GiveBetter x California

Champions for Health

Specialty-care access, immunization and physician support

Research time: ~7 min on GPT-6 Astra Light + ~5 min on GPT-6 Astra Medium + ~13 min on GPT-6.1 Sol
  • Research — reviewed programs, finances and impact evidence.
  • Modeling — estimated costs, QALYs and uncertainty.
  • Source audit — checked claims, assumptions and calculations.

Updated: 2026-10-02

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Summary

What do they do? Champions for Health coordinates donated specialty care for uninsured San Diego County residents through Project Access San Diego. Its staff help eligible patients navigate referrals, appointments and treatment, connecting donated clinician time with people who face access barriers. The organization also supports community immunization and physician education; our numerical comparison below covers the specialty-care pathway.

Why we’re interested in this organization:

  • Coordination can turn otherwise unused donated specialist capacity into care for patients with persistent symptoms or functional limitations.

  • Treatment may improve health and, for selected working patients, reduce medicine costs or restore paid work.

  • Original filings and dated patient counts let us distinguish cash-funded coordination from donated clinical resources.

Our main reservations:

  • The most recent dated cohort and financial year do not match, so future throughput and the share of a new gift reaching specialty care are forecasts.

  • Clinical case mix, treatment benefit versus alternatives and additional provider capacity are not measured locally.

  • Recovery and travel can reduce household resources, while the impact of immunization and other programs remains outside the priced comparison.

What do you get for your dollar? $30.7M per DALY in California. DALY is our one-year comparison unit. QALY-based health gains and income-welfare equivalents retain their original assumptions; they are not measured clinical DALYs. Conditional partial specialty-care forecast including signed household resources; other portfolio effects unresolved..

DatedFY2023–24:79 unique people,373 overlapping appointments,45 procedure records. Forecast repeat adjustment yields36 unique procedural patients,18 therapeutic and18 diagnostic-procedural, plus43 nonprocedural; branch makeup is not measured. Central$100000normalizer yields1.914917547 extra patient-equivalents, health.005071872655126345, resources−.001809875630476703.

1. What do they do?

Project Access San Diego (PASD) connects uninsured San Diego County residents with donated specialty consultations, procedures and follow-up. The current program page describes eligibility for adults aged 18–50, exclusions when public coverage is available, navigation support and limits imposed by specialist availability. The relevant intervention is coordinated access to clinically indicated care, not purchasing an arbitrary medical bill or counting every referral as a completed treatment.

The dated FY2023–24 report records 79 people, 373 appointments and 45 procedures or surgeries. These are overlapping activity measures: a person can attend several appointments or receive more than one procedure. The undated homepage instead reports 335 people and 63 surgeries. We do not assign those larger totals to FY2025 or combine them with the dated cohort. For the next-gift comparison we explicitly forecast 79 annual unique patients using the last dated cohort; the higher-throughput scenario shows how strongly that assumption matters.

Patient accounts describe severe gallstone pain and an elbow injury that interfered with work. They establish why access can matter, but they do not measure an untreated comparison, quality-adjusted life years or after-tax earnings. The organization also runs immunization and physician-support activities. Their benefits are not demonstrated to be zero; we have not established an additional health-and-income estimate for them. The published numeric comparison is therefore partial specialty-care impact, not a complete organization return.

2. Monitoring and information sharing

The annual report gives a useful activity denominator, but not a contemporary patient-level causal study. We need to distinguish unique people from repeated encounters, therapeutic treatment from diagnostic work, and short-term improvement from benefit that would persist beyond later alternative care. The reported 98.5% reduction in missed workdays lacks baseline day totals, respondent selection, wage incidence and an untreated comparison. It is not a causal income coefficient.

