GiveBetter x SF

Roots Community Health

Conditional whole-organization value of a $100,000 unrestricted gift

Research time: ~18 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? Current referrals cover complex primary care, diabetes, counseling and medication management, plus benefits, re-entry, education and family navigation. A general gift supports the whole organization. This model quantifies only a prospective sustained-BP-treatment component while retaining all gift costs. More

Why this approach interests us

  • Roots offers complex primary care and navigation. Randomized treatment evidence supports cardiovascular risk reduction when care achieves a sustained blood-pressure difference.

Our main reservations

  • Current high-risk case mix, complete course costs, gift allocation and additional clinical outcomes are not measured. Historical care-team proposals are not current results.

What do you get for your dollar?

Our conditional central estimate is $3.56 million per 10 Bay-resident QALYs. The favorable donor scenario is $94,166, but $141,249 with additional resources and $381,400 when health is clipped to the five-year care window. These are different scopes, not interchangeable prices. The pessimistic scenario has slightly negative health. Inspect formulas, inputs and sources.

central donor cost / 10 qalys
$3.56M Bay / $3.38M US — Same $100,000 gift: 0.281152 Bay QALYs, 0.295950 US QALYs. SF remains unquantified with zero numerical credit, not evidence of no SF patients.
whole-gift boundary
$100,000 once — Central25% BP course allocation,75% shared and other portfolio work with unquantified health. Allocation is judgmental, not audited spending.
recipient
Roots Community Health · EIN26-2583954 — Official giving disclosure verifies this California recipient; not Seattle Roots or Roots of Health in the Philippines.
central gross resource envelope
$112,500 — Includes hypothetical additional public/partner resources; not net incremental societal cost. Family time omitted.

1. What do they do?

Current referrals cover complex primary care, diabetes, counseling and medication management, plus benefits, re-entry, education and family navigation. A general gift supports the whole organization. This model quantifies only a prospective sustained-BP-treatment component while retaining all gift costs.

Allocate the whole gift

The BP allocation reserves five years of direct cash. Shared and other work keeps its cost but has no quantified benefit here.

Reach a selected high-risk cohort

Course cost includes screening, ineligible candidates and failed engagement. The20% central first-event risk does not describe all referrals.

Change treatment beyond usual care

The achieved BP difference includes incomplete uptake and persistence. Financial additionality separately tests whether the gift replaces already-funded activity.

Count finite first-event consequences

Only first cardiovascular events during five care years count. Finite postevent consequences are discounted; a separate clipped scenario tests dependence on later health.

Scope of this review. All quantified health is US-resident health. Bay and SF are nested resident-share priors, not clinic counts. No duplicated patient-time benefits with other clinical or navigation reports.

2. Monitoring and information sharing

Blood-pressure-lowering trial populations

Ettehad et al.2016 randomized-trial meta-analysis. RR0.80 (95%CI0.77–0.83) for major cardiovascular events per10mmHg achieved systolic reduction.

Our assessment. Supports treatment mechanism, not Roots' achieved difference, local risk or health utility. Verified from author-institution indexed abstract; not fresh full-paper retrieval.

Intermediate-risk adults without cardiovascular disease

HOPE-3 randomized trial. Benefit concentrated in highest baseline-BP third; middle and lower thirds neutral.

Our assessment. Do not extrapolate high-risk treatment gains to every primary-care referral.

Roots clinical and navigation clients

Current provider referral and giving disclosures. Actual complex primary care and navigation verified; official EIN disclosed.

Our assessment. Neither service listings nor old proposals demonstrate incremental health or current capacity.

3. Qualitative assessment

Roots offers complex primary care and navigation. Randomized treatment evidence supports cardiovascular risk reduction when care achieves a sustained blood-pressure difference.

Key reservations

  • No current BP-specific complete price, high-risk backlog or achieved between-counterfactual BP outcome.
  • Whole-gift allocation is judgmental; current audited functional spending was not retrieved.
  • Severity, utility, duration and resident shares are priors. Noncore benefits and harms remain unquantified.
  • The favorable donor estimate crosses the threshold only jointly; the resource-inclusive and clipped versions do not.

