may save your application by clicking "save" at the bottom of the application page. After clicking "save" you will receive an email from JotForm with a link to continue working on your application later. If you close your browser without saving your application first, your information will be lost.
4.) Supplemental documentation required with this application should be uploaded as PDFs or JPEGs. These include:
- California Residency Documentation
- Dysautonomia Diagnosis Certification
- Page 1 of Form 1040
- Dysautonomia Healthcare Expense Documentation
- (if applicable) Documentation of 2024 Income Change
5.) Carefully review the application for accuracy before it is submitted.
6.) The following essay questions have a 400 word maximum:
- Essay Question 1: How has living with dysautonomia impacted your life? Please use specific examples (such as changes in health, ability level, life goals, career, social life, finances, etc.).
- Essay Question 2: Why are you applying for a LADN Grant? Please describe any resources and help you currently utilize, the overall costs of and your need for financial support in your dysautonomia care, and how this grant would fit into your care plan.
- Essay Question 3: Please describe the impact $1,000 would have on your dysautonomia healthcare. You will be asked to fill out a spending plan table below. There will also be space to provide documentation of expenses in the following section.
7.) A confirmation email will be sent to you following your grant application submission.
8.) Contact LADN at LADN@la-dn.org if you have questions or need technical assistance.