GiveBetter x California

Youth ALIVE!

Violence prevention, hospital intervention and trauma healing

Research time: ~9 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-13

Donate

Summary

What do they do? Youth ALIVE! supports Oakland survivors of violence through hospital intervention, violence interruption, counseling, mentoring and family support. Caught in the Crossfire offers practical help and sustained support intended to reduce retaliation and repeat injury. The California model retains full donation costs but quantifies only a cautious, five-year hospital-intervention health pathway.

Why we’re interested in this organization:

  • A concrete hospital-based pathway reaches people shortly after serious violence, when practical support may prevent further harm.

  • Newer pooled evidence favors hospital violence intervention, although its quality is low.

  • Current state award details and original financial records allow specific questions about additional capacity and funding substitution.

Our main reservations:

  • The reported 96% not-reinjured figure has no concurrent untreated comparison and is not 96% effectiveness.

  • The QALY anchor is a model with serious limitations, not measured health utility from a trial.

  • A $5 million state award explicitly covers the credited program and related services; the use of an extra unrestricted dollar remains unpriced.

What do you get for your dollar? $27.3M per better life: ten additional quality-adjusted life years in California. Hospital-intervention health only.

Unique hospital-intervention clients, service completion, violent reinjury/death and health utility. Current118clients and96%without reinjury are descriptive, not the causal change used in the model.

1. What do they do?

Caught in the Crossfire sends community intervention specialists to survivors' hospital bedsides and provides ongoing practical support. Youth ALIVE!'s broader portfolio includes violence interruption, Pathways mentoring, Teens on Target, counseling, homicide-family support and advocacy. The numerical model is partial health accounting across the entire recipient: all gift costs remain charged, while only additional CiC-like service receives health credit. California includes the Oakland/Alameda service footprint; no population-share multiplication is needed. Statewide policy and national replication effects remain unquantified.

2. Monitoring and information sharing

Current results report 118 CiC clients in 2025 and 96% without reinjury, alongside other program activity. These overlapping populations must not be summed as unique beneficiaries, and citywide homicide declines cannot be attributed to this organization without a counterfactual. The 2020 CalVIP local evaluation documents missing data and loss to follow-up. Its trauma-symptom assessment had 24 initial and 17 follow-up respondents; such selected before/after reports do not identify causal QALYs. The strongest next monitoring step is unique referral-to-enrollment-to-completion flow plus comparable injury and validated utility follow-up, including people not served.

3. Qualitative assessment

The local Becker 2004 matched retrospective study found no statistically significant reinjury or death difference. Criminal-justice outcomes are not automatically health outcomes. A 2026 systematic review pooled ten studies and favored HVIPs for violent reinjury (OR 0.60,95% CI 0.38–0.94), but evidence quality was low and heterogeneity substantial. This supports a plausible mechanism, not confident transfer to every current recipient or an unrestricted gift.

The health anchor comes from Chong's 2015 Markov model, evaluated in NICE's evidence table. It models 4.64 versus 4.62 QALYs over five years, not observed participant utility. NICE rated it partially applicable with potentially serious limitations and no apparent probabilistic sensitivity analysis. We retain the short horizon and evidence-transfer discount rather than adding a lifetime multiplier. The published payer costs/ICER are inconsistent across records; the donor model does not reverse-engineer health from the preferred dollar figure.

4. What do you get for your dollar?

The original 2024 return reports $7,305,670 full functional expenses, including program $5,995,624, management $819,196 and fundraising $490,850; adding $23,148 of separately netted event costs gives $7,328,818 gross expenses. The comparable 2022 and 2023 totals add $6,478 and $9,759 of event costs respectively, giving $5,360,166 and $6,466,145. The three-year gross-expense average is $6,385,043.

