Alameda County Ryan White Emergency Financial Assistance (EFA) Program

2021-22 EFHA Application Submission Process for Funded Sites

(Updated 3-1-2021)

Cardea receives funds from the Alameda County Department of Public Health Department (ACDPH), Office of HIV Care to provide emergency financial assistance to clients living in Alameda County who are Ryan White eligible. This program is funded by the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program. Download an information flyer about the program.

The PRINCIPAL PURPOSE of this assistance program is to provide limited one-time or short-term payments to stabilize Ryan White eligible beneficiaries in their current home and to help them with food and utility payments during times of emergency need. These funds are not intended to provide continuous or long-term assistance or support client to secure housing. The goal of EFA is to move the client towards self-sufficiency.

ELIGIBILITY PROCESS for Ryan White. Primary intent of these funds is to provide services to low income, underinsured people living with HIV. Ryan White is always the payer of last resort. Eligibility for Ryan White is based on (see Table 1):

  • HIV status with proof of diagnosis
  • Residency — must live in Alameda County
  • Health insurance status
  • Income – Less than or equal to 300% of the Federal Poverty Limit (see Table 2).

Alameda Table1

Alameda Table2

+RW eligibility needs to be verified every 6 months.

+Services are provided regardless of current or past health condition (no denial for pre-existing conditions).

RWHAP funds may only be used for HIV-related needs of eligible individuals. All clients are eligible beneficiaries of Ryan White funds regardless of age, gender, sexual orientation, race, ethnicity, disability, income, geographical location of residence with Alameda County or other factors unrelated to qualifications of service. Clients with Department of Veteran’s Affairs benefits are also eligible for Ryan White services. Ryan white program funds are used as the payer of last resort.

In Alameda County, Ryan White clients may request emergency financial assistance (EFA) via their case managers from Ryan White funded sites. Upon receipt and review of application and case manager’s case notes, Cardea staff will review eligibility and client’s emergency need to be able to provide financial assistance.

Approximate limits per person per year but subject to change based on availability and spending:

These funds are for one-time emergency need and not for ongoing support.

HOUSING: $500 – 1,000 housing per client/year

When calculating rent we will base it on client’s out of pocket rent after any subsidized housing support.

UTILITIES: $300 utilities support per client/year

FOOD CARDS: $50-$100/year based on case manager’s evaluation and with the allocated funds available to your agency.

Cardea will closely monitor spending throughout the year. If funds are depleting faster than anticipated, modifications will be made:

  • to annual limits
  • clients who have already received EFA once during that grant cycle will not be able to receive funds again until the next grant cycle

Below are the step-by-step instructions for Housing and Utilities:

STEP 1) Case manager should verify Ryan White Program Eligibility by completing this Verification Form. The information on the form needs to be verified every 6 months.

Eligibility is based on:

  • HIV status with proof of diagnosis
  • Income (see limits above)
  • Residency — must live in Alameda County
  • Health insurance status

STEP 2) Case managers should have client read and sign Consent to Enroll in EFA Program and Release of Information form.

STEP 3) Case manager should provide some short case notes from their last visit with the client to help support client’s application for emergency financial assistance. Case notes should include information on why client has this emergency, how it relates to their health and plans that are in place to help alleviate need for further EFA funds. Case notes will be reviewed with application by Cardea staff to determine eligibility and need for emergency services. You may use your own case notes or you may utilize this form: Ryan White EFA Program Client Case Notes.

STEP 4) Gather supporting documentations for proof of need for housing or utility assistance. This includes:

For housing: —late rent notice and W-9 are required. We may require additional supporting documents if deemed necessary by EFA Staff.

  1. Official notice/invoice or letter of rent overdue dated within the last 15 days. Must include:
    • Landlord’s name and address
    • Client’s name and address indicating they are the tenant
    • Amount overdue
    • Monthly rent amount paid by the client

    If landlord is not able to provide an official notice, please have the landlord complete this Statement of Delinquent Rent Notice.

