The Resource List

Introduction

Welcome to the Resource List! This two part project is a bit different from the usual content found in CRPScontender creative works, as it does not focus on explaining CRPS in plain English. Instead this List and its associated Google Sheets Database is a mutual aid project intended to assist those in the USA who are facing financial strain due to their CRPS (or other disabilities) causing hurdles with their ability to maintain employment or earn income. 

Many individuals with CRPS had their condition develop rather suddenly after an injury, surgery, or spontaneous development, and in many cases may not be very familiar with programs available to low income and/or disabled people. As CRPS can bring about psychological impairments with memory, multitasking, word retrieval, brain fog, and fatigue, it can be challenging or overwhelming to research those programs or even find out which programs are available in the first place. 

It is our hope that the Resource List and the associated references will remove a great deal of that stress by providing a convenient curation of program summaries and offering a solid platform as a launch point to find needed aid. 

Part one, The Resource List, offers multiple short overviews of available options. The longest section of this List, taking up well over half of this document, is the section on homelessness, due to the dangers it poses to those with CRPS and its lack of organized structure.

Part two, the Database, offers multiple pages of links to relevant websites where additional eligibility or program information can be found and, in some cases, direct links to applications. There are also some links to additional information on certain laws or legal processes. The Database will be updated occasionally in attempts to keep it current; if you find any broken links or suggestions for additional links and resources, please contact the email listed on the CRPScontender website and include the link and the program to which it was supposed to connect you.

We hope this Resource List is useful, educational, and that it assists in improving peoples’ quality of life through the ability to make autonomous decisions and relieving stress to make informed choices in one’s own best interest.  

Federal Programs

Affordable Connectivity Program: The ACP is a FCC federally-funded benefit that helps low-income households pay for broadband internet by contributing $30 per month towards the internet bill or $75 per month for households on qualifying Tribal lands. It can also provide a one-time discount of up to $100 to help purchase a qualifying tablet, desktop computer, or laptop. **The funding for this program ran out April 2024; it was an extremely popular and vital program and hopefully Congress will allocate more funding for it in the coming months.**

Lifeline: The Lifeline Program is a FCC federally-funded benefit that helps low-income households pay for wired or wireless phone service by contributing $9.25 monthly or $34.25 for those living on Tribal lands; depending on the service provider and plan selected, this can completely cover the entire cost of the monthly phone bill, including talk, text, and data. Individuals can bring their own phones with them, or a new smartphone may also be provided.

Supplemental Nutrition Assistance Program: SNAP is a USDA federally-funded benefit administered by states to aid low-income households in obtaining healthy and sufficient amounts of food. While usually all those who live together and purchase and prepare their meals together are considered one household under SNAP, there are exceptions for specific circumstances. Boarders/live-in tenants, housemates, and roommates are considered distinct households or “assistance units,” so long as they purchase and prepare food separately. The disabled with live-in aides are allowed to shop, purchase, and prepare food with the assistance of their aides without penalties or being considered the same assistance unit, even if that live-in aide is a paid family member. There are often work requirements unless a person is disabled or meets specific exemptions. 

Special Supplemental Nutrition Program for Women, Infants, and Children: WIC is a USDA federally-funded, state-administered program that provides targeted aid for low-income pregnant, breastfeeding, and postpartum parents, infants, and children up to five years of age who are nutritionally at risk. 

Temporary Assistance for Needy Families: TANF is a time-limited, state-administered, federally-funded program to help families with dependent children or pregnant people experiencing financial hardship cover bills related to housing, child care, utilities, and food. Job training assistance is also provided, and finding a job and working at least 30 hours a week within three years of receiving benefits is a requirement of the program. 

Low Income Home Energy Assistance Program: LIHEAP is a federally-funded HHS program that helps reduce the strain of the costs related to summer cooling and winter heating energy bills, minor home repair, weatherization for home energy efficiency, replacing or repairing energy equipment.

Child Care: Head Start and Early Head Start are federal programs for children ages 0-5 available to low-income families at no cost; children with additional support needs are welcome in the programs, and some children above the income threshold limits may be accepted due to needing additional support with disabilities. Additionally, state-funded childcare financial assistance programs are available, though requirements vary, and there are also state-funded and county-funded prekindergartens for children ages 3-5 with part-time or full-time schedules; both of these are usually free or at a considerably reduced rate. Some local non-profits offer aid, and some colleges, hospitals, park districts, employers, and gyms offer free or low-cost childcare while using their facilities. Seasonal programs can offer relief during long summer breaks. 

Healthcare 

Medicare: Medicare is an insurance option provided at the federal level via the SSA for those who are at the designated age of retirement, receiving SSDI under their or a parent’s credits if a Disabled Adult Child (DAC), or those with ESRD and ALS/Lou Gehrig’s disease. Medicare acts as a “full coverage” health insurance and can be combined with other types of coverage for expanded benefits. As of 2006, there are three core portions of Medicare coverage: Part A/(Inpatient) Hospital, Part B/Outpatient Physician and Standard Medical, and Part D/Prescription benefits. Additionally, there is a lesser known benefit called Part C that combines the three core Medicare benefits together. These parts combined offer coverage for doctor’s appointments, hospice, inpatient hospital stays, outpatient observational hospital stays, substance abuse and mental health treatment, home healthcare, physical/occupational/speech therapy, vaccines, physician-administered and self-administered drugs, surgery, DME/durable medical equipment, home healthcare, and specialist visits. Medicare is considered the gold standard for health insurance by the American disabled community, but there are costs and legal caveats with coverage in specific situations that we will go into detail over that aren’t as well known or openly discussed.

To start off, let’s cover the basics of Medicare as there are a number of ways that coverage can be tailored for an individual’s specific needs. When one first becomes eligible for Medicare, they will have to make a critical choice for coverage for the lifetime of the benefit between Original Medicare or a Medicare Advantage Plan, also known as Part C. Original Medicare includes Parts A and/or B that are managed and administered directly by the Center for Medicare and Medicaid Services (aka CMS) or a Medicare Advantage Plan that includes Parts A AND B ONLY (Part A & B only Medicare Advantage Plans are also known as MAs, and Medicare Advantage Plans with Part D included are known as MAPDs) are managed and administered by a private insurance company by authorization from CMS.  

Part A: Coverage includes home healthcare, hospice, formal admissions for inpatient hospital stays (NOT observational inpatient admissions), skilled nursing facilities only immediately following a formally admitted inpatient hospital stay of at least three days and is not for custodial only care (i.e. assisted living, residential care homes, group homes, long term care facilities), surgery, labs and tests.

Part B: Coverage includes preventive care like yearly check ups and well women visits, outpatient care, medical supplies/durable medical equipment (DME), medically necessary services (diagnosis and treatment for medical conditions that meet CMS accepted standards of medical practice), ambulances, clinical research, mental health treatment (inpatient, outpatient, partial hospitalization, and intensive outpatient programs as of January 1st, 2024), substance abuse treatment including methadone, limited drugs like those that require a medical professional to administer, some vaccines, drugs that require DME to administer like insulin for reusable insulin pumps and breathing treatments via a reusable nebulizer, standard glucometers, continuous glucose monitors (i.e. Freestyle Libre, Dexcom g7 systems), oral end-stage renal disease/ESRD drugs, drugs used during ESRD dialysis like EMLA/lidocaine for venous access during hemodialysis and calcimimetic medications, blood clotting factors for hemophilia, medically necessary intravenous (parenteral) and tube (enteral) feeding, at home IVIG for primary immunodeficiency disease, anti-rejection/immunosuppressive drugs following a transplant that Medicare paid for, specific oral cancer drugs that also have an injectable version, oral anti-nausea drugs when given during a 48 hour window of receiving chemo or as a full replacement for IV anti-nausea meds while receiving chemo.

Part D: Coverage includes prescription self-administered outpatient drugs that are medically necessary and have an FDA approval, vaccines and vaccine administration not covered by Part B, commercially available combination drugs with at least one Part D covered active ingredient, and are not used for anything considered excluded [i.e. cosmetic, hair loss, weight management, erectile dysfunction, fertility, symptomatic cough and cold treatments, OTC products, vitamins and minerals, bulk chemicals/ingredients used for compounding, non-FDA approved medications and research chemicals (can also be called Less Than Effective Drug Efficacy Study drugs or LTE-DESI/DESI drugs), drugs purchased in another country, drugs from manufacturers that have not signed a pricing discount agreement with CMS, drugs that are only used during tests, and drugs covered by Part A & B]. 

General costs associated with Original Medicare include a yearly deductible, a monthly premium, 20% coinsurance for providers and healthcare services, a daily coinsurance for hospital stays, and prorated coinsurance for skilled nursing facilities and/or acute care rehabilitation hospitals. The associated costs with Original Medicare can add up quickly for the chronically ill, disabled, and complex care patients, but can be more beneficial for some as it acts like a PPO where one can see any doctor or specialist they’d like as long as the provider accepts Medicare. These costs can potentially be offset by an optional plan called a Medicare Supplement Plan (aka a Medigap Plan) where it will cover some to all of one’s deductible, coinsurance/copays, and offers additional benefits not provided at all by Medicare like coverage when traveling outside of the country, additional days for SNF, outpatient drugs, hospital stays, and additional coverage for blood transfusions up to the first 3 pints. Medigap plans are ONLY available as an option when one first becomes eligible for Medicare, require both Part A AND B coverage selections, cannot be combined with a Medicare Advantage Plan, and outside of a few limited scenarios is not available anytime after selecting a Medicare Advantage Plan.

Standalone Part D Plans (PDPs) are optional and provided through private insurance companies authorized by CMS, but do require at minimum Part A OR Part B coverage. Medicare Advantage Plans with Part D (MAPDs/MA-PDs) require BOTH Part A and B coverage to enroll. Costs associated with standalone PDPs and MAPDs plans are a yearly deductible, monthly premium, and copays/coinsurance . Medicare beneficiaries may opt to switch between Original Medicare with a PDP or an MAPD plan during the yearly Open Enrollment Period. These out of pocket costs will vary from plan to plan, even when they are different plans offered by the same insurance company. Some plans are created without a yearly deductible, monthly premiums, or both; additionally some plans may have set copays versus a coinsurance (meaning paying a set percentage of the cash price) or even have set copays for medications on specific lower tiers but higher tier drugs like specialty drugs can have coinsurances. 

When it comes to exact drugs being covered, PDP and MAPD plans have different drugs covered and not covered under a Formulary structure, so it is very important to check that which drugs one takes are covered by which plan and at what cost along with the other associated costs and benefits to determine which plan is the best option for individualized situations. CMS does mandate that that all formularies must include categories and classes of drugs to cover all diseases, specifically a minimum of two drugs for each one of 148 categories/classes of drugs, must not be discriminatory in any way, and must include all or substantially all drugs for 6 protected classes: cancer treatment, antipsychotic and antidepressants, antiepileptic/anticonvulsant drugs, immunosuppressants, and antiretroviral drugs. 

If a plan does not have a drug one takes on it or one gets a prescription for a new drug that is not listed on the formulary, but is still eligible for coverage, a patient has the right to request coverage for that Non-Formulary drug in three primary ways. The most common is by requesting a Coverage Determination/Prior Authorization to show that they have tried the formulary alternatives covered in the past and either the medication didn’t have any effect or a substantial effect, the patient had an allergic reaction to a formulary alternative, the formulary alternatives are contraindicated, that there are drug-drug interactions with the formulary alternatives and other medicine the patient takes, or the formulary alternatives have caused significant adverse events. The second most common way to obtain coverage for a non-formulary medication is to try at least one month each of two formulary alternatives that are preferred. Finally, a non-formulary exemption can be requested should a patient and their doctor have clearly defined reasons on why they should be exempted from being required to try and fail the preferred formulary alternatives for their condition. The biggest takeaway is that drugs on the highest tiers and that are non-formulary but covered will have the highest copays/coinsurances.

Things to consider when looking at MA and MAPD plans outside of the yearly deductible, monthly premiums, and copays/coinsurance, are:

 1. What additional benefits does each plan provide beyond what Original Medicare offers?

2. What plan type is the policy? Will the plan type require a referral for specialists or non-PCP visits? What kind of network does it have? Will the member be able to see any doctor across the country?

A. Health Maintenance Organization (HMO): These plans require one to choose a Primary Care Provider (PCP) from the plan’s network of providers. These plans restrict specialist visits to only with a referral from their in-network selected PCP and the specialist selected must also be in-network as well; otherwise the plan will not cover visits to out-of-network specialists, to in-network specialists without a referral (can also be called a self-referral), and any labs, tests, studies, procedures, surgeries, treatments, and prescriptions ordered by an out-of-network/self-referred specialist. HMOs traditionally have some of the lowest out-of-pocket costs, but the trade off is they do not offer any out-of-network benefits, may only offer away from home care in cases of true emergency, and may restrict one to only seeing providers within certain counties, states, or regional districts. HMO MAPD plans have Part D coverage already integrated under one roof, and one cannot select a standalone PDP plan when they have an HMO MAPD plan. The only time one is allowed to select a standalone PDP plan separate from an HMO is with an MA only HMO.

B. Preferred Provider Organization (PPO): Plans that have a PPO structure are much less restrictive in regards to providers, have in-network AND out-of-network benefits, and more commonly have away from home non-emergency coverage (aka Nationwide Passport coverage/benefit); members still must chose their PCP, but they are able to see any specialist they’d like without a referral, specialists can be covered through an in-network or out of network benefit, and even select an out-of-network PCP. The additional benefits and network options do tend to come with higher out-of-pocket costs compared to HMOs, but for those with CRPS, PPO structured plans can offer the most bang for the buck overall as there are less hoops to jump through to have niche focused providers, a much broader pool for covered specialists, and less stress when trying to establish care as a new patient. If someone tends to have all or most of their medical team from one hospital or clinic group that is in-network with a PPO and just one to a few providers that accept the plan as out-of-network, these types of plans can still be cost effective overall when looking at the bigger picture of out-of-pocket dollar amounts versus the stress, worry, and time that is involved when trying to find providers knowledgeable and experienced in treating CRPS, the secondary symptoms/sequelae, and that will work with them collaboratively while also being in-network. Additionally, if one has to travel any significant distance for care from a knowledgeable CRPS expert, PPO plans should be explored to ensure one can still see the away from home providers and get the treatment they need at reasonable out-of-pocket costs. PPO MAPD plans have Part D coverage already integrated under one roof, and one cannot select a standalone PDP plan when they have an PPO MAPD plan. The only time one is allowed to select a standalone PDP plan separate from an PPO is with an MA only PPO.

C. Private Fee for Service Plan (PFFS): PFFSs plans are not as commonly known like HMO and PPO plans are, but these plans tend to have the most options and broadest coverage  when it comes to Medicare Advantage plans. Just like HMO and PPO MA/MAPD plans, PFFS plans are provided by private insurance companies authorized by CMS. The biggest differences are that PFFSs provide coverage under fixed copays for individuals services, one does not have to select or have a PCP mandatorily but can be selected optionally, referrals are not needed to see a specialist, and many plans do not have networks like HMOs and PPOs do in lieu of allowing one to see any Medicare contracted provider but the provider might only accept payment from the PFFS plan for some services and not others (and is the only major plan type to allow for balance billing); the PFFS plans that do have networks can have stipulations on when out-of-network providers and services are covered (i.e. out-of-network care might only be covered in emergency or urgent situations, emergency or urgent care when away from home), but any in-network providers will accept payment from the PFFS plan every time. PFFS plans have the highest out-of-pocket costs of all the plan types, and can even be higher than Original Medicare costs. Not only will one still have to pay the standard Part B monthly premium, PFFS plans more often than not have an additional monthly premium on top of the standard Part B premium. The costs for PFFS plans, along with available plans, will vary heavily from state to state and plan to plan; this type of plan will need the most investigation and research to determine if it’s a good fit for one’s needs and budget. PFFS MAPD plans have Part D coverage already integrated under one roof, and one cannot select a standalone PDP plan when they have a PFFS MAPD plan. The only time one is allowed to select a standalone PDP plan separate from a PFFS plan is with a MA only PFFS.

D. Plans for unique populations: The least known group of MAPD plans are called Special Needs Plans (SNPs). SNPs are designed to provide targeted, specialized care for individuals in three major categories: 

 I.   Chronic Condition Special Needs Plans (C-SNPs): C-NSPs are plans designed for Medicare Beneficiaries with at least one, if not more than one, qualifying chronic condition like

II.  Institutional SNPs (I-SNPs): I-SNPs are tailored for the unique needs of individuals who reside in long term care whether it be in skilled nursing facilities, nursing homes, assisted living, receiving skilled nursing facility level care at home, intermediate care facilities like LTACH, and/or those in mental health institutions.

III. Dual-Eligible (D-SNPs and Medi-Medi): The last demographic that has tailored options for coverage are those that are Medicare AND Medicaid beneficiaries. Individuals that fall into being Dual Eligible have two broad options to pick from at the highest level, even before looking at the plan type they prefer, between an integrated Dual-Eligible Special Needs Plans (D-SNPs)  that seamlessly combines Medicare and Medicaid benefits under one unified plan or for two separate plans, one plan each for Medicare and Medicaid (Medi-Medi). Both D-SNPs and Medi-Medi plans work to coordinate care, but D-SNPs are much more rigid and have less flexibility when it comes to the providers one can see, require referrals to see specialists, have smaller networks, do not have out-of-network benefits, and operate similar to HMOs. Providers must accept both Medicare AND be contracted with their state’s Medicaid program to even apply to be an in-network provider for a D-SNP plan. These plans are great for those who need a seamless, all-in-one option and do not need care outside of their home state or county. Conversely, if someone needs more flexibility on what providers they see and where, travels for significant amounts of the year, or has providers out of state, selecting separate Medicare and Medicare plans offers the best of both worlds at the trade off of needing to understand how the separate plans work together and spending more time ensuring that both plans are accepted by the hospitals, clinics, and providers they seek. 

3. What kind of programs are available to help cover standard out-of-pocket costs and what are the eligibility requirements? There are two major avenues available to help people with their premiums, yearly deductibles, and even copays: 

A. The SSA has a federal program called Extra Help/Low Income Subsidy (LIS) that can lower or even eliminate Part D out-of -pocket costs in PDP and MAPD plans for those with limited income and financial resources. If an individual  receives SSI or qualifies for Medicaid, the SSA will automatically enroll the Medicare beneficiary into Extra Help. Additionally, a Medicare beneficiary can reach out to the SSA to apply for Extra Help over the telephone or on their website if they have not been automatically enrolled, but still meet the eligibility criteria. Extra Help is only.available to those living in one of the 50 states of the US, it is not available for residents of Puerto Rico, American Samoa, Guam, the Northern Mariana Islands, and the US Virgin Islands. Residents of these territories are encouraged to reach out to their local Health and Human Services/Medicaid offices to enquire about programs and aid for their unique territories

B. Medicare beneficiaries additionally may qualify for Medicaid based on the eligibility criteria for their state of residence. There are four different programs, each with different portions of out-of-pocket costs they will offset or eliminate and that have different means based eligibility, that are called Medicare Savings Programs (MSPs): 

I. Qualified Medicare Beneficiary (QMB) Program helps cover premiums for Parts A and B; deductibles, copays, and coinsurance for Part B; and enrollment into Extra Help for Part D out-of-pocket costs with a $0 yearly deductible and monthly premium, and no more than an $11.20 copay per prescription per month in 2024. Prescriptions considered excluded by Medicare like OTCs, vitamins and minerals, and nutritional supplements, are usually covered by Medicaid. Coverage for fertility, sexual dysfunction, hair-loss, cosmetic, weight management, and compounded drugs will vary from state to state. 

II. Specified Low-Income Medicare Beneficiary (SLMB) Program helps cover Part B premiums and enrollment into Extra Help for Part D out-of-pocket costs with a $0 yearly deductible and monthly premium, and no more than an $11.20 copay per prescription per month in 2024. Prescriptions considered excluded by Medicare like OTCs, vitamins and minerals, and nutritional supplements, are usually covered by Medicaid. Coverage for fertility, sexual dysfunction, hair-loss, cosmetic, weight management, and compounded drugs will vary from state to state.

III.  Qualifying Individual (QI) Program helps cover Part B premiums and enrollment into Extra Help for Part D out-of-pocket costs with a $0 yearly deductible and monthly premium, and no more than an $11.20 copay per prescription per month in 2024. Enrollment in the QI program is different than all the other MSPs as enrollment is based on a yearly basis, one must reapply every year to remain in the program, applications are approved on a first come, first served basis with priority given to individuals who were in the QI Program the year prior, and anyone who qualifies for Medicaid is automatically ineligible for the QI Program for that year. 

IV. Qualified Disabled & Working Individual (QDWI) Program helps cover Part A Premiums only for individuals that meet the income and resource requirements AND have a disability, are working, and lost SSDI and premium-free Medicare Part A because of returning to work.

Resources for understanding Medicare options, your rights, enrollment process, and laws: When choosing a Medicare plan it can be overwhelming trying to sort through what options are best suited for an individual’s level of care needed and their budget, even more so if an individual has any kind combination of Medicare, Medicaid, and Employer-sponsored benefits through a job, spouse’s employer, or family coverage. Medicare.gov has great tools to help narrow down what plans are offered in each area, provider and hospital search, and ways to find Part D coverage, but for those that find these online tools to be unintuitive, info overload, or downright confusing can additionally speak with a local insurance professional, the State Health Insurance Assistance Program (SHIP), or a social worker/case manager to assist in finding coverage options within budget, coverage that meets an individual’s needs or highest concerns, and can even help in understanding the nuances of Medicare and insurance laws and rights. Although “insurance agent” and “insurance broker” can be used interchangeably in conversation, there are distinct differences between these two types of licensed insurance professionals. Understanding the roles of Medicare insurance agents and brokers can help beneficiaries make informed decisions. Although both types of insurance professionals assist with selecting insurance plans, there are crucial differences between the two types. 

Medicare Insurance Agents: Medicare insurance agents are professionals who represent specific insurance companies and sell Medicare plans offered by those companies. Insurance agents can fall into two categories: captive agents, who work exclusively for one insurance company and sell only that company’s products; and independent agents, who represent multiple insurance companies but may have limited agreements with certain carriers. Insurance agents can provide detailed information about the plans they offer, including coverage, benefits, costs, and network details, help beneficiaries complete the enrollment process for the plans they represent, and offer ongoing support for issues related to the plans they sold.

Medicare Insurance Brokers: Medicare insurance brokers are independent professionals who work on behalf of the beneficiaries to find the best Medicare plans suited to their needs. Insurance brokers have access to a broad range of Medicare plans, including those from multiple insurance companies. This allows them to compare a wider array of options and find the most suitable plan for the beneficiary. Insurance brokers can offer comparisons across many plans from different insurers, highlighting differences in coverage, costs, benefits, and networks, provide tailored recommendations based on the beneficiary’s healthcare needs, preferences, and budget, help beneficiaries navigate the enrollment process for the chosen plan, provide continued support for any issues or questions related to the beneficiary’s Medicare coverage.

State Health Insurance Assistance Program (SHIP): The Administration for Community Living’s Office of Healthcare Information and Counseling (OHIC) oversees and manages SHIP programs at the state and local level. Each state has their own SHIP program and can offer different aid beyond assisting Medicare beneficiaries select the right coverage options like one-on-one assistance, counseling, and education for individual Medicare beneficiaries, their families, and caretakers. Each state’s SHIP is called a grantee, and across the US mainland, islands, and territories there are 54 total SHIP grantees consisting of over 2,200 local offices providing services at no cost to residents.

State Pharmaceutical Assistance Programs (SPAPs): Before the Medicare Modernization Act of 2006 (MMA) passed in Congress, states individually ran locally funded programs and initiatives to help at-risk and low income populations afford their prescriptions. While the passage of the MMA brought about Part D, it also added federal recognition and funding to SPAPs. CMS has outlined the criteria each state must meet to have their programs designated as “qualified SPAPs” to receive extra benefits like federal funding and grants and CMS support. Eligibility requirements, individual programs, and application processes can vary drastically from state to state.

