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The split is an analyst marginal prior, not provider accounting.","costs":"Annual donor cash cost $350/$200/$700 central/favorable/pessimistic for each of five years. Entire five-year envelope prepaid/reserved from the gift at time0, no interest credited. Includes medication, labs, visits/coordination and overhead within this stream, all failures retained. $200 favorable is an optimistic contextual claim, not verified complete course price. Additional unpaid annual $450/$300/$650 is gross nominal resource stress, not discounted incremental social cost.","finite_health":"Five-year achieved average treatment difference conditional on implementation, inclusive of missed visits, receipt and persistence versus usual accessible care. Only first composite cardiovascular event differences during years1–5 are counted. Event-year first-risk differences discounted, then finite event-specific utility loss or survival flow discounted from event. No lifelong blood-pressure effect. Constant competing mortality applies to all post-event health flows; case-specific extra mortality omitted except fatal first events. Core estimates assume the difference in first events during years1–5 creates durable event-specific consequences, not that every prevented event merely reappears just after year5. Later CVD catch-up is not explicitly modeled. This assumption can overstate benefit. Two calendar-window sensitivities clip every health tail at end of care year5, retaining complete costs and harms.","causal_boundary":"Source RR .80 per10mmHg is trial-meta-analysis anchor; exponentiation across achieved BP differences and application to five-year cumulative risk are modeling transfers. No-new-gift usual-care risks and achieved local differences are judgments. No additional adherence multiplier. Funding additionality addresses activity replacement separately from clinical usual-care substitution embedded in achieved BP difference.","event_partition":"Fatal composite event, nonfatal stroke, nonfatal MI and nonfatal HF shares sum1. Shares refer to avoided FIRST events, not all diagnoses; death not counted again as nonfatal injury. Mortality curve is finite, not sourced lifetime QALYs. Stroke source EQ-5D supports scale only, not causal no-stroke utility or all CVD events.","geography":"Global means all counted US health. Bay includes SF; Monterey and Santa Cruz excluded from nine-county Bay. .85/.95/.70 Bay shares are unmeasured resident allocation priors, not clinic-count ratios; all SF shares0 pending evidence.","funding_overlap":"Most medications and physician/lab/space support can be donated; add resource value, do not duplicate cash item. Current medication dispensing varies by clinic, Northern Peninsula lists prescriptions but not medications. Public coverage/other free clinics remain baseline. Operation Access referral partnership surgery benefits excluded entirely.","harm":"Shared harm per offered five-year course is an all-recipient present-valued health decrement before funding additionality, independent donor harm is a gift-specific health loss even at zero additionality. Same regional share applied explicitly. No monetary opportunity-cost subtraction.","sources":[{"id":"delivery","publisher":"RotaCare Bay Area","type":"Official clinic/program pages","title":"Current free-clinic portfolio and Northern Peninsula services","published":"Undated","url":"https://www.rotacarebayarea.org/nopeninsula","retrieved":"September 8, 2026"},{"id":"portfolio","publisher":"RotaCare Bay Area","type":"Organization-authored annual report","title":"2024–2025 Annual Report","published":"July 2024–June 2025 reporting period","url":"https://www.rotacarebayarea.org/_files/ugd/ebfb22_0d7dcc9504274e84b20fda5e4f93ec56.pdf","retrieved":"September 8, 2026"},{"id":"filing","publisher":"RotaCare Bay Area / IRS Form 990","type":"Provider-posted tax filing","title":"FY2024–25 Form 990","published":"July 1, 2024–June 30, 2025; preparer January 16, 2026","url":"https://www.rotacarebayarea.org/_files/ugd/ebfb22_030f1d31567346b1874f3aa9cd1d1513.pdf","retrieved":"September 8, 2026"},{"id":"sanrafael","publisher":"RotaCare Bay 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