We allow repeated procedures through a judged 0.8 unique-procedure fraction. Applied to 45 procedure records, this gives 36 unique procedural patients within a fixed 79-person cohort. Half are assumed therapeutic: 18 therapeutic and 18 diagnostic-procedural equivalents, leaving 43 nonprocedural equivalents. The combined diagnostic/nonprocedural branch thus contains 61 of the 79 modeled people. Duplicate procedure records do not become new patients. Neither the repeat fraction nor this contemporary therapeutic split has been observed; the 2013 surgery-day report provides historical plausibility, not current composition.

For therapeutic patients, the model considers symptomatic hernia, persistently unrepaired fracture, refractory abnormal uterine bleeding and gallstone care. Condition shares and utility changes are transport judgments. A hernia trial finding little advantage in minimally symptomatic men does not prove the benefit assumed for more symptomatic patients; an uncontrolled fracture cohort does not identify California utility gains. The abnormal-bleeding trial supports finite clinical change but has comparator crossover. C-GALL challenges assigning a generic positive health gain to uncomplicated symptomatic gallstones: our center gives that pathway zero gross relief while retaining a separate judged treatment burden. A positive gallstone case is a sensitivity, not the preferred result. Cataract benefits are not imported from an age-mismatched older-adult trial.

The most decision-relevant missing evidence is a dated unique-patient cohort linked to the latest dedicated program costs, indication and procedure mix, comparable follow-up, and a gift-sized plan for extra funded coordination and committed provider slots. Population anecdotes or a financial deficit cannot substitute for those observations.

3. Qualitative assessment

Champions offers a plausible coordination mechanism: uninsured patients may need specialist care even when public coverage, later treatment or another charity does not provide timely access. Its public program descriptions and original filings make the mechanism and accounting inspectable. Donated clinicians can reduce the cash required for coordination, but their time is still a social opportunity resource; waived charges are neither a cash saving to every patient nor a measured welfare gain.

Our assessment is conditional on clinically indicated treatment and actual additional access. A private gift can preserve coordination, replace another grant, remain in reserves or encounter a provider bottleneck. Funding response of 0.5 is a declared forecast rather than an elasticity estimated from program revenue. The low direct PASD revenue and ongoing private support make additional coordination plausible, but they do not verify that half of the forecast patients would otherwise go untreated. The 20-patient capacity ceiling is likewise a diagnostic prior, not 20 confirmed available slots.

Program reporting supports ongoing activity, while current eligibility and changing immunization expenses caution against transplanting older throughput. Financial transparency does not establish treatment efficacy, marginal funding room or an unrestricted-gift allocation. We judge this a researched specialty-care opportunity with substantial unresolved parameters, rather than claiming measured organization-wide cost-effectiveness. Improvements in local follow-up and marginal capacity evidence could change both the central estimate and its ranking substantially.

4. What do you get for your dollar?

Our revised partial specialty-care estimate is approximately $30.7M per DALY: one modeled equivalent year in California. The original health-only diagnostic was $3.3M. The change is not simply adding an income bonus: it replaces a generic benefit-per-dollar bridge with named care pathways, finite incremental benefit, recovery burdens and a signed household-resource ledger. The numerical estimate is a conditional forecast, not a quoted donation purchase or a complete-portfolio return.

What does a dollar support? The latest original filing identifies $556,597 in PASD expense. Allocating recipient support and event costs proportionally gives $668,112 in modeled full PASD cash-like expense. Against a forecast of 79 annual unique patients, this is about $8,457 per coordinated patient-equivalent. This average is not a verified marginal fee. We forecast that 32.4% of an unrestricted gift reaches PASD, using its share of program expenses, and that half of the corresponding coordination changes access rather than replacing funding. An exploratory $100,000 budget therefore produces about 1.915 additional unique patient-equivalents. The budget is an arithmetic normalizer, not a recommended gift size.

Using the same proportional share in gift allocation and cost loading cancels the PASD expense share centrally: the implied people before funding response equal gift × 79 / $2,062,752 whole-recipient cash-like expense. This is a coherent allocation convention, not independent evidence of cheaper PASD productivity. The latest dedicated PASD cost is paired with an explicitly transferred 79-person forecast, not an observed FY2025 matched cohort. The mixed FY2024 PASD/contract/student-support category remains an adverse cost-boundary diagnostic.