  2. W9 from landlord with business name, address, social security number or EID number. W9 should be completed, written legibly and signed and dated within the last two years. W9 is a Federal and State requirement that must be adhered to in order for us to make payments. A blank W9 form can be found on the IRS website. Please alert Landlords that they will receive a 1099 form from Cardea for the funds distributed to them during the year. 
    +If you need something to provide to the landlord to request supporting documents and W9, we have created this letter.

    • If client is subleasing or paying rent to a relative or friend – please provide proof of past payment to this landlord or a rental agreement.

For utilities: —past due bill is required

  • Copy of past due bill from utility company (electric, gas, water, trash, or phone) on their letterhead with account number and mailing address for sending the check. 

    Please note:

    • Client’s name and an Alameda County address must be on bill. If client is not listed on the bill, attach lease showing they live at that address.
    • Clients should also be enrolled in the cost-saving programs offered by the utility company.

STEP 5) ++New If application is for housing, case manager must call the landlord to verify:

  • amount due,
  • mailing address for check (confirm location is open to receiving mail during SIP)
  • who the check needs to be made out to which should match what is on the W9
  • any special notations of the check
  • Case manager should then request a W9 from landlord and explain to landlord that if approved, the check will be coming from Cardea within the next 2-4weeks.

STEP 6) Case manager should enter client into ARIES if not already entered. Ensure that all the required information is entered and completed in the ARIES database. Case managers should have clients sign the ARIES Client Share/Non-Share Consent Form. Assure that the form allows for “share” so Cardea can have access to client’s information.

STEP 7) Case manager with support from their clients should now complete the EFA Application Form at the following link or by using this QR code:

Alameda Qr

STEP 8) After online submission of the EFA Application Form, case manager should send all the required supporting materials to Cardea via secured fax to (510) 210-1304 or via encrypted secure email to [email protected]

Documents you need to scan and send:

    1. RW Eligibility Verification Form with Aries number (Step 1)
    2. Signed Consent to Enroll in EFA Program and Consent to Release of Information (Step 2)
    3. Case manager case notes (step 3)
    4. Proof of need documents (step 4)
    5. ARIES Client Share/Non-Share Consent Form (step 5)

Additional documents for non-Ryan White Funded agencies like Kaiser to send in:

  1. Proof of income

STEP 9) Case managers will be contacted via email if documents are missing or if application was approved/denied. Please allow 3 business days for the application to be reviewed. After the application is approved, please allow another 7-10 business days before check is mailed out.

STEP 10) If housing request is approved, please notify the landlord of approval and amount and let them know the check is being mailed from Cardea with notice attached.

STEP 11) If check has not reached landlord within 3-4 weeks of having been mailed out, contact us to reissue check. To reissue check, we will first have you sign a form insuring your agency will pay the $35 check reissue fee.

Step by Step Instructions for Food Cards ($50-100/year)

Ryan White agencies will be given packets of food cards in $25 denomination for Safeway. Each Ryan White agency will have only a limited number of cards to be used at your discretion based on need of clients.

Immediately upon distribution of the card(s), case managers will need to enter information into the same online form that you use for housing and utilities:

The form will ask for Client information, card batch number and the last 4 digits of the food card(s) distributed to that particular client.

+please note we are not responsible for lost, stolen food cards. Agencies are responsible for the safety of the cards. If cards are lost, agency will be responsible for reimbursing Cardea for the equivalent amount.

Grievance Process

If your organization or client do not feel good about the services provided, please fill out this form and email it to [email protected]. Please allow 10 business days for us to respond. A written response advising of the final decision with regard to the grievance and the basis for the decision will be sent. If we are unable to resolve your grievance we will put you in touch with ACPHD for further support:

Pamela Casey-Lewis, MS, RD
Program Manager
ACPHD-Division of Communicable Disease Control and Prevention
1000 Broadway #310 Oakland, CA 94607

Program Feedback

We want your feedback about the EFA program. Provide anonymous feedback here:

Case Managers Feedback Form

Client Satisfaction Survey:

Cardea Contact Information:

Shailey Klinedinst, EFA Program Director & Emma Singer, EFA Client Eligibility Coordinator 
[email protected] (best way to contact us) 
510-291-8273 to leave a message
Secured Fax (510) 210-1304

+please do not give out our website or email or phone to clients. Clients must go through your agency to access EFA services.