Market for Impact

Summary

What do they do? The reviewed Hearing and Speech Center pathway provides hearing assessment and hearing aids to eligible adults. It includes fitting, batteries, rehabilitation and follow-up rather than the device alone. The pathway is described through its partnership with Project Homeless Connect. More

We include this hearing-care pathway among our top-ten research candidates because of its:

Focus on fitted, supported hearing care that can improve communication.
External randomized evidence of improvement in hearing-related health utility.
Model that accounts for clinical time, follow-up and unsuccessful offers rather than pricing donated devices alone.

Our main reservations about Hearing and Speech Center are:

The historical recipient's tax-exempt status is unresolved; a current eligible recipient must be verified before a direct gift.
The assumed cost and additional treatment capacity are not supported by a current provider quote.
Study results may not transfer to local patients, sustained hearing-aid use is uncertain, and PHC overlap must be excluded.

What do you get for your dollar?

GiveBetter considers supported hearing care a plausible way to improve everyday functioning, but does not recommend a direct gift to this recipient until its status is resolved. We assume $1,500 per offered care package: $600 for clinical labor, $250 for refurbishment and molds, $250 for support, $200 for coordination and failed offers, and $200 for overhead and contingency. These are analyst assumptions; a separate donated-device resource allowance is not included in that donor price. Source

The clinical study supplies a 0.12 health-utility improvement, not 0.12 QALYs or a saved life. Our central calculation halves that effect for transfer uncertainty, assumes 80% completion, half a year of effective benefit and 50% funding additionality. The result is 0.012 modeled QALYs per offer.

At the assumed $1,500 cost, that is $1.25 million per 10 QALYs. The estimate explains why completed fitting and sustained use matter; distributing a hearing aid without those steps would not deliver the same modeled benefit. More

What information has Hearing and Speech Center shared about its program?

The reviewed material identifies a clinical pathway and active clinical registration, but not a current completed-course denominator or local utility follow-up. Clinical registration does not establish charitable tax status. The IRS-data review found automatic revocation for the historical EIN without verified reinstatement or a successor recipient. More

What is GiveBetter’s qualitative assessment of Hearing and Speech Center?

There is a credible clinical mechanism and a concrete local partnership. Administrative uncertainty about who can receive a donation is separate from whether the clinic provides useful care, and does not establish misconduct or closure. We keep the research while withholding a direct-gift recommendation. More

1. What do they do?

PHC’s Core Senses page names the Center as its hearing partner and describes screening, necessary aids, batteries, support and follow-up without requiring insurance. The Center describes donated-device refurbishment. Neither page supplies a current eligible backlog, stock yield or price.

Start with an eligible willing adult

This denominator begins after clinical eligibility. Add broad outreach/screening costs if needed.

Offer assessed and fitted care

One or both ears as indicated produce one person-level outcome; failed offers remain in costs.

Support useful incremental hearing

Count use and benefit before equivalent alternative care catches up, within a finite funded window.

Scope of this review. The shared hearing ledger is phc-hsc-adult-hearing-aid-access. PHC’s separately reviewed glasses pathway is distinct; do not credit hearing QALYs twice or silently reroute a gift to PHC without confirming control and restriction. Clinical registry status is not charitable eligibility.

2. Monitoring and information sharing

Selected Singapore adults with hearing loss seeking aids; analyzed groups 264 and 163

Kaur et al., 2020 delayed-start community-centre study. Reported HUI3 utility increment 0.12 after three months.

Our assessment. Modified control questionnaire and short follow-up limit transfer. Do not import the paper’s five-year ICER, infer first-ever use from ten-year nonuse, or add dementia/mortality benefits.

66% response subset

One-year telephone follow-up. 71.4% of respondents reported use.

Our assessment. Not whole-cohort persistence and not evidence for the four-year local favorable case.

SF shared hearing pathway

PHC and provider websites. Necessary hearing care and follow-up are described.

Our assessment. Website freshness, marginal costs and actual additional slots are unresolved.

Historical EIN 94-1322198

Primary IRS bulk-data audit, datasets labeled June 9, 2026. Automatic revocation effective November 15, 2025; posted March 10, 2026; reinstatement field blank. No matching entry was found in the checked IRS Publication 78 data.

Our assessment. The dataset date does not exclude a later reinstatement or successor organization. An active National Provider Identifier (NPI) does not establish tax-exempt status, current service availability or closure.

3. Qualitative assessment

Assessed, fitted and rehabilitated hearing care can improve hearing-sensitive health utility; donating a device alone is not the intervention.

Key reservations

Recipient status must be resolved before promoting a donation route; the model is clinical research, not tax advice.
The hypothetical $900 four-year course is unusually optimistic on support costs and persistence.
Medi-Cal, Medicare Advantage and appropriate OTC alternatives may shorten incremental access; the cited 2024 Medi-Cal handbook is not a verified 2026 plan-specific authorization.
Patient time and additional outreach are unpriced. Clinical labor is paid in the constructed budget even if currently volunteered.

Benefits not included in our estimate

No second PHC hearing credit, extra retention multiplier or per-ear multiplication.
No imported five-year lifetime ICER, dementia prevention, mortality or employment benefit.
No implication that automatic revocation proves clinic closure or misconduct.

4. What do you get for your dollar?

$1.25M per 10 QALYs

The 0.12 external HUI3 increment is utility, not QALYs. We retain half for local transfer, assume 80% pre-fitting completion, half an effective incremental year and 50% financing additionality. The result is 0.012 QALY per offered $1,500 course. These local inputs are explicit judgments, not a measured Center effect.