Medicaid: Under the Affordable Care Act, federally-funded, state-administered health insurance plans with no premiums or copays are available to those with disabilities and other factors, with eligibility varying state to state. For the vast majority of states which have expanded Medicaid, individuals and households can also qualify if they have a household income between 133% to 185% below the Federal Poverty Level (FPL), depending on the state. Many states will also completely cover the cost of most prescription medications or charge a small nominal fee.

Children’s Health Insurance Program: CHIP is a targeted program to provide medical insurance coverage to children up to the age of 19 who would otherwise be uninsured due to their parents making too much money to be covered by Medicaid but too little money to afford a marketplace plan. Each state offers a CHIP plan, but has its own rules for qualification. CHIP is based on Modified Adjusted Gross Income (MAGI) and states vary from 101-400% of the Federal Poverty Level for upper limits of eligibility. 

Medicaid Personal Care Program: Through home and community-based services, the elderly and those with disabilities that require assistance with the Activities of Daily Living and Instrumental Activities of Daily Living can hire a personal aide to help them for a certain number of hours per month. The cost of the personal aide is covered by Medicaid. The purpose of these kinds of programs is to help individuals remain in their own homes and communities for as long as possible to avoid needing a long-term care facility. The personal aide can be someone initially unknown to the patient or, under self-directed programs, someone the patient selects themself; in many states, this can include friends and family members, though some states do have limitations on spouses and parents who are required to care for minor children. Regardless, the self-directed personal care program can be an excellent option, especially for those who can no longer work and want to provide some financial compensation for the labor their loved ones have been doing unpaid. It can also help relieve a mental weight of feeling like one shouldn’t ask for help when one needs it because they’re already doing so much for free, or feeling like one isn’t contributing at all, financially or otherwise, which can leave relationships becoming more and more disbalanced in the able-bodied person’s favor. 

Insurance Case Management: A health insurance case manager is a healthcare professional who works for the insurance company, usually a nurse. Their caseload consists of clients with more complex or chronic health issues or higher needs to ensure they are receiving necessary care; they keep track of appointments, help with appointment scheduling or transportation arrangement, provide connection to community services or social services, and coordinate continuity of care. Case managers are generally available at no-cost to patients.

Marketplace Health Insurance Subsidies: For those who have an income too high to qualify for Medicaid, there is an option that limits healthcare premiums to 0-8.5% of a person’s income. Generally these subsidies and tax credits are for households that earn between 100-400% of the federal poverty level; however, due to the American Rescue Plan and Inflation Reduction Act, the upper limit of these restrictions have been temporarily eliminated through 2025, unless those alterations are further extended. 

Medical Insurance Drug Formularies and Handbooks: Insurance companies provide formularies that detail which medications the policy will and will not cover, as well as which treatments, labs/studies, imaging, and procedures require prior authorization and which diagnoses, failed prior interventions, and other documentation is required for coverage under one’s specific policy; knowing where and how to find and read this information can cut out significant time when needing to find solutions to healthcare issues and only having access to certain doctors every few months or even more infrequently. These documents can be obtained in different formats, languages, and methods for accessibility. Being prepared in advance with what the insurance company requires to cover certain healthcare can prevent considerable frustration, wasted time, and potential bills that one may not be able to afford or necessary treatment being denied. 

Federally Qualified Health Centers: FQHCs are federally funded nonprofit clinics and hospitals that treat medically underserved populations with comprehensive services, including preventative care, dental care, mental health care, substance abuse services, specialty services, and the ability to arrange transportation to and from the clinic, as well as interpreters, if needed. These clinics accept Medicare and Medicaid and also operate on a sliding scale basis for cash pay, and they offer care regardless of one’s ability to pay. Many sliding scale clinics offer inclusive services for LGBTQ+ individuals and some specifically focus on that target demographic to ensure their healthcare needs are met in a respectful manner. To access the FQHC Government Database, please see the associated Database. 

Hospital Low-Income Assistance: Many hospitals (and in some states all hospitals) offer assistance and bill reduction to households that earn below certain income thresholds, whether or not they have insurance. There may be an application that needs to be requested from the hospital’s billing or financial assistance department to have the aid applied. In some cases, it can totally wipe out balances and in others, massive reductions in totals are seen. If one cannot afford to pay the total balance in a lump sum, getting on a payment plan to pay some amount on a regular basis will prevent the bill from going to collections and negatively impacting one’s credit score. If debt collectors are already in contact about a medical debt, they can be told about the application for financial aid and requested to pause their collection attempts while the application is going through the system. Medical debt under $500 is no longer reported on credit reports, and it now takes 12 months before unpaid medical debt over $500 is added to one’s credit report; they can remain for seven years from the original date of delinquency. 

University Therapists: If counseling with a certified professional is too expensive, an option to explore are university students studying to become therapists who need clinical hours to graduate. They often offer a significantly reduced hourly rate and need to have a supervisor to ensure they are following correct procedures and proper clinical practices. 

Patient Assistance Programs (PAPs): For those without insurance or who are underinsured and who cannot afford their medications, many pharmaceutical manufacturers offer PAPs for those who fall under their income limits and can provide financial aid to make medication and any needed services to administer the medication free or significantly reduced in price. While some application processes are straightforward, others receive criticism as being set up to be difficult for the user with obfuscated criteria. Healthcare teams often are required to sign paperwork and provide a valid prescription order. Manufacturer coupons and cards (MCCs) are a way to lower the cost of brand name drugs. MCCs help cover the cost of the patient’s responsibility as a copay or coinsurance. MCCs and PAPs are not available to be used in combination with government insurance, only private or commercial insurance. Those with government-funded plans still may qualify for certain PAP/MCC programs, but they will be required to sign a form or give a verbal statement that they will not be using their government-funded plan to cover any portion of the drug and/or administration fees for the PAP/MCC covered drug. 

Pharmacy Discount Cards: PDC, through sites like GoodRX, offer significant savings on prescription medications; however, all of these medications must be purchased out-of-pocket and often are not counted towards insurance deductibles later, though receipts can be submitted. These discount cards can be utilized as needed and may only make sense for certain prescriptions while the rest go through insurance; however, if insurance is denying coverage, it might be worth exploring what PDCs are available. 

The 340B Drug Pricing Program: 340B is a federal initiative in the United States designed to help healthcare providers serving vulnerable populations. It enables eligible healthcare organizations, known as “covered entities,” to purchase outpatient drugs at significantly reduced prices. This program, established under the Public Health Service Act and administered by the Health Resources and Services Administration (HRSA), aims to stretch scarce federal resources, allowing these organizations to provide more comprehensive services to underserved communities.

Healthcare providers that qualify for the 340B program include those serving a high volume of low-income or uninsured patients. Eligible entities typically encompass: Disproportionate Share Hospitals (DSHs); Federally Qualified Health Centers (FQHCs); Ryan White HIV/AIDS Program grantees; State AIDS Drug Assistance Programs (ADAPs); Family planning clinics; and Hemophilia treatment centers. These entities must register and undergo audits to remain eligible to participate in the 340B program. 

The program mandates that pharmaceutical manufacturers provide outpatient drugs to covered entities at significantly reduced prices, often 20-50% lower than the average wholesale price. These reductions allow patients who might otherwise be unable to afford their medications receive necessary treatment. Participation in the program enables healthcare providers to expand services, including mental health support, addiction treatment, and preventative care, thereby improving overall patient outcomes, and is essential for maintaining financial stability and continuing to serve their communities effectively.

The 340B program prohibits “duplicate discounts,” where both a 340B discount and a Medicaid rebate are claimed for the same drug. While this specifically addresses Medicaid, similar principles apply to avoid improper billing with Medicare, Marketplace, and Employer-sponsored insurance plans. When a patient with Medicare Part D coverage fills a prescription at a 340B pharmacy, the claim is processed through the Medicare Part D plan at the plan’s negotiated rates. Similarly, if a patient with employer-sponsored insurance fills a prescription at a 340B pharmacy, the claim is processed at the commercial rates negotiated between the employer-sponsored insurance plan and the pharmacy. The 340B discounted price is not applied to any of these transactions.

Cost Plus Drugs: This online pharmacy sells only generic medications. They tout transparent pricing and low costs, with manufacturing, a flat pharmacy dispensing fee, and flat shipping fees. Medications require prescriptions from a prescriber. Cost Plus Drugs accepts some insurances and is working to expand their in network status with various insurance plans. At this time they do not have any controlled substances or temperature sensitive drugs like some injectables, specialty drugs, and insulin. 

Transportation

Non-Emergency Medical Transportation (NEMT): A state-administered arm of medical transportation for those who are eligible for Medicaid, NEMT ensures that those who have no other way of getting to or from medical appointments or who would struggle to afford the costs of gas can still make it to their doctor’s visits. Whether that is through a curb-to-curb delivery, bus passes, train tickets, ferry funds, reimbursement for mileage, tolls, and parking, or gas vouchers, NEMT offers several ways to get to appointments. For long distance appointments, an overnight hotel stay may also be covered by the agency. Appointments do need to be reported in advance and gas vouchers are only valid at participating gas stations. Some NEMT centers may also provide expanded services to the broader community and not limit their services to Medicaid recipients only. NEMT centers will go by many names depending on location. Some states only offer one service provider while others have contracts with several providers or with ride sharing services like Uber or Lyft.

Paratransit: This specialized public bus service is for those with disabilities that prevents them from taking the fixed route bus lines; it provides curb-to-curb service for trips of any type, including shopping, getting to work or school or a religious service, visiting friends or family, going out for entertainment or public recreation, attending medical appointments, and many other services. Paratransit hours and service area reflect those of the fixed bus line routes. Efficiency is a priority, so scheduling in advance is required. Paratransit offers single use, monthly, or quarterly passes; eligibility for a paratransit pass may also qualify one for a free or discounted pass on the regular fixed bus lines. Elderly individuals may qualify for a free pass on both fixed and paratransit bus lines in certain areas. 

Demand-Responsive Transport: Commonly known as Dial-A-Ride, these services allow individuals who are unable to utilize standard public transportation to reschedule pick-ups and drop-offs via telephone, aiding in closing the gap for those with mobility challenges. This kind of transit may be restricted to those with permanent or long-term disabilities and the elderly. Curb-to-curb drop off like Paratransit is generally provided and there is often more flexibility than fixed line schedules. 

Rural Mobility: The Rural Public Transportation Systems provide mobility assistance to those who live away from cities and major metropolitan areas who often do not have access to fixed bus routes, helping them get to shopping centers, medical appointments, legal obligations, recreation, and the like via curb-to-curb service. This may be through a shuttle service, dial-a-ride, or volunteer transportation through local community action groups. These services are primarily for those with disabilities, those unable to operate a vehicle due to age or lack of a vehicle, and those with low-income. Reservations are usually required in advance.

Accessible Parking Passes: Disability parking placards and plates are available on a temporary or permanent basis. A person will need their medical provider to fill out a form from their state DMV/DOL, as well as write a prescription for them to take with that form to the state agency. The parking passes provide permission to utilize accessible parking nearer the entrances of buildings for less walking and weather exposure. Based on one’s location, they may also provide a timeframe of free parking at metered parking spots, waive fees to certain state or local parks, or provide the ability to get free or reduced bus passes.

Reduced Fare Transit Passes: Many cities and towns offer reduced fares and monthly passes for the elderly, disabled, students, youths, and veterans.

Work Accommodations

Americans with Disabilities Act: The ADA provides workplace protections for workers with physical or psychological limitations both while working and while job seeking; it requires employers to provide reasonable accommodations to qualified applicants or employees, so that the individual has an equal opportunity, can enjoy equal benefits and privileges of employment, and can perform they essential functions of the job successfully. However, the ADA does require documentation to be filled out by the individual’s doctor and submitted to their employer’s independent medical review board/agency for approval. Some employers may provide benefits traditionally covered under FMLA, like Intermittent leave for appointments, under an ADA accommodation for those who have not met the federal requirements to qualify for FMLA.

Family and Medical Leave Act: FMLA provides workplace protections for employees of public employers and private employers who have 50 or more employees within 75 miles. The employee has to have been employed for at least 12 months and worked at least 1,250 hours (about 25 hours a week) during that time. FMLA offers up to 12 weeks of unpaid leave with job protections during the course of a year for the employee or an immediate family member’s serious physical or mental health condition; the leave may be used all at once or intermittently. FMLA requires medical professional documentation and certification to be submitted similar to an ADA accommodation.

Department of Vocational Rehabilitation: The DVR offers assistance to those with physical, sensory, and/or mental disabilities who desire to work but struggle with barriers to maintaining sustained employment. The DVR provides individualized aid in job training, help finding employment, keeping a job, or advancing up the ladder, as well as developing community ties with employers who are disabled-employee-friendly. 

Social Security

Supplemental Security Income: SSI is a federal needs-based program to blind or disabled adults and children and those 65 or older with little or no income or resources/assets. SSI has strict criteria, with 61% of applications being denied by the end of the full appeal process. The resource/asset limit that a person can have without being penalized or disqualified from the program is very low, and at the time of writing it is $2,000 per individual and $3,000 per married couple; however, there are ways to protect some assets through entities like special needs trusts, ABLE accounts, and SSA standardized exceptions. 

Standard SSA resource exceptions include, but are not limited to:

• Your primary residence including the land it is on;
• Household goods and personal effects; 
• One vehicle, regardless of value, used for transportation (even if it is inoperable due to being in need of repairs; it may remain in this state for up to 12 months while still being covered by the exemption); 
• Property used in a trade or business used to self-support;
• Up to $6,000 of nonbusiness property which is essential to self-support; 
• Resources of a blind or disabled individual which are necessary to fulfill an approved plan to achieve self-support;
• Life insurance with a face value that does not exceed $1,500;
• Burial spaces and certain burial funds up to $1,500;
• Housing assistance, including Section 8 Housing Choice Vouchers;
• Grants, scholarships, fellowships, or gifts to be used for tuition or educational fees (for 9 months following month of receipt);
• Title XVI or title II retroactive payments (for 9 months following the month of receipt);
• Refunds of Federal income taxes and advances made by an employer relating to an earned income tax credit (for 12 months following the month of receipt);
• Refundable child tax credit (for 12 months following the month of receipt);
• Payments received as compensation for expenses incurred or losses suffered as a result of a crime (for 9 months following the month of receipt);
• Relocation assistance from a State or local government (for 9 months following the month of receipt);
• Payments made from State-provided pensions to aged, blind, or disabled veterans (or their spouses);
• Retroactive SSI or Social Security benefits for up to nine months after you receive them (including payments received in installments);
• Dedicated financial institution accounts for disabled children;
• Certain trusts (e.g., those established by will or certain Medicaid trusts that will repay the State, upon the death of the beneficiary, for the costs of medical assistance provided to that individual);
• Up to $100,000 of funds in an Achieving a Better Life Experience (ABLE) account established through a State ABLE program
• Money saved in an Individual Development Account (IDA)
• The first $20 of most income received in a month;
• The first $65 of earnings and one–half of earnings over $65 received in a month (though there is an upper limit to this amount that is updated yearly, and once earnings have reached or exceeded the monthly cap, cash benefits for the next month will be $0.);
• The value of Supplemental Nutrition Assistance Program (food stamps) received;
• Home energy assistance;
• Non-cash assistance based on need funded by a State or local government, or an Indian tribe;
• Small amounts of income received irregularly or infrequently;
• Food or shelter based on need provided by nonprofit agencies;
• Loans to you (cash or in–kind) that you have to repay;
• Money someone else spends to pay your expenses for items other than food or shelter (for example, someone pays your telephone or medical bills);
• Income set aside under a Plan to Achieve Self-Support (PASS)

Applying for SSI can be a confusing process, and many applicants benefit from a lawyer or a state facilitator to assist them through it. Most SSI lawyers work on contingency, meaning they will help the applicant through their case without payment, and the applicant will only owe the lawyer money if they win the case, which they will take as either a percentage or a flat rate from the back pay of the SSI retroactive payments. State facilitators are often paired with other state programs that provide interim cash assistance to those the state has screened and think will qualify for SSI; these are often known as some variation of Aged, Blind, and Disabled cash programs and there will likely also be a medical case worker as well to assist in making sure the applicant is attending their medical appointments. 

SSI is one of the most restrictive social support programs currently active, and it often requires utilization of multiple other programs in adjunct to be able to be able to live. The SSA office is more interested in what a person cannot do than what they can do. 

Social Security Disability Insurance: SSDI is a federal merit-based program that is organized by credits earned through earned income reported on yearly tax returns. While the monetary value per credit adjusts year to year, as of this writing, that number has never yet breached $2,000 per credit; refer to the SSA website for updated yearly income amount needed per credit. A person can earn up to a maximum of four credits per year. In most cases, workers need to have earned 40 credits over the course of their career with 20 of those credits in the last decade to qualify for SSDI. 

However, if a person becomes disabled at a younger age, the number of credits needed to qualify can be different and a recent work test and duration work test are added to allow for qualification. If a person becomes disabled before the age of 24, they may be eligible for SSDI if they have earned six credits in the three year period when their disability starts. For someone aged 24 to 31, take the age at which they became disabled, subtract 21, then divide the result by 2; that’s how many years of work credits are necessary to qualify, so multiply that number by 4 and that’s the total number of work credits that individual needs to be eligible. For a person who becomes disabled at 31 or older, they need at least 20 work credits in the preceding 10 years before their disability began to be eligible for SSDI. 

SSDI benefits are based on average lifetime earnings before becoming disabled. Certain other benefits, such as workers’ compensation, pensions, public disability, and continuing to work, can all reduce the monthly payments from SSDI.

Disabled Adult Child Benefits: In cases where a person had a disabling condition develop before age 22, preventing their ability to participate in Substantial Gainful Activity, the Adult Child can draw on their parent’s or legal guardian’s Social Security retirement or disability benefits after a parent/legal guardian begins to utilize them. Adult Children are entitled to draw from whichever parent has the higher payment, and may draw half from a living parent and three-quarters from a deceased parent; a parent’s own benefit amount is not impacted by their child receiving the DAC benefit. Until that point, the Adult Child may qualify for means-restricted SSI; however, neither SSDI or retirement funds have asset or resource limits associated with them. Being switched from SSI to a non-mean-tested payment also switches healthcare from Medicaid to Medicare after a 24-month waiting period, though it is generally permitted to remain on Medicaid during the waiting period and after, as it offers essential healthcare services. There are specific limitations on the Adult Child participating in Substantial Gainful Activity (which is a specific monthly dollar amount that is adjusted with each year) before their parent claims their Social Security funds. 

State Supplemental Payment Programs: Certain states offer additional monthly cash payments with state funds to those who have been approved for SSI, increasing the monthly income for those individuals. These programs need to be applied for and are not automatic. 

Aid for the Aged, Blind, and Disabled Programs: Some states offer an interim ABD/AABD program for individuals who are unable to work but who have not yet been approved for SSD/I. Applying for SSD/I is usually a requirement to participate in these programs, and the participant will likely be assigned to a SSI facilitator to help them through the application process and entire disability case, unless they prefer to obtain their own lawyer. If the individual is approved for SSD/I later, some states will perform a clawback from any awarded back pay of SSD/I to help cover the costs of running the program, essentially providing a 0% interest loan for the money they offer during the Social Security application period. Please note, each state that does clawback any funds from awarded back pay usually only pulls a set amount per month that is below what the monthly SSD/I benefit. ABD programs provide monthly cash to program participants to help cover some of the costs of living while waiting for their SSD/I application to be approved, which is the amount they are recovering. If the application is denied and all appeals are also denied, the state does not get any of their money back, just like a contingency-based lawyer would not get paid if they lost the case; if applying to an ABD program in one’s own state, do double check to ensure this is the correct understanding of state-specific policies and regulations. Some states continue to provide ABD funds after SSD/I approval. 

Finances

ABLE: Achieving a Better Life Experience accounts are special savings accounts that protect liquid resources from asset limitations and means testing that many programs have in order to qualify for benefits; resources in ABLE accounts are exempt from those asset restrictions up to the first $100,000. Earned income deposited directly into ABLE accounts is also tax exempt, and contributions can be made by any person or trust using post-tax dollars; however, there are annual limits on how much can be contributed, both as gifts from all individuals and as earned income by the account owner. ABLE accounts have investment options or can be used as a simple saving account. Some states have quarterly fees to maintain accounts. 

Money is permitted to be spent on “qualified disability expenses” which are any expenses related to the designated beneficiary as a result of living life with a disability, including education, food, housing, transportation, employment training and support, assistive technology, personal support services, health care expenses, financial management and administrative services and other expenses which help improve health, independence, and/or quality of life.

Before January 1, 2026, a person’s disability had to have begun before the individual was 26 years old to qualify for an ABLE account. After January 1, 2026, the onset of a person’s disability had to have begun before the individual was 46 years old, greatly expanding access to this critical kind of bank account. 

Special Needs Trust: SNTs provide an avenue for a grantor (a family member, friend, or someone else) to provide specific funds for a beneficiary (the disabled person) that is exempted from resource limitations of government programs like SSI and Medicaid because it does not belong to the disabled person. There is a trustee who manages the account (often the grantor or the beneficiary), and the trust can be stand-alone (accessible during the grantor’s life) or testamentary (accessible only after the grantor has died). SNTs can be self-filed or set up with the assistance of an estate lawyer to ensure everything is done properly. 

Pooled Trust: PTs offer a way to invest money and receive dividends without it being held against the resource limitation for government programs like SSI or Medicaid. If a person has resources above what they are permitted, an option to “spend down” is putting money, stocks, mutual funds, or some other less common assets into a pooled trust that will be managed by a non-profit organization. Each individual will receive their own sub-account and receive a proportionate share of the earnings of the entire fund. There are usually regular fees associated with this kind of trust.

Medicaid Asset Protection Trust: MAPTs are irrevocable trusts that can hold an unlimited value of assets, which are no longer owned by the individual and therefore protected from resource limitations and long-term care Medicaid Estate Recovery Program (MERP), which attempts to recoup some of the costs from a person’s estate after their death, including community- and home-based services. MERP is utilized for general Medicaid care for those over 55; do note, when it comes to long-term care, some states pursue estate recovery for state-funded services provided at any age.  A MAPT protects assets for a person’s loved ones from MERP; however, this is something that needs to be thought of in considerable advance so it doesn’t violate Medicaid’s look-back period, which is 60 months in most states. It is strongly recommended that an estate lawyer assist in creating a MAPT to ensure it is done properly and one’s assets are correctly protected from MERP. If a person is needing long-term or community-based care while over their state’s age limit for MERP in the near future before their look-back period will be over, a MAPT is probably not the path forward. 

Qualifying Income Trust: Also known as a Miller Trust, for those with income over the asset limit for Medicaid, a QIT may be allowed in some states as a way to be permitted to receive services. Income will be deposited into the account and the trustee will distribute it for certain qualified expenses, such as personal needs, a spouse’s living expenses, and any remaining funds cover medical expenses not paid for by Medicaid. When the individual dies, the state, as the listed beneficiary of the account, claims the remaining balance of the trust, up to the actual total paid by Medicaid. 

Credit Cards: When income is limited, credit card debt can rack up and be difficult to address, particularly if one has a high annual percentage rate (APR). Calling credit card companies to see if one qualifies for a promotional interest rate can help reduce the APR for up to a year at a time. Alternatively, most major credit companies offer hardship programs that reduce or eliminate interest for up to a year, waive late fees, and extend or suspend payments for a time. For those with a temporary lapse or significant reduction in income, a hardship program or promotional APR may be able to prevent a default, settlement, or bankruptcy from negatively impacting their credit history. 

For those with multiple credit cards with balances that are causing financial stress, a consolidation loan may be worth exploring to bundle them all into one monthly payment at a lower interest rate. Some lenders offer riders where for a small additional monthly fee should one lose employment, be unable to work for more than 30 days due to illness, or become permanently disabled, their minimum monthly payment is waived for as few as one month up to all the remaining payments on the loan. Another option to consider is debt settlement to pay off the balance for significantly less than owed, which can save one considerable funds but can negatively impact one’s credit score; original creditors typically expect 50-75% of the total debt, but may accept less. 

