GiveBetter x SF

San Francisco Public Health Foundation

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

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? The foundation supports diverse public-health programs through fiscal intermediation, sponsorship and philanthropic support. Only a hypothetical navigation-to-additional-cure component is quantified here. End Hep C SF's peer-navigator page describes a ninth cohort, but gives no cohort date. Historical service and a live organization support a plausible pathway, not proof of today's additional treatment capacity. More

Why this approach interests us

  • The foundation has a documented EndHepCSF funding relationship and an established peer-navigation pathway. Added support could help otherwise untreated people reach and complete curative care.

Our main reservations

  • Existing public contracts, funded clinical partners and restricted project balances may replace new donor activity. The general gift's allocation, current navigator staffing, extra cure probability and later counterfactual treatment are uncertain.

What do you get for your dollar?

Our conditional central estimate is $18.31 million per 10 SF QALYs. A demanding joint favorable case reaches $35,811 donor and $80,932 gross resources; if those people would instead be cured one year later, these become $364,248 and $823,200. Current navigator capacity after the documented contract period is not independently verified. Inspect formulas, inputs and sources.

central donor cost / 10 qalys
$18.31M SF / $17.75M Bay / $17.39M US — Same $100,000 gift: 0.054616 SF, 0.056340 Bay and 0.057490 US QALYs. SF is inside Bay inside US; these are never additive.
whole-gift boundary
$100,000 once — Central 10% hypothetical HCV allocation; 90% other foundation work retains all cost with unquantified health. This is not a restricted End Hep C project gift.
recipient
SFPHF · EIN 94-3117093 — Officially hosted 2024 Form 990 covers July 2024–June 2025 and identifies foundation name, EIN and website. Not calendar-2024 accounts or fresh IRS eligibility certification.
central gross resource envelope
$113,000 — Adds hypothetical noncash delivery inputs and payer-funded medication to donor cash. Not net incremental societal spending or a verified current DAA price.

1. What do they do?

The foundation supports diverse public-health programs through fiscal intermediation, sponsorship and philanthropic support. Only a hypothetical navigation-to-additional-cure component is quantified here. End Hep C SF's peer-navigator page describes a ninth cohort, but gives no cohort date. Historical service and a live organization support a plausible pathway, not proof of today's additional treatment capacity.

Allocate the whole foundation gift

An analyst 10% central allocation funds complete navigation offers. Partner delivery, screening failures, unsuccessful engagement and relevant administration are included in each offer; remaining foundation costs stay in the numerator.

Add navigation beyond funded care

Financial additionality tests replacement of existing funding. Clinical cure probability separately compares offered support with care already available through public and community providers.

Verify additional cures

Count confirmed additional cures among offered viremic people, not training, assessment, contacts or referral counts. No integrated-clinic trial effect is assigned to ordinary peer navigation.

Limit the health gained

Finite health is reduced for reinfection, excess competing mortality and later counterfactual cure. No separate transmission, naloxone or opioid-treatment health is added.

Scope of this review. EndHepCSF, SFPHF and clinical partners cannot each claim the same cure and patient-time. Service location does not establish residence; SF/Bay shares are unmeasured priors. Assessment contracts do not buy a counted treatment.

2. Monitoring and information sharing

Foundation-sponsored EndHepCSF and partner agencies

Official service page, fiscal records and public contract documentation. An established navigator structure and restricted EndHepCSF funding relationship exist. Current navigator page describes a ninth cohort without a date.

Our assessment. Supports a plausible current pathway, not verified post-contract staff capacity or an extra cure. Current assessment funding is not treatment.

People with HIV/HCV and substance use; RNA-positive cure denominator

CTN-0064 randomized care-facilitation trial. SVR12 in 6/41 intervention participants versus 5/53 controls.

Our assessment. Small uncertain secondary cure outcome; central 5-point difference is a labeled local prior. Do not transfer integrated-care-versus-referral efficacy to ordinary navigation.

External age-40 fibrosis-stage scenarios

McEwan et al. modeled HCV progression and SVR benefit. Discounted QALY increments of 0.23–0.64 per ten-point SVR improvement imply 2.3–6.4 per additional cure.

Our assessment. Primary results and 3.5% discount methods inspected. Local age/severity and timing are unmeasured; finite reallocation is a heuristic rather than a disease-model rerun.

People who inject drugs; 55 cured intervention participants

Accessible-care randomized trial post-cure follow-up. Four reinfections during 57.9 post-cure person-years.

Our assessment. Short follow-up informs a stress hazard, not a verified sustained SF rate. The trial's larger integrated-care effect is not used as navigation efficacy.

San Francisco Public Health Foundation

Officially hosted Form 990 and FY2025 audited statements. 2024 return for fiscal year ended June2025 identifies EIN 94-3117093. Audit records $423,296 restricted to EndHepCSF at June2025.

Our assessment. Historical entity and project relationship evidence. Restricted balance is neither current unrestricted cash nor proof of a treatment backlog or funding shortage.

3. Qualitative assessment

The foundation has a documented EndHepCSF funding relationship and an established peer-navigation pathway. Added support could help otherwise untreated people reach and complete curative care.

