REDUCED TRAVEL COSTS
FOR THOSE MOST IN NEED
The Treatment Access Program aims to reduce transportation barriers for rural people in treatment for breast cancer. The program is administered and funded by Pink Lemonade Project’s Toni Mountain Fund.
Criteria
There are no gender restrictions. Patients are eligible if they meet each of the following requirements:
- They are currently receiving breast cancer treatment (i.e. surgery, chemotherapy, radiation). Chemotherapy may include antibody-drug conjugates (ADC), Her-2 targeted therapy, or immunotherapy. Patients with MBC are eligible for TAP and considered for their unique situation.
- They have limited income (at or below 250% of the Federal Poverty Level).
- They live or receive treatment in Oregon or the SW Washington counties of Clark, Cowlitz, Klickitat, Pacific, Skamania, or Wahkiakum.
- They travel a minimum of 25 miles, one-way, to treatment.
Assistance
Eligible patients may receive the following, as funds are available:
- A check for travel to treatment and support services.
• $100 if they will travel fewer than 1,000 total miles during the application period.
• $200 if they will travel 1,000 or more total miles during the application period. - A check for lodging and food expenses if they must stay one or more nights for treatment. Lodging and food assistance is not available without transportation assistance.
The Treatment Access Program allows patients to receive up to $400 in a disbursement and up to $800 per fiscal year (January – December). Health professionals may reapply on behalf of the patient up to the limit.
How to Contact Us
Direct line: (360) 952-3814
How the Treatment Access Program works
Patients in treatment must go through their local healthcare provider / navigator to determine if they are eligible for assistance. The navigator / healthcare provider should do the following:
- Work with the patient to verify eligibility and complete all fields of the “Treatment Access Program Patient Application”. Please do not submit an incomplete application, as following up with you spends program resources on administrative time instead of patient assistance.
- If the patient needs lodging assistance, please try other programs first. For example, if a patient is travelling to Clackamas, Deschutes, Lane, Multnomah, or Washington Counties for treatment, they may be able to utilize American Cancer Society’s Hotel Partners Program (800-227-2345). Funding for food is still available if another lodging program is used.
- Reapplication is allowed, up to $800 in the fiscal year (January 1 – December 31), as long as the patient is in active treatment for breast cancer.
Pink Lemonade Project will process the complete application and mail a check directly to the patient.
Tips on Maximizing the Program
- Complete all fields of the form and contact Pink Lemonade Project with questions prior to applying. Incomplete/incorrect forms cause us to spend the program’s resources on administration rather than on patient assistance.
- Choose the amount of funding that maximizes the disbursements for your patient. Re-apply up to the fiscal year limit of $800.
- If your patient travels to more than one clinic for treatment, choose one for mileage reporting purposes.
- Keep track of the months for which you are applying and do not overlap on future applications. See first bullet.
- Encourage your patients to apply for other assistance programs such as SNAP, TANF, WIC, and unemployment.
Step 1: Patient Must Complete the Release of Information (ROI) Form
A completed Release of Information (ROI) Form is now required for enrollment in this program. This form should be completed by the patient or their authorized representative (e.g., Guardian, Executor of Estate, Health Care Power of Attorney).
Step 2: A Care Provider Must Complete This Form
The form below must be completed by a care provider, not the patient.