These are all options for those who may still be able to work part time, have worker’s compensation, receive social security payments, are the beneficiary of a trust, or otherwise are gifted money for their living expenses—those who have enough financial liquidity to pay off their debts in full eventually and just need some temporary breathing room or those who are willing to take the credit hit for a settlement if they have the resources to afford such an expenditure—and whose balances are small enough as to be practical for this approach.

Bankruptcy: For those who do not have enough financial liquidity to pay their debts eventually—the math just isn’t mathing—and whose balances not just for credit cards but for all debts are not small enough to be reasonable, practical, or manageable, for those who do not need some breathing room for a period but who are instead being crushed under the weight of their debt and their inability to repay it, there is bankruptcy. For individuals, there is Chapter 7 and Chapter 13. 

A Chapter 7 liquidation bankruptcy is a total discharge of debts with few exceptions such as alimony, child support, back taxes, and a few others; while federal student loans were broadly not allowed to be discharged, the Justice Department and Education Department have started taking a new approach and approving them under circumstances of undue hardship. It generally takes three to six months from filing to discharge. This is a means-tested method of debt relief intended for low-income households. Many items are able to be claimed as exempt and kept by the person(s) filing, but the specific codes vary by state; a household will have to choose whether they are using their state or the federal exemptions in their filing, depending on what better suits their circumstances. The belongings that are considered non-exempt (if there are any) will be put into the care of the bankruptcy trustee and sold to repay a portion of the owed debt before the remainder of the balance is discharged. The fees associated with filing for bankruptcy are often able to be waived for those who are unable to afford to pay. While many people hire a bankruptcy lawyer, particularly if they have complicated finances, there are bankruptcy specific non-profits like Upsolve that will walk a person through the process for free; it is also permissible to self-file. Chapter 7 remains on one’s credit report for 10 years, and it will cause a significant amount of damage at the beginning. Taking steps to repair one’s credit if one has filed for bankruptcy is important, particularly if there will be any apartment or house hunting in the following several years. A secured credit card with low utilization and on-time payments can assist in this endeavor. 

A Chapter 13 reorganization bankruptcy is a restructuring of payments to be able to catch up when one is severely behind on their bills, especially if their house is in the process of foreclosure. These types of bankruptcies allow filers to keep all their possessions. Bankruptcies put a halt to collection efforts from all creditors, including mortgage companies. The court has discretion in deciding which bills will be repaid in full, reduced, or discharged, though certain things like alimony, child support, and back taxes must always be paid in full.  Chapter 13 is a broader category that allows for higher income earners to utilize the process. It takes several months for the paperwork to process, but then takes an additional three to seven years for the repayments to be made. These payments are made directly to a bankruptcy trustee who will then distribute individual payments to individual creditors. During this time, regular mortgage payments must be made on-time. If the repayment plan becomes unmanageable during the years of repayment, it is the filer’s responsibility to inform the court so their plan can be modified; otherwise their case might be thrown out or converted to a Chapter 7 bankruptcy. Chapter 13 remains on one’s credit report for seven years, and it will cause a significant amount of damage at the beginning. However, the continuing history over multiple years of paying creditors on time will carry some of the weight of repairing one’s credit score as the rest of the reorganized payment plan is executed.  

Student Loans: Federal student loans offer several Income-Driven Repayment (IDR) plans, including the new SAVE plan. While each of these plans varies a bit from the next, broadly, they offer loan forgiveness after 10-25 years of repayment (and a monthly value owed of $0 based on income counts as a month of payment) and cap the monthly rate at 5-20% of discretionary income  (150%-225% of the Federal Poverty Level, depending on the selected IDR plan). For some federal loans to be eligible for IDR plans, they may need to be consolidated, whether that’s with all federal loans together or only bundling select loans together to qualify. Be aware that outside certain qualifying circumstances due to the Covid-19 National Emergency, consolidating federal loans will reset the monthly count for forgiveness. Loans in default are not eligible for IDR plans; for those who want to get on an IDR plan who currently defaulted, they will need to either rehabilitate or consolidate their loans to bring them back into good standing. The Fresh Start program can quickly bring defaulted federal student loans back into good standing, though this program is being phased out. Additionally, there are deferment and forbearance options. Discharge of federal student loans through bankruptcy has increased sharply in approval under undue hardship circumstances in recent years.

The Total and Permanent Disability (TPD) discharge program is a path for those with federal student loans to be relieved of the burden of repaying them due to an inability to maintain Substantial Gainful Activity. Individuals can apply themselves or authorize someone to apply on their behalf. They can have documentation certifying their disability from the VA, the SSA, or several kinds of medical professionals. There is a three year monitoring period for those approved via SSA and Physician Certification documentation, though those approved under VA certification are not subject to this process; while in the past this included income monitoring, as of July 1, 2023, rules changed and now discharged loans will only be reinstated if the applicant takes out new student loans during the monitoring period. The IRS considers TPD loans officially discharged at the end of the three year monitoring period, and it is during that year that the discharge may impact a household’s taxes, federally and in some states.

The new federal student loan forgiveness waiver program currently under review offers several avenues of discharge; the one most likely to be relevant to those with CRPS reading this list is the Hardship waiver for those at high risk of future default due to indicators such as high medical and caregiving expenses.

Private student loan creditors may offer discharge for those with a total and permanent disability. For short-term relief, deferment and forbearance may be available; refinancing at a lower interest rate or for a lower payment may be an option for those who can get approved for a new loan. As a last resort, one can seek discharge through bankruptcy.  

The private loan holder Navient has recently opened a pathway for loan forgiveness for borrowers who were defrauded by their schools. This program mirrors the federal Borrower Defense to Repayment program, but requires that the applicant submit supporting documentation. 

Mortgage: For those having difficulties making their house payments or falling behind on their mortgage, it is recommended to call one’s lender as soon as possible to discuss which options are available. Broadly, there are: 

• mortgage modifications, which adjust loan terms to make payments more manageable; 
• refinancing, if one has good credit, substantial equity, and can get a lower interest rate; 
• forbearance, which will significantly reduce or suspend payments for up to 12 months, though all those payments will be expected to be repaid; 
• a repayment plan, which will allow one to catch up on their missed payments or what accumulated during forbearance over several months; 
• selling the house for more than is owed, to pay the balance and keep the profit; 
• renting out a room, part of the home/property, or the entire home/property to keep up on the mortgage payments without losing the asset. Note that this could negatively impact one’s eligibility for benefits as it will not be exempt from resource limits if it is not a primary residence; 
• short sale, where the lender accepts less than is owed for settling the mortgage, though this often carries a negative credit impact, it is less damaging than a foreclosure; 
• deed in lieu of foreclosure, where the household vacates the home and all ownership claims to settle the mortgage debt, though this carries a negative credit impact, it is less damaging than a foreclosure and the lender may even offer a financial incentive, providing some capital to get settled in a new housing situation; 
• foreclosure, in which the lender claims the asset due to non-payment, and there is a significant credit impact which remains on the report for seven years.

Lawyers: For those who need assistance with worker’s compensation cases or applying for Social Security, many lawyers who specialize in those areas will work on a contingency basis, with their fee being up to a federal maximum of 25% or $7200, where they will only get paid if they win the case and their fee will come out of the winnings. 

Housing and Homeownership Loans

Essential Housing Programs: While these programs go by various names across different states, the core concept is housing assistance and essential need aid for unhoused individuals or those in Aged, Blind, and Disabled programs who are in the interim period of having applied for SSD/I but do not have the financial means to maintain housing in the meantime. Program eligibility varies by location and is usually time-limited. They will often cover up to a set amount monthly for rent and/or utilities and may also assist with covering move-in costs for the security deposit. 

Housing Choice Vouchers: Also known as Section 8, the HCV program assists the very low income, the disabled, and the elderly obtain housing that they otherwise would be unable to afford. It offers a wider range than the income-based housing listed below, as while it does also include the choice to live in apartments and townhomes, it includes access to single family homes. With the housing voucher, the tenant’s portion of rent is based on 30% of their household’s income and the government subsidizes the rest of the fair market rental rate. Housing choice vouchers need to be utilized for the first year in the public housing authority zone where the individual is called up from the waitlist, but after that—if the household wishes to move elsewhere—the voucher transfers with the household anywhere in the United States via a process called portability. If a person is willing and able, it may be easier to apply for a housing choice voucher in a less desirable area, live there for a year, and then move to a more preferred location, taking the housing voucher to the new housing location to continue to receive support. Housing size is based on household size. Caregivers who are separate tax entities are permitted to reside within the home and their income and assets will be exempt from program eligibility requirements and rent calculations; they need to be labeled as “live-in aides”. Live-in aides do not need to be paid professionals, though they certainly can be; they can be anyone who resides with the tenant to provide round-the-clock care and can be a family member or a friend and they may be uncompensated for the labor, assistance, and support they provide. There are likely to be required forms to fill out as to the aide being essential to the disabled person’s care and well-being. 

Supportive Housing for Persons with Disabilities: Also known as Section 811, the SHfPwD program assists extremely low-income, non-elderly people with physical disabilities or chronic mental health conditions live as independently as possible by providing funds to develop and subsidize housing for this target demographic; in a household of more than one person, at least one adult member must have a disability and household income must be at or below 30% of the area median income (AMI). Tenants pay about 30% of their adjusted monthly income towards rent and utilities and the remaining costs of operation are covered by the program. 

Supportive Housing for the Elderly: Also known as Section 202, the SHftE program assists very low-income seniors achieve housing security by providing funds to develop and subsidize housing for this demographic. At least one person in the household must be 62 years old at the time of initial occupancy and have 50% or less of the AMI to qualify. Tenants pay 30% of their adjusted monthly income towards rent and utilities with the remaining costs of operation being covered by the program. 

Income-Based Housing: These kinds of properties are subsidized by HUD and often have waitlists. Households can apply to as many properties/waitlists as they desire, but keep in mind that most require routine check-ins to maintain one’s spot on the list and keep one’s contact information up to date. Monthly rent paid by the tenant is based on 30% of the individual’s monthly income and can be as low as $0 a month if the person has no income; the remainder of the fair market value of rent will be covered by the government. Residence size is based on the number of individuals in the household. Live-in caregivers are permitted to reside in income-based properties also; however, the caregiver’s income and assets are not counted towards eligibility or rent mathematics, and the caregiver is generally not considered a standard tenant and is only permitted to reside in the domicile for so long as they are fulfilling their duties as a caregiver. Caregivers need to be listed on applications as “live-in aide” so that the administration can appropriately assign bedrooms and exempt assets and income. 

Income-Capped Housing: Apartment complexes that receive tax credits upon construction but do not receive on-going subsidies are called Low Income Housing Tax Credit (LIHTC) housing; complexes are required to set aside a certain percentage of units for earners who make under a certain percentage of the AMI. The tenant is responsible for paying the full value of rent. LIHTC apartments are often newer with a more spacious feel to them and they generally have little to no waits when compared to income-based housing.   

HUD Resource Locator Tool: The interactive HUD Resource Locator is a map of the United States with all HUD offices, Public Housing Authorities, assisted multifamily properties, low income housing tax credit properties, USDA rural housing, public housing buildings, public housing developments, and homeless services/CoC grantee areas listed. It includes the housing or development’s specific target service demographic, property information, management contact information, and total affordable units. 

Breaking Leases Due to Domestic Violence: In many cases, it is a tenant’s right to terminate a lease early if they are a victim of domestic violence, harassment, sexual assault, stalking, and other crimes by legally recognized household members. There are often several options of documentation that are permitted to be included with the written notice of termination to the landlord, including a copy of a protection order, a copy of a law enforcement agency report, or a copy of a written affidavit from a qualified third party, which often includes medical professionals, social workers, therapists, counselors, domestic violence agency employees, and clergy members. States have varying laws regarding what qualifies as DV crimes, specifics on who the perpetrator must be, and when a lease can be broken under the provision;  therefore it is imperative to speak with a local attorney, legal aid office, or the county DA office’s victim’s rights advocate to ensure the proper steps are taken.

Long-term Airbnb / Hotel / Motel Stays: For those who do not want to commit to a multi-month or year-long lease, who have credit issues, income limitations, long waitlists, or additional challenges with other options listed in this section, places that are generally considered for very short-term or even nightly stays often offer discounts for those who wish to stay for a weekly or monthly stint. These kinds of places do not do credit checks and income only matters in so much as they get paid. Places that advertise long-term stays or weekly rates are more likely to have systems in place for immediate housing locally. Places like Hamptons Inns, Fairfield Inns, and Extended Stay America can offer discounts to those with AARP, AAA, current military service members and families, veterans, and seniors. 

For those with pets, there are many pet-friendly locations; some may charge an additional fee, and some may not. For those with additional Emotional Support Animal documentation, hotels and motels are public areas and are not required to admit ESAs; some No Pet places may be willing to make an exception if one politely states their case, but don’t count on it; it is much more likely that pet-friendly locations will be willing to waive or reduce their pet fees for those with ESA documentation.

Airbnb does perform background checks periodically when booking. If there are any issues with Airbnb not permitting a stay or locking an account after a background check, it may be able to be resolved with customer service or additionally by booking the stay under a family or friend’s account if they will be staying at the reservation for any amount of time. Many Hosts offer automatic discounts for areas that allow stays longer than 28 days, and one may also get an additional discount by messaging the host and politely explaining the intended length of stay with any possible extensions. Most of these hosts are happy to block off their listing for any anticipated but not set in stone extensions as long as it is discussed before booking. If looking at an area that has high rates, expand the search to include areas further away from the city center like outer suburbs or the edge of rural areas for lower rates and listings that can accommodate multi-week/multi-months stays.

USDA Loans: This pathway offers a zero down payment and low interest rate option to homeownership with the ability to extend the mortgage term and closing costs can be rolled into the mortgage; the target demographic is very-low to moderate income earners buying their first home. The USDA offers three major subtypes of loans: Direct loans, Loan guarantees, and Home improvement loans and grants. 

The Section 502 Guaranteed and Direct loans are only for qualifying rural areas (which actually covers a much wider swathe than one might think!), defined as “open country or any town, village, city, or place, including the immediately adjacent densely settled area, which is not part of or associated with an urban area.” 

The Section 502 Guaranteed loan has more leeway for higher income earners, with allowances up to 115% AMI. 

The Section 502 Direct loan is for very low and low income earners—below 50% and 80% AMI, respectively—without safe, decent, and sanitary housing; those who qualify can purchase, build, rehabilitate, improve or relocate a dwelling in an eligible rural area.

The Section 504 Home Repair Loan and Grant program is targeted at low income individuals aged 62 and over to fix hazards at home. The loans are capped at $40,000 and the grants are capped at $10,000; however, they can be combined for a total of $50,000. The loans can have up to a 20 year term and are locked at a 1% fixed interest rate. 

FHA 203(B) Loan: This pathway offers a 3.5% down payment option to homeownership with a 15 or 30 year term and closing costs can be rolled into the mortgage; the target demographic are those seeking a primary residence without the funds for a large down payment and with a lower than average credit score.

FHA 203(k) Loan: Also known as a rehab loan or a renovation loan, this pathway offers a way for new or existing homeowners to mortgage significant repairs into the purchase price of the property or for less costly renovations, known as standard or limited mortgages, respectively. Projects must start within 30 days of closing and be completed within six months. 

HUD Manufactured Home and Lot Loans: Under Title I, Section 2, this program helps provide a pathway to new or used manufactured home ownership at a lower interest rate, longer termed mortgage than traditional loans where manufactured homes are considered personal property. Borrowers may also purchase a lot of land on which to place their home, up to a certain dollar amount, though this is not required and if the borrower prefers to lease a land lot instead, they may do so as long as the lot complies with FHA requirements. Maximum loan limits are: $69,678 and 20 years for a manufactured home only; $23,226 and 15 years for a lot only; and $92,904 and 25 years for a manufactured home and lot combination. 

HUD Home Equity Conversion Mortgage: Also known as a reverse mortgage, this loan can be utilized by those 62 and older who own their primary residence outright or have a small remaining balance on their mortgage. For those who meet the requirements of this program, the HECM can allow the borrower to withdraw some of their home equity as liquid income to pay for home repairs, medical expenses, living costs, or other things they decide to spend that money on while continuing to live at home. 

Fannie Mae HomeReady Mortgage: This pathway offers a 3% down payment option to homeownership and down payment funds are permitted to come from multiple sources, including gifts and grants. This loan program is oriented towards first-time buyers and those seeking to downsize with lower income and lower credit scores. Mortgage insurance is eligible to be removed after paying off 20% of the mortgage. A unique aspect of this program is the ability of long-term housemates or co-renters to transition to a live-in tenant situation and have the tenant rental income count towards the mortgage calculation, even though the tenant will not be on the mortgage itself. Tenant rental income may not account for more than 30% of the total loan holder income; however, this option may offer more flexibility for disabled individuals without the ability to qualify for a mortgage on their own. 

Freddie Mac HomePossible Mortgage: This program offers a 3% down payments option; down payment funds are permitted to come from gifts, grants, and other sources. This pathway is oriented towards very low- to low-income borrowers, and mortgage insurance is eligible to be removed after paying down 20% of the loan. Non-occupant co-borrowers are allowed to assist those who otherwise would not qualify on their own. Long-term housemates who desire to transition to a live-in broader situation are allowed to count the tenant rental income towards the mortgage calculation, though the tenant will not be on the mortgage itself and the rental income may not account for more than 30% of the loan holder’s income. 

Family Opportunity Mortgage: While this official name has been discontinued, the program components continue through conventional mortgages under Fannie Mae. Family Opportunity loans allow for parents of disabled adult children or adult children of elderly and/or disabled parents who are low income and/or unable to maintain steady employment and therefore unable to qualify for a mortgage on their own purchasing power to buy a second home for that family member while being listed as a owner-occupant without being required to live there as a primary residence and maintaining the financial benefits of owner-occupied financing, such as lower down payments, interest rates, and property taxes, as well as mortgage interest and property tax being tax deductible. There is not a distance restriction limiting how far the family member may be from the mortgage holder’s actual residence; however, the mortgage holder must be able to afford both their own monthly housing expenses and the monthly mortgage of the Family Opportunity loan, in addition to any other debt they carry, for which lending institutions generally prefer a 45-50% debt-to-income ratio for this situation.  

Co-operative / Commune / Co-ownership: For those who prefer a more communal approach to housing, there are several options available that allow individuals to pool resources with others of a similar mindset. This offers the ability to have a private space for personal use as well as common areas that are maintained and accessible by all. These pathways require careful planning and selecting living partners who mutually agree to certain standards to prevent growing resentment and hostility; having a written agreement and perhaps even meeting with an attorney can be a good idea to keep everything clear for all parties. While manual underwriting of mortgages technically has no limitation on the number of borrowers, automated underwriting generally limits to four or five borrowers, depending on the lender. The borrowers can be blood related, married, partnered, in a business relationship, or simply friends—being family is not required to take a mortgage out with another person or people, though one should select carefully as there will now be a long-term financial obligation with them. The lowest credit score of the group will be utilized to set the interest rate. The two primary ways of co-ownership through a standard mortgage are: joint tenancy, in which ownership shares are divided equally, each owner can sell their share without permission from the other shareholders, and when one owner passes away, their share is divided equally among the remaining owners; and tenancy in common, in which ownership shares are divided proportionally based on property investment, owners may not sell their share without permission from all other shareholders, and each owner may select their own beneficiary to inherit their share upon their death. 

Veterans Affairs Specially Adapted Housing Grants: CRPS has a long-standing history of being a soldier’s disorder; the US Department of Veterans Affairs offers three different kinds of housing grants intended to make homes more liveable, accessible, and independence-friendly for service members who received permanent and totally disabling, service-connected injuries. These grants are the Specially Adapted Housing Grant, the Special Housing Adaptation Grant, and the Temporary Residence Adaptation Grant. The grant amounts can vary with each fiscal year.

These grants can be used to build a new home or remodel an existing home for accommodations needed to make the dwelling safer, more accessible, or able to provide more independence for the disabled veteran. The SAH and SHA grants are intended for homes that will be the veteran’s permanent primary residence, whether owned by the service member or their family member; these two grants do not need to be utilized all at once and can be broken up into six different uses throughout the veteran’s lifetime. The TRA grant is intended for service members temporarily residing in a dwelling not owned by the resident that needs modifications for better accessibility; this grant needs to be utilized within one year of approval. 

Another option available for veterans is the Home Improvement and Structural Alterations Grant to make permanent interior alterations to the veteran’s primary residence. This grant has funding available for service members with both service-connected and non-service-connected conditions, though there are different maximum grant limits depending on how much of one’s disability is related to one’s service.

Homes for Our Troops: HFOT is a nonprofit organization oriented towards severely injured, post-9/11 veterans who qualify for Specially Adapted Housing grants through the VA. HFOT serves all branches of the military and builds brand-new specially adapted homes at no-cost to the veteran and with no mortgage for the veteran to pay. HFOT does not provide remodels or rehabilitation services at this time, and the building process generally takes about two to four years. The veteran is involved in the selection process of where the home will be built.

Habitat for Humanity: HFH is a nonprofit organization that assists with building and improving access to affordable housing, with a foundational concept of sweat equity—whether on the construction site, in HFH ReStores, assisting with administrative tasks or food preparation, taking homeownership classes, or other options—as a core component for those without the financial liquidity to take the route of a traditional mortgage. HFH does have a financial component as well, and requires applicants who are both in need of better housing and able to pay an affordable mortgage. HFH is non-discriminatory and LGBTQ+-friendly.

Rebuilding Together: RT is a nonprofit organization that assists with repairing or remodeling existing homes for families, older adults, those with disabilities, and disaster survivors. There are local chapters all across the nation that work year-round to help improve their communities and the lives of the households that they impact. Common repairs RT accomplishes are: bathroom modifications, roof repairs, HVAC systems, doors and windows, interior and exterior painting, yard work, mold remediation, fire safety prevention, and installation of wheelchair ramps. 

Tax Lien Sale: When individuals become very delinquent on their property taxes, the county government will put the property up for auction to recoup what they are owed. If the current owner(s) can come up with the funds to pay their debt, the property is removed from the auction line up; however, if they cannot, the property is sold to the highest bidder. Any secondary liens, such as a mortgage, are wiped off the record by the county to offer the new owner a free and clear deed for the price of the auction bid. The new owner will be responsible for property taxes at that address going forward. 

Land: An alternate route is purchasing a plot of undeveloped or semi-developed land and developing it more over time, but having a place of one’s own to utilize in the meantime. Checking local ordinances, codes, and bylaws, as well as permitting requirements and how strict the county is in enforcing those regulations, will be necessary. If one cannot get approved for a traditional mortgage or a bundled land and construction loan, the likelihood of getting approved for a land loan through a bank is low, as it is the house that carries most of the value to the bank. There are hard money lenders, which often are willing to take riskier loans at higher interest rates; there are owner-held mortgages, which involve buying directly from the prior owner and often involve a significant down payment; there is buying the land outright. There are multiple websites that focus specifically on selling land and acreage without housing on it that are not the traditional MLS web pages. Knowing whether the land already has electricity, internet, water, and waste/septic can impact the price significantly, as otherwise the person living there will need to install those rather expensive utilities at their own expense or find another way forward.  

For those on SSI, the SSA does not consider payment of land lot rent or mortgage that does not include the cost of an actual residence (bring one’s own domicile) to be considered in-kind support or maintenance. If a friend or family member is paying one’s lot rent or mortgage, while the disabled individual owns or pays the loan for their own trailer or manufactured home, that is perfectly acceptable to the SSA without any reduction to the disabled person’s SSI. If the friend or family member pays for essential things that come into the home—like electricity, water, sewer, or gas—that would be considered in-kind support and maintenance and could impact SSI payments. If the disabled person pays those essential sheltering costs, the SSA has no issues. For further information, see the SSA POMS SI 00835.465.D.4 on ISM and Households – Household Costs – Use of Land linked in the Database or available online.