Each selected pathway receives a finite half-year incremental health area, with no benefit tail beyond it. Gross health is discounted at the quarter-year delivery delay plus the exposure midpoint; judged recovery/adverse effects occur at treatment arrival. This yields 0.01 gross health years less 0.0041986 burden, or 0.0050719 credited health years per exploratory budget. The half-year area represents relief after alternative care, catch-up and fade; it is not an endpoint held indefinitely. Hernia, fracture, abnormal-bleeding and diagnostic-management utilities and success rates remain judgments, not contemporary PASD measurements.

Household resources include otherwise-paid medicine avoided, restored net paid work, additional postoperative wage loss and residual travel/appointment cash costs. We assume five or ten potentially restored paid days only on selected hernia/fracture paths, then discount for counterfactual recovery, treatment success and actual paid-wage incidence. Gallstone relief is unestablished centrally, so it receives no linked medicine/work saving. Three net lost paid days on procedures and $10 residual cash per appointment-equivalent are explicit burden priors after assistance and baseline alternatives. We do not count donated medical bills, unpaid productive time, gross employer output, baseline survivor wages or recurring lifetime earnings.

For each household, all first-year cash changes are netted before conversion using Coefficient Giving's reference crosswalk: 0.5 × people × log(1 + net resources / $30,000 annual household consumption). This is one first-year consumption exposure, discounted at delivery plus a half-year midpoint, separate from the clinical horizon. It contributes −0.0018099 equivalent years centrally because recovery/travel costs exceed the small modeled savings and paid-work gains. Health plus resources gives 0.00 combined years. Negative resource effects are not silently zeroed.

The preferred overlap premise is that clinical function/pain and nonmedical consumption are separate domains. Half/full overlap scenarios remove only positive gross health credit; negative clinical changes and procedure or independent resource harms remain. Unknown health or income makes the combined result unknown, whereas known-zero pathways remain zero. A complete-portfolio estimate remains unknown because immunization and physician-support effects are not priced. The partial figure is not asserted to be a lower bound on complete organization impact.

Sensitivity is large and unweighted. Extending the effective health area to one year gives about $8.1M; two years gives $3.3M, while the household-resource exposure remains one year. The undated 335-patient future-throughput case gives about $7.2M. Removing ordinary resource effects gives $19.7M; allocating all of a gift to PASD gives about $9.9M. None is an empirical confidence limit. The historical $3.3M remains visible for comparison, but it does not validate any of these forecasts.

Model, assumptions and sensitivity

Whole exploratory donor budget; only conditional PASD clinical and household-resource effects priced. Proportional cash-like overhead/events charged once; donated clinical opportunity costs and other portfolio effects remain unresolved.

California share=1 for modeled eligible San Diego County residents. Fixed unique cohort; no imported metropolitan population share or extra children/caregiver multipliers.

N=min(capacity,gift*allocation/costPerPerson*funding); each disjoint path contributes utility*success*finite exposure*delivery discount minus treatment burden. Overlap removes positive gross health only. I=.5*sum(people*log1p(net first-year household resources/baseline))*separate first-year discount minus independent income harm. Combined=credited health+I; price10=10*gift/combined if positive and known.

