The goal of our nutritional supplement program is to prevent malnutrition and improve healthcare outcomes for dialysis patients. Each applicant can receive a 3- or 4-month supply of supplements (depending on their product choices) in any one fiscal year. Nutritional supplements are delivered to the dialysis center from which the request was submitted.
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To qualify, household income must be at or below 400% of Federal Poverty Level with liquid assets not exceeding $2,000 (See FPL Chart)
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The application must document that at least ONE of the following pertains to the patient:
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Albumin < 3.7 g/dL or,
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nPCR (normalized protein catabolic rate) < 0.9gm/kg/day
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90% standard body weight and/or
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> 10% undesirable weight loss within 6 months and/or
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> 7.5% undesirable weight loss within 90 days
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For patients <18 years old, no weight gain over a 3-month period or any amount of undesirable weight loss over 2 months
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For pregnant patients in their 2nd & 3rd trimester, their weight gain is < 0.3 kg/week
Forms:
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Financial Statement (if not already completed within the last six months for other assistance requests, or if there are changes to income)
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For new applications, assistance must be requested by a renal dietitian or a nephrologist who completes the online application at: https://www.GrantRequest.com/SID_6273?SA=SNA&FID=35033/
- To access a saved or previously submitted application use https://www.GrantRequest.com/SID_6273?SA=AM
Helpful docs:
Renewal:
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Patients are eligible one time per fiscal year. The full 3–4-month supply is distributed in one order