The Employee Giving Committee accepts requests on Mondays and Wednesdays. Once an employee
submits a request, they will receive a response within 72 hours of the request being reviewed.

Program guidelines
To assist patients/participants who do not have access to basic necessities that affect their health and well-being.
Those who do not qualify for this program:
  • AltaMed employees including: contractors, per diem, interns and/or AltaMed fellows
  • Family members of an AltaMed employee (including domestic partner, children, siblings, aunts, uncles, cousins, nieces, nephews, and/or grandparents)
Examples of eligible needs are:
  • Food & related items
  • Specialist appointment co-pay
  • Medication/Rx co-pay
  • Transportation to specialist appointment
  • Seasonal clothing (jackets, shoes)
  • Home essentials
Is this a Managed Care patient?
Services and support are available for our managed care patients and can be accessed by sending a referral to the Medical Management Department. Below are examples of resources available through AltaMed Net:
  • Community Based Adult Services
  • Home Environment
  • Low Income Utility Resources
  • In Home Supportive Services (IHSS)
  • Transportation
  • Disability Resources
  • Foundation Referrals
  • Low Income Eye Glasses Resources
  • Long-Term Services and Support (LTSS) / Multi-Purpose Senior Services Program (MSSP)
  • Substance Abuse
  • Food Resources
  • Housing Resources
  • Low Income Funeral Benefits Resources
  • Mental Health
  • SSI Benefits Information
Fund Request

FUND REQUEST FORM

Employee Information

This information is needed so that we can contact you if your request is approved.

PATIENT/PARTICIPANT INFORMATION


Please send any additional documents verifying need to [email protected]

PATIENT/PARTICIPANT NEEDS


You will receive a response after the request is reviewed by the Employee Giving Committee, no earlier than a week after submission. If you have any questions, please email [email protected]. Thank you for being an advocate for the community we serve!