Dated cohort
"79 people;373 appointments;45 procedures" overlapping native activity counts (observed). Dated FY2023–24 report, not an observed2025 cohort or causal gain. [annual24]
Latest dedicated PASD expense
556597 USD FY2025 (observed). Original same-entity program expense; no donated clinical valuation. [original-2025-IRS990]
Cash-like normalizer
2062752 USD FY2025 (observed). Tax expense plus netted event expense, excluding recognized donated services; accrual-based, not cashflow. [original-2025-IRS990] [original-2025-IRS990ScheduleD]
gift
100000 USD exploratory normalizer (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
allocation
0.3238936580279041 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
costPerPerson
8457.117606131333 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
funding
0.5 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
capacity
20 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
uniqueProcedureFraction
0.8 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
therapeuticFraction
0.5 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
clinicalExposureYears
0.5 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
resourceBenefitFraction
0.5 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
clinicalTransfer
1 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
healthGrossScale
1 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
healthHarmScale
1 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
gallstoneUtility
0 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
diagnosticUtility
0.01 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
medicineAnnual
60 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
netPayPerDay
100 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
paidCashIncidence
0.5 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
postopLostDays
3 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
netCashPerAppointment
10 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
baselineConsumption
30000 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
discount
0.03 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
delayYears
0.25 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
overlap
0 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
independentHealthHarm
0 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
independentIncomeHarm
0 declared model parameter (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
healthUnknown
false diagnostic flag (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
incomeUnknown
false diagnostic flag (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
otherPortfolioUnknown
true diagnostic flag (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
incomeZero
false diagnostic flag (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
allPatientHealthZero
false diagnostic flag (judgment). Inspectable forecast/control. Throughput, allocation, utility, finite exposure, patient cash incidence and additionality are not measured causal effects; see report and candidate memo. [annual24] [pasd] [original-2025-IRS990]
Disjoint central patient health and cash ledger
"[{\"id\":\"symptomatic_hernia\",\"people\":0.1745241308698283,\"grossHealth\":0.0030953472460599337,\"overlapRemoved\":0,\"proceduralHarm\":0.000692956813057993,\"healthNet\":0.0024023904330019406,\"firstYearMedications\":27,\"firstYearRestoredWork\":112.5,\"firstYearRecoveryLoss\":150,\"firstYearExtraTravel\":47.21518987341773,\"netFirstYearResources\":-57.71518987341773,\"firstYearExposureYears\":1,\"receiptTimeYears\":0.75,\"incomeEquivalentYears\":-0.00016435561109671195},{\"id\":\"severe_gallstone\",\"people\":0.1308930981523712,\"grossHealth\":0,\"overlapRemoved\":0,\"proceduralHarm\":0.0010394352195869894,\"healthNet\":-0.0010394352195869894,\"firstYearMedications\":0,\"firstYearRestoredWork\":0,\"firstYearRecoveryLoss\":150,\"firstYearExtraTravel\":47.21518987341773,\"netFirstYearResources\":-197.21518987341773,\"firstYearExposureYears\":1,\"receiptTimeYears\":0.75,\"incomeEquivalentYears\":-0.0004221913752873339},{\"id\":\"unrepaired_fracture\",\"people\":0.08726206543491415,\"grossHealth\":0.003439274717844371,\"overlapRemoved\":0,\"proceduralHarm\":0.0012992940244837368,\"healthNet\":0.002139980693360634,\"firstYearMedications\":24,\"firstYearRestoredWork\":200,\"firstYearRecoveryLoss\":150,\"firstYearExtraTravel\":47.21518987341773,\"netFirstYearResources\":26.784810126582272,\"firstYearExposureYears\":1,\"receiptTimeYears\":0.75,\"incomeEquivalentYears\":0.00003808387127527736},{\"id\":\"refractory_aub\",\"people\":0.04363103271745707,\"grossHealth\":0.0012789802856983754,\"overlapRemoved\":0,\"proceduralHarm\":0.0004330980081612456,\"healthNet\":0.0008458822775371298,\"firstYearMedications\":25.5,\"firstYearRestoredWork\":0,\"firstYearRecoveryLoss\":150,\"firstYearExtraTravel\":47.21518987341773,\"netFirstYearResources\":-171.71518987341773,\"firstYearExposureYears\":1,\"receiptTimeYears\":0.75,\"incomeEquivalentYears\":-0.00012248162187395128},{\"id\":\"diagnostic_and_nonprocedural_management\",\"people\":1.4786072198693783,\"grossHealth\":0.001456914984642407,\"overlapRemoved\":0,\"proceduralHarm\":0.0007338605138287772,\"healthNet\":0.0007230544708136298,\"firstYearMedications\":0,\"firstYearRestoredWork\":0,\"firstYearRecoveryLoss\":0,\"firstYearExtraTravel\":47.21518987341773,\"netFirstYearResources\":-47.21518987341773,\"firstYearExposureYears\":1,\"receiptTimeYears\":0.75,\"incomeEquivalentYears\":-0.0011389308934939832}]" modeled patient-equivalents and first-year net household USD (judgment). Combined diagnostic/nonprocedural complement is not duplicate records converted to patients. HealthNet is after overlap; clinical burdens have treatment timing; resource exposure is one first year. [annual24] [pasd] [give] [hernia-trial] [fracture-cohort] [aub-trial] [c-gall] [income-method]

