Helping Hand Referral Application (Law Enforcement/State Attorney Referral)

Helping Hand Referral Application

Geographic Scope: Pinellas, Pasco, or Hillsborough Counties (through State Attorney's Office referrals)

Referral-Based Program:

• Assistance provided by referral only through approved agencies
• Limited resources used responsibly and effectively

Approved Referral Sources (As of February 2026):

• Law enforcement agencies
• State Attorney's Office for Pinellas, Pasco, or Hillsborough Counties
• Victim advocates working in coordination with above agencies
• Referrals outside these approved sources cannot be considered

Primary Eligibility - Individuals/families who experienced sudden or destabilizing crisis through no fault of their own:

• Domestic violence survivors
• Human trafficking survivors
• Sexual assault survivors
• Sudden death of spouse or child
• Other catastrophic incidents (reviewed case-by-case)

Secondary Eligibility - May also consider:

• Working single mothers or single fathers
• Children with chronic or serious medical needs
• Young adults who have aged out of foster care
• Abused, neglected, or abandoned children
• Underprivileged teenagers

"Crisis Through No Fault of Their Own" Criteria:

• Reasonable efforts made to gain/maintain employment when possible
• Required legal filings (such as child support) completed when applicable
• No history of substance abuse impacting stability
• No criminal history
• No pattern of long-term reliance on charitable organizations without progress toward independence

What They Fund (Examples of Assistance if Approved):

• Short-term, needs-based assistance
• Grocery or gas gift cards
• Household items (kitchen supplies, furniture, hygiene items, bedding, cleaning supplies)
• Clothing, school supplies, children and baby essentials
• Utility assistance or holiday assistance
• Other essential items for family stabilization

Board Policy:

• Background checks required for all assistance recipients
• Automatic disqualification for violent, theft, or drug criminal history

Emergency Resources:

• Active crisis: Call 2-1-1
• Crisis resources: Visit https://www.crisiscenter.com/

Application Process

Referral Source Confirmation:

1. Agency making referral (select one):
   • Law enforcement agency
   • State Attorney's Office for Pinellas, Pasco, or Hillsborough
   • Victim advocates working in coordination with above agencies
2. Referral Agency Information
   • Name of agency/department making referral
   • Contact person name (first and last)
   • Phone number of referral agency contact
   • Email of referral agency contact
   • Applicant photo ID (required)

Applicant Personal Information:

1. Full demographic information
   • Full name (first, middle, last, suffix)
   • Date of birth (month, day, year)
   • Address (street, city, state, zip code)
   • Phone number
   • Email address
   • Ethnic background (for statistical purposes only)
2. Household Information
   • List of household member names and dates of birth (adults and children)

Employment Information:

1. Employment Status
   • Currently employed? (Yes/No)
   • Where currently employed (if employed)
   • Explanation of unemployment (if applicable)
   • Most recent pay stub (file upload required)

Financial Information:

1. Income and Expenses
   • Total household monthly income (include job-related income, social security, cash assistance, child support)
   • Total household monthly expenses
   • Bank statements required upon request
2. Assistance Programs
   • Receives food stamps? (Yes/No)
   • If yes: amount per month
   • Department of Children and Families (DCF) involved? (Yes/No)
   • If yes: case worker name and phone number
   • Receives housing assistance (HUD, Section 8, etc.)? (Yes/No)

Type of Assistance Needed:

1. Select all that apply:
   • Utility assistance
   • Transportation
   • Visit to donation center (items include hygiene, kitchen supplies, bedding, cleaning supplies, clothing, etc.)
   • DV safety assistance
   • Child and baby needs
   • Advice/resources
   • Grocery assistance
   • School supplies
   • Holiday assistance
   • Other

Circumstances and Background:

1. Detailed narrative
   • Explanation of circumstances surrounding request for assistance
   • Include background information and/or court case information

Criminal History:

1. Background check authorization
   • Has applicant or anyone in household been arrested, convicted of, or plead guilty to a crime? (Yes/No)
   • If yes: description of nature of crime and subsequent rehabilitation

Transportation:

1. Car/reliable transportation? (Yes/No)

Documentation Agreement:

1. Confirmation statement
   • Agreement to provide supporting documentation upon final approval (Yes/No)

Application Statement and Consent:

1. Certification
   • Applicant certifies all answers are true, accurate, and complete
   • Understanding that omission/misrepresentation results in immediate rejection
   • Authorization for background check and reference checks
   • Agreement to abide by all Hands Across the Bay rules and regulations if assisted
   • Understanding that application does not constitute guarantee of assistance
   • Understanding that decision is contingent on successful completion of lawful pre-assistance checks
2. Privacy and Data Consent
   • Agreement to privacy policy
   • Confirmation that all information provided is true and accurate to best of knowledge
   • Understanding that submission does not guarantee assistance
   • Applications reviewed based on need and available resources