GiveBetter x SF

Healthier Kids Foundation

Earlier appropriate child vision, dental and hearing care within HKF's expanded portfolio

Research time: ~16 min on GPT-5.6 Sol Medium
  • Research — organization and evidence review.
  • Modeling — cost-effectiveness analysis.
  • Historical estimate for research done before time tracking.

Published: September 8, 2026.

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Summary

What do they do? VisionFirst, DentalFirst and HearingFirst lead to family follow-up and insured/partner care. The expanded organization also runs wellness, education, coverage/appointment and newborn services plus Kids in Common and Turning Wheels for Kids; all costs stay. More

Why this approach interests us

  • HKF follows up with families and helps them use existing coverage to obtain appropriate corrective care sooner.

Our main reservations

  • Clinical completion, severity mix, marginal funding, future allocation and utility transfer are uncertain. Screening and referral counts are not QALYs.

What do you get for your dollar?

Central Bay cost is $3,763,882 donor and $6,308,330 modeled associated resources per10 QALYs. No SF-city health is identified centrally. Inspect formulas, inputs and sources.

central bay donor /10 qalys
$3,763,882 — 0.265683 Bay QALYs per$100,000 whole gift.
central bay associated resources
$6,308,330 — $167,602 gross envelope; not net/exhaustive societal cost.
favorable bay donor / resources
$45,304 / $147,744 — Joint favorable assumptions; resource case remains above$100k.
sf-city / funding room
No identified health / Unknown — No observed SF patient share or verified marginal tranche.

1. What do they do?

VisionFirst, DentalFirst and HearingFirst lead to family follow-up and insured/partner care. The expanded organization also runs wellness, education, coverage/appointment and newborn services plus Kids in Common and Turning Wheels for Kids; all costs stay.

Budget the full organization

Use explicit ten-category allocation informed by prior-year financial structure, not a vision-only restriction.

Pay for the full screening pipeline

Negative screens, referral navigation and program administration consume cash before any completed care.

Count appropriate, additional, nonoverlapping care

Financial substitution, clinical completion, treatability and primary-person overlap filters address different losses.

Count only finite earlier-care health

Discount benefit; stop it with alternative-care catch-up, recurrence and a hard horizon; subtract harms.

Scope of this review. Ordinary HKF unrestricted gift, EIN77-0545774. Public coverage and school/clinic services continue. No lifetime prevention or school-to-health conversion.

2. Monitoring and information sharing

188 low-income San Francisco preschoolers, not HKF

Observational preschool cohort. 133 met the school wear threshold across the school year.

Our assessment. Supports sustained use plausibility, not a measured .70 fraction of all-day useful wear, care completion or QALYs.

Zambia refraction/presbyopia recipients,41/113 followed

Uncontrolled before/after EQ-5D. Follow-up preference utility was .075 higher.

Our assessment. .025 child utility is a judgment with severe setting/age/attrition limitations. Weak-source and null scenarios included.

85/167 followed after dental treatment under GA

Uncontrolled three-month child pre/post study. Oral and overall child scores improved; raw CHU9D sum is not preference utility.

Our assessment. Restrict to symptomatic treatable subset; .08 utility and finite pain-time are explicit priors, not questionnaire conversion.

Young children with persistent OME

Randomized ventilation tubes versus watchful waiting. Indexed abstract reports no significant additional QoL improvement.

Our assessment. No permanent hearing/development credit; tiny short-term .01 bridge is speculative, with zero-hearing and negative scenarios.

3. Qualitative assessment

HKF follows up with families and helps them use existing coverage to obtain appropriate corrective care sooner.

Key reservations

  • FY2025 return is a primary filing, not inspected audited statements; expanded 2026 portfolio allocation remains a prior.
  • Undated source activity counts do not establish a current marginal queue or causal completion.
  • Adult spectacle utility does not identify pediatric effect; tooth pain and transient hearing bridges are explicit judgments.
  • Family care already financed through Medi-Cal/CCS, schools and health plans can replace or shorten donor-caused gains.
  • Clinical partner capacity may displace other patients; harms/displacement data are not locally measured.
  • Gross outside-resource assumptions are not full net societal accounting.
  • Unquantified policy, cycling, wellness, family and other health could materially change whole-organization impact.

