Contact Us

350 Capitol Street,
Room 730
Charleston, WV 25301
Ph: (304) 205-6357
Fx: (304) 558-4194

Contact Us

Emergency and Special Assistance Programs

C19 - TOC                 Table of Contents                

Section 19.1              Definitions

Section 19.2              Emergency  Assistance

Section 19.3              Reserved for Future Use

Section 19.4              Reserved for Future Use

Section 19.5              Indigent Burial Program       

Section 19.6              Reserved for Future Use

Section 19.7              Special Reduced Residential Service Rate (20% Utility Discount Program)

Section 19.8              Tel-Assistance

Section 19.9               Lifeline

APPENDIX A             Emergency Assistance Income Limits

APPENDIX B             Reserved for Future Use

APPENDIX C             Hospitals with Border Status for Medicaid

APPENDIX D             Public Forms  
 
                                 DFA-67-A - Burial Billing 
                                 DFA-BU-1 - Application for Burial Benefits 
                                 DFA-BU-2 - Affidavit of Responsible Relative 
                                 DFA-EA-1- Application for Emergency Assistance

                                 DFA-TA-2 - Tel-Assistance/Lifeline Application
                                 DFA-TA-3 - Tel-Assistance/Lifeline Fact Sheet
   
APPENDIX E             Reserved for Future Use