Funding Guidelines

  • Applicant must first contact Employee Health and HR to discuss current their current situation discuss any additional resources available.
  • If applicant is requesting assistance with Liberty Hospital medical bills they must first apply for Financial Assistance through the billing department.
  • Applications must be submitted by the employee requesting assistance. Applications submitted on behalf of employees will be denied.
  • Applicants are eligible for up to $750 assistance once in a twelve month period.
  • Applicant must meet the guidelines for a “defined crisis”. A “defined crisis” includes:
    • Loss of home or disruption of the use of home due to fire or natural disaster, defined as: a tornado, flood, or earthquake.
    • Death of a spouse/partner, resulting in loss of income.
    • Assistance with funeral support for an immediate family member where no insurance or other coverage is available.
    • Devastating illness, injury, or accident of employee or an immediate family member living in the home (spouse/partner, child, or dependent living in the home) which results in the loss of income to the household.

Questions should be directed to foundation@libertyhospital.org.

Hughes Family Assistance Fund

"*" indicates required fields

1
2
3

Applicant Information

Name*
MM slash DD slash YYYY
Current Address*
Do you have (check all that apply)

Liberty Hospital Employment Information

MM slash DD slash YYYY