Benefits not included in our estimate

  • Mortality prevention or lives saved
  • Lifetime amblyopia prevention or permanent deafness reversal
  • Academic achievement, income and developmental scores converted to QALYs
  • Additional caregiver utility overlapping child/family measures
  • Wellness, obesity education, coverage and newborn benefits beyond quantified clinical streams
  • Kids in Common policy and Turning Wheels cycling health
  • Any treatment benefit after finite horizon or alternative-care catch-up
  • Second generic health gain for an overlapping child

4. What do you get for your dollar?

A whole gift produces uncertain earlier-care time, not one QALY per screen

Central health separates three clinical streams and retains53% unquantified portfolio cash. Operational caps are priors, not confirmed available appointments.

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

Finite earlier-care QALYs: Nscreen=gift×allocation/(screen cost+referral yield×navigation); Ncomplete=min(Nscreen×funding additionality,cap)×yield×completion. Q=Ncomplete×treatable×nonoverlap×utility×use×no-alternative-at-start×discounted finite exp(−mortality−catch-up−loss) years − harms.
Overall 0.268366814; Bay 0.265683146; SF0 QALYs. $167,602×10/Bay Q = $6,308,330.

Model inputs and assumptions
Whole gift allocation
15% vision / 18% dental / 14% hearing / 53% other (range: Clinical ranges 5–35% / 5–30% / 5–20%; total portfolio must equal 100%.). Explicit current marginal priors informed by historical vision15.27%, dental19.51%, hearing15.77%, other programs26.75%, management15.37%, fundraising7.31%. Expanded programs and flexible-gift priorities may differ. The remaining53% includes wellness8, education5, coverage/appointments7, newborn3, Kids in Common4, Turning Wheels3, general operations/fundraising23. No administrative double charge. Observed source facts distinguished from analyst priors.
Screen and navigation cash
$30/screen plus $50/vision or dental referral; $75/hearing referral (range: Screen $15–60; navigation $25–150.). Direct pathway and program administration priors. Cost per screened child includes negative screens; no $75 already-identified-referral shortcut. Vision's historical $777,628 and undated20,000 annual screens suggest a roughly$39 program-cost scale, not a matched-year marginal quote; central combined cash is$37/screen. Separate central operations share remains paid. Observed source facts distinguished from analyst priors.
Referral yield
14% vision / 29% dental / 4% hearing (range: Scenario ranges 7–25% / 15–40% / 2–8%.). Official undated follow-up-need estimates, not sensitivities or confirmed disease rates. Positive screen is not completed appropriate care. Observed source facts distinguished from analyst priors.
Financing and absorption
50% financially additional; cap1,000 additional screens/pathway (range: 0–100%; cap0–5,000.). Priors, not verified capacity. Replacing county, insurer or other charity funding lowers added capacity; no automatic funding multiplier from historical grants or deficit. Observed source facts distinguished from analyst priors.
Completed clinical episodes and treatability
Completion70/65/60%; treatable80/35/25% (range: Completion20–85%; treatable40–95/10–60/5–40%.). Clinical completion is beyond paperwork closure: appropriate examination and treatment when indicated. Treatability excludes false positives, painless dental concerns and non-correctable findings. All nominal clinical costs retained before that filter. Local causal completion/severity data unavailable. Observed source facts distinguished from analyst priors.
Preference-utility bridge
Vision .025; symptomatic dental .08; short-term hearing .01 (range: Signed ranges -.02–.05 / -.05–.15 / -.02–.025.). Explicit judgments, not measured HKF utilities. Vision adult/Zambia uncontrolled .075 provides weak scale context only. Child dental CHU9D summed score change2.48 is not a2.48-QALY or .0248-utility effect. Hearing randomized OME QoL null makes0 a serious alternative. No academic/development score mapping. Observed source facts distinguished from analyst priors.
Effective benefit and overlap
Useful benefit70/90/80%; disjoint people100/90/85% (range: Use40–95%; overlap exclusion0–30% for later streams.). SF preschool study's71% is children meeting school wear threshold, not71% all-day wear; .70 effective-use is a transfer judgment. Primary-person ledger vision then dental then hearing; costs/harms of overlapping cases remain. Observed source facts distinguished from analyst priors.
Finite earlier care
Horizons2/.5/.5 years after treatment; delays .15/.15/.2 years (range: Vision .5–3 (hard max5); dental/hearing .25–1; delay0–1.). At start,60/60/50% lack equivalent alternative; exponential alternative catch-up hazards .7/2/2 per year. Independent correction-loss/recurrence hazards .15/1/1. All are priors. This explicitly ends benefits when ordinary care catches up. No whole-lifetime amblyopia, saved lives or permanent hearing assumption. Observed source facts distinguished from analyst priors.
Discount and survival
3% annual discount; .0002/year mortality hazard (range: Discount0–5%; mortality0–.002.). Priors. Expected caseload already alive at intervention start; delay discounts only. Mortality applies once during finite benefit; utility is not a survival benefit. Observed source facts distinguished from analyst priors.
Signed health and harms
Per added completed episode .0001/.0005/.0002 QALY loss; independent0 (range: Episode0–.01; independent0–1 QALY per gift.). Gift-date PV losses for procedural/transient harms outside signed lasting utility. Conservative: charged before treatability, overlap and alternative filters. Null utility retains harms; true all-health-null scenario explicitly removes them. Independent harm survives zero activity. Observed source facts distinguished from analyst priors.
Associated outside resources
$2/nominal screen; $300/$500/$500 per nominal completed episode; $10k other (range: Per-screen0–10; per-episode0–1,000/2,000/2,000; other0–$30k.). Paid by insurance/partners/donated inputs or patient time, not free. Gross associated activity envelope, including nonadditional financed activity; not net induced societal spending and not exhaustive other-portfolio accounting. No savings offsets. Observed source facts distinguished from analyst priors.
Overall, Bay and SF
100% US overall / 99% Bay / 0% SF-city (range: Bay90–100%; SF0–1% only hypothetical sensitivity.). Service focus Santa Clara/Silicon Valley supports Bay;99% residence is prior. No identified SF-city health, so SF central ratios null. Nested geographies, not additive. No local credit from headquarters alone. Observed source facts distinguished from analyst priors.

