top of page

Partner Referral Overview

Maryland Senior Emergency Assistance Fund relies on trusted partners across the state to identify older adults at risk and help submit complete referrals. Typical partners include:

  • Area Agencies on Aging and senior centers
  • Hospitals, clinics, and care coordinators
  • Housing and homelessness service providers
  • Community-based organizations and faith-based groups
  • Government agencies serving older adults

Our goal is to complement, not replace, existing local and state resources.

Partner Referral Form

Use this form if you are a case manager, social worker, or other professional submitting on behalf of a senior.

  • Referring organization name
  • Referrer name, title, email, and phone
  • Applicant name, date of birth, and Maryland address
  • Brief description of the emergency and risk if not addressed
  • Amount requested and how funds will be used
  • Other resources tried or secured
  • Document uploads

Referral Guidelines

When considering a referral, please:

Confirm that the individual is age 60 or older and resides in Maryland.

Obtain consent from the senior to share relevant information.

Verify the emergency need with documentation (for example, a bill, notice, or invoice).

Provide complete, accurate information in the referral form so that we can make a timely decision.

Explore other available resources first (local funds, public benefits, charity care, and similar supports).

Professional Partner Referral Form

For partner agencies and professionals submitting referrals on behalf of seniors.

Please enter the name of your agency or organization.

Please provide the name of the person we may contact if follow-up is required.

Please use initials only to protect client privacy.

Emergency Type
Housing/Rent
Utility Shutoff
Medical/Prescription
Other
Is this situation urgent?
Yes- eviction or shutoff pending
No- standard review

Urgent cases may qualify for expedited review when documentation is provided.

Please upload any relevant notices or statements. Documentation helps expedite review.

Resources for Partners

We support our partners with the materials and direct coordination needed to advocate effectively for Maryland seniors.

Program Materials

Access our one-page overview of the fund, available for digital distribution or printing for your clients.

Partner Toolkit

  • Sample referral checklist
  • Basic talking points for staff
  • Policy and eligibility updates

Contact for Referrals

For partner inquiries or case status, please email us directly at info@marylandsenioremergency.org

bottom of page