Facilities

For those who no longer feel that they are able to live independently or remain in their home with the support of an in-home personal care program, there are several options of residential care for those with higher support needs. While most of these options are usually oriented at seniors, younger individuals are also able to utilize these residential facilities, though they may have more limited choices due to their age. These facilities can be paid for via private insurance, self-pay, or Medicaid’s long-term care program.

Assisted Living Facility: ALFs offer apartment-style living with communal spaces, dining rooms, social events, basic medical monitoring, and assistance with Activities of Daily Living, like dressing, bathing, eating, and cleaning. Residents can leave the facility during the day to attend to personal tasks, medical appointments, social events, and similar occasions; facilities often provide additional amenities for stimulation and socialization. ALFs offer the most independence and autonomy of long-term residential care, but are often not the best setting for those who need more complex and intensive medical intervention.

Residential and Group Care Homes: GCHs offer a similar level of care as assistive living facilities, but in a more intimate setting with fewer residents. GCHs provide aid with housekeeping, laundry, meals, and personal care needs like dressing and bathing. They often do not provide the same access to on-site medical care as any of the other types of facilities due to their small size, and the available level of medical care can vary from location to location. Because there are fewer residents in GCHs, there are often more interactions between staff and residents in group homes than in assisted living facilities. Though group homes also offer less social interactions with other residents and additional facility perks such as a spa or on-site shopping, GCHs do host activities and social events for their residents. While GCHs do not offer round-the-clock nursing care, staff is available 24 hours a day to provide supervision to residents and assistance if necessary.  

Continuing Care Retirement Community: CCRCs offer the full range of residential living—from independent to skilled nursing and memory care—all on one campus; this prevents residents from having to make multiple stressful moves to different environments and making new connections with staff and other residents as they require different levels of care as their health declines or improves over time. Many who choose CCRCs select a “life plan” which keeps their monthly rate steady, despite whichever level of care they need at the time, adjusting only yearly for inflation. These communities often have age restrictions and a wide range of amenities, programs, and social activities.

Nursing Homes: NHs offer round-the-clock medical care in a much more clinical setting than assisted living facilities. There is considerably more structure and less autonomy in NH environments, and meals are provided on a more regulated and monitored basis. Residents are still provided assistance with Activities of Daily Living, more comprehensive medical care than an assisted living facility, and may take day trips or short vacations away from the NH. For those with extremely complex care needs, there are Skilled Nursing Facilities.

Long Term Acute Care Hospital: LTACHs are round-the-clock care rehabilitation centers generally focused on shorter-term stays after a hospital stay due to a major medical event or complex health conditions that require intensive intervention. These facilities incorporate multiple therapeutic specialities—like physical therapy, occupational therapy, speech therapy, and wound care, among others—into one location for high-quality patient care. In most cases after the rehabilitation period, patients are either discharged home or sent to a long-term care facility.

Parks Passes

National Pass: The America the Beautiful National Parks and Federal Recreational Lands Access Pass is a free, lifetime pass for permanently disabled American citizens and permanent residents whose disability severely limits one or more major life activities. It provides free admittance and parking to the pass holder and up to three additional adults in fee areas of parks under the care of the National Park Service, U.S. Department of Agriculture – Forest Service, Fish and Wildlife Service, Bureau of Land Management, and Bureau of Reclamation. The Access Pass also provides a 50% discount on amenity fees such as camping, boat launches, and interpretive services; these additional benefits are limited to the pass holder. 

State Passes: Many states offer some sort of discount for state park access passes to disabled residents. Benefits and eligibility requirements vary by state. They may waive or offer reduced parking, camping, moorage, and boat launch fees. 

Amusement Parks: Access Passes for those with disabilities may be available at multiple amusement parks, even if they are not prominently advertised. These passes may provide discounts on park rates or offer accommodations, such as fast tracking in lines. 

Thousand Trails: While Thousand Trails does not offer a disability discount, for those who like to camp often, whether in RVs or cabins, the annual camping pass provides a reasonable rate to access over 200 campgrounds across the nation in five mix-n-match regions. 

Food

Fruit and Vegetable Prescription Programs: Doctor’s offices—particularly those that focus on serving low-income patients—may participate in a program where a provider can write a prescription for a patient that offers monthly vouchers for fruits and vegetables to supplement nutritional needs. While specific limitations may vary program to program, vouchers often cover fresh, canned, and frozen fruits and vegetables. 

Double Up Food Bucks: DUFB and other SNAP benefit doubling programs are nonprofit programs across the country intended to help food stamp recipients increase their intake of fresh fruits and vegetables while also boosting local commerce at farmer’s markets. For each dollar spent, another dollar is offered for free, up to a certain daily limit, which varies market to market. Some grocery stores and convenience stores also participate in Double Up programs. 

Food Banks: Local food banks rely on residents utilizing their services to continue receiving their grant funding. Food bank and/or pantry quality and quantity can vary from one to the next; some have income restrictions and some do not, while some require personal information forms and some do not. Food banks can greatly supplement a household’s food supply and keep a person or family with full bellies instead of empty ones. For a non-comprehensive list of national food banks, see the associated Database, call 211, or google what’s available in the local area. 

TooGoodToGo: An app oriented around reducing food waste from restaurants allows people to purchase the day’s leftovers at a steep discount rather than being thrown out. While this app is still being rolled out in the US, more companies are joining, so if it isn’t available in one’s own area yet, check back in a while. 

Cashback Coupon Apps: Apps to get digital coupons, offers, and points for cashback on primarily food and grocery store items, such as Ibotta, Fetch, Shopkick, Receipt Hog, and Checkout 51, among others.

Supplementary Meal Pick-up and Delivery Programs: Some services offer meal delivery to an individual’s home, addressing hunger, isolation, and sometimes additional needs for the elderly and disabled from organizations such as Meals on Wheels and Lasagna Love; some of these are paid for with community donations and sometimes health insurance can assist in covering the cost. Meal Exchanges are for college students who are able to exchange dining room meals from their campus meal plan for specific items from specific restaurants, in accordance with their school’s policy and their specific meal plan. 

Religious Non-Profit Programs

Catholic Charities: CC offers assistance with food pantries, group dining, home food delivery, case management, counseling, behavioral health, job training, day programs, companion programs, caregiver support, emergency housing, temporary housing, and long-term supportive housing, adoption and fostering, among other programs. CC is one of the nation’s largest affordable housing providers, offering aid to those with low income, the elderly, the disabled, and the chronically homeless. 

Saint Vincent de Paul’s: SVdP may offer assistance with food provision, group dining, thrift stores, warming centers, job training, case management, rental and utility assistance, homelessness programs, rapid rehousing, supportive housing, low income housing, and veteran’s services, among other programs. 

Lutheran Family Services: Depending on location, LFS can assist with counseling and mental health services, housing assistance, medication management, supported employment and employment assistance, collaborative home services, relief nursery, adoption and fostering, and anger management courses, among other programs. 

United Methodist Church Family Services: Slightly different names in different locations, the UMC may be able to offer assistance with case management, homelessness, those with physical, mental, or psychological disabilities, psychiatry, out-patient mental health counseling, and at-home treatment, adoption and fostering, among other programs. Among various Christian denominations, the United Methodists are some of the most LGBTQ+ welcoming; in the Methodist schism over LGBT acceptance, the anti-LGBT wing now goes by the Global Methodist Church.  

Salvation Army: The Salvation Army may offer assistance with food assistance, aging services, homeless shelters, transitional housing, permanent supportive housing, domestic violence, rent/mortgage/utility assistance, job training, veterans services, LGBTQ+ support, after school programs, and summer camps, among other programs. The Salvation Army website claims that each of their shelters and housing services are specifically open to LGBTQ+ individuals, and that they pay particular care to LGBT youth, who make up the majority of LGBT homeless individuals. 

Jewish Family Service: Depending on location, JFS can assist with emergency services (rental assistance, emergency housing, bus tickets, food vouchers, counseling stipends, and case management) and the food bank program, adult and aging services and home care associates, family life education, clinical counseling, youth and children’s services, association for Jews with disabilities, vocational guidance, and adoption and fostering, along with other programs.

Sikh Temples: Sikhs regularly offer free meals open to all after their temple services. 

Muslim Centers: Muslim community centers may offer aid with food banks, rental and utility assistance, senior services, shelter for homeless individuals, and medical clinic assistance, among other programs. 

Local Religious Centers: Area- or religion-specific religious organizations may offer more resources to their communities. Quite a few of the religious organizations additionally provide services for those of a different denomination openly while others may require a referral or interview upon request.

Other Resources

Menstrual Products: The recurrent expense of menstrual products can add up. There are several reusable options, including cups, discs, sponges, cloth pads, and absorbent period underwear, that can be cleaned and used for years. The cups and discs often hold several times more than tampons and take considerably less space when they need to be stored; they are made with medical-grade silicone. There are also organizations that donate menstrual supplies to those in need, including The Alliance for Period Supplies, Access Period, Helping Women Period, and She Supply. A local health department, health advocacy organization, Planned Parenthood, libraries, religious centers, or larger food pantries may also have menstrual products available at no cost.

Pet Parasite Prevention: For those with canine companions, a regular expense is a heartworm and other internal parasite preventative, such as Heartgard or Trifexis. The main active ingredient in these medications is the dewormer Ivermectin. For those that prefer to buy Ivermectin directly, cattle/bovine and swine injectable 1% sterile solution or an 0.08% sheep drench can be given ORALLY, though proper decimal and conversion math is required to use the appropriate amount. In standard tablet form canine internal parasite prevention, Ivermectin is dosed at 0.0015 – 0.003 mg per pound (or 1.5 – 3 mcg per pound); see the Database or online resources for more detail. Some dogs are more sensitive to drugs including Ivermectin due the MDR1 gene mutation, such as collies and sheepdogs, and require a low dose. 

In standard preventative tablets, felines are recommended to be dosed at 0.012 mg per pound (or 12 micrograms per pound). In a 1% solution, every 0.1 mL contains 1 mg (or 1000 mcg) of Ivermectin. Properly dosing cats and small dogs can be extremely challenging, and it is very important that toxic doses not be administered, especially as this drug builds up in the body over time if given in excess. Ivermectin is a neurotoxin if it is overdosed, and toxicity has been reported in cats as low as 0.1 mg (100 micrograms) per pound and in dogs at 0.9 mg (900 micrograms) per pound, though dogs with the MDR1 mutation sensitivity can be affected by toxicosis at 0.04 mg (40 micrograms) per pound. A 1cc insulin syringe will have the clearest and smallest demarcations of measurement. Confirm with a veterinarian to ensure this pathway is appropriately enacted for the pet and they are protected, not harmed, by these cost-saving measures. 

Ivermectin is not effective for flea and tick prevention. 

Pet Vaccinations and Spay/Neuter: Many local animal non-profits offer low-cost spay and neuter clinics for cats and dogs. Prices are often weight-based and may include additional charges if additional steps need to be taken for more complicated surgeries.

These same low cost clinics often double as vaccination clinics, though they do not provide standard veterinary services. Many pet stores will have traveling vaccination clinics on a regular basis. For those who feel comfortable administering vaccinations themselves, many pet supply and feed stores (such as Tractor Supply Co or North 40) offer an array of vaccines—except for rabies, which must be administered by someone with state licensure—and this is generally the most cost effective way, though proper record keeping is important, particularly if boarding or doggie daycares are going to be utilized.

Temporary Pet Fostering: For those who do not wish to or cannot bring their pets with them into homelessness or who need to temporarily rehome their pet(s) while they recover from an injury, illness, or surgery and are unable to provide needed care to their animals, or are escaping domestic violence, some shelters and animal non-profits offer short-term animal fostering for households in difficult situations, offering them time to become more stable before welcoming their pet back into their family.

Homeless Pet Food and Vet Care: For others, the thought of temporarily releasing one’s pet is unbearable or there may not be a fostering program available in one’s local area. In these cases, there are often non-profit groups that work in partnership with local veterinarians to provide free or greatly reduced emergency services to the pets of homeless individuals. Many local areas also offer food banks for pets for those owners who are struggling to purchase enough; some organizations may limit this program to homeless individuals while others have broader thresholds that welcome low-income, housed individuals and their furry family. 

Goodwill Outlet: As opposed to traditional Goodwill stores, Outlet stores or “the bins” are where things are sold by the weight or where they are more open to offers. Things are generally significantly cheaper here than at traditional Goodwills, though they are often more disorganized and require digging through the bins to find fantastic items for pennies on the dollar. 

Auction Services: Whether online or in-person, auction houses can offer a pennies on the dollar return on goods, and often items for auction are government surplus, repossessed or seized property, or donated belongings, in operable or useable condition—though there are damaged goods to be on the lookout for, whether that is mechanical, structural, or cosmetic damage. Sites like Bid4Assets, Proxibid, and Copart all offer electronic bidding. 

RSDSA: Looking for a CRPS-informed doctor in the area or an additional support group? The RSDSA is a 501(c)3 not-for-profit organization with 40 years of experience providing support, education, and hope to all affected by CRPS, as well as their caretakers, loved ones, and families.

Emancipation of Minors: Under most circumstances, remaining under a parent’s protection and care until legal adulthood is the best course of action. However, this is not always the case and in some situations it is safer and healthier for the minor to extricate themselves from an abusive or severely neglectful environment or relationship. For those with CRPS, this can be a particular concern when being denied necessary medical care, repeatedly physically pushed far beyond one’s limits or being physically abused, or chronic sympathetic activation that flares and further entrenches CRPS symptoms through emotional or psychological abuse. Legal requirements for emancipation varies across states, but the courts often consider whether emancipation best serves the minor’s interests and ask for evidence regarding financial sufficiency, if stable living arrangements have been made, if one is currently enrolled in school or has completed high school education, and one’s circumstances and maturity. After being emancipated, a minor is responsible for their own living expenses, signing their own contracts, paying for and preparing their own food, and paying for and obtaining their own healthcare. They are also able to apply for public benefits and social services without their parents’ knowledge, participation, or financial information. 

Interpersonal Violence: Many people may recognize the signs of a physically or sexually aggressive and intimidating relationship and correctly label it as abusive; however, there are several other kinds of abuse that are just as damaging that do not ever require physical contact. In fact, non-physical and non-sexual abuse can take even longer to heal from emotionally and psychologically because there was no flesh wound to validate the harm. While psychological abuse (such as verbal and emotional abuse, shaming, humiliation, gaslighting, ostracization, belittling, threatening, degrading, ignoring, ridiculing, and the silent treatment, among other behaviors including financial abuse, emotional incest, codependency, and enmeshment) is growing in cultural awareness, some may think it is not as severe as an issue as physical abuse because it leaves behind no marks and no scars; however, this is incorrect. The primary place where the visible marks and scars are left is in brain matter, neurological structuring, and demyelination of neurons; while this is invisible to the naked eye, it is very clear to current fMRI technology. Imaging studies reveal that those who have experienced psychological abuse, as well as those who have experienced physical abuse, can have brain trauma on par with combat veterans.

Acts of physical aggression are often long down the road of a well-established abusive relationship, and some extremely abusive, coercive, and cruel relationships may never have a physical component. Abuse and abusive people center around control, power, and exploitation; this has a tendency to increase in intensity slowly over time during the development of a relationship. This can be particularly true in situations where one partner is especially vulnerable due to financial instability, a disabling health condition, leaving an abusive childhood family or partner, or many other circumstances. 

Having CRPS can create a situation where someone who once was considerably more able to protect and provide for themselves has been forced into a context where they are incredibly vulnerable to being taken advantage of, dominated, coerced, controlled, and/or manipulated by those around them and becoming significantly and increasingly dependent on those people due to a lack of alternatives. This can lead to a severe power imbalance in interpersonal relationships, even in those that are genuinely loving, respectful, and grounded in human dignity and mutual equality, but especially in those that are not. Unless all parties, particularly the non-CRPS individuals, are very mindful of the power dynamics and enthusiastic consent versus coercive control within the relationship, they can quickly become unhealthy, toxic, and even abusive due to the significantly reduced autonomy and access that the person with CRPS now has. This reduction of freedom and empowerment due to CRPS is not, in most cases, the fault of a partner or parent, but it is their responsibility as someone who holds significant leverage and who should be loving and supportive to not further restrict autonomy and freedom and to be a force of empowerment and increased access where possible. 

CRPS creates high stress for everyone involved: the person who has it, their loved ones, and close contacts. It is a condition that specifically affects the sympathetic nervous system’s defensive “fight or flight” function, and it can leave people extra irritable, anxious, and even have serious difficulty navigating complex decision making. Sometimes people who are not abusers can behave in ways that are inappropriate, unjust, and not respectful or loving, especially under high stress conditions. When this happens it is important to self-reflect, take responsibility for one’s own actions, genuinely apologize, and work towards preventing such behaviors from repeating themselves. 

However, it is also important to know how to spot the difference between someone having a bad day that is out of character and the mask of an abuser slipping to reveal their true character. In Why Does He Do That?, Lundy Bancroft has an excellent section that covers this topic well:

“It is true that almost everyone yells at one point or another in a relationship, and most people, male or female, call their partner a name from time to time, interrupt, or act selfish or insensitive. These behaviors are hurtful and worthy of criticism, but they aren’t all abuse, and they don’t all have the same psychological effects that abuse does. At the same time, all of these behaviors are abusive when they are part of a pattern of abuse. Being yelled at by a respectful partner feels bad, but it doesn’t cause the same chilled, ugly atmosphere that an abuser’s yells do.

The term abuse is about power; it means that a person is taking advantage of a power imbalance to exploit or control someone else. Wherever power imbalances exist, [. . .] some people will take advantage of those circumstances for their own purposes. [. . .] Thus the defining point of abuse is when [one person] starts to exercise power over [another person] in a way that causes harm to [the latter] and creates a privileged status for [the former].”

Hierarchy is about power and who has it and why. It is about the relationship of power between people—specifically about an imbalance of power. 

When one person holds more power than another—whether or not this power is lorded over or exploited or leveraged—there is hierarchy. This structure becomes particularly apparent and harmful when there is abuse or exploitation at play. 

What is power? Broadly, power is the ability to do things. This can be further split into power ‘to’ do what one wants or power ‘over’ other people. Sometimes this hierarchical power is direct and easy to recognize; sometimes it is indirect and harder to pick out.

Abuse is about exerting one’s own power over another by controlling another person, the environment, or the situation unfairly to one’s own benefit, often against the other person’s will. Abuse is a boundary violation, often intended to intimidate, and founded on a lack of consent.  

Consent is a critical and foundational component to any healthy relationship. Consent should always be uncoerced and freely given, reversible and able to be withdrawn at any time, informed with clear boundaries, enthusiastic and engaged, and specific to that particular time and place.

Any relationship dynamic that involves unwanted hurt, exploitative power imbalances, coercive control, contempt, and adverse psychological manipulation is highly likely to be abusive. Relationships that frequently utilize threats, intimidation, and love bombing are all highly likely to be abusive, particularly if they are patterns of behavior. Relationships that take the guise of power-exchange-play and other kinks, but which are not firmly rooted in fully-informed and risk-aware consent that can be freely withdrawn at any time without penalty or hesitation is at the very least unhealthy; reciprocal, continuous, earnest consent is what separates power-play dynamics and other kinks that people may engage in for stress relief, creative fun, or personal pleasure from the detrimental and long-lasting negative impacts of abuse. 

For those who know or now may be considering that they are in an abusive relationship and would like more information on how to get out or more deeply explore the abusive relationship dynamic, there are several resources available to examine in the Database or online to get connected with domestic violence specialists and support groups for further assistance, as well as danger assessments, evidence collection apps, safety plan guides, and extra help for those who need to leave with pets. 

Homelessness / Houselessness / Transience

Due to the severity of the consequences and dangers of being transient—particularly if you have repeated cold exposure or negative interactions with law enforcement with the increasing criminalization of being unhoused—and because the state of being homeless is not a program one can simply read a short description of, see if they qualify for, and then apply, this section will be considerably longer than all the others. With luck, most of you will never need the information contained in this section of this Resource List, but to be clear: homelessness is a wide pit with a steeper incline the closer you get to the center, and it only takes a few mistakes or mishaps to slip closer and closer to the gaping maw at the center that is so hard to crawl out of once you fall into it, especially for those without social support, assets or resources, or the ability to maintain substantial gainful employment to truly change their situation in a long-term meaningful way. 

With two-thirds of Americans living paycheck to paycheck, the transition from being housed to unhoused can be rapid. A person’s fortunes can change significantly for the worse in short order. 40-57% of homeless people are disabled, putting those with CRPS and other chronic physical or mental health conditions that create significant barriers to employment at considerable risk. This section is about providing some pointers to a very difficult situation, particularly for those who might only have a certain amount of money to work with and are concerned with financial instability. 

More sheltering situations might qualify as legally being considered a “homeless individual” according to federal law than one may realize, so here is an overview of what US Code defines as homelessness:

1. an individual or family who lacks a fixed, regular, AND adequate nighttime residence—

2. an individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground;
3. an individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements (including hotels and motels paid for by Federal, State, or local government programs for low-income individuals or by charitable organizations, congregate shelters, and transitional housing);
4. an individual who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided;
5. an individual or family who—

(A) will imminently lose their housing, including housing they own, rent, or live in without paying rent, are sharing with others, and rooms in hotels or motels not paid for by Federal, State, or local government programs for low-income individuals or by charitable organizations, as evidenced by—

6. unaccompanied youth and homeless families with children and youth defined as homeless under other Federal statutes who—

When it comes to being unhoused, there are four primary “levels” of security: 

1) couch-surfing or staying with friends or family: this allows for real shelter and access to amenities like a kitchen, bathroom, and a place to sleep knowing that you won’t be driven away, attacked, or have a negative interaction with law enforcement or other people outside of the home during the night.

2) shelters and transitional housing: this allows for shelter and access to amenities like a bathroom, a bed, and a meal; however, many of these facilities (particularly shelters) have strict requirements, check-in/check-out times, might require a certain number of hours per day committed to shelter chores without exception for disabled residents, may separate people, and some have open concept bedding layouts with foot lockers. If you have a job, schooling, or other obligations that do not align with shelter doors being locked or unlocked, if you have concerns around the spread of illness in close, shared spaces, if many people all sharing one bathroom while you need frequent and urgent access to a toilet, if you have medications that policy would require to be kept under lock and key, if you are unable to work for the facility each day (if they have that requirement), or if you are unwilling to be separated from your group, a shelter may not be a viable option for your circumstances. If you have pets, particularly a large dog(s), some shelters may be unwelcoming or may be extra stressful with the stimuli and unknown people and environment. Many shelters are run by religious organizations and often require adherence to their religious rules or attendance of religious services to be admitted, so some individuals may be uncomfortable or unwilling to use their services. If you are transgender, gender diverse, or otherwise part of the LGBTQ+ community, shelters can cause additional hurdles or safety concerns. Most shelters and transitional housing have drug and alcohol policies and will drug test those who wish to use their complexes. Some shelters allow prescribed medications to remain with their users (if so keep close watch over them, as many go missing); others may take all medications and lock them up overnight, returning them in the morning; others may demand even prescription medications be thrown away if you want to stay. 

3) “glamping” / luxury homeless: this group has shelter from RVs, travel trailers, cars with or without tents, and generally move from place to place with the power of mechanical assistance to avoid drawing too much attention to themselves. Campgrounds, national or state parks, the side of the road, parking lots. This allows for independence and not being beholden to the limitations, restrictions, safety concerns, and lack of dignity at many shelters and may hold an appeal for those without friends or family willing or able to provide a place to stay. It can provide some shelter and a degree of privacy, especially in the travel trailer/RV group, which often has access to a full if small kitchen, a bathroom, electricity, and a bed with an actual mattress.

4) street homeless: this is the most dangerous, most stressful, least protected group who are most vulnerable to hostile humans and negative interactions with law enforcement that can carry long-term ramifications, especially as more places around the country are increasing punitive penal measures for sleeping outside. Stay out of this category by whatever means possible; if you do fall into it, do what you can to get out of it ASAP, unless it puts you into an abusive situation. The physical, psychological, emotional, and financial stress of being on the street is extremely detrimental in CRPS. You will also be exposed to the elements, particularly cold, which will have far-reaching ramifications in CRPS care long after you are no longer without a permanent shelter of your own. Some housed individuals are highly hostile to street homeless individuals, so use discretion if you accept food from any passers-by, as sometimes food may be deliberately off, filled with things like toothpaste, or mildly to moderately poisoned to make you ill; accepting things in their original, unopened packaging helps prevent this very unfortunate event, which is made all the worse if you do not have access to a bathroom.