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

DONOR DOLLARS PER 10 QALYS: 10 × $1,500 ÷ (0.12 × 0.5 × 0.8 × 0.5 × 0.5)
$1.25M

Model inputs and assumptions

Complete course cash commitment: $1,500 (range: $900–$2,500). $600 paid clinical labor, $250 refurbishment/molds, $250 support, $200 coordination/failures and $200 facility/admin allowance; all constructed costs. Low / judgmental.
External utility increment: 0.12 (range: 0.01–0.12). Three-month hearing-sensitive HUI3 result. The low value is instrument sensitivity, not a local trial finding. Low / judgmental.
Clinical/population transfer: 50% (range: 50–75%). Singapore selected older adults differ from SF adults experiencing homelessness. Low / judgmental.
Pre-fitting completion: 80% (range: 50–90%). Separate from later nonuse already included in effective exposure. Low / judgmental.
Discounted effective health years: 0.5 (range: 0.25–2; extended case separate). Central stops after one calendar year; favorable stops after four. Annual profiles already include ramp, nonuse, mortality and alternative-care catch-up. Low / judgmental.
Financing additionality: 50% (range: 25–75%; zero possible). Replacement funding reduces new services. Public coverage and other accessible care belong in the comparator, not automatic free-benefit claims. Low / judgmental.

Finite-horizon scenarios and explicit nulls

central: $1.25M. 0.012 incremental QALYs; 1 calendar-year window
favorable extended access stress: $74.07K. 0.1215 incremental QALYs; 4 calendar-year window
pessimistic instrument and access: $160M. 0.00015625 incremental QALYs; 1 calendar-year window
null budget substitution: No finite positive price. 0 incremental QALYs; 1 calendar-year window
hypothetical signed harm: No finite positive price. -0.001 incremental QALYs; 1 calendar-year window
zero funding shared harm cancels: No finite positive price. 0 incremental QALYs; 1 calendar-year window
zero funding independent harm persists: No finite positive price. -0.001 incremental QALYs; 1 calendar-year window

Uncertainty. End-of-year discounting is 3%. Central annual incremental exposure fraction 0.515 gives 0.5 discounted years; favorable 0.538054 in each of four years gives two. These are constructed schedules, not observed adherence. The whole cash budget is committed at time zero, including support across the entire calendar window. Shared pathway harms sit inside financing additionality; independent donor health harms can persist outside it.

The attractive extended case is not a complete resource bargain

A judgmental $600 donated-stock allowance raises central cost to $1.75M/10 QALYs and the extended case to $123K. This is gross cash-plus-stock per commissioned offer, not a net societal ICER or a retail device price.

CENTRAL CASH PLUS STOCK: 10 × ($1,500 + $600) ÷ 0.012
$1.75M

QALY conversion assumptions

central: $1.75M. Gross resource diagnostic; patient time unknown
favorable extended access stress: $123.46K. Gross resource diagnostic; patient time unknown
pessimistic instrument and access: $224M. Gross resource diagnostic; patient time unknown

At central health, the donor budget must fall below $120 to beat $100K/10 QALYs. Keeping $1,500 would require 6.25 effective years—impossible within the one-year core horizon, not an available sensitivity. No healthcare savings or unpriced extension is credited.

5. Funding and previous grants

The September 9 IRS-data review found automatic revocation for the historical EIN, with no verified reinstatement or successor recipient. This does not establish clinic closure or misconduct. Resolve the legal recipient before considering a gift; the health model alone cannot clear this warning.

IRS data list the historical EIN as automatically revoked, with no reinstatement date recorded. Later reinstatement or a successor is unverified. This does not establish clinic closure; no direct gift is recommended.

The favorable $150 support allowance must cover all four years, about $37.50 annually, not just two effective years. Loss, repairs and replacement may make that unrealistic. No current restricted package or additional fitting capacity is verified. No insurance requirement does not imply no public alternatives.

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

Cost-utility analysis of hearing aid device for older adults in the community. Kaur et al.. Primary delayed-start study. Published: 1 December 2020; retrieved: 2026-09-08.
Core Senses partnership. PHC. Primary program disclosure. Published: Not stated; retrieved: 2026-09-08.
Donated-device pathway. Hearing and Speech Center. Provider disclosure. Published: Not stated; retrieved: 2026-09-08.
Tax-exempt bulk data and dataset dates. IRS. Primary identity data. Published: Dataset labeled June 9, 2026; retrieved: 2026-09-08.
Automatic-revocation records. IRS. Primary bulk ZIP. Published: Dataset labeled June 9, 2026; retrieved: 2026-09-08.
Publication 78. IRS. Primary bulk ZIP. Published: Dataset labeled June 9, 2026; retrieved: 2026-09-08.
Clinical NPI—not exemption. CMS. Primary registry. Published: Record updated June 8, 2026; retrieved: 2026-09-08.
Hearing-aid coverage. Medicare. Official coverage. Published: Current page; retrieved: 2026-09-08.
2024 Medi-Cal handbook. DHCS. Historical official baseline. Published: 2024; retrieved: 2026-09-08.
OTC hearing-aid boundaries. FDA. Official device guidance. Published: Current page; retrieved: 2026-09-08.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): $2,460,673. Organization size is separate from the modeled cost-effectiveness of a donation.

Hearing and Speech Center of Northern California

Historical whole-entity Form 990 total expenses.

FY2020–2022 only: not current spending. Historical EIN's revocation and any reinstatement remain unresolved.