Summary
What do they do? Friendly Visitor matches connect LGBTQ older adults with volunteers for regular companionship and practical connection. An organization-authored November 2025 description reports 80 current pairs and weekly or biweekly contact, following assessment. This model asks what an additional six-month match might achieve. More
Why this approach interests us
- Regular, affirming contact may reduce loneliness and depressive symptoms for isolated LGBTQ older adults.
Our main reservations
- Local evaluation is uncontrolled with incomplete follow-up; external befriending trials do not supply a clean local QALY coefficient.
What do you get for your dollar?
Our central analyst estimate is $5.33M per better life (10 QALYs). This is a proposed six-month Friendly Visitor match, not Openhouse housing or a measured local QALY result. Inspect the model →
- central estimate
- $5.33M — per 10 incremental QALYs; subjective health bridge
- positive scenarios
- $593K–$320M — Not confidence bounds; null and harm possible
- cost per match
- $1,000 — Assumed six-month cash budget, not a quote
- funding room
- Unverified — Existing grants are not an available donor tranche
1. What do they do?
Friendly Visitor matches connect LGBTQ older adults with volunteers for regular companionship and practical connection. An organization-authored November 2025 description reports 80 current pairs and weekly or biweekly contact, following assessment. This model asks what an additional six-month match might achieve.
Assess and match
Identify an isolated person who wants the service and a suitable, supported volunteer.
Sustain useful contact
Staff screening, training, supervision and transport support are real delivery inputs; an assigned match is not automatically a sustained relationship.
Measure incremental health
Compare with usual contact and support, tracking retention and preference-based health utility rather than treating visits as health outcomes.
Scope of this review. Exclude housing construction, rent assistance and the wider intergenerational program. A mixed-program grant divided by 80 current pairs is not a marginal-match cost.
2. Monitoring and information sharing
Openhouse participants across several services
Local uncontrolled evaluation, 2017–2021. Friendly Visitor follow-up was small and incomplete: 22 baseline respondents and 16 matched six-month respondents.
Our assessment. Selection, missing follow-up and the absence of a comparison group prevent a causal health-utility estimate.
345 Australian aged-care residents
External randomized trial. Reported lower depression and loneliness at 16 weeks, without significant anxiety or social-support differences.
Our assessment. Different setting and population; symptom-scale effects are not QALYs and are not inserted as utility.
Community-dwelling older adults offered telephone friendship groups
External feasibility trial. Volunteer recruitment and retention problems stopped delivery early; participant recruitment targets were met, but planned economic evaluation was incomplete.
Our assessment. Volunteer capacity and sustained service delivery can defeat a plausible theory of change.
3. Qualitative assessment
Regular, affirming contact may reduce loneliness and depressive symptoms for isolated LGBTQ older adults.
Key reservations
- The health-utility bridge is subjective.
- The marginal match budget and capacity need a current quote.
- Incomplete follow-up may select the participants who benefit most.
- Replacing existing funds or offering unwanted contact can erase or reverse benefits.
Benefits not included in our estimate
- Housing construction and rent assistance
- Volunteer health benefits
- Mortality or dementia prevention
- Loneliness and satisfaction points directly relabeled as QALYs
4. What do you get for your dollar?
Central scenario: $5.33M per 10 QALYs.
We assume a $1,000 cash cost, a .01 health-utility improvement for half a year when effectively engaged, 75% sustained engagement and 50% funding additionality. These are judgment calls with explicit uncertainty, not measured Openhouse coefficients.
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 × $1,000 ÷ (0.01 × 0.5 years × 75% × 50%)
$5,333,333 per 10 QALYs
Model inputs and assumptions
- Cash cost per new match
- 1000 (range: 600 / 1000 / 2000). Assumed $1,000: ten staff hours at a $60 loaded hourly cost plus $400 screening, training, transport and administration. Not an Openhouse quote. Volunteer time is an additional in-kind resource, not free societal capacity. Analyst assumption.