The exploratory model gives a prior-weighted signed illustration of about $27.34 million per ten California QALYs. Its central conditional case is $14.29 million; favorable $2.07 million and cautious-positive $147.06 million, with null and harm cases included. The favorable case has only 5% assumed probability but supplies 66.1% of weighted health. These subjective weights and effect-transfer parameters are not confidence estimates. The historical county contract ratio is only a favorable delivery benchmark, not a current price or full resource cost. Additional partner resources raise the weighted gross-resource illustration to about $28.08 million per ten, still not a complete societal cost estimate.

Model, assumptions and sensitivity

Full ordinary recipient gift, not restricted CiC purchase. All uncredited program/advocacy costs retained. Partner/clinical resources separately added as sensitivity; not comprehensive societal cost. C=100000 normalization only.

All quantified CiC-like benefit occurs in Oakland/Alameda, hence California share1. This is credited-service scope, not claim that all real recipient effects are local. National replication and statewide policy health are omitted, not credited at zero because of geography. No Bay-to-California population multiplier.

N=C*a*f*s/c, where a=CiC allocation, f=funding additionality, s=service realization, c=delivery and allocated overhead per added client before realization. q5=(4.64-4.62)=0.020 modeled five-year undiscounted QALYs. Q_CA=N*q5*t*g, with t=evidence transfer and g=1 for credited local service. GrossResources=C+N*x, x=external resources per realized client. Signed central illustration Q=sum_s weight_s*Q_s; price10=10*C/Q only when Q>0. No lifetime, recurring annual or independent psychotherapy benefit is added to q5.

C
100000 USD ordinary gift (judgment). Normalization only
q5
0.02 modeled undiscounted QALYs per participant overfiveyears (observed). Observed publication/model output, not observed clinical effect;4.64minus4.62 [nice] [chong]
historical contract
267294 USD contract amount (observed). July2023–September2024record reused from accepted Bay report; fresh retrieval certificate failure [county-contract]
historical minimum comprehensive clients
180 clients (observed). Contract denominator, not extra clients or current demand [county-contract]
historical cost benchmark
1484.9666666666667 USD per minimum comprehensive client (judgment). Derived historical ratio used only favorable floor; not full resource or current marginal quote [county-contract]
a conditional central
0.4 CiC allocation fraction (judgment). Whole recipient scope; not measured marginal program budget [results]
f conditional central
0.35 funding additionality fraction (judgment). New state/county/payer funding may substitute; exact gap unknown [calvip-scope] [dhcs]
s conditional central
0.9 realization fraction (judgment). Enrollment and delivery loss prior
c conditional central
1800 USD per added client before realization (judgment). Historical benchmark adjusted by judgment to include delivery and allocated overhead; not a verified current marginal cost or capacity quote. [county-contract]
t conditional central
0.5 evidence-transfer multiplier (judgment). Serious model limitations, local nonrandomized evidence and newer heterogeneous pooled results [nice] [becker] [jawa]
x conditional central
750 USD external resources per realized client (judgment). Unsourced sensitivity for induced partner care; no false full-cost precision
g
1 California credited-service share (judgment). Oakland/Alameda clinical footprint [cic]
weights
"harm0.10;null0.35;cautiousPositive0.35;conditionalCentral0.15;favorable0.05" scenario probability priors (judgment). Retained v2 subjective distribution; not confidence interval or measured frequencies
other programs and policy health
null incremental California QALYs (unknown). Additional clinical/utilities or policy causal chains missing; numerical model assigns no credit while retaining costs [results] [evaluation2020]
harm parameters
"{\"a\":0.2,\"f\":0.15,\"s\":0.8,\"c\":2500,\"t\":-0.25,\"x\":1500,\"weight\":0.1}" joint scenario vector (judgment). Exact v2 priors; not independently estimated local parameters [nice] [county-contract] [calvip-scope]
null parameters
"{\"a\":0.2,\"f\":0.15,\"s\":0.8,\"c\":2500,\"t\":0,\"x\":1500,\"weight\":0.35}" joint scenario vector (judgment). Exact v2 priors; not independently estimated local parameters [nice] [county-contract] [calvip-scope]
cautiousPositive parameters
"{\"a\":0.25,\"f\":0.2,\"s\":0.85,\"c\":2500,\"t\":0.2,\"x\":1500,\"weight\":0.35}" joint scenario vector (judgment). Exact v2 priors; not independently estimated local parameters [nice] [county-contract] [calvip-scope]
central parameters
"{\"a\":0.4,\"f\":0.35,\"s\":0.9,\"c\":1800,\"t\":0.5,\"x\":750,\"weight\":0.15}" joint scenario vector (judgment). Exact v2 priors; not independently estimated local parameters [nice] [county-contract] [calvip-scope]
favorableStress parameters
"{\"a\":0.7,\"f\":0.6,\"s\":0.95,\"c\":1484.9666666666667,\"t\":0.9,\"x\":300,\"weight\":0.05}" joint scenario vector (judgment). Exact v2 priors; not independently estimated local parameters [nice] [county-contract] [calvip-scope]