 Van Life or Full-Time RVing

For those with lump-sum resources or with a small, but steady stream of income and for whom roommates in a house or standard apartment, subsidized housing, or other options aren’t preferred or possible, full-time RVing could be a functional and viable avenue for a time. If this is a path that interests you, here are some things to consider, though it is absolutely recommended to do more specific research before committing to the approach. Mistakes in this path—especially for those with limited resources—are costly, and it only takes one or two major mishaps or catastrophes to go sliding down a spiral that ends up with no assets, no liquidity, and no shelter while on the street, one of the worst possible positions to be in. Understand this intimately and take the steps in advance to mitigate it. It is much easier to be proactive in times of stress than reactive in emergencies. 

Even without things going horrendously wrong and preventing catastrophe, it is important to understand this pathway should not be considered lightly or, frankly, pursued by those who have better alternatives: this is still being homeless. It is hard on the body, just not as hard as being fully exposed to the elements without any privacy or space to call your own. It is still extremely stressful, just not as stressful as not having a bed or access to a toilet or the ability to store food or cook a meal or haul your belongings. This is luxury homelessness, but it is homelessness nonetheless and it ought to be treated with the seriousness it deserves and the understanding of the physical, psychological, emotional, and financial toll it will exact on those who choose or are forced into this path. 

This List is not intended to be fully comprehensive; it is intended to cover major points for people who have never been homeless, who are not familiar with trailers or the places that could cause them to stumble, who have a difficult time concentrating, holding on to several pieces of information at once, reading across multiple forums, threads, and boards to research a concept that they don’t have experience with, don’t want to face, and is activating for their stress-flaring pain condition. This is meant to provide a solid platform, not to answer every question a person could have.  

To you, the person reading this because you’re preparing for homelessness, because it is necessary: This is about survival. Your sympathetic nervous system is going to be under a ton of increased stress while homeless, and your CRPS will be impacted by that. The sympathetic system is for escaping life or death threats, and you’re about to be in one, probably for a long time. It’s going to be really hard, and you’ll probably do things you would have never even considered before to get by. This is about survival, and we all do what we need to do to stay alive. We can do hard things, things we never would have considered doing. Be gentle with yourself where you can, and when you’re no longer homeless, remember that it takes years to recover from the trauma experienced while unhoused. 

While no one likes to think they could end up in a situation like homelessness, knowledge is power.

First, select a type of unit: fifth wheel campers, travel trailers, and truck bed campers are the safest options because they do not have engines in them; all of these campers can be physically detached from the vehicle that pulls them. If there is a mechanical failure in the vehicle, it can be taken to the mechanic, DIY repaired, or replaced without losing access to your shelter in the meantime. While RVs offer the same (or better) size and internal amenities as campers, they require specialized mechanics and parts and are expensive to repair. While vans offer some stealth, are much more mobile, and can be kitted out with a bed, kitchenette, toilet, and perhaps shower, they don’t offer much floor space and head room is limited unless you pay for specific models with raised roofs, which can be quite uncomfortable for those with CRPS who have mobility issues and for whom stretching and PT are often critical components of daily life. While vans have easier access to mechanics and cheaper parts than RVs, you still lose access to your entire home anytime it needs to be repaired in a shop; if something happens to a major mechanical part, such as the engine or transmission, and it is destroyed or too expensive to replace, you have not only lost the vehicle, but every modification that has been built into the van. 

Fifth wheel campers can only be hauled by trucks with a specific kind of hitch in the center of the truck bed over the rear axle. The benefit of this is that it allows for more stable and safer towing due to weight distribution; it also allows for more maneuverability and sharper turns. Due to the overlap of the rear of the truck bed and the front of the fifth wheel, several feet of trailer length can be shaved off of actual road space, making for a shorter truck/trailer rig when compared to a bumper pull camper; however, this does mean the truck bed space is not as available for storage. Fifth wheels have higher ceilings than bumper pull travel trailers and truck bed campers and are generally considered to be the most spacious of travel trailer options when compared to similar sizes; a drawback of this means they do require higher clearance for bridges, trees, and the like. Fifth wheels are generally much larger, ranging from 25-45 feet in length, and heavier than bumper pull trailers due to the additional amenities they contain; they require heavy duty, three-quarter (250 / 2500) or one-ton (350 / 3500) trucks to tow them; due to their size and weight, expect lower gas mileage. However, due to the way the hitch attaches to the towing vehicle and the weight, fifth wheels are usually less likely to feel the effects of being blown around by high winds during transport. Each state has specific regulations for licensure requirements for the combined length and weight of tow vehicles and their payload, as well as exemptions for those driving recreational vehicles; it is important to check with your state and each state you will be traveling through to ensure that you or your driver will be able to legally drive on a standard driver’s license or if the individual will need to get an endorsement, upgrade license classes, or even get a CDL. The majority of states do not have any special restrictions on recreational vehicle licensure, but be sure to check and ensure you are within the law. 

Bumper pull travel trailers can be hauled by a wide variety of vehicles, so long as they have tow packages and are appropriately sized for proper braking distance and so the engine is not overstrained. Travel trailers are generally much more lightweight than fifth wheels, which makes them more prone to becoming sail-like under high wind conditions on roads, but also permits much smaller vehicles than heavy duty trucks to haul them. They are also smaller across the board, ranging from 12-35 feet in length; this can make them less intimidating for those who may be uncomfortable with driving large trucks and huge trailers. When compared to the privacy and roominess of fifth wheels, which significantly contributes to their weight, bumper pull travel trailers maintain a trim figure by sticking with the necessities and having fewer slide outs, reducing both square footage and weight.

Truck campers are small campers of 6 to 18 feet in length that slide into the bed of a truck; the sleeping area rests over the cab and the end may extend beyond the bed by a few feet in larger models. Truck campers by far offer the smallest square footage, but they still provide a sleeping area, a bathroom (though not always with a shower), and a main area with a sink, stove, oven, refrigerator, and seating and eating location. Truck campers have retractable feet, so they can stand on their own power outside of the truck bed to be used, though supporting the floor and providing additional structure is recommended to extend the life of the jack supports. 

Second, select a specific unit: New versus used? Generally used is the more economically sound option, as campers depreciate by approximately 40% in the first five years. Private sellers are often more willing to negotiate on price and may even be willing to take somewhat of a loss if their real motivation is to get rid of an older unit they no longer use. 

Decide how much length you’re comfortable hauling and how much space you’ll need. If you’re somewhere it snows or ices, consider hauling in the winter and the insulation of the roof and walls. Consider the amount of space after 6, 12, 18, 24, 36, 48 months and if you’ll be able to tolerate it; one would hope circumstances would improve before you’re stuck in a situation like this for several years, but what if it doesn’t and you cannot afford to replace the trailer? Is the first one you bought sizable enough that you haven’t gone crazy living in such a small space, especially if you’re sharing with other people or animals?

Most people want to sell their property for the highest value and will hide problems. Keep an eye out for red flags that indicate deeper issues: rippling in the shell internally or externally reveals water damage, which indicates there was a leak at one point which may or may not be fixed and there now may or may not be mold in the walls and it may damage electrical wiring; soft spots in the floor or roof reveal degrading components; musty smell or visible mold, you can try to clean it, but it’ll likely come back unless it was on metal only, as spores are microscopic. 

Also be on the lookout for other damages: smoke damage, electrical components that don’t work (especially roof vent fans, the range fan, the air conditioner, the auto power slide, and the power jacks), malfunctioning propane components (particularly the water heater, heater, and fridge), a malfunctioning water system (water pump, toilet, leaky pipes—if the water pump is running when nothing else is on, there’s a leak somewhere—, all the taps, shower), the awning, and—if equipped—the solar array. 

Many of the things in the paragraph above can be repaired, but they can be used to drive down the price. However, if you notice things in the red flag paragraph, it’s likely best to walk away unless there are extremely compelling reasons, like being practically or literally gifted the unit. There are RV and travel trailer specialists and assessors at places like RV centers that may be willing to look over a potential purchase for free or for a nominal fee upon request; however, the current owner of the unit would need to transport it to that location for inspection and if there is a serious problem, they will likely be unwilling to do so. Also if they are in a rural area or no longer have a vehicle capable of transporting the trailer, that also could cause them significant difficulty in transportation. Alternatively, there are multiple videos and articles available online explaining how to do a proper inspection of a potential purchase, so that you do not buy a lemon and are able to get a trailer suited to your needs in your budget.  

Power sources: All campers should have three power sources: propane gas (for the oven, stove, hot water heater, propane heater, and fridge), deep cycle DC [direct current] 12v or 6v batteries (for DC lights, vent fans, some aspects of the propane part of the fridge or a full part of the fridge if the unit has a dual- or tri-power fridge, some safety sensors, the water pump, and the radio), and an AC [alternating current] grid power connector cord (for AC lights, outlets, microwave, air conditioner, and tri-powered fridges, if equipped). Some campers are 30 amps and some are 50 amps; it is important to know which one yours is. Both of these ratings are considerably higher than your standard 15 amp outlet, so if you’re plugging into a house directly or via extension cords, you will need to utilize adapters to get grid power into the camper. Confusingly, the 50 amp trailers actually offer a total of 100 amps split across two 50 amp circuits. 30 amps or 50 amps (actually 100 amps total), depending on your model, is the total amount of electrical amperage that can be used at one time across all AC powered devices; if you attempt to draw more power than this, you will overload your system and trip a breaker that will need to be reset, so be mindful of what you’re running at one time, especially if they are multiple high power-draw devices, like microwaves, air conditioners, pressure cookers, space heaters, or hair dryers. 

AC power cannot be used unless you are directly connected to a grid power source, a generator, or you are using an internal piece of equipment called a DC/AC power inverter or Uninterrupted Power Supply (UPS), which combines an inverter and another high end piece of equipment called a charge controller that gives it a wider range of function than a standard inverter. An inverter pulls DC power from the 12v or 6v batteries and inverts it to usable 120v power; this puts a massive draw on the stored DC battery power and is not sustainable for a long period of time unless the trailer has a large battery bank. Inverters are less likely to be found in older trailers, but they can be purchased aftermarket, combining the AC to DC converter that recharges the batteries and the DC to AC inverter that takes stored battery power to use when you don’t have access to grid power into one unit; the larger the inverter is, the more load it can handle and the more draw it will take from the battery bank. Even if you’re just running the inverter to charge a phone—a task which does not draw much power—if you have a large inverter, you may be putting a significant drain on your batteries just to power the inverter itself, so it is important to understand how much wattage you need your inverter to be able to handle while under full load, how much draw the unit itself takes to run alone, and if you intend to use the unit for a larger project after you are done living in the trailer (such as a larger battery bank in a home, in which case a larger inverter would likely be desired). Inverters are often expensive pieces of equipment, particularly at sizes that can handle larger electrical loads, so if you need to purchase one, do the necessary math and research your options to find a quality unit at an economical price. If you intend to run any delicate electronics such as computers or medical equipment on your inverter, a pure sine wave inverter will be much safer for your expensive yet fragile equipment, even if it does significantly increase the purchase price. To size your inverter, take the sum total of the watts you’ll use at one time and multiply it by 1.25. 

Running solely on battery power will drain the batteries quickly, and they will need to be recharged, so that the batteries aren’t damaged; this can be done through grid or generator power and an AC/DC converter (which is a standard piece of equipment in most trailers) or a combined inverter converter or uninterrupted power supply (which may come in newer models or need to be purchased separately), slowly trickle charging as you drive (though this will take a very long time, especially if the batteries are low), or having a solar set-up within the trailer that passively recharges the batteries. Damaged batteries will have difficulties holding a charge or will not charge. While expensive lithium batteries can be repeatedly drained without cause for concern, the standard deep cycle RV lead acid batteries found in many trailers cannot be drained below 11.5 volts without permanent damage. For best results, they should never drop below 12.06 volts (50% discharge); though short and occasional ventures below 12.06v and above 11.5v will not permanently damage them, it will reduce the batteries’ lifespan. Even though they are called 12 volt batteries and are considered 100% charged at 12.6 volts, they actually hold a charge closer to 13.2-14.5 volts while being fed new power, even under load, just like a car battery. If there is white corrosive build up on the batteries, that should be removed, as it impedes electrical flow.

The deep-cycle batteries built to provide continuous power to campers are not the same kind of batteries intended to provide massive but short-lived starting power to cars. Deep cycle batteries measure power in a unit called amp-hours (Ah), which conveys how many amps of current the battery could continuously release for 60 minutes until it was fully discharged. The slower a battery bank is discharged the less heat it will produce and the more efficiently it will be able to utilize its energy. Remember that lead acid deep cycle batteries should not be discharged below 50% to preserve their function; if your battery bank has a total of 200 Ah, that means you only actually have 100 Ah available for use before you start hitting dangerous territory. If you only have 100 Ah actually available and you can’t recharge your battery bank for three days, then each day, you can use about 33 Ah through each day and night on DC-powered items. Batteries are expensive to replace, and the entire battery bank should be replaced together, not one battery at a time.

Generators are important pieces of equipment, especially for those that intend to spend a lot of time away from places with easy access to grid power. Inverter generators are significantly more quiet, discreet, and far less disruptive than standard generators; while they are usually more expensive up front, they are often worth the expense, as many campgrounds will only allow inverter generators to be run. They often will also run on both gasoline or propane. Sizing a generator to your needs is important; generators carry two numbers: standard running load wattage and peak load wattage (which is relevant for starting up electronics, as they usually have a higher draw when powering on). Peak load is a burst of extra wattage the generator can sustain for a short period. This will require some math, but you’ll want to add up all the watts of what you’ll run in your trailer (especially make sure to account for the air conditioner!) at the same time and then add an additional 10-20% on top of that. Generators are not required for those who will always have access to grid power (such as those who are staying at someone’s property and connecting to their house power), but if things go sideways and you part ways with the property owner, a generator is a good tool to have in your possession before it is necessary.

Solar systems provide passive energy and recharge battery banks without noise in a discreet way. Permanent systems can be attached to the trailer itself and run at all times, but there are also portable systems that can be deployed at will. There are four major components to a solar system: the solar panels, the solar charge controller, the batteries, and the inverter. Additionally, there are the connecting pieces such as roof brackets (recommend ones that do not penetrate the roof to prevent possible leaks), wire of differing sizes for different sections, circuit breakers, a battery disconnect (to be able to work on the electrical system safely in the future or store it), a voltage monitor (optional, but highly useful), MC4 connectors, bus bars, cable lugs, and an entry gland. 

While solar kits can be purchased, individual parts can be bought separately if you find it more economical to approach it that way. Solar panels are something that are fairly easy to find used locally in many places, if you do not have an address to which to mail them. If you are alone, consider how you will transport them and lift them, as especially the higher wattage panels can be bulky, unwieldy, and weighty; there should be some sort of padding between them to protect the panels, so they don’t damage each other before they find their permanent home. 

Charge controllers direct the flow of energy from the solar panels, keeping in going one direction, as well as protecting the battery bank from multiple kinds of electrical damage and maintaining a steadier rate of charge. Solar charge controllers come in two main categories: Pulsed Width Modulation (PWM) or Maximum Power Point Tracking (MPPT). PWM controllers are more affordable and are better suited for smaller, less complex solar systems. MPPT controllers are more costly and are considerably more efficient when it comes to harvesting solar power and are much more versatile both in voltage, amperage, and wiring range. Charge controllers are a necessary piece of equipment for any solar project that isn’t based on trickle charging and should never be skipped, as you could otherwise end up with a ruined battery bank, destroyed internal wiring in the rig, or an electrical fire; don’t take the risk.  Purchase a solar charger that is rated for amps higher than than the maximum output of the solar panels to prevent overloading. 

Solar systems can be installed professionally or done DIY; however, if you do it yourself, please research extensively and ensure you have a solid understanding of the process and all the steps, as electricity is involved, and it may be in a tight, confined area, depending on where your electrical bay is located. 

The primary equations for electricity relevant to trailers are: 

When wiring power sources, particularly battery banks and solar arrays, there are three primary methods of connection.

Wiring in Series: Where positive terminals connect to negative terminals; the voltage is additive, but the amount of amp-hours stay the same. [Two 6v batteries with 100 Ah each become a 12v battery bank with 100 Ah total.]

Wiring in Parallel: Where positive terminals connect to positive terminals and negative terminals connect to negative terminals; the voltage stays the same, but amp-hours are additive. [Two 12v batteries with 100 Ah each becomes a 12v battery bank with 200 Ah total.]

Wiring in Complex Series-Parallel: Primarily used in solar arrays, this allows for both increasing the voltage and the current (amperage) by having two circuits of solar panels connected in series wiring, which adds voltage together, and then connecting those two circuits together in parallel wiring, which adds amperage together.

When hooked to grid power (also commonly called shore power in RV communities), particularly at campgrounds where electrical wiring may vary from location to location, a Electrical Management System (EMS) to protect the trailer electrical system from power surges, voltage inconsistencies, and improperly wired shore power that can cause considerable and expensive damage trailer systems is generally considered a very wise investment. This is not often as necessary if hooking up to someone’s house power, but if using a generator, battery backup systems without a built-in EMS, or an unknown connection that may be wired incorrectly or have inconsistent power, these somewhat expensive pieces of equipment can be life-savers and prevent significant to catastrophic damage. 

Sealing the Roof and Delaminating Siding: The integrity of the roof is one of the most important aspects for the longevity of any trailer, particularly to prevent water damage, especially at the weakest points most likely to leak called laps, where different larger structural pieces connect and screws are inserted. Lap are often covered with sealants like: Dicor, which can be reapplied over itself without removing prior layers but does have a tendency to crack over time; several kinds of Flex RV sealants like ProFlex or SikaFlex, check which kind of roof your trailer has because some of these sealants will not work with EPDM (rubber) roofs; silicone sealant, silicone is industry standard for housing construction, however it does not stick to anything and nothing sticks to it, not even additional layers of silicone, and it is extremely difficult to remove. While caulking style sealants are generally considered cheaper to apply for touch ups and maintenance, they are something that has to be done regularly as the sealant becomes brittle and cracks, particularly Dicor, the most popular option. If you end up living in this situation for more than a year or intend to keep this trailer in storage once you are no longer using it as a safety net and have mobility, fine motor, and/or repeated sealant financial expenditure concerns and want to put in the effort once then not do it again, there is also the waterproof roof sealant tape option, a highly sticky, highly durable, strongly bonding tape developed to withstand exposure to the sun and elements. It is also useful for repairing leaks or damage in other areas of the roof or exterior structure to seal holes. The two prominent providers of this kind of RV tape are Eternabond and Beech Lane. For any tape purchased for long-term exterior use, UV resistance should be a feature or it will degrade much more rapidly. If you have additional concerns about UV exposure, there are UV protectants that can be applied over the roof sealant tape to provide another layer to the top, such as 303 Protectant. A long-lasting seal with roof tape is heavily reliant on proper site preparation and the application of force to bond the tape to the roof. 

The flat parts of roofs also need to be cleaned and sealed regularly or they will likely develop mold and mildew and, if they are EPDM, begin to chalk. Molding on top will not damage the roof itself, but is unsightly and could permanently discolor the roof (particularly EPDM roofs) if left unattended for too long. There is the cheaper, much more labor intensive option of washing then resealing the trailer roof regularly. The more expensive and do-it-then-mostly-let-it-be way is a rubber, fiberglass, or epoxy roof coating that adds a significant protective barrier over the roof itself; there is also a silicone version of this, so be sure to research carefully if this is something that interests you, and remember that nothing will stick to silicone, so if that is the path you choose, you have to plan very carefully. 

Delamination is what happens when the siding starts to bubble, ripple, blister, and warp. Camper shells are made, sandwich-like, around a core of styrofoam insulation, plywood on either side, and a fiberglass exterior with decorative interior walls. These are all glued and sealed together to protect their structural integrity and prevent rot. When a leak occurs somewhere and breaks the seal, this allows moisture into the interior of the shell wall and over time, this can start to break down the wood and insulation, leading to rot and mold. Unfortunately, most of this damage is taking place in the inner layers before it starts to become externally visible with the delamination bubbling. If you can catch it early, it is sometimes possible to fix it with a delamination repair kit of marine-grade bonding resin to reconnect the layers and seal the leak to prevent future degradation. However, if there is considerable water damage to the inner layers or a growing mold colony within the walls of the trailer, this is unlikely to be able to be fixed with a repair kit. Camper insurance generally does not cover RV delamination repairs, as the most frequent cause of this issue is failure to routinely re-seal the seams with lap sealant as required.   

Propane Use: Some trailers only hold a single propane tank at a time while others can hold two tanks; some dual tanks can automatically switch over to the second full tank when the first becomes empty and others need to be manually switched. Propane powers five main things in a trailer: the fridge, the stove, the oven, the hot water heater, and the propane heater. They each use a different amount of propane for their tasks, and that will vary unit to unit depending on the size, but the propane draw will broadly be in that order from least to greatest. 

Propane’s energy is measured in British Thermal Units (BTUs), and it can be measured in either gallons or pounds, whichever you prefer, and are burned per hour of usage; a gallon of propane has about 90k BTU; a pound of propane has about 21k BTU. A 20 pound tank holds slightly under five gallons of propane; a 30 pound tank holds about seven gallons; a 40 pound tank holds about nine and a half gallons. 

The propane heater is by far the largest propane user in the trailer. A 15k BTU heater can go through a gallon of propane in six hours of run time; a 30k BTU heater can go through a gallon of propane in three hours. A helpful rule of thumb for sizing propane heaters: 1k BTU output per linear foot of trailer. Due to the expense of propane and how rapidly RV heaters burn through their fuel supply, it is far more economical to heat the person rather than heat the space and far easier to heat small spaces than large spaces. If you have access to regular grid power, an AC electric space heater may be much more cost efficient than the propane heater, though it does pose a greater fire risk that should be monitored; using two electric heaters approximately three feet from each end of the trailer to create a heat envelope inside the unit is an efficient, effective way to keep the place warm, particularly if one or both of the heaters is a radiator-style plug-in option. 

While hot water heaters generally range from 30k-65k BTU, they often don’t run for a full hour at a time, only taking twenty to thirty minutes to heat up. This puts the BTUs at 10k-33k, which uses half a pound to a pound and a half of propane per hot water tank; there are also tankless hot water heater options, though they are generally more expensive upfront and more difficult to install. For those without a functioning hot water heater or who have emptied their fresh water tank for the season, cold water in containers for general use can rapidly be warmed by heating a small amount of water on the stove, in the microwave, or in a coffee pot or electric kettle and adding it to the cold water. If the container is insulated, the water can remain heated this way for multiple hours. 

Trailer oven burners are generally 2200-7500 BTUs. The ovens are not full-sized and often do not heat evenly or retain their heat well; this heating issue can partially be solved by getting fire bricks to place above the propane flame but under the wire rack to absorb and evenly distribute the heat. Expect anything cooked in the oven to take considerably longer to be fully finished than in a standard oven, even up to twice as long as the recipe states, and note that the temperature listed on the knob may not actually reflect the interior temperature, and may be off by 50 degrees or more, which can easily be overcome—up to a certain temperature—by simply turning the knob up higher once you figure out how far your particular oven is out of calibration, if at all. Many propane ovens have pilot lights that may require manual lighting to actually get the flame going; if this is the case, a long handled lighter with a flexible tip can be very useful. The propane ovens take quite a long time to achieve their preheated temperature. Smaller dishes of the 8×8 variety will be what are likely to fit in the mini ovens. The heat from the oven will bleed out into the entire trailer, noticeably increasing the temperature throughout the unit; take this into account when planning. During the cooler months, this may be helpful, as it can warm the interior passively while in use cooking food; the oven should never be utilized as a primary active heating source in and of itself due to the dangers of propane. However during hotter weather, the heat-bleeding can make things unbearably uncomfortable; the microwave, toaster ovens, toasters, pressure cookers, induction cooktops, and slow cookers are all electric alternatives to propane-using stove or oven cooking aparati. Butane camp stoves create a smaller flame than propane stove and use smaller tanks, if electric sources are not an option; one 8 ounce can of butane provides about 75 minutes of burn time on high flame. 

