Two Foundations. One Goal...

To Support Duchenne Families.

Little Hercules Foundation and Team Joseph have a strong history of working together to fund promising research.  Recently, we decided that while we believe in the promise of future treatments, we also saw the need to help families right now.  In this moment.  We identified two priorities—to offer families financial assistance with expenses related to the care of a child or young adult with Duchenne, as well as provide guidance to families in order to access FDA approved treatments.

In order to work most effectively and efficiently, Little Hercules Foundation will provide case management services to patients and caregivers who have been denied access to FDA approved treatments for Duchenne. Team Joseph will take the lead on providing assistance that includes, but is not limited to, equipment (scooters, manual wheelchairs, shower chairs, etc.), accessible ramps, transportation to clinic visits, vehicle modifications, and home modifications.  Assistance is also available for educational opportunities, such as conferences, so families can educate themselves about the therapeutic landscape and improved standards of care.

The process is simple, and the only criteria for applying is a diagnosis of Duchenne muscular dystrophy.


ACCESS TO APPROVED TREATMENTS

Have you been denied access to any FDA-approved treatment and need assistance with appeals? We can provide you one-on-one case management services to assist you in the appeals process, regardless of whether you receive health care coverage through Medicaid, a private health plan, or both. The only criteria to receive assistance is proof of a DMD diagnosis confirmed by genetic testing. If you haven't completed genetic testing, we encourage you to learn more about it, including how to obtain free genetic testing, by visiting PPMD's Decode Duchenne site.

Please complete the following online application and someone from Little Hercules Foundation will contact you. If you have any questions about this program or online application, please email courtney@littleherculesfoundation.org, call Little Hercules Foundation at (614) 389-0026.



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We require proof of DMD diagnosis confirmed by genetic testing. Please visit PPMD's Decode Duchenne site here for information on how to obtain free genetic testing.

Contact Information
Medical Information
Appeals Information
Case Manager Information
Authorization to Disclose Health Information
I, {{form.first_name}} {{form.last_name}}, an individual, intend for Little Hercules Foundation, a 501(c)(3) charitable organization, (“LHF”) to be treated as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information or other medical records. It is my intention to waive the requirement that LHF be given only the "minimum necessary" information, and it is my express intent that LHF shall have full and unfettered access to any and all information that I provide personally or via any other personal representative. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (aka HIPAA), 42 USC 1320d and 45 CFR 160-164. This Authorization to Disclose Health Information is intended to be a “valid authorization,” as that term is used in the Health Insurance Portability and Accountability Act of 1996, as amended, and in regulations promulgated thereunder, including, without limitation, 45 C.F.R. §164.508, or any successor regulatory provision. I hereby authorize: • any physician, healthcare professional, dentist, health plan, hospital, clinic, laboratory, pharmacy or other covered health care provider, any insurance company, the Medical Information Bureau, Inc., or other health care clearinghouse that has provided treatment or services to me, or that has paid for, or is seeking payment from me for such services except as may be specifically limited below:
• to give, disclose and release to LHF, without reservation, • all of my individually identifiable health information and medical records regarding any past, present or potential future medical or mental health condition, to include, but not be limited by, all information related to the diagnosis and treatment of HIV/AIDS, sexually transmitted diseases, mental illness and the mental health records protected by the Lanterman-Petris-Short Act, and drug or alcohol abuse, except as specifically limited below:
The authority given LHF shall supersede any prior agreement that I may have made with my health care providers to restrict access to or disclosure of my individually identifiable health information. This authorization shall terminate on the first to occur of: (1) Two (2) years after my death; or (2) Upon my written revocation actually received by the LHF. Proof of receipt of my written revocation may be by certified mail, registered mail, facsimile, or any other receipt evidencing actual receipt by the covered entity. This revocation shall be effective upon the actual receipt of the notice by the covered entity except to the extent that LHF has taken action in reliance on this Authorization. By signing this Authorization, I acknowledge that the information used or disclosed pursuant to this authorization may be subject to re-disclosure by the person or persons named in this authorization and the information once disclosed will no longer be protected by the rules created in HIPAA. I understand that although federal law does not protect health information which is disclosed to someone other than another health care provider, health plan or health care clearinghouse, under California law all recipients of health care information are prohibited from re-disclosing such information except as specifically required or permitted by law. I understand that I have the right to receive a copy of this authorization. Agreed this {{date.format('Do')}} day of {{date.format('MMMM')}}, {{date.format('Y')}}.

TRAVEL / EDUCATION / EQUIPMENT ASSISTANCE

Our foundation partner, Team Joseph, provides assistance for procuring necessary medical equipment, travel assistance for those who travel long distances for expert care or clinical trial screening/visits, and support to attend educational meetings and conferences for those wishing to better understand Duchenne, standards of care, and the therapeutic landscape. Visit Team Joseph by clicking on the logo below for more information about these services and to apply online.

MAKE A DONATION

Little Hercules Foundation relies on the generosity of individuals around the world, like you, who believe in our mission and in the power to make a difference in the lives of those diagnosed with — and families fighting against — Duchenne muscular dystrophy.

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