Prior-weighted signed illustration: Cost: $100K; California QALYs: 0.0365823609957567; all-population QALYs: 0.0365823609957567. Weighted sum of five explicit scenarios, including harm andnull; all credited healthCalifornia. Grossresources=102731.03934992928

harm: Cost: $100K; California QALYs: -0.004799999999999897; all-population QALYs: -0.004799999999999897. {"name":"harm","weight":0.1,"cicAllocation":0.2,"fundingAdditionality":0.15,"serviceRealization":0.8,"donorCostPerAddedClient":2500,"evidenceTransfer":-0.25,"externalResourcesPerClient":1500,"giftCashDirected":20000,"additionalCash":3000,"addedClientsBeforeRealization":1.2,"realizedAddedClients":0.96,"qalyPerRealizedClient":-0.004999999999999893,"giftQaly":-0.004799999999999897,"grossResources":101440,"externalResources":1440,"bayQaly":-0.004799999999999897,"sfQaly":0,"donorCostPer10Qaly":null,"grossCostPer10Qaly":null}

null: Cost: $100K; California QALYs: 0; all-population QALYs: 0. {"name":"null","weight":0.35,"cicAllocation":0.2,"fundingAdditionality":0.15,"serviceRealization":0.8,"donorCostPerAddedClient":2500,"evidenceTransfer":0,"externalResourcesPerClient":1500,"giftCashDirected":20000,"additionalCash":3000,"addedClientsBeforeRealization":1.2,"realizedAddedClients":0.96,"qalyPerRealizedClient":0,"giftQaly":0,"grossResources":101440,"externalResources":1440,"bayQaly":0,"sfQaly":0,"donorCostPer10Qaly":null,"grossCostPer10Qaly":null}

cautiousPositive: Cost: $100K; California QALYs: 0.006799999999999856; all-population QALYs: 0.006799999999999856. {"name":"cautiousPositive","weight":0.35,"cicAllocation":0.25,"fundingAdditionality":0.2,"serviceRealization":0.85,"donorCostPerAddedClient":2500,"evidenceTransfer":0.2,"externalResourcesPerClient":1500,"giftCashDirected":25000,"additionalCash":5000,"addedClientsBeforeRealization":2,"realizedAddedClients":1.7,"qalyPerRealizedClient":0.003999999999999915,"giftQaly":0.006799999999999856,"grossResources":102550,"externalResources":2550,"bayQaly":0.006799999999999856,"sfQaly":0,"donorCostPer10Qaly":147058823.5294149,"grossCostPer10Qaly":150808823.52941495}