- Incremental health utility while engaged
- 0.01 (range: 0.03 / 0.01 / 0.002). Subjective .01 utility gain, not a measured Openhouse effect. External befriending evidence supports investigating depression/loneliness, but neither those scales nor local satisfaction scores are converted numerically into QALYs. Analyst assumption.
- Effective benefit duration
- 0.5 (range: 0.5 / 0.5 / 0.25). Half a year at the assumed effect in the central scenario; unfavorable .25 equivalent years allows later onset or fading. No lifetime extrapolation. Analyst assumption.
- Sustained effective engagement
- 0.75 (range: 0.9 / 0.75 / 0.5). 75% analyst assumption for proposed matches sustaining useful contact, not a completion rate inferred from 80 active pairs or incomplete local follow-up. Analyst assumption.
- Added funding capacity
- 0.5 (range: 0.75 / 0.5 / 0.25). 50% judgment for new effective matches versus replacement funding. Marginal capacity and actual funding room are unverified. Analyst assumption.
Illustrative $100,000: 100 proposed matches and 0.1875 additional QALYs
- Favorable positive: $592.59K per 10 QALYs. 1.69 QALYs per $100,000; capacity unverified
- Central analyst estimate: $5.33M per 10 QALYs. 0.188 QALYs per $100,000; capacity unverified
- Unfavorable positive: $320M per 10 QALYs. 0.00313 QALYs per $100,000; capacity unverified
Uncertainty. Zero added contact, zero health improvement or fully replacement funding means no finite positive-benefit price. Signed negative utility retains possible harm. The positive scenarios are stress cases, not confidence intervals.
Loneliness, satisfaction and QALYs are different measures.
The .01 utility gain is a subjective health assumption. External randomized befriending findings make the mechanism plausible but do not numerically calibrate this value. The local quality-of-life scale is a satisfaction measure, not preference-based utility.
ADDED HEALTH PER PROPOSED MATCH: 0.01 × 0.5 years × 75% × 50%
0.001875 QALYs
QALY conversion assumptions
No conversion of satisfaction points, no volunteer QALYs and no assumed mortality or dementia prevention. Engagement and funding additionality address different losses.
5. Funding and previous grants
No priced marginal match plan or verified additional volunteer/staff capacity.
The city intergenerational grant combines staff, operating costs and a partner subcontract across a wider service scope. It is context, not a cost-per-match denominator. Volunteer time is outside this donor-cash numerator but constrains delivery.
This review does not establish a verified marginal funding offer or a complete history of grants.
Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.
6. Sources
- Fighting Ageism: LGBTQ Seniors and Friendly Visitors Connect. Openhouse development manager / SF Bay Times. Organization-authored description: 80 current pairs; not a causal outcome or full-year cohort. Published: 2025-11-06; retrieved: 2026-09-07.
- 2023–2027 intergenerational program grants. San Francisco Human Services Agency. Pages44–54: mixed-program annual budget, not marginal Friendly Visitor cost. Published: 2023-07; retrieved: 2026-09-07.
- Local evaluation final report. Openhouse / California Reducing Disparities Project. Uncontrolled multi-program evaluation; incomplete FVP follow-up; satisfaction is not health utility. Published: 2021-11-30; retrieved: 2026-09-07.
- Befriending intervention randomized trial. BEFRIENDAS researchers / PubMed. Australian aged-care trial; depression/loneliness effects, not a transferable QALY estimate. Published: 2025; retrieved: 2026-09-07.
- Telephone friendship groups for older people. NIHR / PLINY researchers. Volunteer recruitment/retention and delivery failure; incomplete planned economics: capacity warning. Published: 2014; retrieved: 2026-09-07.
Annual expenses: years and sources
Average annual expenses (three consecutive fiscal years): $5,359,334. Organization size is separate from the modeled cost-effectiveness of a donation.
Openhouse
Whole legal entity Form 990 Part IX total functional expenses; latest original reconstructed filings checked, fiscal-end year from printed reporting dates. Older fallback rows from IRS extracted API.
Latest original filings checked; ProPublica extracted API lags these original returns.