Central conditional specialty-care and household resources: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario central. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

low Funding: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario lowFunding. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

legacy Funding: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario legacyFunding. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

high Funding: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario highFunding. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

complete Replacement: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario completeReplacement. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

replacement With Harms: Cost: $100K; California health QALYs: -0.01; all-population health QALYs: -0.01. Income-equivalent healthy years: -0.01. Exact declared overrides encoded in calculator scenario replacementWithHarms. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

low Capacity: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario lowCapacity. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

mixed Category Cost: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario mixedCategoryCost. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

undated Throughput: Cost: $100K; California health QALYs: 0.02; all-population health QALYs: 0.02. Income-equivalent healthy years: -0.01. Exact declared overrides encoded in calculator scenario undatedThroughput. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

whole Recipient Cost: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario wholeRecipientCost. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

all Gift Pasd: Cost: $100K; California health QALYs: 0.02; all-population health QALYs: 0.02. Income-equivalent healthy years: -0.01. Exact declared overrides encoded in calculator scenario allGiftPasd. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

quarter Year: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario quarterYear. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

full Year: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario fullYear. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

two Years: Cost: $100K; California health QALYs: 0.03; all-population health QALYs: 0.03. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario twoYears. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

gallstone Positive: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario gallstonePositive. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

gallstone Negative Full Overlap: Cost: $100K; California health QALYs: -0.01; all-population health QALYs: -0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario gallstoneNegativeFullOverlap. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

diagnostic Zero: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario diagnosticZero. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

health Unknown: Cost: $100K; California health QALYs: unknown; all-population health QALYs: unknown. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario healthUnknown. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

income Unknown: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Exact declared overrides encoded in calculator scenario incomeUnknown. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

income Zero: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario incomeZero. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

income Zero With Harm: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: -0.01. Exact declared overrides encoded in calculator scenario incomeZeroWithHarm. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

benefit Zero Retains Harm: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario benefitZeroRetainsHarm. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

full Overlap: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario fullOverlap. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

half Overlap: Cost: $100K; California health QALYs: 0.00; all-population health QALYs: 0.00. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario halfOverlap. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

consumption15000: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario consumption15000. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

consumption60000: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario consumption60000. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

no Medicine: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario noMedicine. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

no Paid Work: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: 0.00. Exact declared overrides encoded in calculator scenario noPaidWork. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

resource Harm: Cost: $100K; California health QALYs: 0.01; all-population health QALYs: 0.01. Income-equivalent healthy years: -0.01. Exact declared overrides encoded in calculator scenario resourceHarm. Health and first-year net resources are distinct finite ledgers. Unknown components remain unknown; signed harms persist. These are unweighted diagnostics.

Historical specialty-care estimate: $33.0M; preserved comparison: Cost: $2.4M; California health QALYs: 0.72; all-population health QALYs: 0.72. Old judged f=.25; k=5000; a=.5; b=.25; u=.05; T=1; g_CA=1; d=.03. Arithmetic implies $3.3M per DALY, not a verified marginal donation return.

Complete portfolio remains unknown: Cost: $100K; California health QALYs: unknown; all-population health QALYs: unknown. Immunization, physician support and opportunity-cost effects are unresolved; conditional partial PASD estimate is not a complete-portfolio lower bound.