Conditional central, not weighted illustration: Cost: $100K; California QALYs: 0.06999999999999851; all-population QALYs: 0.06999999999999851. {"name":"central","weight":0.15,"cicAllocation":0.4,"fundingAdditionality":0.35,"serviceRealization":0.9,"donorCostPerAddedClient":1800,"evidenceTransfer":0.5,"externalResourcesPerClient":750,"giftCashDirected":40000,"additionalCash":14000,"addedClientsBeforeRealization":7.777777777777778,"realizedAddedClients":7,"qalyPerRealizedClient":0.009999999999999787,"giftQaly":0.06999999999999851,"grossResources":105250,"externalResources":5250,"bayQaly":0.06999999999999851,"sfQaly":0,"donorCostPer10Qaly":14285714.28571459,"grossCostPer10Qaly":15035714.285714606}

favorableStress: Cost: $100K; California QALYs: 0.4836472199151393; all-population QALYs: 0.4836472199151393. {"name":"favorableStress","weight":0.05,"cicAllocation":0.7,"fundingAdditionality":0.6,"serviceRealization":0.95,"donorCostPerAddedClient":1484.9666666666667,"evidenceTransfer":0.9,"externalResourcesPerClient":300,"giftCashDirected":70000,"additionalCash":42000,"addedClientsBeforeRealization":28.283463152932725,"realizedAddedClients":26.86928999528609,"qalyPerRealizedClient":0.017999999999999617,"giftQaly":0.4836472199151393,"grossResources":108060.78699858583,"externalResources":8060.786998585827,"bayQaly":0.4836472199151393,"sfQaly":0,"donorCostPer10Qaly":2067622.7606052607,"grossCostPer10Qaly":2234289.427271931}

Counterfactual: Risk-reduction referral and existing state/county/payer-supported service continue. A gift must add realized service beyond these sources; current CalVIP funds explicitly overlap CiC. Evidence transfer discounts the historical modeled intervention versus modern participants and standard care.

Attribution: One additional realized client course, not each contact or mediation, is the native unit. Reinjury, counseling, practical support and family outcomes within the same course cannot each receive duplicate health credit. Police/citywide homicide trends and coalition appropriation totals are not assigned to the recipient.

Retains prior accepted v2 five-state subjective distribution for comparability. The central row is the prior-weighted signed illustration, not the separately labeled conditional central scenario. All weights, allocation, funding, realization, resource and transfer inputs are judgments. QALY difference has limited published precision; payer-cost records conflict. A finite five-year partial-health model can be computed, but marginal donor return is not established.

Sensitivity

  • Prior-weighted signed price$27.3356m per tenCAQALYs; gross$28.0821m. Conditionalcentral$14.2857m; favorable$2.0676m; cautiouspositive$147.0588m. Null/harm have no finite positive price.
  • Removing the favorable5%case and renormalizing remaining weights gives$76.61m per ten. The favorable tail contributes66.10%of signed expectedhealth.
  • At conditionalcentral7realized addedclients/$100k, reaching$1M per ten requires0.142857QALY/client; reaching$100k requires1.42857QALY/client. These exceed the0.010transferred five-year anchor by14.29and142.86times.
  • At conditionalcentral0.010QALY per realizedclient, the two hurdles require100or1000 genuinely additional clients/$100k, versus7modeled. A program-output count cannot satisfy this without donor additionality.
  • At full publishedq5=.020, even without evidence discount, required genuinely additional clients are50or500/$100k for the two hurdles. This exposes how a favorable hospital-payer ICER differs from an unrestricted donor price.
  • Non-CiC portfolio needs an additional0.96342QALY/$100k above the weighted model to reach$1M per ten, or9.96342QALYs for$100k, with overlap removed.
  • The five-year anchor is undiscounted. Applying a positive time discount without an annual utility trajectory would lower health, but an exact discounted conversion is not fabricated.
  • California scope retains every quantified Bay benefit. Additional statewide policy health could improve the result only after coalition contribution, implementation, payer displacement and clinical effects are modeled.

Unresolved inputs

  • Current costed next-dollar plan and staff/waitlist capacity reconciled to$5mCalVIPaward and county/payer funding.
  • Medi-Cal enrollment/claims and uncovered clients, not merely legal benefit eligibility.
  • Program-level marginal allocation and full delivery/partner costs rather than historical contract ratio.
  • Unique comparable enrollment/completion/reinjury data and validated health utilities, with attrition and confounding addressed.
  • Unrounded annual health trajectories and reconciliation of Chong/NICE cost/ICER inconsistency.
  • Independent causal outcomes for violence interruption, counseling, family support and additional policy changes; coalition and clinical overlap resolved.

