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To qualify for a Community Support Grant for Persons with Disabilities, you must be a resident of New Trier Township. See the FAQs Sheet on pages 6-7 for other eligibility requirements.
Please make sure you have completed all the items in the following checklist BEFORE submitting your application for a Community Support Grant for Persons with Disabilities. Failure to provide all documentation, including the primary diagnostic codes (required), and certification of medical eligibility (required), will render applicant ineligible for the Grant.
New Trier Township Attn: Community Support Grants Program 739 Elm St Winnetka, IL 60093
ALL CHECKS WILL BE ISSUED BY MARCH 31, 2021.
By checking the box "I agree", and acknowledge that 1) all the information supplied on this application is true and correct to the best of my knowledge. 2) I have read the FAQs Sheet incorporated as part of this application and I understand and agree to the terms and conditions of the community support grants program, and 3) I understand that submitting this application is no guarantee that the funds will be awarded me.
By checking the box I "intend and authorize" the New Trier Township Social Services Administrator to 1) be treated as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information or other medical records 2) I authorize any physician, other health-care provider, insurance company, and health-care clearinghouse to give, disclose and release to the Administrator, without restriction, all of my individually identifiable health information and medical records regarding the past, present or future medical or mental health condition 3) The authority shall supersede any prior agreement that I may have made with my healthcare providers to restrict access to, or disclosure of, my individually identifiable health information and 4) I further understand and agree that information disclosed pursuant to this authorization may be subject to disclosure in connection with my application for, or the award of, a grant.
Your patient/client is applying for the New Trier Township Community Support Grants Program for Persons with Disabilities. We require professional certification that the applicant is eligible. Under the program guidelines, individuals (children or adults) with the following disabilities, who are residents of New Trier Township, are eligible for a financial assistance program offered by New Trier Township:
It is mandatory that you supply a written diagnosis and check the appropriate category above into which it falls.
It is mandatory that you provide DSM-5 or ICD-9 diagnostic codes, whichever is applicable.
Attach whichever is applicable: 1) Certification of Eligibility completed and signed by provider, 2) SSI/SSDI Benefits letter, 3) CAU client confirmation letter, OR 4) NTHS Transitions Program enrollment letter.
Most individuals with a disability live at home and are cared for by their families. Some of these individuals will require family support their entire lives. Their families make not only personal, but also great financial sacrifices to make this possible. This Township program provides financial assistance that helps in meeting some of the special service needs and unusual expenses related to a person with a disability. Each person selected will receive a grant up to $1,500 based upon the number of applicants.
New Trier Township government is committed to identifying and developing initiatives that will enhance the quality of life for residents, with a focus on youth, seniors, and persons with disabilities. The Township has had a strong history of funding service providers (i.e. social service agencies). As part of the Board of Trustees' strategic planning process, a strong desire developed to provide service on behalf of individuals. The Board has investigated the concept of "money following the person." With close to 9% of the Township’s population identified in the 2000 U.S. Census as a person with a disability there is a measurable market opportunity. In order to have significant impact it was determined the program would cover a wide range of services.
Individuals, children or adults, with the following disabilities, are eligible:
All applicants must be a resident of New Trier Township.
All applicants must be a resident of New Trier Township. Adults may:
A Licensed health care provider will be required to complete the Certification of Eligibility that appears on Page 5 of the application.
For children, services might include but are not limited to:
For adults, services might include, but are not limited to:
Interested persons will be asked to fill out an application form that can be obtained by calling or visiting the Township office, or downloaded from the Township website. Applications must be submitted to the Township office by January 22, 2021 before 5:00 pm, or postmarked no later than January 22, 2021. All participants will be notified by mail by February 28th, 2021.
New Trier Township Social Services.
Applications must be postmarked no later than January 22, 2021.
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