General Welfare Consolidated Assistance Application

 

Note: All fields marked with a red asterisk (*) are required.

  • Personal Information

  • Or best contact phone number.
  • Eligible Benefits

  • Eligible Expense Distributions. Adult Tribal Members between the ages of 18-55 are thus eligible for up to $2950 per month in consolidated general welfare assistance. Elder Tribal Members aged 55 or greater are thus eligible for up to $3550 per month in consolidated general welfare assistance.
  • Indicate the funding amount requested, which can be anywhere between $0-$3000 depending on age.
  • Indicate the funding amount requested, which can be anywhere between $0-$1500 depending on age.
  • Indicate the funding amount requested, which is $600 for applicants 55 and older. If this benefit doesn't apply to you please write in N/A.
  • Indicate the funding amount requested, which can be anywhere between $0-$750 depending on age.
  • The Total Benefit Amount should include the amounts you've listed above.
  • Signature

  • Drop files here or
  • Terms and Conditions

    The Snoqualmie Tribal Council wishes to ensure that no tribal member in the community will be without basic fundamental necessities of life. The General Welfare Policy (“Policy”) will not completely fund all members’ financial and other needs, but is designed to lessen the burden of living expenses in their everyday lives. It is the intent of the Tribal Council that the Policy be funded from the Tribe’s general fund, which will not be subject to state or federal taxation and will not reduce fixed income or other benefits of the recipients.

    I certify the information contained in this application is complete and accurate to the best of my knowledge. I understand that I am signing this application, if I knowingly give false information which results in payment to which I am not entitled, the Tribe may treat the payment as taxable and issue me a Form 1099-MISC and/or pursue remedies to recover funding.

  • By checking this box I acknowledge that I have read and agree with the preceding terms and conditions.

Application Instructions

Below are the instructions and criteria for applying to the General Welfare Consolidated Assistance.

Criteria for Consolidated Assistance

To be eligible for the Consolidated Assistance benefit, you must be an Enrolled Adult Snoqualmie Tribal Member.

To apply for the Consolidated Assistance program you must:

  • A. Complete a Consolidated Assistance Program Application;
  • B. Provide each of the following to be eligible for each benefit:
    • 1. Proof of health insurance coverage for the health care benefit.
      • (a) Letter of Creditable Coverage from health insurance carrier and/or copy of insurance card verified as active by Tribal Member Benefit Department.
      • (b) Copy (front and back) of insurance card must be retained for benefit records.
    • 2. Proof of residency for the housing assistance benefit.
  • C. Program benefits are subject to change and may increase/decrease based on available funding.
Program Limitations
Eligible Expense Distributions Standard Monthly Funding Election Ranges
Housing Assistance $1700 $0 – $3000
Health Care Assistance $800 $0 – $1500
Elders Assistance $600 $600
Food and Clothing Assistance $450 $0 – $750

 

Adult Tribal Members between the ages of 18-55 are thus eligible for up to $2950 per month in consolidated general welfare assistance.
Elder Tribal Members aged 55 or greater are thus eligible for up to $3550 per month in consolidated general welfare assistance.

All eligible Tribal Members may elect to use the Consolidated General Welfare Assistance for any eligible expense in any category, provided the election is within the ranges above and does not exceed the total amount of eligibility.

Limits on Housing Assistance Distribution
  • Housing Assistance. Funds shall only be used to pay for Eligible Expenses at the Tribal Member’s primary
    residence only. Eligible Expenses include:
    • 1. Basic utility services, specifically water, sewer, trash, electricity, gas, and heat source (natural gas / propane / firewood / pellets); and
    • 2. Basic communication services, specifically landline and/or cellular telephone, internet, and basic cable services.
    • 3. Rent / Mortgage / Property Taxes.
Limits on Health Care Assistance Distribution
  • Health Care Assistance. Funds shall only be used to pay for eligible medical expenses, for non-prescription drugs, or for expenses that are beneficial to the general health of the Tribal Member, such as vitamins and participation in wellness programs.
    • 1. Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices intended for these purposes.
    • 2. Medical expenses must be used primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health.
    • 3. Medical expenses include the premiums one pays for health insurance that covers the expenses of medical care, and the amounts one pays for transportation to receive medical care.
    • 4. Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.
    • 5. Medical expenses also include traditional medicine and healers, including homeopathic healers, medicine and practices.
    • 6. Wellness Programs, such as gym memberships, purchase of gym/ wellness equipment, and any items that contribute to overall health and wellness.
    • 7. Eligible medical expenses are defined as those:
      • (a) Incurred while the Tribal Member is eligible on the program;
      • (b) Not attributable to a deduction allowed under IRS Code Section 213 for any prior taxable year; and
      • (c) Not covered, paid or reimbursed from any other source, including but not limited to IHS and CHS.
    • 8. Non-eligible medical expenses.
      • (a) Cosmetic procedures. Specifically, cosmetic surgery is not an eligible expense. This includes any procedure that is directed at improving a patient’s appearance and does not meaningfully promote the proper function of the body and/or prevent and/or treat illness or disease.
        • (i) An exception will be made if the surgery or procedure is necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease. Prior approval and notification of services to the Department will be required at least 90 days prior to the services requested. Proper documentation should include a letter of medical need from the medical doctor performing the service outlining services to be performed and the scheduled date of service. An itemized medical bill will be required after the procedure is performed to substantiate all expenses.
      • (b) Controlled Substances. Out-of-pocket expenses associated with the used of controlled substances (such as marijuana, laetrile, etc.) that are not legal under federal law, regardless if such substances are legalized by state law, are not an Eligible Expense.
Limits on Elders Assistance Distribution
  • Elders Assistance. The funds shall only be used to pay for Eligible Expenses for unmet needs. Elders are any Tribal Member aged 55 years or older. Eligible Expenses include but are not limited to daily life expenses, costs associated with housing and home maintenance, transportation expenses, food, healthcare, clothing, debt payoff, and goods for the home or Elder. Eligible Expenses exclude alcohol and controlled substances, and gambling.
Limits on Food and Clothing Assistance Distribution
  • Food and Clothing Assistance. Funds shall only be used to pay for Eligible Expenses per household.
    • 1. Eligible Expenses include:
      • (a) Food and personal hygiene expenses.
      • (b) Clothing expenses.
    • 2. Eligible Expenses exclude alcohol, tobacco products, soda, energy drinks, pet food and supplies, and fast food items.
Applications and Supporting Documents can be attached to this E-form, scanned, faxed, mailed, or hand-delivered to the Snoqualmie Tribal Office at:

Mailing Address:
ATTN: General Resources Department
P.O. Box 969
Snoqualmie, WA 98065

Fax Number: (206) 202-4535

Email: generalresources@snoqualmietribe.us