It is critically important to properly ventilate the area when cooking with propane ranges and ovens due to the health risks of breathing propane, either by running the range vent fan, the roof vent fan in the main kitchen area (though this will cause cooking oils and grease to accumulate on the vent screen over time, if you have one; however, it can be cleaned), or by opening windows (and ideally directing some sort of fan or airflow towards the window). It is also critical to ensure that when you are done cooking, all the burners are fully turned off and not slowly leaking propane into your living space for hours at a time.   

The stovetop range usually has one large approximately 9000 BTU burner and two smaller approximately 6500 BTU burners. While all of these burners can be used simultaneously, they are quite close together and can be challenging to manage for those with fine motor difficulties. Ensuring the range fan is functional is important so that the heat and smoke exits the trailer or it will remain and fill the space, eventually setting off the smoke detector. If the fan isn’t working, it is a part that can be replaced, and it is well worth the expense and the time of figuring out how to do so. If you are in an older or well-used trailer, it may be that the motor has simply burned out and needs to be replaced, which is not a particularly challenging task and greatly improves safety and quality of life. 

When in transit, it is safest to turn off any flammable gas at the source; this is particularly the case for propane, as it runs throughout the entire camper and often comes in large tanks. 

Fridge: A dual- or tri-powered RV fridge is generally cooling about a third of the time it is running. A 10-12 cubic foot fridge will go through about 1.5 pounds or ⅓ of a gallon of propane per day (actively cooling 8 of the 24 hours it is on); a smaller fridge will go through about 1 pound or ¼ of a gallon of propane. The specific BTUs of the fridge will impact the propane usage, as will the atmospheric temperature; the greater the distance the fridge is attempting to cover, the more propane or electricity will be used to cool it. How often and how long the door is opened will also impact its ability to cool.

Trailer fridges are only designed to run at specific angles that are close to level; they are also extremely expensive, particularly three-way fridges that can run on AC, DC, and propane. If the trailer is too far tilted and the fridge is turned on and run in that tilted way, it will severely damage the cooling system in the fridge and freezer, creating crystals in the fluid that runs through the pipes that cannot be uncrystallized. This will negatively impact the fridge’s ability to cool, remain a stable temperature, and not ice over, if it will even run at all. Sometimes a solid bang on the pipes will dislodge a blockage of crystals to allow the fluid to flow again if it is totally blocked, but it will not resolve the issue completely. Removing ice from the fins can also temporarily help, but again it will not fix a damaged cooling system. 

If the slope in the trailer is too steep, do not run the fridge until it is more level to avoid damage to the refrigerator and freezer, as repeated food poisoning or having to throw out food that has gone off is not pleasant or economical. Particularly if you live somewhere that gets very hot, a damaged fridge may not be able to keep up with a temperature difference, especially during the summer. Look up your fridge model and find its degrees of safety front to back (which is the trailer’s side to side for the typical side-attached refrigerator) and side to side (which is often the trailer’s front to back). An online slope calculator may be useful for this, with the degrees being placed in the angle, the length or width of the trailer being placed in the run, and the rise will be how unlevel the trailer can be one direction or the other before you leave the safety zone. 

If the fridge does get damaged and you are unable to replace it with another RV-specific fridge but have steady access to shore AC power, some people prefer to replace their RV fridge with a standard home fridge that plugs into the wall. However, this option only really works if you have regular grid electricity, as they usually draw too much power to run on battery banks or solar panels. 

Leveling Blocks and Wheel Chocks: When parking to stay, particularly for an extended time, it is important that the camper is close to level and unable to move. Wheel chocks or wooden blocks prevent the tires from shifting after being detached from the hauling vehicle or while weight is shifting around inside due to habitation. Leveling blocks specially designed by RV companies or DIY options made out of things like wood or horse mats can help cover the uneven distance between the sides of the camper as the ground slopes and dips, creating a more balanced environment in the interior.

Staying Warm: Those living this way due to low income might not have the ability to run electric, butane, or propane heaters with regularity, leaving them relying on other methods for warmth, particularly in northern regions where it gets particularly cold and ice can easily coat the walls inside due to the humidity of exhaled breath. Heating pads draw little amperage and can easily run on solar power during the day, as there is enough sun to provide power, and can also easily run in tandem with charging phones and power bricks. However, do monitor the solar charger or voltage monitor as the sun starts to set to ensure there is enough time for the batteries to be fully charged before night falls and the inverter needs to be turned off. 

During the evening and night, metal-disc-activated, reusable, sodium acetate gel hot packs are wonderful because they offer heat twice if you time it right. To reuse them, you boil them—do it inside something cloth (like a pillowcase) because if the hot pack itself touches the hot metal pot, it bursts; if you pull them out and give them a quick pat dry, then transfer them directly to under your bedding like a historical bed warmer, they remain hot for a surprisingly long time, especially ones sized for the shoulders, core, and thighs. Then once they get cold in several hours, you can pop the metal disc and heat them again.

Heated vests powered by rechargeable battery banks can also be quite useful, particularly if you have to spend time exposed to the elements. The smaller and more insulated you can make your sleeping area—by closing doors, curtains, layering blankets and thermal layers, or whatnot—the easier it will be to heat with your breath, body heat, and residual warmth from any heating sources like a cooktop, especially if you have any other people or animals with you. An unheated trailer will protect you from the wind chill, rain, and snow, but it will otherwise almost equalize with the external temperature. It is completely possible for the inside of a trailer to be in the upper teens and low twenties for days on end while you’re living in it, if the circumstances support that, and being constantly exposed to that kind of cold has long-term consequences when it comes to CRPS. The double heater envelope menthod listed in the Propane section is an effective way to keep the interior of the trailer 60F or higher even during very windy, icy, snowy, below freezing temperatures; this method is particularly economical if a person is paying a flat rate for access to electricity.

The thicker and higher rated the insulation in the walls, the better, particularly for exposure to freezing and below freezing climates. There are arctic rated insulated trailers that offer more protection. If needed, additional foam insulation boards can be velcroed, glued, or otherwise connected to the wall for additional r-value; ideally it will be done in such a way that the insulation can still be removed to be cleaned behind once in a while to prevent mold. These boards can be made more aesthetically appealing with peel and stick wallpaper, acrylic and permanent markers, or paint. Cold will seep in through gaps in insulation or cracks such as doors, windows, and vents. There are specific products sold that are basically big pillow insulation for vent fans and shrink film for windows and small sealant cracks during cold weather to help address that issue, or a DIY project could be attempted. If the weatherstripping around your door is worse for the wear, door weatherstripping is replaceable and does not require a professional to install. 

Mold: Trailers are prone to mold, particularly during the winter when things are kept closed up, unventilated, and breath hangs in the air and sinks. Low amperage draw dehumidifiers can be quite helpful, especially for those with access to constant power. DampRid and other humidity soaking products can be useful, though they are not reusable and may not be a feasible option for all. Removing screens—perfect mold breeding grounds—from windows before the cold truly sets in is a smart move, as is regularly cleansing window frames with bleach or—even better—vinegar. Other prone to molding areas that should be regularly checked for cleaning include where the wall meets the floor, corners, and cabinets; pay close attention to where the mattress(es) is close to the wall, especially where your head and all your breathing is, both because your breath is more likely to create mold in damp, unventilated corners and because breathing in mold all the time is a health hazard. If the mold gets into the mattress, that’s a major problem; getting a waterproof mattress encasement can help prevent having to purchase an entirely new mattress or otherwise sleeping on a mold pile. However, waterproof encasements can cause increased discomfort for those who sweat, as the water vapor is more likely to cling to the sheets and the person than evaporate; layering more than one set of sheets over the encasement can also assist in distributing sweat. Check the air conditioning unit for mold before using it again and clean it with vinegar or Lysol, so it isn’t distributing mold spores throughout the camper. 

Cold Weather Skirting: For those who will be living in their trailers year-round or during cold parts of the year in areas that experience uncomfortably cold temperatures, skirting your trailer can significantly assist in retaining any heat that you produce and majorly reduce wind chill. Trailer skirting is a barrier that goes around the lowest part of the camper, covering the tires, water tanks, and empty space below the trailer where the wind can whip through and suck away considerable heat through the flooring.

There are a wide array of materials that can be used to block the wind and snow from getting underneath the trailer, and several companies specialize in creating RV and trailer skirts specifically as their main order of business, though these are usually quite expensive and not very friendly for those on a shoestring budget. Some like to utilize plywood or foam insulation boards to create a more firm barrier against the elements, though these can be heavy or unwieldy for those with muscle weakness or motor difficulties; they also can be difficult to store for those with limited space or those who need to move locations regularly. 

A polyethylene vapor barrier in black at least six millimeters thick provides solid protection against the wind, rain, and snow while soaking up whatever heat the sun offers during the day; it is not heavy or so unwieldy that it is a pain to work with or keeps falling down and it cuts smoothly while being thick enough that it doesn’t puncture easily and it wipes off dirt, mud, and other gunk simply with a damp rag or a bristle brush. For those willing to put in some labor and able to do some mathematics to cut the correct lengths from the vapor barrier roll, this is one of the most affordable ways to have a functional trailer skirt; if it is removed with care, it can be used for several years. Be sure to leave enough length to weigh down the bottom.

To attach it to the trailer, if you’re staying in one place for a longer length of time or a whole season, duct tape (especially extra strength duct tape) works well. If you’ll be moving regularly from established place to established place, snap button fasteners applied with a handheld tool also work well and are more easily applied than the traditional tool; do not use silicone sealant to attach the flat sides of the snaps to the trailer. Poly tarping stretches a bit in the heat and contracts in the cold, so if you’re putting up your skirt at the end of summer, remember to account for that in your calculations or as it contracts some of your snaps might pop off the trailer under the tension. 

Tarping, foam board insulation, and plywood can all be used in conjunction to create a solid layer of weather protection, especially for larger campers and those who will be parked in one location for an entire winter season. 

If you are in places where discretion is necessary, setting up a skirt is not advised, as that can draw unwanted attention and signal a greater permanence of presence while taking the needed time to install and tear down the skirting. If you will not be in that location long, the effort of being exposed to the cold to put up and then remove the skirt for the comparatively short time it will be in use is generally not worth the effort or risk. 

Roof Air Conditioning and Slide Protection: The polyethylene vapor barrier tarping can also be used to create a cover for the air conditioner(s) to protect it from winter conditions. If your trailer does not come with a slide cover(s) of its own, the tarping can also be used for this to help protect it from elemental debris. 

Winterizing Tanks: For those that live in trailers during cold weather and need to continue using their amenities during the freeze, tanks that hold dirty water can have RV and Marine antifreeze poured down the drains to mix in with the waste in the tanks to prevent it from freezing, allowing them to continue to be used year-round; it is non-toxic and not comparable to the antifreeze put in cars, but better safe than sorry, so always double check the materials you are using by reading labels before assuming they are safe and pouring them into your water tanks. Depending on your local weather, you may decide to keep using your fresh water tank or you may decide to drain it for the season; potable water and RV antifreeze don’t mix, but the antifreeze can be put into drained fresh water systems to help protect the seals and gaskets from the cold. For those who choose to keep using their systems, heated hoses, heat tape, and heated cables can help prevent the water from freezing where it is at its thinnest, most exposed point and causing significant damage to the trailer. 

There are some aftermarket kits that can add a handwashing station water connection to the incoming water line to the toilet, allowing the water that is used to cleanse hands to be recycled for flushing the toilet. 

For those who prefer to empty the tank and not take the winter freezing water risk, there is a drainage valve at a low point of the undercarriage to help get the remaining standing water out of the tank to discourage mold and contaminate growth during the winter. While without access to the water pump system, five gallon jugs get pretty good water pressure, though fully filled they are about 40 pounds each, which understandably may be too heavy for some to handle especially during icy winter months and particularly if they are alone in their homelessness; for those who prefer lighter options, two gallon jugs—which weigh closer to 15 pounds—or water dispensers meant for a fridge can all sit on the rim of the sink and provide water to drink, wash hands, cook with, and clean dishes. If you shut off the fresh water tank, you will also need to find an alternate way to rinse the toilet and tube to the black tank after use; something as simple as water bottles with flip lids that squirt well works fine. 

Black Tanks, Deodorizer, and Toilet Paper: While freezing weather generally prevents the black tank from creating a particularly notable odor, that is not the case during warmer and particularly hot weather. Year-round black tank deodorization is strongly recommended, with increases in frequency in hotter temperatures. Additional air fresheners for the bathroom may be preferred, if affordable. If you’re the kind of person who uses your vents and fans to create an air current, it can suck odor from the bathroom into the rest of the trailer, so ensure the door is shut and if you have a bathroom window, crack it open so those odors have somewhere else to go. The more water you use in your black tank, the less odor you will have; however, you will also have to empty your tank more frequently and you will go through your fresh water supply more quickly. Depending on your situation, this might not be a problem whatsoever; however, if you are doing a lot of dry camping or boondocking or are somewhere where you do not have easy access to fresh water or a sewer dump or the ability to move your trailer, then using less fresh water in the black tank and finding other ways to combat the odor might be a necessity.

When traveling, the movement of the road will cause the contents of the water tanks—particularly the black tank containing human excrement—to churn. This can create an extremely unpleasant odor when entering a camper after moving locations and eau de human waste hangs in the air. This can be prevented and mitigated by emptying the dirty water tanks frequently, especially before traveling from one location to another, and using a higher ratio of water / deodorizer to waste in the black tank. For those with regular access to a household septic tank or campgrounds that have a sewer dump during camping season or have year-round accessibility due to warm weather, this could be nothing but a minor hassle. For those without such a support structure or whose local campgrounds close for a large portion of the year due to inclement weather, this can create a significant hurdle to address, especially for those with smell sensitivities caused by their CRPS and limited access to fresh water. 

For those who use campers recreationally, it is generally recommended that the black and gray tanks are emptied every three to five days or when the tanks read ⅔ to ¾ full, indicating that they are going through enough fresh water to fill their black tank in just a few days. For those in survival situations, this is not always a possibility, as such critical resources like fresh water can be precious, scarce, and unable to be literally thrown down the toilet.

When you empty your tanks, especially your black water tank, it is highly recommended to wear gloves, mask, and waterproof, closed-toed footwear when you do so—either disposable gloves or a pair of long, reusable gloves that come up to the mid forearm which you do not use for any other task; if preferred to prevent any internal spillage, tape the gloves temporarily to your sleeves with masking or scotch tape. Sanitize your hands after you have finished with the task to cleanse any contaminants. Most sewer dumps have a water hose available nearby; it is strongly urged to rinse out your exit plumbing and sewer hose when you are done emptying your tanks, so that any waste remaining in the hose can be washed out before it goes back into storage. When emptying tanks, it is best to start with the black tank, wait for it to almost completely drain, and then open the gray tank; this allows the less dirty gray tank water to help clean the human waste out of the sewer hose and trailer plumbing before doing a final rinse with the water hose. Make sure your tanks are fully closed before you continue on your way, so that you aren’t slowly leaking dirty water into the exit plumbing that will explode out at you before you can attach the sewer hose the next time you empty your tanks. 

Black tanks require a special and pricey kind of RV toilet paper and cannot handle regular toilet paper being put down the toilet. If you want to use standard toilet paper or wipes, it’ll need to be put in a trash can or container to be thrown out. If you are a regular user of wet wipes, baby wipes, or shower replacement wipes, there are NO camper black water tank safe options available at the current time, and they will need to be disposed of in the trash. Alternatively, a low wattage or non-electric, water-only bidet can be installed or other options may need to be explored.

Since one of the major benefits of camper living is a functional and private toilet, it can be a major psychological and physiological blow if a part of the toilet breaks. The upside is that as long as you can figure out your toilet’s model number, most parts are replaceable in sections; if you need to replace the entire toilet, that can be done too. 

Fresh Water and Sewer Dumps: Many state parks will provide a free fresh water tank refill and sewer dump as part of their camping fee, and they also generally also offer the ability to just pay for use of the sewer dump and fresh water station as a stand alone fee without having to have camped; some states offer discounts for the disabled or veterans. Many private campgrounds will offer a similar set up, though usually at a more expensive rate. Some private businesses will allow for overnight parking with permission and even offer use of restrooms or water stations and sewer dumps; check online resources to see which businesses are currently participating. Some cities, counties, and municipality water suppliers will allow people to by water in bulk from them directly, as long as they come pick it up (this is generally for off-grid individuals who need to haul water out to their homesteads); if your trailer is stationary and you want to haul a large amount of water to it directly to avoid paying a third party to haul water out for you, then ensure that the container(s) you are using are food grade. A drill-powered transfer pump can be very useful in this scenario to move water from the containers to the fresh water tank without actually having to lift them until they are empty and light again. Remember: water weighs over eight pounds a gallon. If you opt to ignore refilling the tank and go with five, two, or one gallon containers refilled at the grocery store instead, water is food, and it is covered by SNAP. Many gas stations have sinks where staff are willing to let you fill a few gallons for free, and some gas stations also have free sewer dumps, especially those close to casinos. Water and Ice stores can refill any size container for as low as pennies per gallon, but on average expect to budget $0.25-$0.75 per gallon.

Some campsites come with access to water hookups. If you’re staying in a trailer on someone’s property, they may let you connect to their water spigot. In these cases, an in-line water filter can help protect you and your system against any contaminants that might be in the pipes or water. A water pressure regulator can protect your internal plumbing from too intense water pressure causing damage from an external hookup. Using PTFE plumber’s tape at fresh water hose connections when refilling the water tank or using the trailer’s pressurized plumbing system will help prevent water leakage at the connection points.

Potable water is the most vital resource in a survival situation. This is especially true if you empty your fresh tank during cold seasons and utilize more rural and uninhabited areas for economic reasons or to avoid being harassed. If you get stuck or your vehicle breaks down and you are far away from resources, what you have is what you have, and water is critical.

Sanitizing the Fresh Water Tank and Protecting the Water Pump: For health reasons, it is recommended to sanitize the fresh water tank and all pipes that carry clean water at least once every six months, particularly for full-timers, to cleanse and kill any contanimates in the system; do it more frequently if you are concerned or if there is a funky odor. RV stores and the camper aisles in large department stores usually offer fresh water tank sanitizer in a liquid solution or tablet form; however, this can be an expensive way forward. 

A more economical approach is utilizing general use bleach that is easily found at most department stores and quite affordable. While the rest of the directions are easily accessible online, the bleach to water ratio is 1/4 cup bleach for every 16 gallons of fresh water or 1 ounce for every eight gallons (only during the sanitation cycle; do not drink bleach or add it to regular potable water for normal use).

To keep the water pump functional and extend its lifespan, do not run this piece of equipment dry. When you hear it sputtering or see that water is not coming out in a proper stream, that likely means your water tank needs to be refilled and your pipes have some air in them (or else you have a leak somewhere compromising the sealed system). To prevent damage, stop running the pump until more water has been added or the leak has been repaired. If you hear the water pump running while all the taps have been off for an extended period, that means you are losing water somewhere slowly and the pump is restoring pressure in the system. Check that all taps, shower heads, and toilet installations are fully off; if they are, then check the joints where different PEX pipes connect, particularly around the toilet and near the water pump and by the hot water heater; if those are all solid, then start checking the pipes themselves for cracks, particularly the ones on the exterior undercarriage if it is winter and you are still using your fresh water tank.

The water pump should always be turned off while in motion. If any bumps or jarring of the rig loosen a water fixture during the drive, water will flow continuously until someone shuts it off or the tank runs dry. If your fresh water tank holds considerably more than either of the individual dirty water tanks, the dirty tank could fill before the fresh tank empties, leading to an overflow situation that ends up all over the floor. 

Showers: For those who still wish to shower in the privacy of their own trailer but have emptied their fresh water tank, there are camping shower bags that can be filled with water and used in the shower cubicle to go to the gray tank while being highly efficient with water.

If you do not have the fresh water reserves to take showers in your own facilities or even if you do, finding a gym where you can shower is highly useful. Planet Fitness generally is recommended due to their low monthly rates and hours of operation. The YMCA may also have a reduced rate for those in need of financial assistance; if you don’t need the gym aspect of the YMCA, check to see if they offer just a shower pass, which is often significantly cheaper and is paid for per use instead of per month and doesn’t require all of application steps that their scholarship program does. If the YMCA shower pass is time limited and you need additional time, ask the branch manager for an ADA accommodation. Many state parks have coin-operated showers. 

Keeping Cool: Campers can quickly increase in internal temperature when the external weather is warm to hot, particularly if there is no airflow or ventilation within the trailer. There are several options for airflow and cooling that require different levels of electricity to sustain. Opening windows and using the screen door requires no power consumption; however, it can very much put the interior and any noise on display, which may be a safety or comfort concern depending on location. Stand-alone battery-powered fans are often some of the least powerful fan options, but will not put a direct draw on the AC grid or DC battery bank systems; this can be particularly useful if you want circulation directly near a person during the entire night without worry that it will impair limited power resources that cannot be easily spared or replenished. DC battery bank powered vent fans can often provide a strong interior current, especially if your trailer has fans with a large diameter and the ability to have one fan suck air in while another pushes air out; even these fans can drain a battery bank if run too long without recharging the battery bank, so be sure to monitor the voltage levels, though if a solar system is in place, you’ll be much less likely to run into issues here. Wired fans that run on AC grid power take considerably less amperage than the air conditioner system and are usually more powerful current makers than both battery-powered and vent fans; due to the minimal energy draw in comparison to the main air conditioning system, multiple grid power fans can usually be run at one time to create a solid current or a specifically directed air flow without particular concern, as long as there is steady access to grid power. Finally air conditioners draw the most power by a wide margin, but they also offer something no other option does: the ability to actually reduce the temperature instead of just moving air. 

It is far easier to maintain a cooler temperature than to attempt to reduce a hot temperature to a tolerable one. Letting cooling techniques start early before the heat of the day sets in helps immensely. Using structures that provide shade and block the sun’s rays, such as trees, rock formations, buildings, pavilions, umbrellas, and the trailer’s own awning, can prevent a great deal of heat from reaching the trailer in the first place. 

Air Conditioner: Trailers are metal boxes, and they conduct heat. Without a cooling system, they can easily start bumping triple digit temperatures inside during the summer, even in northern climates; this is not only extremely uncomfortable to endure, but also dangerous to one’s health. Roof air conditioner units are electricity hogs that run on either generators or grid power. If they get damaged, they do come in parts, so sometimes it is possible to find which part of it needs repairing or replacing and fix just that section for a reasonable rate. However, if it is a Freon issue or the core of the unit itself, roof RV air conditioners are quite expensive to replace and usually require a skilled technician to install. 

If this happens, there are alternatives. Portable floor A/C units are one option, though they do require a way to vent their heat output, they can be moderately pricey (though not anywhere near as expensive as a new roof unit), and they eat up valuable floor space in a small area. Connecting vent tubes to windows or other vents to put the hot air created by the floor unit outside will be needed. Drawbacks of these styles of A/Cs are that they have a tendency to be louder than others and they often don’t last as long before breaking; however, they are the simplest to set up if a replacement is necessary, though finding a way to prevent it from rolling while on the move may be a challenge and will need to be addressed. 

Window A/C units are another option; the difficulty here is the oddly shaped trailer windows that do not open in a standard way. To overcome this, a window can be removed, especially if you will be in one place for an extended period. Trailer windows are held in place with a combination of compression and butyl tape; remove the inner frame and use a slender wedge to pry the outer frame away from the trailer shell and the window will pop out in one piece and can easily be put back in later with some new butyl tape and some sealant on the upper third to prevent water leakage. A housing to hold the window A/C unit in place will have to be constructed to work around the lack of standard window and frame, but this can be done with four sections of plywood—two interior, two exterior, and two above the A/C, two below the A/C—and 2” thick wood to fill the gap between the boards. Used window A/C units can easily be found online fairly inexpensively and are available in many sizes that cool many different square footages at different amperage draws; they are generally highly dependable. 