All $100,000 remains in the donor numerator

  • central: Bay associated resources: $6,308,330/10 QALYs. Overall/Bay/SF QALYs 0.2683668144 / 0.2656831463 / 0.000000000. Donor overall/Bay/SF $3,726,243 / $3,763,882 / No finite positive ratio; resources $6,245,247 / $6,308,330 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • favorable: Bay associated resources: $147,744/10 QALYs. Overall/Bay/SF QALYs 22.29596967 / 22.07300997 / 0.000000000. Donor overall/Bay/SF $44,851 / $45,304 / No finite positive ratio; resources $146,267 / $147,744 / No finite positive ratio. Gross associated envelope $326,115. Full gift retained; positive.
  • cautious: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs -0.0006453380120 / -0.0006388846319 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $130,670. Full gift retained; harm.
  • historical_allocation: Bay associated resources: $6,182,610/10 QALYs. Overall/Bay/SF QALYs 0.2807828888 / 0.2779750599 / 0.000000000. Donor overall/Bay/SF $3,561,471 / $3,597,445 / No finite positive ratio; resources $6,120,784 / $6,182,610 / No finite positive ratio. Gross associated envelope $171,861. Full gift retained; positive.
  • low_funding_additionality: Bay associated resources: $31,541,652/10 QALYs. Overall/Bay/SF QALYs 0.05367336288 / 0.05313662925 / 0.000000000. Donor overall/Bay/SF $18,631,216 / $18,819,410 / No finite positive ratio; resources $31,226,236 / $31,541,652 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • low_completion: Bay associated resources: $16,494,007/10 QALYs. Overall/Bay/SF QALYs 0.07918456153 / 0.07839271592 / 0.000000000. Donor overall/Bay/SF $12,628,724 / $12,756,287 / No finite positive ratio; resources $16,329,066 / $16,494,007 / No finite positive ratio. Gross associated envelope $129,301. Full gift retained; positive.
  • rapid_alternative_care: Bay associated resources: $451,524,609/10 QALYs. Overall/Bay/SF QALYs 0.003749400391 / 0.003711906387 / 0.000000000. Donor overall/Bay/SF $266,709,312 / $269,403,346 / No finite positive ratio; resources $447,009,363 / $451,524,609 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • one_year_vision: Bay associated resources: $7,607,830/10 QALYs. Overall/Bay/SF QALYs 0.2225268741 / 0.2203016054 / 0.000000000. Donor overall/Bay/SF $4,493,839 / $4,539,232 / No finite positive ratio; resources $7,531,751 / $7,607,830 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • weak_vision_utility: Bay associated resources: $10,951,995/10 QALYs. Overall/Bay/SF QALYs 0.1545788264 / 0.1530330381 / 0.000000000. Donor overall/Bay/SF $6,469,191 / $6,534,537 / No finite positive ratio; resources $10,842,475 / $10,951,995 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • no_hearing_health: Bay associated resources: $6,334,477/10 QALYs. Overall/Bay/SF QALYs 0.2672591061 / 0.2645865151 / 0.000000000. Donor overall/Bay/SF $3,741,687 / $3,779,482 / No finite positive ratio; resources $6,271,132 / $6,334,477 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • vision_only_positive_health: Bay associated resources: $12,609,245/10 QALYs. Overall/Bay/SF QALYs 0.1342623199 / 0.1329196967 / 0.000000000. Donor overall/Bay/SF $7,448,106 / $7,523,339 / No finite positive ratio; resources $12,483,153 / $12,609,245 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • no_additional_capacity: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs 0.000000000 / 0.000000000 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; zero.