Counterfactual: Coverage eligibility, other charity care, conservative treatment, later care, replacement grants/donors and provider bottlenecks. Dated79 people is a forecast for next-gift productivity, not an observed2025 denominator.

Attribution: Gift allocation and proportional unit-cost loading share a convention and cancel centrally; do not claim separate measured PASD efficiency. Funding response, repeat fraction, therapeutic/indication mix, clinical transfer and net household incidence are distinct declared priors. Clinical/provider resources are not credited as cash income.

Finite unweighted judgment diagnostics; no identified marginal return, empirical confidence bounds or complete-portfolio lower bound. Negative recovery/travel effects retained. Unknown is not zero; positive-only overlap never erases harms.

Sensitivity

  • lowFunding: $153.3M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • legacyFunding: $61.3M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • highFunding: $19.2M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • completeReplacement: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • replacementWithHarms: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • lowCapacity: $117.4M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • mixedCategoryCost: $45.0M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • undatedThroughput: $7.2M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • wholeRecipientCost: $70.0M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • allGiftPasd: $9.9M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • quarterYear: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • fullYear: $8.1M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • twoYears: $3.3M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • gallstonePositive: $16.2M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • gallstoneNegativeFullOverlap: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • diagnosticZero: $55.4M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • healthUnknown: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • incomeUnknown: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • incomeZero: $19.7M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • incomeZeroWithHarm: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • benefitZeroRetainsHarm: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • fullOverlap: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • halfOverlap: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • consumption15000: $69.1M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • consumption60000: $24.0M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • noMedicine: $31.9M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • noPaidWork: $26.8M per DALY. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.
  • resourceHarm: no finite positive estimate. Declared prior diagnostic, not a probability interval; same scenario appears in the inspectable table.

Unresolved inputs

  • Contemporary unique patients reconciled with dedicated PASD cash costs.
  • Current repeat/therapeutic/indication mix and finite comparative clinical outcomes.
  • Actual otherwise-paid medicine, net paid-work/recovery/travel and household consumption.
  • Gift-sized eligible cases, provider commitments and marginal funding allocation.
  • Incremental immunization/physician-support effects and full social opportunity costs.

Health and income breakdown

For the modeled $100K: 0.01 health QALYs + 0.00 income-equivalent healthy years in California: $30.7M per DALY. Income equivalents are welfare comparisons, not observed QALYs or DALYs.

Method and caveats.

5. Funding and previous grants

The donation recipient is San Diego County Medical Society Foundation dba Champions for Health, EIN 95-2568714. Original FY2023–25 Form 990 and Schedule D expense reconciliations support continuing operations and preserve one legal entity across financial years. Financial directory labels need care: a link labeled 2023 audit opens a FY2022 return packet, so we do not claim a fresh audit opinion from that label.

Spending breakdown: FY2025 reports $556,597 PASD expense and $977,407 immunization expense within $1,718,456 total program expense, plus $244,040 management and $1,225 fundraising expense. Separately netted event costs add $99,031. The cash-like recipient normalizer is therefore $2,062,752, excluding $315,966 recognized donated services. It is accrual-based, not a direct cash-flow statement. Donated clinical resources are excluded from the donor-cash denominator but remain an unresolved social opportunity cost; they are not free additional income.

The three-year recognized-resource series, including original tax expense, event costs and Schedule D donated services, is $3,621,619 in FY2023, $5,011,784 in FY2024 and $2,378,718 in FY2025, averaging $3,670,707. The separate cash-like series is $3,239,627, $4,710,054 and $2,062,752. These bases must not be mixed. Immunization expense fell from $3,161,535 in FY2024 to $977,407 in FY2025, making extrapolation of older vaccine activity unsafe.