Benefits not included in our estimate

  • Other primary and behavioral health outcomes
  • Housing, employment, re-entry and family benefits
  • Pulse-oximetry advocacy and broader policy effects
  • Economic welfare, recurrent CVD and overlapping partner benefits

4. What do you get for your dollar?

Finite cardiovascular outcomes, not visits counted as health

Central courses start three months after the gift. Annual first-event risks reproduce five-year cumulative risk exactly. Events occur at midyear; health flows begin one year afterward. Core finite consequences assume prevented early events are not merely delayed until after year5.

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

Whole-gift clinical bridge: N=gift×BP allocation/course cash. R1=R0×0.8^(achieved SBP/10). Q=N×funding additionality×(sum of annual first-event differences×finite discounted health consequences−shared harm)−independent donor harm.
Central:12.5 offered courses,0.25 incremental first events prevented,0.295950 US QALYs and0.281152 Bay QALYs.

Model inputs and assumptions
BP allocation / five-year course cash
25% / $2,000 (range: 10–50% / $1,000–$4,000). Whole gift remains numerator. Costs include selection, unsuccessful engagement and direct clinical delivery; other institutional costs remain outside this allocation. Analyst judgment.
Five-year usual-care risk / achieved SBP difference
20% / 10mmHg (range: 5–30% / 3–20mmHg). Applies to selected high-risk offered-course cohort. Achieved difference includes adherence; no second adherence multiplier. Local judgments; external causal RR.
Financial additionality
50% (range: 0–80%). Replacement of existing activity differs from the clinical no-gift comparator. No verified priced tranche. Analyst judgment.
Fatal share and finite health consequences
20% fatal;0.75 utility for10 years; nonfatal0.10 loss for5 years (range: Fatal share10–30%; finite fatal5–20 and nonfatal2–5 years). Mutually exclusive first-event consequences;5% annual postevent competing mortality,3% discount. Not published lifetime QALYs. Analyst judgment.
Course duration / start delay
5 years / 3 months (range: Start delay1.5–6 months). Complete cash reserved at gift. Delay shifts events and care-year5 clipping window. Analyst judgment.
Bay / SF resident share
95% / zero quantified credit (range: Bay90–98%; SF0). No current resident utilization denominator establishes these shares. Bay includes SF. Allocation prior; SF unquantified.
Additional gross resources per offered course
$1,000 (range: $0 lower-bound cost sensitivity). Gross associated inputs outside donor cash, not an established genuinely incremental amount. No double charging of donor cash items. Family time omitted. Unpriced stress.
Shared course harm
0.001 discounted QALY/course (range: Zero-gain and independent-harm cases included). Shared harm before funding additionality; independent donor harm survives zero additionality. Not a sourced adverse-event rate. Explicit judgment.

