PMH Goldfields Family Assistance Trust

Download a claim form application here

pmh

(Revised 7th June 2011)
Name of the Trust
PMH Family Assistance Trust (herein called “the Trust”).

Objectives
To provide assistance for transport, accommodation and other expenses associated with hospital admission, for the families and carers of children from the Eastern Goldfields undergoing medical treatment away from the families normal place of residence.

Claims will be referred to “the Trust” by medical and hospital professionals and the Social Work Department of Princess Margaret Hospital or other medical facility. Claims will not be means tested.

All claims will be dealt with expediently to avoid hardship to families. Assistance will only be provided for air travel under special circumstances. The trust will also assist, where possible, to provide quality of life equipment and services in the home for children with long term illness and disabilities.

Management of the Trust
The Princess Margaret Hospital Foundation will operate “the Trust Account” and be responsible for the payment of claims, preparing the financial reports and other statutory requirements.

The Board of the Rotary Club of Boulder will ensure there is sufficient funds to properly maintain the operation of “the Trust”.

Reporting to the Rotary Club of Boulder
“The Foundation” will report on the activities of “the Trust” to the Rotary Club of Boulder on an annual basis.

The Princess Margaret Hospital Foundation will provide an audited Annual Report on the activities and finances of “The Foundation”.

Qualifications for Assistance
Assistance will be limited to parents and siblings, registered carers and patients who are undergoing treatment and who would normally reside in the Shire of Dundas, City of Kalgoorlie/Boulder, Shire of Coolgardie, Shire of Menzies, Shire of Leonora, Shire of Laverton, the Shire of Wiluna and the Shire of Yilgarn.

Assistance will only be provided to the parents/carers and siblings who are not entitled to any assistance from government agencies or other organisations for the claimed expenses.

Operation of “the Trust”
Computer generated claim forms will be available from the Social Work Department at Princess Margaret Hospital, Rotary Club members and on the website at www.boulderrotary.com.au

Claimants will be required to complete the designated claim form. Original Tax Invoices from travel providers, accommodation providers, and other expenses must accompany all claims.

Advance payments may be made subject to a doctors referral The claim is to be signed by the Doctor, the Clinical Nurse or the Social Worker at PMH.

If the claimant has paid the account and is requesting a refund then all receipts should be attached to the claim. The form is then to be forwarded to “the Rotary Club of Boulder” for assessment. “The Rotary Club” will assess all claims within 48 hours not including weekends and public holidays.

Payment of Claims
Once the Rotary Club has assessed the claim, if all is in order, the Club will advise the PMH Foundation to pay out the claim or part thereof.

If the claim is less than $2,000 and if all is in order, the Fund Manager will authorise the Trust Manager to pay the claim, or part thereof.

For claims over $2,000 the Fund Manager will recommend payment up to that figure and seek the approval of the Board for the balance.

Claims for accommodation over an extended period may be entitled to periodic payments.

Once “the Foundation” has been advised that a claim is approved, payment is to be made within 48 hours (not including weekends and public holidays).

Advance Payment of Claims
In some cases advance payments may be made to families subject to a doctor’s referral.

Accommodation
Claims for accommodation must include the account from the accommodation provider.

Travel
Claims for travel must include the account from the travel provider.
Claims for fuel for travel should include receipts.
Claims for fuel will only apply to travel between the normal residential address and the medical facility.

Marketing
The Rotary Club of Boulder will be responsible for promoting “the Trust” to hospital and medical professionals.

Rotary Club of Boulder will promote “the Trust” on its website.

Frank Andinach
7th June 2011

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