All clients of Legal Hospice of Texas must meet certain requirements to qualify for services. Answering the questions on this survey will help you to know if you can qualify. You must answer every question truthfully. If and when you register as a client, written documentation of your answers will be required.

 

Section 1 – Health Condition/Diagnosis

  • I am HIV+ or I have AIDS
  • A doctor has told me that I have a terminal illness
  • A doctor has told me that I have one of the following illnesses: Parkinson’s Disease; Alzheimer’s Disease; Lou Gerhig’s Disease (ALS); Muscular Dystrophy; or, Multiple Sclerosis
  • A doctor has told me that I am at “end stage” of a chronic illness

If you did not check at least one of the boxes above, you do not qualify for our services.

 

Section 2 – County of Residence

  • I live in one of the following counties: Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hunt, Johnson, Kaufman, Navarro, Rockwall

If you did not check the box above, you do not qualify for our services.

 

Section 3 – Legal Issue

Vocational issues

  • Have you been recently terminated from your job? Is your health status causing you problems at work? Do you know there may be protections to help you keep your job? Do you need job retraining?

Insurance issues

  • Has your Health Insurance coverage unexpectedly stopped?  Are you having problems understanding  MEDICAID, COBRA, ACA or other insurance eligibility

Disability/Employment issues

  • Are you thinking about applying for Social Security? Have you been denied Social Security, Long Term/ Short Term Disability, or unemployment? Are you ready to try going back to work after being on Social Security?

Housing issues

  • Have you been threatened with eviction or Foreclosure?

Estate Planning issues

  • Are you interested in having Texas-specific legal documents to specify who you would like to act for you (or disqualify from acting for you) regarding health or financial decisions if you are unable to act for yourself?

If you did not check any of  the boxes above, you do not qualify for our services.

 

Section 4 – Income and Assets

Income for HIV+ clients living in Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hunt, Kaufman, Navarro, and Rockwall counties is capped at 400% of Federal Poverty Level.

  • Currently, that cap is $60,240 for a single person; $81,760 for a family of 2; $103,280 for a family of 3; $124,800 for a family of 4.

I am HIV+ and I live in Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hunt, Kaufman, Navarro, or Rockwall County AND my income is not more than that listed above.