Vent Covers: A great deal of heat comes from the sunshine through the vents in the roof; blocking the sun’s rays, particularly in the hotter months, can significantly cut down on the internal temperature. There are specific external vent covers designed for this specific purpose, but if your trailer doesn’t come with them and they are not in your budget, any sort of interior covering will be a massive assist. Keep in mind that you’ll still want to be able to turn on the vent fans for circulation, so ideally something fabric or at least flexible so a corner can be pulled down to access the controls and increase air would be best. 

Window Coverings and Privacy: Windows are where thermal transfer will happen the most and where you will be the most exposed when it comes to privacy, though the walls are thin in general and sound does carry easily. Cold and heat and light will come in through the windows; adding blackout curtains can help retain some of your internal temperature regulation, as well as block out both light coming in and light going out. Reflective windshield barriers and Reflectix radiant bubble insulation can be put in windows to help keep heat in during the winter and keep heat out during the summer; it also offers additional privacy, and it can be easily removed if you prefer to take it down. When purchasing a trailer, those with window tinting or reflective applications offer additional privacy to those with clear windows that provide easy views to the interior of the unit. 

Slide: Slides or tip outs extend the square footage of a trailer. A trailer may have none to multiple. While most people prefer to automatically extend their slides under electrical power, if you cannot do this for some reason, slides always have a manual option; however, this option requires hundreds of rotations, so prepare for it to take a long time. Some people are able to attach a power drill and do it quickly that way, but not all trailers are able to accommodate that trick. If you need to manually extend or retract your slide, there is a piece of equipment called the slide brake or slideout room controller; you need to find out where yours is (check the path between your breaker box and where your power slide button is) and disconnect the wire that says To Motor, otherwise the motor will remain engaged and you will be fighting against it the entire time and it will make the job about six times harder than it needs to be. Once the slide is in the position you want it to be in, reconnect the To Motor wire, so that the slide is held in place; this is especially important if you are about to drive, otherwise the slide might start to move out while you are on the road due to inertia. 

Supports: Jack supports are the jacks that are part of the trailer that extend to hold its weight when it is standing independently; sometimes the internal gears wear or strip from use or age, but these can be replaced. Jack supports can be extended automatically or manually. Rear stabilizers help prevent shaking and rocking of the trailer while it is stationary and people are moving inside; sometimes these are part of the trailer and sometimes they can be purchased separately and added later. Slide supports offer additional structure for the slide to rest on when it is extended; they are purchased separately. For fifth wheels, a king pin stabilizer offers additional structure to the front of the trailer that hangs above the ground; it is purchased separately.

Lighting: Particularly if your trailer is older, the lights in your trailer might not be very efficient, creating a high amperage draw and limiting your electricity use and, if you have a solar set up, solar efficiency. Replacing old bulbs with low watt, low amp LED bulbs and strips can be highly efficient when it comes to electricity, even if it does cost some money. It also may not be necessary to have a light bulb in every housing; if you have a double-headed light, try putting in just a single bulb and see if it adequately lights the area for you or if you do indeed need to add that second bulb. If some lights don’t work electrically, puck lights that run on batteries can be an alternative; leaving them loose, adding adhesive, or a magnet to the back can make them versatile. Ones with magnets on the back are quite useful for the stove hood when cooking while attempting to be discreet. LED strip lights can be a great addition, especially for those with regular access to grid power. For those who rely more on battery and solar power, LED solar-powered lights can offer a way to brighten a camper with limited energy draw and without dipping into battery bank reserves.

Cabinets and Countertops: If you’re moving regularly, your cabinets may pop open while you’re in transit, spilling their contents everywhere. Prevent this by taking shoelaces, other string, or thin rope and tying cabinet doors closed; you can tie the oven and the fridge shut too, especially if you aren’t confident in your hauling skills and hop curbs or similar things at times. If you have cabinets behind your slide when it is retracted and they aren’t tied shut, particularly if one of them can bump into a slide window if it pops open, put a dish towel around its handle to protect the window. Alternatively, remove the cabinet doors behind the slide entirely and put appropriately sized pieces of wood in the openings instead that come up about halfway, leaving the top open and accessible to be reached even when the slide is retracted. That way you can access what is in those cabinets even if you have to live with the slide retracted for a while, instead of losing access to a large section of your storage, which may contain critical components. The wood pieces will prevent things from falling out in transit and when stationary with the slide out, the wood pieces can be removed and stored until needed again. 

For those whose cabinet doors loosen at the hinges, sometimes simply retightening the screws will revitalize the cabinetry. However, when the screw holes are stripped and tightening no longer works to fix the problem, breaking off toothpicks and inserting one or a few into the screw holes can offer a solution to resize the hole while being a soft enough wood to still be able to manually screwdrive the screws into the hinges again. 

Keep cabinet doors open during winter, particularly if you are unable to maintain a temperature above 60F. This will help prevent moisture condensation and mold growth in damp cabinets. In cabinets with double doors, only one door needs to be open. This is more important for cabinets on the shell wall and doesn’t matter so much for interior cabinets. 

When in transit, countertops and other flat, smooth surfaces should be cleared or things will fall off of them onto the floor. Things can be put into the sinks or moved directly to the floor or other places to prevent them from creating a mess while driving. 

Loose material in drawers and cabinets will move during transit. Organizational containers and buckets can help keep items in their proper places. As the rig rattles down the bounces, potholes, and speed bumps of the road, personal belongings will gain slight lift and then come crashing down onto whatever surface they were resting on; this can be particularly detrimental to glassware, ceramics, and other breakable materials. Replacing delicate items with more durable ones, putting layers of padding in between items that could crack or shatter, and closing the gap (putting a plastic bowl between the top of the cabinet and the plates), so that they cannot get lift can all help prevent messes and meltdowns during highly stressful situations.  

Carpets: For those without the space or electrical ability to run a vacuum cleaner, carpets can be admirably cleaned with a stiff-bristled brush. For those who prefer not have carpet and have the resources or frugal-finding skills to obtain different flooring, pulling up the carpet and padding in a camper is generally not considered a professional level task, though putting down or trimming the new flooring may be more challenging, depending on the type of flooring utilized.  

Tire Covers: If parking in one place for an extended length of time, UV rays can degrade tire rubber and cause a tire blowout the next time the trailer or vehicle is moved. Help reduce this likelihood by blocking UV radiation from the sun with coverings over the tires. This is particularly important if the trailer is put into storage in a place exposed to the sun where it is expected to remain for a considerable period after you get into stable housing but desire to retain your trailer as an asset in case you ever find yourself homeless again and needing shelter. 

Camper Storage: If putting the camper into storage, there are fully enclosed, partially enclosed, and unenclosed options. When campers are going to be exposed to the elements for an extended time without use, it is best to protect them, either with the shelter of a building or a fabric cover. There are specially made camper covers for trailers of all types and lengths, but if that is out of budget, a tarp and some rope is far superior to full UV, rain, ice, snow, and hail exposure to maintain its quality.

Brake Controller: If you have to outfit your own vehicle or purchase a new truck to haul a rig, there is an extremely important piece of equipment called a brake controller that actually goes in the hauling vehicle but without which towing is extremely dangerous. Brake controllers send signals to the trailer, in accordance with the controls being activated in the main cab, to light up turn signals, parking lights, and—most importantly—the trailer’s own braking system. Without it, your vehicle will be attempting to stop the momentum of the entire rig, which will rapidly burn through your brake pads and might not even work depending on how steep the hills are in your area combined with the weight of your fully loaded rig. Brake controllers can be professionally installed or done DIY. 

Towing Hitch: Another necessary piece of equipment is the hitch that allows the vehicle to connect to the camper to haul it safely. It is important that the trailer is level while it is in motion, which—depending on the height of your vehicle—may require some adapter pieces. It is even more important that your hitch is appropriately rated for the gross weight of your camper when it is carrying your belongings and when the water tanks are full. 

Every vehicle will also have a maximum towing capacity—also known as the tow rating—that should not be exceeded. Individuals that ignore the towing capacity put extra strain on critical vehicle components, such as the engine, transmission, drivetrain, brakes, and tires; tow vehicles require structural reinforcement to haul their loads and should not be overburdened. 

While bumper style hitches can be professionally and often DIY installed, fifth wheel and gooseneck style hitches usually require professional installation due to either needing to cut through the truck bed or otherwise weld things together. As these are located over the rear axle and will haul significant weight, mistakes here could be catastrophic. For those interested in purchasing a different vehicle better suited to their towing needs, searching for vehicles that come with pre-installed hitches could help significantly, particularly if there is a time crunch. 

For those with trucks or looking for trucks, the long beds are generally preferred for towing fifth wheels as opposed to short beds because on tight turns the long beds are less likely to have the front of the trailer and the rear window or frame come into contact.  Additionally, for the very large, very heavy fifth wheel campers, a dual rear wheel style truck may offer better traction, stability, and towing power. 

Internet and Signal Boosters: Affordable phone plans from MVNOs or Lifeline providers offer access to data via mobile wireless 4G LTE internet. There are also hotspots that provide service. For those looking to expand their service range, signal boosters could be explored.

If you’re staying in one location but it is rural or has poor service without standard internet providers, satellite (which also works from place to place) or fixed wireless (which uses radio waves from local towers to rented antennas and is often cheaper than satellite) are options to look into as alternatives. Campgrounds often offer wi-fi to their campers. Libraries and other public spaces usually offer internet to use, and libraries also offer access to public computers; if you don’t have a library card there, you can ask for a guest pass to use their computers. 

Downloading songs, videos, games, audiofiles, books, and the like to use offline when you are out of service range is a good idea if you intend to spend a considerable amount of time in out of the way areas to avoid being harassed, especially in far out places like federal or state land conservation areas. 

Age and Appearance: Many private campgrounds and rental lot communities have age restrictions on trailers of 10, 15, or 20 years or otherwise require units to be in a condition that meets certain standards of appearance. Consider this when purchasing your trailer, as you cannot make your unit any newer than its year, and it will only get older. Some places will also have size limitations due to space available. 

PO Box and Address Service: Before losing access to your current residential address, consider how you’re going to get mail going forward. Some people have friends or family that will allow mail to be sent to their address; this can in some cases create issues with legal domiciles, health insurance, vehicle or trailer insurance, social benefits, or other legal records, so take a look into this to ensure it doesn’t backfire on you. Others prefer to use professional RV mail forwarding services; these services provide a physical address for their clients to use and some of them also help their clients gain residency in that state if they so desire, though that is not usually required. Others prefer to use postal service boxes; to make PO Boxes look more like standard apartment addresses, the post office street address can be used followed by the box number, and the mail will still make it to the correct location. 

For those who purchase a trailer or vehicle shortly before losing access to their current primary residence, remember that the title to your new possessions will take several weeks to arrive unless you pay a premium for a Quick Title; you can have that sent to your new address to ensure you receive the documentation proving you own this asset instead of it potentially arriving in the mail at your old address after you’ve already left it.  

Insurance: There is specific insurance for trailers and even more specific insurance for those who live in them full-time, which covers things like personal liability, personal possessions, collision, comprehensive, medical payments to others, and loss assessment coverage. If you are using a trailer or RV as a permanent residence and do not have full-timers insurance and instead have a recreational policy, your insurance provider may deny your claim. Insurance relies heavily on “garaging” addresses or the physical address where the vehicle will be located; getting insured as a person without a physical address is not easy. It is far simpler to have policies active before leaving your current physical address at your primary residence. 

Storage Unit: For those seriously considering this full-time trailer life option out of necessity, it is likely you do not have a strong social support network to assist you, where you can put your things during this trying time. If that is the case, you may well need additional storage to keep your belongings that you do not keep in your trailer secure. While many units do not offer this perk, some do provide an outlet (generally in the larger units for car mechanic’s power tools) and you may be permitted to plug in a deep freezer as they are very cost effective when it comes to electricity; if so, this can greatly expand your food storage options, as trailer freezers are quite small. If you are someone who has your pet(s) with you, consider the complex’s pet policy; some are pet friendly, some are ambivalent and willing to work with you, and some are strictly no animals on the premises. Consider their insurance requirements, as that is often not included in their displayed rate but is usually mandated and increases the cost. 

Places to Stay: State parks, private campgrounds, and federal lands are all places to consider. For those without the financial resources to afford the safety of campgrounds on the regular, but who do have enough physical and psychological well being to do a few hours of fairly low key work a day in exchange for a camping site, camp hosts are often provided with full utility sites and sometimes paid a wage on top of that, usually for four hours or less (about 20 hours a week) of labor consisting of checking in campers and preparing sites for the next visitors after the previous campers have left.

On Bureau of Land Management (BLM) federal lands, dispersed camping (boondocking or dry camping as opposed to designated campsites) is free and an individual can stay for up to 14 days out of 28 days before needing to move at least 25 miles from the original location. On National Forest Service lands, dispersed camping is permitted for up to 14 days at a time out of 28 days before needing to move at least 5 miles away from that site. There are additional guidelines that should be followed to preserve the nature reserves, so if you decide to go to federal lands, be sure to check those out first. If you want to go to a designated campsite, the federal America the Beautiful! pass offers 50% off of campsites and many states offer discounts to disabled residents. Apps like TheDyrt and FreeRoam can help provide additional information about places to stay.

Casinos may have RV parking available, though you will likely need to register your vehicle inside. If it is for patrons only, even a dollar or two in the slot machines is a paying customer and is far cheaper than pretty much any other paid site. Casinos often have parking lot security that makes rounds throughout the night. They may have a limit on how many nights a week you can register and a time by which you have to leave in the morning. Other private businesses may also welcome RVers to stay overnight in their parking lots, though this should be checked online and verified with each individual business. 

Know what your local codes are when it comes to vehicles and/or trailers being parked in one place for a period of time before code enforcement can be called. There may be a period of time provided to move your property. If your property is impounded, there are likely high fees imposed to get it back, which just makes getting out of homelessness harder or else puts you in a worse, less protected position if you are unable to pay the fees to get your property back. The fees will continue to accumulate until you can either pay them off or sell your possession to pay your debt, if you do it fast enough; if you don’t do it fast enough and the auction of your possession does not cover the fees your possession has accumulated, you will still owe the impound yard a bill and if you do not pay it, the bill will go to collections and impact your credit score. 

For those more interested in staying in one place, look into manufactured home communities; some have specific spaces where trailers can hook up to utilities, though they may have age or appearance restrictions or limitations on income, credit scores, other background check information, or pets. There are also the closer squished and generally more run down RV parks; depending on state laws, there may be a maximum amount of time that a person is allowed to live in a trailer in an RV park before the trailer has to move. In both of these situations, be aware that lot rent may be changed on you with minimal notice. 

There is also the option of staying in the yard of a family member or friend if your local area codes permit such a thing or if your codes aren’t strictly enforced, providing you with the security of not having to move constantly or be subjected to the true negative interactions with law enforcement or other individuals while not having to be in the other person’s house and keeping some privacy for yourself. You could also try this with a stranger in a more landlord style situation, though know that your landlord would be right next to you and remember that the walls of trailers are thin and sound carries. This could put you in a pretty vulnerable position, depending on what kind of person the landlord is and how much they feel entitled to know your business and control your life because you’re living on their property with them. 

There is also renting land from someone who does not live on that land, but which is not in a rental lot style community, providing more space and privacy. Be aware of landlords who don’t fulfill their legal obligations despite knowing full well that the documents they want you to sign and what they’re offering (a full-time rental lot) are not aligned. These kinds of landlords often know exactly what kind of demographics they are targeting and will withhold information and services on the (usually correct) assumption that they will not be held to account because their desperate tenants will otherwise be much more transient. 

If paying in cash, particularly if the landlord requests being paid that way, a receipt of your payment is meant to be provided without asking. A recreational lease is not a residential lease. A landlord has minimum obligations of standards of living they are supposed to provide, which may vary state to state. A person can live in a camper for a period of time on their own property and not be considered homeless; a person cannot reside in a camper long-term on someone else’s property and not be considered homeless, especially if that property does not have all basic amenities. Check your tenant rights in your state if you are in this situation; even if you cannot do anything about it, knowing that your rights are being violated by someone taking advantage of your situation can be mentally fortifying. If you are in a situation similar to this, you likely still qualify for homeless resources, as this is essentially camping on a rented lot.

Transportation Services: For those who are uncomfortable driving large trucks with large rigs or who can no longer drive or who do not have the financial resources to afford both a trailer and a truck or who only need to move a trailer infrequently, there are trailer transportation services who will come with their own vehicles and move your trailer for you from one location to the next and set it in place for you for a fee. If you will be moving regularly, this is an expensive option and not very budget friendly. Be on the lookout for those who will attempt to change the price on you if they realize you are in a bind or who present themselves as more competent than they actually are; if you find a professional driver or company with quality work and a reasonable rate, hold onto their contact information. 

Moving on the Regular and Living in a Camper Long-Term: Campers were designed for recreational use, not for long-term residential living; as such, they do not meet building codes and that becomes very apparent if you reside in them for an extended period. If your circumstances require moving regularly to remain discreet, perhaps even multiple times a day, consider how that over time will add wear and tear to your possession. Every time you move a trailer is basically like taking it through its own earthquake, and those add up. The less you have to move your trailer, the better for its structural integrity, especially if you intend to live in it for an unknown period of time. Recreational vehicles are intended for short periods of use and long periods of storage, not years of daily living, particularly if you are unable to afford or physically carry out the required maintenance. If you will be in a position where living in your trailer for multiple years is a possibility or a certainty, take precautions from the very beginning to counteract the cumulative damage of daily living in something that was not built nor intended for that purpose, especially if your trailer is older.

SSA, Asset Valuation, and Exemptions: While using a trailer as a primary residence—even if you’re homeless while you’re residing in it, with no fixed address—the trailer is exempt from the SSA resource and asset limit. As soon as you are no longer living in it as your primary residence, due to finding stable housing or doubling up in someone else’s home as your primary residence, it will no longer be exempt and will have its value counted towards the resource limit, which may be worth taking into account when selecting a camper. The SSA uses NADA / JD Power to find the value of the year, make, and model of your specific trailer. If you disagree with the online value due to damage or additional factors, you can get it appraised and submit a letter from the appraiser to the SSA disagreeing with the book value; there are professional trailer and RV appraisers who primarily assess damage and there are also RV centers who primarily deal with trade-ins who may be willing to offer their assistance if you explain your situation.  

Necessary Additional Items: Sewer hose with end caps to empty black and gray tanks; fresh water hose to refill tank or use pressurized water system; black tank deodorizer; tire leveling blocks; wheel chocks to prevent motion once parked; towing hitch; tire pressure gauge suited to the size of trailer tire pressure; waterproof PPE / gloves

Useful Additional Items: Slide supports to stabilize the slide; king pin support to stabilize a fifth wheel; sewer hose elbow adapter; sewer hose support to keep hose off the ground and at a gradual angle; RV and marine battery trickle charger to use generator or grid power to recharge battery bank; Electrical Management System (EMS) to protect the trailer electrical system from power surges, voltage inconsistencies, and improperly wired shore power that can cause considerable and expensive damage trailer systems; in-line water filter to remove contaminants before entering the trailer water system; thread sealing PTFE plumber’s tape to prevent water leakage at hose connections; water pressure regulator to protect the plumbing system from external water pressure that is too high; electrical tape; multimeter; hitch lock; DC air compressor; inverter/uninterrupted power supply; winter tire equipment or chains

Other Additional Items: 30 amp or 50 amp extension cords; 6mm or thicker poly tarping skirting; solar array [major components: solar panel(s), solar charger]; inverter; RV and marine antifreeze; screened portable pavilion; portable/tabletop propane grill; portable/tabletop propane range; solar generator; car jacks and heavily rated jack stands; outdoor chair; easy-remove-easy-attach propane pigtail hose; low wattage dehumidifier; brake controller; wire strippers/cutters

Car Living 

There are a great many YouTube and TikTok channels, websites, blogs, and other online resources for improving one’s situation while doing urban car living, and it is strongly urged that those who will be in these circumstances to explore more specific assistance on the topic, as it can massively improve one’s comfort and longevity while homeless. This section is mostly to direct people’s attention to broad concepts that they may not know about, so that they can research more about it from specific resources suited to their circumstances and vehicle. 

As a general rule, cargo vans, minivans, conversion vans, and short buses offer more living space than compact cars and midsize SUVs. There are many, many plans available for free on how to convert a vehicle’s rear space into a sleeping area or even a transformable sleeping/seating/storage/mini-kitchen area. 

Window tint and having barriers on the inside of windows during the night offers more discretion and reduces the likelihood of being harassed. Putting up a moveable barrier between the front seats and the rear area of the vehicle offers more privacy. A windshield sun shield also offers another layer of protection. 

If there is enough space in your vehicle, there are several kinds of portable toilets that provide safety and comfort of always having the ability to go to the bathroom, even if businesses are closed for the night. If nothing else, having a bottle (and Stand to Pee/”She-Wee” or funnel, if necessary) that can be used when needed and emptied or thrown away later can greatly relieve anxiety and improve comfort. 

Solar generators are quiet, eco-friendly power banks that, depending on the size, can power an array of items. Unlike standard or inverter generators, they do not announce one’s presence through noise, and can be preferred for those in an urban environment. 

There are ways—ranging from quite simple and straightforward to more complex—to set up running water, if the vehicle has the space for a water station. The overarching concept is pulling fresh water from a jug up through a spigot to use (refill bottles, wash hands, clean dishes, etc) and let the dirty gray water drain into an empty jug that can then be dumped when desired. 

A hot plate, electric lunch box, or portable propane/butane range can be used for cooking or heating meals, depending on the set up. For those without the space, ability, or resources to do something like this, look for foods that can be eaten as-is without refrigeration (nuts, nut butter, fruit, some vegetables, breads/tortillas/naan, saltines, granola, canned or on-the-go chicken or tuna, jerky, summer sausage, condiments, almond or soy milk), with the mild cooling an ice chest can offer (pre-cooked meats, yogurts to be eaten quickly, hummus, cheese, butter, some fruit juices, lemon or lime juice with salt and water for DIY electrolyte drink), things that can be eaten with the addition of hot water that can be found at many gas stations or fast food places or heated with a camping stove (noodle cups, pasta, instant potatoes, quick rice, soup), or with the use of a microwave (with SNAP you cannot buy hot food, but some places will sell you cold food and then heat it up for free).

Keeping trash contained to one specific area will assist with preventing the already small area from feeling completely out of control and overwhelming, as it does not take much garbage to eat up the visual space and put additional stress on one’s nervous system. 

For those with larger vehicles who can remove the rear seats, that can create a massive amount of moving and/or sleeping space, though it may require a trip to the dump if you cannot store the seats. For those with smaller cars who need to keep the rear seats, there are inflatable and non-inflatable rear seat mattresses that add structure across the footwells and can make back seat sleeping far more spacious, comfortable, and safer – and create enough room for two to share if you are homeless in a group. The inflatable ones are prone to developing leaks, so a more solid, non-inflatable option with a foldable mattress or egg crate may be the more economical solution if car living is going to extend for a longer period of time. For those comfortable putting down the rear seats, sleeping with feet in the truck and head in the main cabin can provide more room and stability than rear seat mattresses, and if a person is short enough, they may be able to fully extend while sleeping or resting.  

A major drawback of this style of sheltering is that for many with CRPS, physical therapy is a daily or multiple time weekly part of the routine and these vehicles usually do not offer the required space to properly accomplish the exercises. They also, in most cases, do not allow individuals to fully stand upright, and in most smaller vehicles people cannot even fully extend when lying down, especially if there are multiple people in one vehicle. However, even this situation is far superior to being exposed to the elements on the street, and it is likely much more affordable in most circumstances than the full-time RVing option, especially if a person does not already have a trailer of their own and has not really trailer camped recreationally before. 

