Qualifications
To qualify for assistance, an individual:
1. MUST be a resident of Hennepin, Dakota, Anoka, or Washington County.
2. MUST be blind, disabled or 65 years or older.
3. MUST show financial need. Your household income cannot exceed 135% of the Federal Poverty Guidelines.
4. MUST not have any other pet currently enrolled in the program
Requirement 1: Proof that you reside in Hennepin, Washington, Dakota, or Anoka Counties.
*** You MUST provide proof by sending a copy of ONE of the below.
A. Driver's license, Passport, or picture ID with your current address.
B. Utility bill or Bank Statement showing your name on the account with your current address.
C. Social Security Disability (SSD or SSDI) or Supplemental Security Income (SSI) Award Letter or Bank Statement showing your current address.
D. Major VA Disability Award Letter showing your current address.
E. If you are homeless, fill out and sign the last page on the application.
Requirement 2: Proof that an adult individual is blind, disabled, or 65 year old or more.
*** You MUST provide proof by sending a copy of ONE of the below.
A. Picture ID showing your birthdate showing your age as 65 years or older
B. Birth Certificate showing your age as 65 years or older
C. Driver’s license with birthdate showing your age as 65 years or older
D. Passport showing your age as 65 years old or older
E. Social Security Disability (SSD or SSDI) or Supplemental Security Income (SSI) Award Letter or Bank Statement showing direct deposit of SSD or SSI.
F. Major VA Disability Award Letter equal to or greater than 50%
G. SMRT Certification from the State of MN or MNChoices Plan showing SMRT certification (we only need the page with the SMRT box checked).
H. Letter showing enrollment in MA-EPD (Medical Assistance for Employed Persons with Disabilities).
Requirement 3: Proof that an individual is living at or below 135% of the federal poverty guidelines.
*** You MUST provide proof that you are enrolled in ONE of the following programs and that your total household income meets the guidelines in the table at the beginning of this section by sending a copy of one of the below.
A. Supplemental Security Income (SSI) Award Letter or Bank Statement showing direct deposit of SSI.
B. Medicaid (Minnesota Medical Assistance) - Include a copy of your determination letter.
C. SNAP enrollment form (Food Stamps) or copy of your card with your name visible.
D. Letter showing you are enrolled in MSP (Medical Savings Program) managed by the state of Minnesota.
E. Letter showing the state of county is paying your Medicare premiums.
Requirement 4: Fully completed application, including signature and all supplemental materials.
1. MUST be a resident of Hennepin, Dakota, Anoka, or Washington County.
2. MUST be blind, disabled or 65 years or older.
3. MUST show financial need. Your household income cannot exceed 135% of the Federal Poverty Guidelines.
4. MUST not have any other pet currently enrolled in the program
Requirement 1: Proof that you reside in Hennepin, Washington, Dakota, or Anoka Counties.
*** You MUST provide proof by sending a copy of ONE of the below.
A. Driver's license, Passport, or picture ID with your current address.
B. Utility bill or Bank Statement showing your name on the account with your current address.
C. Social Security Disability (SSD or SSDI) or Supplemental Security Income (SSI) Award Letter or Bank Statement showing your current address.
D. Major VA Disability Award Letter showing your current address.
E. If you are homeless, fill out and sign the last page on the application.
Requirement 2: Proof that an adult individual is blind, disabled, or 65 year old or more.
*** You MUST provide proof by sending a copy of ONE of the below.
A. Picture ID showing your birthdate showing your age as 65 years or older
B. Birth Certificate showing your age as 65 years or older
C. Driver’s license with birthdate showing your age as 65 years or older
D. Passport showing your age as 65 years old or older
E. Social Security Disability (SSD or SSDI) or Supplemental Security Income (SSI) Award Letter or Bank Statement showing direct deposit of SSD or SSI.
F. Major VA Disability Award Letter equal to or greater than 50%
G. SMRT Certification from the State of MN or MNChoices Plan showing SMRT certification (we only need the page with the SMRT box checked).
H. Letter showing enrollment in MA-EPD (Medical Assistance for Employed Persons with Disabilities).
Requirement 3: Proof that an individual is living at or below 135% of the federal poverty guidelines.
*** You MUST provide proof that you are enrolled in ONE of the following programs and that your total household income meets the guidelines in the table at the beginning of this section by sending a copy of one of the below.
A. Supplemental Security Income (SSI) Award Letter or Bank Statement showing direct deposit of SSI.
B. Medicaid (Minnesota Medical Assistance) - Include a copy of your determination letter.
C. SNAP enrollment form (Food Stamps) or copy of your card with your name visible.
D. Letter showing you are enrolled in MSP (Medical Savings Program) managed by the state of Minnesota.
E. Letter showing the state of county is paying your Medicare premiums.
Requirement 4: Fully completed application, including signature and all supplemental materials.
To know before applying
- The ACF is NOT a government sponsored program.
- Only one animal per family for the life of the animal is eligible.
- All funds must be used for necessary veterinary care with a good likelihood of a positive outcome or euthanasia due to illness.
- No funds may be used to cover previously incurred veterinary expenses.
- The client must maintain appropriate control of the pet during the clinic visit.
- Veterinary member clinic contribution per client is $250/year for one pet per family.
- The clinic is not reimbursed by the Foundation for their $250 pro bono donation and it is not tax deductible.
- The Animal Care Foundation has $1,000 available per animal per calendar year to use to supplement the $250 pledged by the member clinic when further care is needed. The clinic will make the arrangements to access these funds if they are needed.
- Clients must pay 10% of any care over the initial $250 por bono amount and anything over the total funds available of $1,250.
- Once a diagnosis is determined and a treatment plan established, it is the client's responsibility to carry out the prescribed treatment plan.
- The Animal Care Foundation and its member clinics reserve the right to refuse service to any client whose behavior affects the safety, security, comfort, or well-being of ACF staff, clinic staff or clients or their animals.
- Only one animal per family for the life of the animal is eligible.
- All funds must be used for necessary veterinary care with a good likelihood of a positive outcome or euthanasia due to illness.
- No funds may be used to cover previously incurred veterinary expenses.
- The client must maintain appropriate control of the pet during the clinic visit.
- Veterinary member clinic contribution per client is $250/year for one pet per family.
- The clinic is not reimbursed by the Foundation for their $250 pro bono donation and it is not tax deductible.
- The Animal Care Foundation has $1,000 available per animal per calendar year to use to supplement the $250 pledged by the member clinic when further care is needed. The clinic will make the arrangements to access these funds if they are needed.
- Clients must pay 10% of any care over the initial $250 por bono amount and anything over the total funds available of $1,250.
- Once a diagnosis is determined and a treatment plan established, it is the client's responsibility to carry out the prescribed treatment plan.
- The Animal Care Foundation and its member clinics reserve the right to refuse service to any client whose behavior affects the safety, security, comfort, or well-being of ACF staff, clinic staff or clients or their animals.
