MAIL APPLICATIONS FOR APPROVAL with ALL completed PAPERWORK including the $200 Copay check to your DISTRICT PROJECT CHAIRS. The PROJECT CHAIRS are as follows:
MD 35 PROJECT CHAIR
PDG Norma Callahan
P.O. Box 1113
Deland, FL 32721
386.453.4877
District L - East:
PDG Norma Callahan
P.O. Box 1113
Deland, FL 32721
386.453.4877
District L - West:
PDG Nell Simmons
10145 Noriega Drive
Pensacola, FL 32514
850.501.6601
District I - North:
PDG Louis Cantrell
1032 15th Avenue
St. Petersburg, FL 33704
727.647.2663
District I – South:
PDG Blair 'Chip' Kunka
8634 54th Avenue West
Bradenton, FL 34210
941.713.7069
District O - East:
Lion Aleta Dick
3110 Oceanshore Blvd #211
Ormond Beach, FL 32176
724-875-9236
r.n.aleta@hotmail.com
PDG Norma Callahan
P.O. Box 1113
Deland, FL 32721
386.453.4877
District O – West:
Lion Dan Fox
2 Smilax Court North
Homosassa, FL 34446
352.382.2127
716.572.4693
District N - North:
Lion Crystal Samuel
4041 Greenwood Drive
Fort Pierce, FL 34982
772.940.9939
District N - South:
PDG Norma Callahan
P.O. Box 1113
Deland, FL 32721
386.479.9896
Florida Lions Eye Clinic
Lion Shaira Ramirez
10322 Pennsylvania Avenue
Bonita Springs, FL 34135
239.498.3937
Florida Lions Foundation For The Blind
Executive Secretary/Treasurer
Life Memberships and Donations
Lion Anita McHenry
256 Fifth Street Northwest
Largo, FL 33770
727.688.4350
THE PROJECT CHAIRS WILL REVIEW THE APPLICATIONS AND SCHEDULE EYE EXAMINATIONS TO DETERMINE THE CORRECT DIAGNOSIS BEFORE SENDING THE CASE TO PDG NORMA CALLAHAN FOR SURGICAL APPROVAL.
PAPERWORK includes the following:
*PAPERWORK includes the following:
- Project Form, which can be found on Foundation’s website: floridalionsfoundation.org
- Financial assessment
- If the person is under 65: DBS or Division of rehab denial.
- If the person has insurance denial of coverage.
- $200 check
Directions for Completing and Submitting
Application Requesting Assistance for Surgery
Attention: When completing and submitting the Application Requesting Assistance for Surgery, the Projects Form must also be completed at the same time.
- No after-the-fact cases will be accepted.
- The sponsoring club pays for examination(s), if possible.
- The Foundation only pays amounts approved on surgical cases.
- The Medical Agencies bills MD-35 Projects Chairperson. This information is provided to them on the Authorization Form when the case is approved.
- When you receive a request for financial assistance for surgery, complete in full both the Projects Form and the Financial Eligibility Application form with necessary signatures using the Poverty Level Schedule as a guideline. Both forms must be completed!
- All clients must apply for assistance from the Division of Blind Services (DBS) and Vocational Rehab before coming to the Foundation. If they are denied assistance from DBS or Voc Rehab, have them get a letter stating reason for denial and submit it with the application. The Foundation does not get involved with clients who have Medicare, Medicaid, or any other form of insurance.
- Your club's co-payment must accompany the required forms when submitting a request for assistance. Please make the check payable to: The Florida Lions Foundation for the Blind, Inc. The requested amount is $200.00 per surgical case for either one or two eyes.
- Please attach a copy of the patient's social security card or a copy of their Green Card if applicable to the forms.
- EMERGENCY CASES:
A. Clubs with emergency cases must immediately notify District Projects Chairperson.
B. One-eye cataract cases are not emergency cases.
C. Esotropia, exotropia, and lazy eye are emergencies only for ages 5 and under.
- If a case is not completed within 6 months following approval, it will be cancelled.
Note: Your assistance in making sure all information needed is provided on the forms will greatly expedite the process. Please remember that it is not the responsibility of the Projects Chairperson to acquire the client's information. It is our responsibility to try to negotiate costs with medical agencies once we receive the precise procedure to be done with the code numbers and the estimated costs.
The Foundation is here to assist all Lions Clubs in
Florida and The Bahamas.