Same $100,000 gift in every scenario

  • central: Bay donor: $3,556,794/10 QALYs. Bay QALYs 0.281152102; US 0.295949581; SF0 quantified. US donor $3,378,954/10 QALYs. Gross resource envelope $112,500; Bay resource $4,001,393/10 QALYs.
  • favorable joint stress: Bay donor: $94,166/10 QALYs. Bay QALYs 10.6195665; US 10.8362924; SF0 quantified. US donor $92,282/10 QALYs. Gross resource envelope $150,000; Bay resource $141,249/10 QALYs.
  • pessimistic: Bay donor: No finite positive ratio. Bay QALYs -0.0000431218920; US -0.0000479132133; SF0 quantified. US donor No finite positive ratio. Gross resource envelope $102,500; Bay resource No finite positive ratio.
  • five year health clip: Bay donor: $11,129,113/10 QALYs. Bay QALYs 0.0898544202; US 0.0945836002; SF0 quantified. US donor $10,572,657/10 QALYs. Gross resource envelope $112,500; Bay resource $12,520,252/10 QALYs.
  • favorable five year health clip: Bay donor: $381,400/10 QALYs. Bay QALYs 2.62192223; US 2.67543085; SF0 quantified. US donor $373,772/10 QALYs. Gross resource envelope $150,000; Bay resource $572,099/10 QALYs.
  • lower risk case mix: Bay donor: $15,253,030/10 QALYs. Bay QALYs 0.0655607433; US 0.0690113088; SF0 quantified. US donor $14,490,379/10 QALYs. Gross resource envelope $112,500; Bay resource $17,159,659/10 QALYs.
  • public baseline strong: Bay donor: $57,438,206/10 QALYs. Bay QALYs 0.0174100145; US 0.0183263310; SF0 quantified. US donor $54,566,296/10 QALYs. Gross resource envelope $112,500; Bay resource $64,617,982/10 QALYs.
  • no additional activity: Bay donor: No finite positive ratio. Bay QALYs 0.00000000; US 0.00000000; SF0 quantified. US donor No finite positive ratio. Gross resource envelope $112,500; Bay resource No finite positive ratio.
  • no clinical gain: Bay donor: No finite positive ratio. Bay QALYs -0.00593750000; US -0.00625000000; SF0 quantified. US donor No finite positive ratio. Gross resource envelope $112,500; Bay resource No finite positive ratio.
  • no gain no shared harm: Bay donor: No finite positive ratio. Bay QALYs 0.00000000; US 0.00000000; SF0 quantified. US donor No finite positive ratio. Gross resource envelope $112,500; Bay resource No finite positive ratio.
  • independent donor harm: Bay donor: No finite positive ratio. Bay QALYs -0.00950000000; US -0.0100000000; SF0 quantified. US donor No finite positive ratio. Gross resource envelope $112,500; Bay resource No finite positive ratio.
  • unpriced resources zero lower bound: Bay donor: $3,556,794/10 QALYs. Bay QALYs 0.281152102; US 0.295949581; SF0 quantified. US donor $3,378,954/10 QALYs. Gross resource envelope $100,000; Bay resource $3,556,794/10 QALYs.

Uncertainty. Core retains finite health after care ends, assuming durable event consequences rather than complete later catch-up. Favorable care-year5 clipping is $381,400/10 Bay QALYs; its resource comparison is $572,099. The negative pessimistic case has no positive cost-effectiveness ratio. Scenarios are not confidence bounds.

5. Funding and previous grants

Conditional research, not a funding recommendation: no verified additional high-risk cohort or current complete care budget.

Official general giving is available, but does not establish BP-specific capacity or allocation. Existing Medi-Cal care and historical county-funded street medicine are baseline. Gross resources count all offers including replacement/failure, not net societal increment.

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. Current referral page. Roots Community Health. Official provider disclosure. Published: Undated; retrieved: September 8, 2026.
  2. Donate; EIN and general giving. Roots Community Health. Official provider disclosure. Published: Undated; retrieved: September 8, 2026.
  3. Care team proposals, not achieved/current outputs. Roots Community Health. Official provider disclosure. Published: 2016–2017; retrieved: September 8, 2026.
  4. Blood pressure lowering trial meta-analysis abstract. Ettehad et al.; Oxford author institution. Primary meta-analysis; author-institution indexed abstract. Published: 2016; retrieved: September 8, 2026.
  5. HOPE-3 blood-pressure randomized trial. Lonn et al.; New England Journal of Medicine. Primary randomized trial. Published: 2016; retrieved: September 8, 2026.
  6. Street Medicine Amid the COVID-19 Pandemic. California Health Care Foundation. Primary funder account, historical. Published: 2021; retrieved: September 8, 2026.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): $27,075,100. Organization size is separate from the modeled cost-effectiveness of a donation.

Roots Community Health Center

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

Original returns checked for legal identity, full-year period and total expenses. Latest three linked original returns.