  • no_funding_additionality: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs 0.000000000 / 0.000000000 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; zero.
  • null_utility_retains_harms: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs -0.02206646606 / -0.02184580140 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; harm.
  • zero_all_health: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs 0.000000000 / 0.000000000 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; zero.
  • signed_health_harm: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs -0.2023302870 / -0.2003069841 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; harm.
  • independent_harm_zero_activity: Bay associated resources: No finite positive ratio/10 QALYs. Overall/Bay/SF QALYs -1.000000000 / -0.9900000000 / 0.000000000. Donor overall/Bay/SF No finite positive ratio / No finite positive ratio / No finite positive ratio; resources No finite positive ratio / No finite positive ratio / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; harm.
  • external_resource_double: Bay associated resources: $8,852,779/10 QALYs. Overall/Bay/SF QALYs 0.2683668144 / 0.2656831463 / 0.000000000. Donor overall/Bay/SF $3,726,243 / $3,763,882 / No finite positive ratio; resources $8,764,251 / $8,852,779 / No finite positive ratio. Gross associated envelope $235,203. Full gift retained; positive.
  • limited_absorption: Bay associated resources: $51,100,520/10 QALYs. Overall/Bay/SF QALYs 0.03312973212 / 0.03279843480 / 0.000000000. Donor overall/Bay/SF $30,184,367 / $30,489,260 / No finite positive ratio; resources $50,589,515 / $51,100,520 / No finite positive ratio. Gross associated envelope $167,602. Full gift retained; positive.
  • regional_sensitivity: Bay associated resources: $6,939,163/10 QALYs. Overall/Bay/SF QALYs 0.2683668144 / 0.2415301330 / 0.002683668144. Donor overall/Bay/SF $3,726,243 / $4,140,270 / $372,624,314; resources $6,245,247 / $6,939,163 / $624,524,714. Gross associated envelope $167,602. Full gift retained; positive.

Uncertainty. Central and favorable are conditional bundles, not confidence limits. Zero/negative health retains costs and suppresses positive ratios. The favorable donor result does not establish favorable full-resource efficiency.

Why this differs from the $375k quick screen

The earlier preliminary screen assumed25% vision allocation and$75 per already-identified referral, with a coarse .04Q per extra completion. Full research pays for the screening pipeline, uses15% vision allocation, filters treatability and models alternative-care catch-up. Neither version is a funding quote.

Historical screening hypothesis only: 10×75 /(.25×.5×.4×.04)
$375,000 donor /10Q, not the current whole-portfolio estimate

QALY conversion assumptions

    Do not add preliminary-screen QALYs to the full model or preserve its number by tuning assumptions.

    5. Funding and previous grants

    No current costed additional-care tranche verified. Research estimate, not a funding recommendation or proof of zero benefit elsewhere.

    FY2025 filed revenue$3,778,505 and expenses$5,091,250; program$3,936,132, management$782,761, fundraising$372,357. Government contributions$289,473 and service revenue$218,705 are existing support, not added donor leverage. Net assets$4,297,786 do not equal available cash. No current costed funding room established; gross external envelope is not net societal cost.

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

    Donate

    Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.