5. Funding and previous grants

The state's Cohort 5 award list awards Youth ALIVE! $5 million for the 2026–29 grant period. The specific project summary covers Violence Interrupters, CiC and homicide-family response, with counseling support. Thus it overlaps the modeled pathway; it is not irrelevant background funding. Separately, DHCS identifies violence prevention among community-health-worker services that eligible providers can supply through Medi-Cal. Youth ALIVE!'s actual enrollment, claims and unfunded eligibility gaps were not verified.

The 2024 return shows $5,219,002 contract revenue plus $159,509 service fees, and $3,358,315 cash plus $206,456 savings at year-end. Net assets included $572,723 donor-restricted and $4,613,423 without donor restrictions. These are historical balances, not proof that all cash is free for expansion or that funding needs are absent. A current staffing/waitlist plan reconciled to state, county and payer funding is required before calling the modeled return an available donation opportunity.

Annual expenses

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

  • FY 2022: $5.4M; Youth Alive, EIN94-3143254, 12-month period, Calendar-year Form 990 functional expenses plus direct fundraising-event costs netted against revenue; gross expense basis.. Source
  • FY 2023: $6.5M; Youth Alive, EIN94-3143254, 12-month period, Calendar-year Form 990 functional expenses plus direct fundraising-event costs netted against revenue; gross expense basis.. Source
  • FY 2024: $7.3M; Youth Alive, EIN94-3143254, 12-month period, Calendar-year Form 990 functional expenses plus direct fundraising-event costs netted against revenue; gross expense basis.. Source

6. Sources

  1. 2025 program results. Youth ALIVE!. Published: not stated; retrieved: 2026-09-13.
  2. Caught in the Crossfire. Youth ALIVE!. Published: not stated; retrieved: 2026-09-13.
  3. Donate and recipient identity. Youth ALIVE!. Published: not stated; retrieved: 2026-09-13.
  4. Original2024Form990, PartsI/VIII/IX/X. Youth ALIVE! / IRS; ProPublica copy. Published: not stated; retrieved: 2026-09-13.
  5. Original2023Form990, including prior2022expenses. Youth ALIVE! / IRS; ProPublica copy. Published: not stated; retrieved: 2026-09-13.
  6. Historical county CiC contract, reused verified prior record. Alameda County. Published: 2024-07-09; retrieved: 2026-09-10.
  7. Hospital-centered violence intervention cost-effectiveness analysis. Chong and colleagues, American Journal of Surgery. Published: 2014-12-18; retrieved: 2026-09-13.
  8. Rehabilitation after traumatic injury AppendixH economic evidence table. NICE. Published: not stated; retrieved: 2026-09-13.
  9. HVIP systematic review/meta-analysis and guideline update2026. Jawa and colleagues, Journal of Trauma and Acute Care Surgery. Published: 2026-08-18; retrieved: 2026-09-13.
  10. Caught in the Crossfire matched retrospective evaluation; corrected DOI. Becker and colleagues, Journal of Adolescent Health. Published: not stated; retrieved: 2026-09-13.
  11. Current CalVIP Cohort5 awards and period. California BSCC. Published: not stated; retrieved: 2026-09-13.
  12. Cohort5 project summary: Youth ALIVE!. California BSCC. Published: not stated; retrieved: 2026-09-13.
  13. Community Health Worker benefit and violence-prevention services. California DHCS. Published: not stated; retrieved: 2026-09-13.
  14. Healing to Scale in Oakland final local evaluation. Youth ALIVE! local evaluation published by California BSCC. Published: not stated; retrieved: 2026-09-13.
  15. Original 2022 Form 990, including separately netted event costs. Youth ALIVE! / IRS. Published: not stated; retrieved: 2026-09-14.