The latest filed deficit of $670,011 and September 30 unrestricted net assets of $1,400,634 describe a dated financial position, not an identified marginal funding gap. A Grossmont grant list names an in-home wellness award, while the current program page says in-home services are not operating; an award is not proof of delivered care. A Prebys announcement also identifies an award whose restriction and cash timing require reconciliation. A new donor should obtain a current workplan, eligible cases and provider commitments rather than equating financial pressure with additional treatments.

The influenza trial checked for this review concerns 1,838 older Dutch adults in a single 1991–92 season. It informs biological vaccination efficacy, not modern local program uptake, paid-work gains or a permanent survival effect. PASD's adult eligibility is not automatically the immunization cohort. Incremental immunization and physician-support impact remain unresolved, not proven absent.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $3.6M; San Diego County Medical Society Foundation dba Champions for Health, EIN95-2568714, 12-month period, Accrual original Form 990 expenses plus separately netted event costs and Schedule D donated services; recognized full-recipient resources. Source
  • FY 2024: $5.0M; San Diego County Medical Society Foundation dba Champions for Health, EIN95-2568714, 12-month period, Accrual original Form 990 expenses plus separately netted event costs and Schedule D donated services; recognized full-recipient resources. Source
  • FY 2025: $2.4M; San Diego County Medical Society Foundation dba Champions for Health, EIN95-2568714, 12-month period, Accrual original Form 990 expenses plus separately netted event costs and Schedule D donated services; recognized full-recipient resources. Source

6. Sources

  1. Current programs and undated annual impact. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  2. Project Access San Diego. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  3. Free immunization program. Champions for Health. Published: not stated; retrieved: 2026-09-13.
  4. FY 2023–24 annual report in June 2025 San Diego Physician. Champions for Health / San Diego County Medical Society. Published: not stated; retrieved: 2026-10-02.
  5. Financial Highlights and report directory. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  6. Ways to Give and recipient identity. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  7. Efficacy of influenza vaccination in elderly individuals. Govaert et al. / JAMA. Published: 1994-12-07; retrieved: 2026-09-13.
  8. Grossmont Healthcare District past grant recipients, FY2025–26. Grossmont Healthcare District. Published: not stated; retrieved: 2026-09-30.
  9. Prebys Foundation community-health grants announcement. Prebys Foundation. Published: not stated; retrieved: 2026-09-30.
  10. IRS-derived latest expense extracts. ProPublica Nonprofit Explorer / IRS. Published: not stated; retrieved: 2026-09-13.
  11. FY 2023 original Form 990. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  12. FY 2023 original Schedule D expense reconciliation. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  13. FY 2024 original Form 990. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  14. FY 2024 original Schedule D expense reconciliation. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  15. FY 2025 original Form 990. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  16. FY 2025 original Schedule D expense reconciliation. San Diego County Medical Society Foundation / IRS. Published: not stated; retrieved: 2026-10-02.
  17. 2013 Surgery Saturday surgical and diagnostic activity. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  18. Patient account of gallstone pain and waiting. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  19. Patient account of elbow care and work recovery. Champions for Health. Published: not stated; retrieved: 2026-10-02.
  20. Watchful waiting versus repair of minimally symptomatic inguinal hernia. Fitzgibbons et al. / JAMA. Published: not stated; retrieved: 2026-10-02.
  21. Revision surgery for distal humeral nonunion. Study authors / PubMed. Published: not stated; retrieved: 2026-10-02.
  22. Medicine or surgery randomized trial for abnormal uterine bleeding. Study authors / JAMA. Published: not stated; retrieved: 2026-10-02.
  23. Conservative management versus cholecystectomy: C-GALL randomized trial. Ahmed et al. / BMJ. Published: not stated; retrieved: 2026-10-02.
  24. Comparing income and healthy-life-year benefits. Coefficient Giving. Published: not stated; retrieved: 2026-09-30.
  25. Randomized influenza vaccination trial in older adults. Govaert et al. / JAMA. Published: not stated; retrieved: 2026-10-02.
  26. Primary influenza trial abstract. Erasmus University Rotterdam. Published: not stated; retrieved: 2026-10-02.