    6. Sources

    1. Ways to Give. Healthier Kids Foundation. Official general giving and EIN 77-0545774. Page retains an older postal address alongside current contact block; no address used as model input.. Published: Current undated; retrieved: September 8, 2026.
    2. Current programs and leadership. Healthier Kids Foundation. Official screening, education, coverage, foster appointment and newborn support; not allocation or causal health evidence.. Published: Current undated; retrieved: September 8, 2026.
    3. Joining Healthier Kids Foundation. Kids in Common. Official continuation of policy, data, partnerships and summit work under HKF; current homepage/team corroborate integration.. Published: Current undated; retrieved: September 8, 2026.
    4. Turning Wheels for Kids. Healthier Kids Foundation. Current homepage linked program; cycling benefits not converted to QALYs.. Published: Current 2026 portfolio; retrieved: September 8, 2026.
    5. FY ending June 2025 Form 990. Healthier Kids Foundation / IRS, rendered by ProPublica. Primary filed return, tax-year 2024 form for FY2025. Public rendered iframe read via Node after browser/XML access limitations. Filing is not itself an independent audit; current expansion not presumed inside historical totals.. Published: Filed December 5, 2025; retrieved: September 8, 2026.
    6. VisionFirst. Healthier Kids Foundation. About 20,000 screens/year, 14% need vision care, over 8,200 glasses using insurance cumulatively; not contemporaneous causal completion rate.. Published: Current undated statistics; retrieved: September 8, 2026.
    7. DentalFirst. Healthier Kids Foundation. 29% need follow-up contact. Testimonial closes screening paperwork before remaining fillings: a closed referral is not proof of completed treatment.. Published: Current undated statistics; retrieved: September 8, 2026.
    8. HearingFirst. Healthier Kids Foundation. 4% need follow-up, CCS navigation. Example includes ear cleaning, not permanent deafness; severity mix unknown.. Published: Current undated statistics; retrieved: September 8, 2026.
    9. Medi-Cal for Kids & Teens member information. California DHCS. Official covered diagnosis/treatment, vision/hearing/dental care, transport, appointment and language assistance; coverage is not guaranteed uptake.. Published: Current; retrieved: September 8, 2026.
    10. FY2025–26 Board budget proposal inventory. Santa Clara County. Official inventory lists $15,000 one-time My HealthFirst expansion allocation. Existing public support, not donor-created leverage or verified renewal.. Published: April 2026; retrieved: September 8, 2026.
    11. Eyeglass wear among low-income San Francisco preschoolers. Sabharwal et al.. Primary observational school-year cohort: 133/188 consistently wore glasses over half the school day. Not 71% of all waking hours, HKF treatment completion, or measured utility.. Published: February 18, 2021; retrieved: September 8, 2026.
    12. Cost-effectiveness of eye care services in Zambia. Griffiths et al.. Primary uncontrolled refraction/presbyopia cohort; .850 to .925 EQ-5D among 41/113 follow-ups. Not child-specific causal utility; used only as weak scale context.. Published: 2014; retrieved: September 8, 2026.
    13. Dental caries treatment and children/families. Knapp et al.. Primary uncontrolled pre/post GA cohort: 85/167 followed at 3 months; CHU9D displayed as summed 13.58 to 11.09, not preference weights. No score-to-QALY conversion.. Published: 2020 online; 2021 issue; retrieved: September 8, 2026.
    14. Ventilation tubes versus watchful waiting: quality of life. Rovers et al.. Primary randomized pediatric OME study; indexed abstract reports no significant between-group QoL improvement. Full page challenged; not treated as full-text verification. Challenges broad hearing utility transfer.. Published: 2001; retrieved: September 8, 2026.
    15. Refractive correction for anisometropic amblyopia. Cotter / PEDIG. Primary prospective noncomparative initial intervention in 84 children aged 3–<7; acuity outcomes, not lifetime utility or timing counterfactual. No extra amblyopia stream credited.. Published: 2006; retrieved: September 8, 2026.

    Annual expenses: years and sources

    Average annual expenses (three consecutive fiscal years): $5,966,395. Organization size is separate from the modeled cost-effectiveness of a donation.

    Healthier Kids Foundation Inc

    Form 990/990-EZ reported whole-entity expenses; includes program, administration and fundraising costs, but excludes any costs netted against revenue.

    Latest original return and prior-year comparative combined with earlier filing data.