Goldfields Family Assistance Fund
We All Need Help & Support Sometimes
Name of the Trust
Rotary Club of Boulder Perth Children’s’ Hospital Goldfields Family Assistance Trust
(Herein called “the Trust”).
To provide financial assistance for:
transport, accommodation and associated expenses, for the families and carers, of children from the Eastern Goldfields Region undergoing medical treatment away from the children’s normal places of abode.
purchase of equipment to be used for treating children in hospitals within the Eastern Goldfields Region.
purchase of quality of life equipment or services in the home of a child with a long-term illness or disability.
Child will mean a person under the age of 18 years at time of treatment.
Eastern Goldfields Region to include the area covered by the shires of Yilgarn, Coolgardie, Dundas, Leonora, Menzies, Wiluna and Laverton and the City of Kalgoorlie-Boulder or areas as defined by the club board from time to time.
The Trust Manager will be as appointed by the members of the Rotary Club of Boulder from time to time.
The Trust Administrator will be as appointed by the members of the Rotary club of Boulder from time to time.
The funds of the Trust will be held in interest bearing deposit with the Perth Children’s Hospital Foundation or any financial institution as agreed by the members of the Rotary Club of Boulder.
Applicants will not be means tested.
The Trust reserves the right to request repayment of the assistance or part thereof, should it be advised the applicant has received additional financial assistance from another source (eg. PATS, insurance claims, compensation etc).
There is no limit on the number of claims that can be made by a claimant.
There will be a time limit for travel, accommodation and associated expense claims of one year from the date of medical treatment.
All claims will be dealt with as much expediency as possible to avoid hardship to families.
The Trust manager will refer all claims to the Trust committee of the Rotary Club of Boulder for approval. Once approved the Trust manager will pass the claim to the Trust administrator for processing.
Ongoing assistance for medical treatment after the child ceases to be a child will be reviewed by the board of the Rotary Club of Boulder, provided the initial claim was made when the child was under the age of 18 years.
Administration of the Trust
The Perth Children’s Hospital Foundation will administer the Trust Account and be responsible for the payment of claims, preparing the financial reports and other statutory requirements.
The Rotary Club of Boulder will appoint a committee annually to manage the Trust on behalf of the Club. The committee will comprise of three members, being members of the Rotary Club of Boulder. The committee shall elect a fund manager to chair the committee.
The committee shall report to the club board monthly and all decisions will be ruled by majority vote.
The board of the Rotary Club of Boulder will make the final ruling on any claim if so required or requested by the fund committee or the applicant.
The ownership of the Trust funds will be with the Rotary Club of Boulder.
Should the Trust or the Rotary Club of Boulder be wound up the funds in deposit with the Perth Children’s Hospital Foundation will be divested to the Perth Children’s Hospital Foundation to be used for the same purpose as for this Trust.
The members of the Rotary Club of Boulder reserve the right at all times to amend any parts of this document.
Reporting to the Rotary Club of Boulder
The Perth Children’s Hospital Foundation will report on the activities of the Trust to the board of the Rotary Club of Boulder on a quarterly basis.
The Perth Children’s Hospital Foundation will provide an audited Annual Report on the activities and finances of the Trust.
Qualifications for Assistance
Assistance will be limited to the parents, siblings and the registered carers of children who are undergoing treatment at a medical facility away from their normal place of abode and who would normally reside in the Eastern Goldfields Region.
Assistance provided will consider any assistance the applicant has received or may be eligible to receive from any other party.
Assistance for funding hospital equipment must be as recommended by the hospital administrator and approved by the board of the Rotary Club of Boulder.
Operation of the Trust
Claimants will be required to complete the designated claim form, as updated.
The form must be signed as indicated by the claimant and a representative of medical staff treating the child and bank account details provided.
The Trust will provide financial assistance as follows:
Meals - rate per person per day for days away from home.
Travel - rate per kilometre for return trip from home to medical facility.
Accommodation – rate per day for days away from home.
Rates to be reviewed annually at July 31, by the club board.
Reimbursement of expenses not covered by above as determined by the Fund committee.
Lump sum assistance for purchase of hospital equipment as approved by Club board.
Payment of Claims
Once the claim has been approved the Trust manager will advise the Perth Children’s Hospital Foundation to pay out the claim or part thereof.
The Trust committee may refer claims for approval by the board of the Rotary Club of Boulder (due to size or special circumstances).
Claims for accommodation over an extended period as determined by the Fund committee may be entitled to periodic payments but will need approval of the board of the Rotary Club of Boulder.
All claims will be paid electronically into the claimants advised bank account.
The Rotary Club of Boulder will be responsible for promoting the Trust to the wider community.
Approval to use the Trust name for fund raising must be granted by the club in writing.
Approved Rates of Reimbursement:
Up to $40 per adult per day
Up to $20 per child per day
(Capped at $1000 per claim)
Travel Up to $0.32 per kilometre
Accommodation Up to $250 per night.
In call cases, receipts must be produced in order for payment to be made.
For more information, please contact
PCH Trust Fund Director
Applicants are encouraged to apply for PATS prior to submitting this application form, Funds eligible through PATS may/will be deducted from any final payments.
CLICK HERE FOR MORE INFORMATION ON PATS