Community Forward SF

Summary

What do they do? Community Forward SF operates respite facilities in partnership with SFDPH, which supplies clinicians and social workers. Public cost reimbursement may pay fixed operating costs despite unused capacity. Referrals or clinical staffing can be the bottleneck. A gift for amenities cannot claim the entire respite-versus-discharge effect. More

Why this approach interests us

• A clinically appropriate respite place may improve recovery beyond an otherwise unsafe discharge.

Our main reservations

• The small external utility difference was not statistically significant; local operational and clinical capacity have different funders.

What do you get for your dollar?

Our provisional best estimate is $1,413,333,333 per better life:10 additional QALYs. This is a narrow, highly uncertain health-only model, not the organization’s overall impact or a verified donation offer. Inspect the assumptions →

best guess

$1,413,333,333 — USD/10 incremental QALYs; conditional donor budget

positive scenarios

$136,296,296–$40,000,000,000 — Joint scenarios, not confidence intervals

health evidence

Null is plausible — A positive best guess does not rule out no added health

funding room

Unverified — Public contracts are not marginal donation offers

1. What do they do?

Community Forward SF operates respite facilities in partnership with SFDPH, which supplies clinicians and social workers. Public cost reimbursement may pay fixed operating costs despite unused capacity. Referrals or clinical staffing can be the bottleneck. A gift for amenities cannot claim the entire respite-versus-discharge effect.

Scope of this review. Count each patient pathway once. Do not add mortality, housing, substance-use treatment or other overlapping benefits without separate causal models and reconciliation.

2. Monitoring and information sharing

3. Qualitative assessment

A clinically appropriate respite place may improve recovery beyond an otherwise unsafe discharge.

Key reservations

• This health-only ledger omits potential resource savings and dignity benefits rather than pretending they are zero. It is not a verdict on all respite care.
• A fourteen-day course is a different dose from the local stay range; it is not used as the favorable same-course budget.
• No extra hospital-days-to-QALYs, mortality or medication-treatment benefit is added.

Benefits not included in our estimate

• Healthcare savings as donor cash
• Unmodeled mortality reduction
• Independent housing and substance-use benefits
• Unpriced public or volunteered resources

4. What do you get for your dollar?

$1,413,333,333 per10 QALYs

Central cost is53 days ×USD300 =15,900.53 is a judgmental midpoint of the published46–60day stay range, not a measured mean. We retain .0009 external QALY gain through three months, transfer .5 and financing .25, yielding .0001125 QALY. Longer local stays receive no automatic extra health multiplier.

A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

DOLLARS PER BETTER LIFE: 10 ×days ×daily cost / {financing × [external QALYs ×transfer −extra net harm]}
$1,413,333,333 per10 QALYs

Hypothetical course budget—not a verified funding tranche

• Favorable same-course: $136,296,296 per10 QALYs. 0.0006750 conditional QALY per offered course.
• Central: $1,413,333,333 per10 QALYs. 0.0001125 conditional QALY per offered course.
• Pessimistic: $40,000,000,000 per10 QALYs. 0.000009000 conditional QALY per offered course.

Uncertainty. Zero actual utility benefit, unchanged care or fully replaced financing gives no finite positive price. Net harms can make health negative; this is not a negative-price bargain.

5. Funding and previous grants

Need a named clinically eligible cohort, additional capacity, all payer contributions and measured health difference versus actual usual care.

Daily prices are assumptions, not current quotes or full clinical resource costs. Public DPH clinical inputs remain unpriced. The five-year contract ceiling and mixed-program client counts cannot establish a marginal cost per admission. If clinical staff are unavailable, extra operating spending may add no admissions.

This review does not establish a verified marginal funding offer or a complete history of grants.

We have not verified a suitable donation route for this reviewed activity. Confirm the legal recipient and intended allocation before donating.

6. Sources

1. Medical and behavioral health. Community Forward SF. Provider disclosure. Published: Undated; retrieved: 2026-09-07.
2. Respite contract analysis, packet pages5–11. SF Budget and Legislative Analyst. Primary public funding and staffing. Published: 2025-12-10; retrieved: 2026-09-07.
3. Bring2020 respite trial and economic analysis. BMC Health Services Research. Primary utility and cost study. Published: 2020-06-05; retrieved: 2026-09-07.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): $16,252,757. Organization size is separate from the modeled cost-effectiveness of a donation.

Community Forward SF Inc (formerly CATS Inc)

IRS Form 990 whole-entity total expenses, Part I line 18; fiscal years ending June 30

• FY2025: $18,468,623
• FY2024: $16,290,002
• FY2023: $13,999,647

FY2023 from prior-year column of FY2024 return; whole entity, not medical respite alone.