With this method, your vehicle is critical. Catching small-to-medium problems before they make the car inoperable can be the difference between being able to afford the repair and being on the street. Maintaining fluid levels, especially motor oil, engine coolant, and transmission fluid, can prevent catastrophic engine and transmission destruction. If there is a head gasket or radiator leak that is small, there are sealants that can be used as stopgap measures. If you do pay for an engine or transmission replacement or other major mechanical repair, pay attention to if it comes with a warranty and the parameters of what that warranty covers, as it may save you hundreds or thousands of dollars or prevent you from selling or scrapping a vehicle and ending up in a significantly worse position. Remaining on top of any vehicle registration, insurance, or loan payments is one of the highest priorities in this situation to ensure you retain both your shelter and mechanical mobility.

For those who cannot afford the trailer option but like the concept of campgrounds for safety, investing in a new or used sizable tent and a portable mattress or cot can greatly increase one’s sense of space and ability to stretch. Battery-powered fans, rechargeable batteries, and a trickle charger solar panel system can assist with increasing airflow and making tent living far more tolerable for those with difficulty regulating their own body temperature, particularly in hotter months. 

  Street Living

The dangers of existing on the street without shelter, exposed to the elements, without easy access to transportation or bathrooms or water, and with the looming threat of hostile interactions with law enforcement, housed citizens, and other homeless individuals cannot be overstated. While those affected by CRPS are assigned female at birth at a rate of about 3-4 to 1, approximately 85% of all individuals who live on the street are cisgender males. 

Being homeless negatively impacts your nervous system and your cognitive functioning due to the overwhelming stress; the longer a person is homeless, the more stark the effects on the nervous system. While the majority of homeless individuals are acutely homeless as a transitory measure, many individuals who are chronically homeless [longer than 12 months or at least 4 separate occasions over the last three years with a total homeless time equaling at least 12 months] are chronically homeless because of either severe mental illness like schizophrenia, severe physical disability, substance use disorders that can cause them to be unsafe to be around, or those who are incapable of abiding by the standard rules of “polite” society. All of these can cause desperation and desperate people can be dangerous, especially if they are fully-grown, angry men without a physical disability who are not fully mentally present in reality coming towards someone they see as a much smaller, much easier target who cannot outrun them or overpower them. 

Law enforcement in many places is becoming increasingly antagonistic to the unhoused populations in their jurisdictions. Getting a record for trying to survive while unsheltered or amassing fines for sleeping in public can severely impair a person’s ability to improve their situation, especially for those who need regular access to medical care or who do not have money to pay off those fines. Some places are creating policies where a certain amount of tickets for public sleeping will result in a ban from the city, which could be highly detrimental if that’s where one’s care team is located or if there are not other places within an accessible distance for those with mobility difficulties. 

While many local residents pretend homeless individuals are invisible and a few may be kind, there is a subpopulation that view the homeless as a disempowered, disenfranchised, undeserving group on whom they can vent their frustrations and aggression without recourse or repercussion. The casual cruelty of this group is something for which to be alert, such as food that has been tampered with for the purpose of making the person who eats it ill offered with a smile or throwing or spraying liquids on a person that cannot change their clothes when the weather is cold in the hopes that they get sick or even just physically attacking someone who looks down and out for their own personal amusement. 

Many places, post-Covid, have public bathroom restrictions. Finding where the accessible bathrooms are in your local area is critical; if you are transgender or gender diverse, this can come with extra legal and physical safety concerns, especially if you live in a place that is legally hostile to your existence. Supermarkets, public libraries, gas stations, and public parks are all places to check. For afterhours or for those who spend time out in more natural areas and who do not have a pre-attached hose and would feel particularly vulnerable with dropping their pants and the public exposure associated with that (take that seriously, especially if your local area’s law enforcement is hostile to the unhoused; that can be a nasty charge that gets you on a highly unpleasant list), there is a camping tool called a Stand To Pee that works like a funnel where you can tuck it under your waistband and direct the other end towards a bush or a collection bottle to empty later, keeping your bits covered. 

For those with mobility difficulties or chronic fatigue, getting a bus pass (if your local area has public transit) can help significantly with getting around and hauling significant weight; many places offer reduced fare passes for the elderly, disabled, or those with student IDs. Additionally, finding some sort of wheeled assistance to help transport your personal belongings that you carry with you day to day can be a considerable force multiplier, so that you aren’t hauling them on your person and burning through your energy stores even faster. The more you carry with you, the more you have to protect, and the slower you will be if you have to get away from a hostile entity; if you can afford a storage unit or have a friend or family member who will allow you to store the majority of your things at their house so that you are only keeping the essentials on your person, that will make being on the move easier. 

The cold, heat, and wet are things to be particularly aware of, especially if you do not have shelter. A good coat, hat, socks, and gloves are necessary if you will be outside for hours at a time when it is below 60F, and even more so if it drops below freezing. A thermal sleeping bag can be ideal for helping retain body heat, but at the very least a high quality blanket is required. Think about what will happen if it rains and the blanket gets wet. Think about what will happen if you sleep in grass and wake covered in dew. Think about what will happen if you sleep on the concrete or in strong winds. 

Protecting your hands and feet from the cold is so important due to the high amount of small blood vessels that constrict in the cold and when stressed and the incredible amount of nerves in them that are fed and maintained by those blood vessels; when too long in the ischemic part of the ischemia-reperfusion injury cycle that is a core component of CRPS, the tissues start to experience damage from lack of sufficient oxygen. Faces are another area that have a huge amount of nerves, and people with CRPS who will be exposed to cold for hours at a time would likely benefit from high collars, hoods that can come over the face, and/or scarves. Extended cold exposure that causes damage can lead to not being able to feel the cold, not being able to feel high heat temperatures until your skin is already burning, and not being able to tell the difference between damp and cold.

Many cities and towns offer warming and cooling shelters during extreme temperature conditions specifically oriented at homeless individuals and those who do still retain housing but do not have heating or air conditioning. It will vary location to location, but many of these extreme weather shelters will accept pets with their owners. 

An umbrella can be of use in rain and light sleet and snow, but also offer some shade during hotter months. The ability to prevent water from being heated by the sun during hotter temperatures is important, particularly for those with body thermal dysregulation. Plastic and metal bottles will rapidly heat the liquids inside them; a large insulated bottle is best, multiple if possible. If you’ll be somewhere where there’s lots of sun and heat, heat exhaustion, sun poisoning, and heat stroke are legitimate concerns that will need to be addressed daily with shade, rest, and adequate hydration. If at all possible to afford or find, sunscreen should be used as a preventative measure for those exposed to high UV radiation, as those with CRPS have a higher likelihood of developing cancer.  

The safety and resources of public libraries should not be overlooked; they are one of the few places where people are not expected to spend money to be allowed to spend time. Charging phones and power bricks is possible. Using computers is easy, and many places offer free printing up to a certain number of pages per month. There are public restrooms and water fountains.  There is temperature control and seating areas. More and more libraries are offering a Library of Things where you can check out passes, tools, or other physical items and return them after you are finished with them. 

For things that cannot be mailed to a PO Box or for those that do not have a PO Box or someone else’s house where you are able to receive mail (and do ensure that doing that won’t mess up any of your or their benefits), Amazon offers Amazon lockers in many cities where you can send your package if you do not have an address to send it to.  

When selecting food, think about it being in your bag. Think about its weight, about if it’ll go off in the heat, if it’ll freeze in the cold, if it’ll pop open and make a mess, ruining your limited possessions. If you eat it and it causes you to have a bad gastrointestinal reaction, will you be able to deal with that? 

If you have medications, especially medications people would be tempted to steal for their own personal use or to sell, think about where you’ll keep them and how many of them at a time you’ll keep with you versus keeping somewhere else. What will you do if you’re robbed and your medications are taken? Will your doctors provide you with more? What if you are now known for having prescription medications and are robbed multiple times by aggressive men much larger than you? You can’t stay awake forever; what if they just take your things while you’re asleep? What will you do? The best way to handle this situation is to prevent it from ever happening. Medications are often the lifeblood for many people with CRPS; getting into a situation where your medications are forcibly removed from you while under such stressful circumstances is a nightmare scenario, and careful consideration should be put into how that can be avoided, especially if you are at a significant physical and gender disadvantage to the kinds of disreputable people who would steal from their fellow homeless. Be cautious when storing medications, and be extra mindful when taking them. 

Again, water is one of the most important things, so having a sizable water bottle and a place where you can refill it is imperative. For showering, read the section in the Full-Time RVing subheader. Laundromats are useful, if you do not have a friend or family member willing to let you use their machine, though it is often rather expensive to wash clothing that way. 

Those with CRPS are more prone than the average person to develop dental problems; due to lack of amenities and facilities, homeless individuals often also develop significant dental issues. Whether that is dry brushing with toothpaste and rinsing with a mouthful or two of water every day or keeping mouthwash or a fluoride rinse with you and pulling it through your teeth to help kill bacteria and break up plaque, any steps that can be taken to keep up with oral hygiene and prevent tooth decay and gum inflammation will benefit you in the long run, especially as dental repairs can rapidly rack up expenses and be the start of multiple issues down the line. 

SCOTUS and Grants Pass v Johnson

A recent ruling from the Supreme Court of the United States on Grants Pass vs Johnson on June 28, 2024 allows the government to cite and fine individuals who sleep outside or camp on public property. After “multiple” citations, which could be as few as two as referenced in the case, criminal trespass charges can be issued with higher fines and jail time up to 30 days. This case was specifically about how law enforcement can handle local homeless populations, even if all other sheltering facilities are full and there is literally nowhere else for the homeless individuals to go. This ruling has the ability to have nationwide ramifications. 

While this ruling does not force states or local governments to change their laws or policies, it has the potential to create a very hostile environment for homeless populations, especially for those who cannot get access to a local shelter, particularly due to limited space, restriction of medications, separation from their caregiver, group, pets, or belongings, mobility challenges, LGBTQ+ status, conflict with the doors locking or unlocking or other restrictive requirements, religious discomfort or trauma, or other personal history. Having outstanding court fines and a criminal record can make finding stable housing or employment significantly more difficult, so it is important to understand the basics of what this ruling permits governments to do, though it is at each government’s discretion if they enact similar laws or not. 

These are excerpts of Justice Sotomayor’s dissenting opinion from the Grants Pass v Jackson case that may provide some additional clarification on how broadly this ruling could be applied [reordered and trimmed for readability]: 

“[G]overnments need wide latitude, including to regulate when, where, and how homeless people sleep in public. The decision below did, in fact, leave cities free to punish “littering, public urination or defecation, obstruction of roadways, possession or distribution of illicit substances, harassment, or violence.” The only question for the Court today is whether the Constitution permits punishing homeless people with no access to shelter for sleeping in public with as little as a blanket to keep warm.

The scope of this dispute is narrow. Respondents do not challenge the City’s “restrictions on the use of tents or other camping gear,” “encampment clearances,” “time and place restrictions on sleeping outside,” or “the imposition of fines or jail time on homeless people who decline accessible shelter options.”

Almost all of these policy solutions are beyond the scope of this case. The only question here is whether the Constitution permits criminalizing sleeping outside when there is nowhere else to go. That question is increasingly relevant because many local governments have made criminalization a frontline response to homelessness. “[L]ocal measures to criminalize ‘acts of living’ by “prohibit[ing] sleeping, eating, sitting, or panhandling in public spaces” have recently proliferated” [. . . which can] “jail and fine those people for sleeping anywhere in public at any time, including in their cars, if they use as little as a blanket to keep warm or a rolled-up shirt as a pillow.”

No one contests that local governments can regulate the time, place, and manner of public sleeping pursuant to their power to “enact regulations in the interest of the public safety, health, welfare or convenience.” [. . .] The District Court’s injunction, for example, permits the City to prohibit “littering, public urination or defecation, obstruction of roadways, possession or distribution of illicit substances, harassment, or violence.” [. . .] The majority’s framing of the problem as one involving drugs, diseases, and fires instead of one involving people trying to keep warm outside with a blanket just provides the Court with cover to permit the criminalization of homeless people.

[The city] adopted three ordinances (Ordinances) that effectively make it unlawful to sleep anywhere in public, including in your car, at any time, with as little as a blanket or a rolled-up shirt as a pillow. The Ordinances prohibit “[c]amping” on “any sidewalk, street, alley, lane, public right of way, park, bench, or any other publicly-owned property or under any bridge or viaduct.” [. . .] A “[c]ampsite” is defined as “any place where bedding, sleeping bag, or other material used for bedding purposes, or any stove or fire is placed, established, or maintained for the purposes of maintaining a temporary place to live.” Relevant here, the definition of “campsite” includes sleeping in “any vehicle.” [. . .] The Ordinances also prohibit camping in public parks, including the “[o]vernight parking” of any vehicle.” [. . .] The City enforces these Ordinances with fines [. . .] and increasing [. . .] if unpaid. Once a person is cited twice for violating park regulations within a 1-year period, city officers can issue an exclusion order barring that person from the park for 30 days. A person who camps in a park after receiving that order commits criminal trespass, which is punishable by [. . .] jail and a [. . .] fine.

Yet the Ordinances do not apply unless bedding is placed to maintain a temporary place to live. Thus, “what separates prohibited conduct from permissible conduct is a person’s intent to ‘live’ in public spaces. Infants napping in strollers, Sunday afternoon picnickers, and nighttime stargazers may all engage in the same conduct of bringing blankets to public spaces [and sleeping], but they are exempt from punishment because they have a separate ‘place to live’ to which they presumably intend to return.” Put another way, the Ordinances single out for punishment the activities that define the status of being homeless. By most definitions, homeless individuals are those that lack “a fixed, regular, and adequate nighttime residence.” Permitting Grants Pass to criminalize sleeping outside with as little as a blanket permits Grants Pass to criminalize homelessness. [. . .] The Ordinances use the definition of “campsite” as a proxy for homelessness because those lacking “a fixed, regular, and adequate nighttime residence” are those who need to sleep in public to “maintai[n] a temporary place to live.” [. . .] The majority proclaims, with no citation, that “it makes no difference whether the charged defendant is homeless, a backpacker on vacation passing through town, or a student who abandons his dorm room to camp out in protest.” That describes a fantasy. [. . . ] Instead, someone violates the Ordinance only if he or she does not “have another home to go to.”

Many do not have access to shelters and are left to sleep in cars, sidewalks, parks, and other public places. [. . .] Respondents here, two longtime residents of Grants Pass who are homeless and sleep in their cars, sued on behalf of themselves and all other involuntarily homeless people in the City, seeking to enjoin enforcement of the Ordinances. The District Court eventually certified a class and granted summary judgment to respondents. As was the case in Martin, Grants Pass has far more homeless people than ‘practically available’ shelter beds. The City had “zero emergency shelter beds,” and even counting the beds at the Gospel Rescue Mission (GRM), which is “the only entity in Grants Pass that offers any sort of temporary program for some class members,” “GRM’s 138 beds would not be nearly enough to accommodate the at least 602 homeless individuals in Grants Pass.” Thus, “the only way for homeless people to legally sleep on public property within the City is if they lay on the ground with only the clothing on their backs and without their items near them.”

Shelter beds that are available in theory may be practically unavailable because of “restrictions based on gender, age, income, sexuality, religious practice, curfews that conflict with employment obligations, and time limits on stays.” [. . .] She cannot stay at Gospel Rescue Mission, the only entity in Grants Pass offering temporary beds, because “she would have to check her nebulizer in as medical equipment and, though she must use it at least once every four hours, would not be able to use it in her room.” [. . .] She is unable to stay at the only shelter in the City because she cannot keep her nebulizer, which she needs throughout the night, in her room. So she does “not know of anywhere in the city of Grants Pass where [she] can safely sleep or rest without being arrested, trespassed, or moved along.”. As she put it: “The only way I have figured out how to get by is try to stay out of sight and out of mind.”

Take the respondents here, two longtime homeless residents of Grants Pass who sleep in their cars. The Ordinances define “campsite” to include “any vehicle.” For respondents, the Ordinances as applied do not criminalize any behavior or conduct related to encampments (such as fires or tents). Instead, the Ordinances target respondents’ status as people without any other form of shelter. Under the majority’s logic, cities cannot criminalize the status of being homeless, but they can criminalize the conduct that defines that status. The Constitution cannot be evaded by such formalistic distinctions. The Ordinances’ definition of “campsite” creates a situation where homeless people necessarily break the law just by existing. “[U]nsheltered people have no private place to survive, so they are virtually guaranteed to violate these pervasive laws.” [. . .] [One] resident who sleeps in a van. Over the course of three days, he was woken up and cited six times for “camping in the city limits” just because he was sleeping in the van. [. . .] When an outreach worker tried to help [a different homeless man] secure housing, the worker had difficulty finding him for his appointments because he was frequently arrested for being homeless. He was arrested 198 times and had over 250 charged citations, all for petty offenses.

Grants Pass’s Ordinances criminalize being homeless. The status of being homeless (lacking available shelter) is defined by the very behavior singled out for punishment (sleeping outside). The majority protests that the Ordinances “do not criminalize mere status.” Saying so does not make it so. Every shred of evidence points the other way. The Ordinances’ purpose, text, and enforcement confirm that they target status, not conduct. For someone with no available shelter, the only way to comply with the Ordinances is to leave Grants Pass altogether. [. . .] The Ordinances, as enforced, are intended to criminalize being homeless. [. . .] The [Grants Pass] council president summed up the goal succinctly: “ ‘[T]he point is to make it uncomfortable enough for [homeless people] in our city so they will want to move on down the road.’ ”[. . .] One action item from this [Grants Pass council] meeting was the “ ‘targeted enforcement of illegal camping’ ” against homeless people. [. . .] The Ordinances by their terms single out homeless people. 

In Robinson v. California, this Court detailed one substantive limitation on criminal punishment. Lawrence Robinson was convicted under a California statute for “ ‘be[ing] addicted to the use of narcotics’ ” and faced a mandatory 90-day jail sentence. [. . .] it made “the ‘status’ of narcotic addiction a criminal offense, for which the offender may be prosecuted ‘at any time before he reforms.’ ” [. . .] [T]he Robinson Court did not rely on the harshness of the criminal penalty itself. It understood that “imprisonment for ninety days is not, in the abstract, a punishment which is either cruel or unusual.”  Instead, it reasoned that, when imposed because of a person’s status, “[e]ven one day in prison would be a cruel and unusual punishment.” [. . .] This Court has repeatedly cited Robinson for the proposition that the “Eighth Amendment . . . imposes a substantive limit on what can be made criminal and punished as such.” [. . .] Robinson should squarely resolve this case. Indeed, the majority seems to agree that an ordinance that fined and jailed “homeless” people would be unconstitutional. [. . .] the Ordinances criminalize conduct (sleeping outside) that defines a particular status (homelessness). [. . .] The Court wrongly concludes that the Eighth Amendment permits Ordinances that effectively criminalize being homeless.

Instead, the majority focuses almost exclusively on the needs of local governments and leaves the most vulnerable in our society with an impossible choice: Either stay awake or be arrested.

Criminalizing homelessness can cause a destabilizing cascade of harm. “Rather than helping people to regain housing, obtain employment, or access needed treatment and services, criminalization creates a costly revolving door that circulates individuals experiencing homelessness from the street to the criminal justice system and back.” When a homeless person is arrested or separated from their property, for example, “items frequently destroyed include personal documents needed for accessing jobs, housing, and services such as IDs, driver’s licenses, financial documents, birth certificates, and benefits cards; items required for work such as clothing and uniforms, bicycles, tools, and computers; and irreplaceable mementos.” [. . .] Incarceration and warrants from unpaid fines can also result in the loss of employment, benefits, and housing options. [. . .] (incarceration and warrants can lead to “termination of federal health benefits such as Social Security, Medicare, or Medicaid,” the “loss of a shelter bed,” or disqualification from “public housing and Section 8 vouchers”). Finally, criminalization can lead homeless people to “avoid calling the police in the face of abuse or theft for fear of eviction from public space.”

Every human needs to sleep at some point. Even if homeless people with no available shelter options can exist for a few days in Grants Pass without sleeping, they eventually must leave or be criminally punished. The majority resists this understanding, arguing that the Ordinances criminalize the conduct of being homeless in Grants Pass while sleeping with as little as a blanket. Therefore, the argument goes, “[r]ather than criminalize mere status, Grants Pass forbids actions.” [. . .] With no discussion about what it means to criminalize “status” or “conduct,” the majority’s analysis consists of a few sentences repeating its conclusion again and again in hopes that it will become true. The flaw in this conclusion is evident. The majority countenances the criminalization of status as long as the City tacks on an essential bodily function—blinking, sleeping, eating, or breathing. That is just another way to ban the person. [. . .] The Ordinances are enforced exactly as intended: to criminalize the status of being homeless. City officials sought to use the Ordinances to drive homeless people out of town.

The Eighth Amendment prohibits punishing homelessness by criminalizing sleeping outside when an individual has nowhere else to go. It is cruel and unusual to apply any penalty “selectively to minorities whose numbers are few, who are outcasts of society, and who are unpopular, but whom society is willing to see suffer though it would not countenance general application of the same penalty across the board.” [. . . ] This Court, too, has a role to play in faithfully enforcing the Constitution to prohibit punishing the very existence of those without shelter. I remain hopeful that someday in the near future, this Court will play its role in safeguarding constitutional liberties for the most vulnerable among us. Because the Court today abdicates that role, I respectfully dissent.

Closing

Living with CRPS while having a strong support system and sufficient finances is challenging; living with CRPS while becoming increasingly impoverished and alone, more and more dependent on a person who takes advantage of the power and control they hold over a disabled person’s life can be debilitatingly crushing on multiple levels.

Living with CRPS can be extremely disempowering, not only physically, but also emotionally and psychologically due to the neurological changes that occur in the condition, leaving a person feeling increasingly trapped and without options. In situations where the interpersonal power dynamics are heavily weighted in the favor of the person without CRPS—even in loving and respectful relationships, but especially in abusive, controlling, and coercive ones—obtaining personal resources and access to programs that belong to the disabled person and are not dependent on the good graces of a changeable interpersonal relationship increases a person’s autonomy and provides the ability to make informed choices in their own best interest with less desperation; it can increase a person’s independence, sense of contribution to their chosen group, or ability to remove themselves from an unhealthy environment that worsens their quality of life.

While we hope many never need the information included in the Resource List, the curation of this project is meant to be assistive to those having difficulties making ends meet, particularly those without solid support networks from friends and family, who need the institutional social safety net, or those who are now particularly vulnerable to exploitation and abuse by controlling, coercive figures who dominate their lives due in part to how CRPS has limited their ability to move freely and provide for themselves.

The unfortunate reality is that a person can do everything right, take all the proper steps, see all the specialists, follow procedure for aid from all the correct channels, put all their effort into keeping their head above water and improving their situation, and still lose. We hope this List helps prevent people from losing more than they have already lost or even regain some of the stability that CRPS has stripped from their lives.

If you know of additional programs of a similar caliber to what you see listed here that you think would benefit the community at large, please send an email to the address listed on this website and community contributions will be considered. While this List is not suited to local-, state-, or regional-only services, nationally available and widespread assistance programs are welcomed. 

For those interested in contributing, do not worry about sending in a polished summary section; however, please do include the program’s name, relevant websites or documentation that help explain the eligibility requirements or program overview, as well as any specific details or tips and tricks that may make things easier on those seeking assistance that wouldn’t be readily apparent, if known. If you would like to be listed in the Acknowledgement section under the special thanks to Community Contributors, please include the name by which you would like to be addressed [First, First L., F. Last, Username, Anonymous (any of these are welcome to be made up to protect your identity)] or if you prefer to remain unlisted, please let us know your preference when sending in your submission.

Those who would like to recommend programs outside of the USA, we have set aside a section in the Database to direct people to helpful resources in other countries submitted and added upon request. However, we do not feel we have the expertise on nor the experience with the intricacies of other nations’ healthcare systems, legal codes, social safety nets, and local languages to properly provide summaries as we do here in this List, so please try to include comprehensive links to either official or very explanatory websites about the programs you’d like to see added for a particular country.

Thanks for sticking with us, we hope you learned something, and we look forward to seeing you next time!

contender and ThePharmachinist