Key reservations

  • Current post-contract navigation staffing and authority to deploy an unrestricted gift remain unverified; the website's cohort has no date.
  • Whole-organization allocation, offered navigation costs, additional cures and funding additionality are judgments, not a current marginal budget.
  • Reference health is already discounted and transformed with an explicit timing heuristic; rapid later cure, reinfection and competing mortality can sharply reduce value.
  • Main donor cost assumes funded DAA access; no current net payer price, extra supply or capacity commitment is verified.
  • Deduplicate cures, resources and patient-time with EndHepCSF, GLIDE, SFAF, SFCHC, Springboard and other providers before any portfolio aggregation.

Benefits not included in our estimate

  • Other foundation-sponsored public-health work
  • Community assessment, training and advocacy beyond counted cures
  • HCV transmission prevention and retreatment
  • Separate naloxone and opioid-treatment survival
  • Downstream medical savings and broader welfare

4. What do you get for your dollar?

Whole-gift costs and a small additional-cure pathway

Central: ten fully costed offers, 0.125 additional cures and 0.459920 retained QALY per cure at the gift date. The health bridge reallocates an external discounted lifetime reference over a finite 20-year window, then applies durability stresses. It is a heuristic, not a rerun of liver disease progression or an observed foundation result.

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 navigation bridge: Offers = gift × HCV allocation / (navigation cash + donor DAA share × extra starts × DAA resource cost). Additional cures = offers × extra cure probability × funding additionality. QALYs = cures × discounted reference Q × retained normalized health weights / (1+d)^gift-to-cure delay − offers × additionality × shared harm − independent gift harm.
Central: 10 × .05 × .25 × .459920 = .057490 US QALYs; × .95 = .054616 SF QALYs. $100,000 × 10 / .054616 = $18,309,818 per 10 SF QALYs.

Model inputs and assumptions
HCV share / complete navigation cash per offer
10% / $1,000 (range: 2–30% / $500–$2,000). Ordinary unrestricted foundation gift. Includes screening failures, unsuccessful engagement, partner delivery and foundation overhead. Not historical program-spending share or current quote. Analyst judgment.
Additional confirmed-cure probability
5 percentage points (range: 1–15 points; explicit zero-gain case). Among confirmed-viremic offered people versus actual available care. CTN-0064 had 6/41 versus 5/53 cures, a small uncertain secondary outcome. Includes completion; no second adherence multiplier. Unmeasured local prior; external navigation context.
Funding additionality
25% (range: 10–75%; explicit zero-activity case). New navigation instead of replacing public funds or other donors. Clinical usual-care substitution is handled separately. Current unfunded cohort and discretionary allocation are unverified. Analyst judgment.
Reference health per additional cure
4 discounted QALYs (range: 2.3–6.4). MONARCH age-40 stage-specific increments imply 2.3–6.4 QALYs per cure. Four is a case-mix judgment; not observed SF survival. Reference total already includes 3.5% discount and general mortality. External modeled anchor; local mix judgment.
Finite health allocation / timing / gift-to-cure
20 years / linearly later / 1-year delay (range: Uniform to quadratically later; delay 0.5–2 years). Weights year^shape/(1+d)^year are normalized to the already-discounted reference before attrition. This avoids discounting its total twice; only the separate gift delay is discounted again. Explicit heuristic.
Reinfection / excess competing mortality
0.069 / 0.03 annual hazards (range: 0.02–0.12 / 0.01–0.06). The accessible-care trial reports 4 reinfections/57.9 person-years. Long-run extrapolation is judgmental. Excess mortality is beyond mortality embedded in the reference. Retreatment unquantified. External short follow-up and analyst priors.
Later counterfactual cure
70% cured 3 years later (range: 20–90% in 1–5 years; universal immediate/one-year stresses). For that fraction, stop incremental health after later cure. Does not credit irreversible disease differences thereafter. Rapid catch-up reverses the favorable threshold conclusion. Unmeasured judgment; decisive sensitivity.
Extra starts / DAA resource cost / donor share
8% / $15,000 / 0% (range: 3–20% / $10,000–$25,000; donor-pays sensitivity). Extra starts are at least additional cures. Main donor share zero assumes payer/assistance payment, not verified current capacity. If donors pay, affordable offers fall and medication is charged once. Resource and access judgments.
Other associated resources per offer
$100 (range: $100 across scenarios). Outside complete donor navigation cash. Gross envelope counts nominal offers/starts before replacement, not net induced public expenditure. Downstream medical savings are not deducted. Unpriced judgment.
Bay / SF residence shares
98% / 95% (range: Bay 95–100%; SF 90–98%). All modeled health is US. SF is a subset of Bay; shares are not established by clinic location or the foundation's name. Unmeasured priors.
Shared implementation / independent gift harm
Zero in central (range: 0.1 US QALY independent loss at zero activity). Shared per-offer burden scales with funding additionality. Independent harm persists at zero activity. Same geography partition assumed here; actual differently located harm needs its own partition. Diagnostic assumptions.

Same $100,000 unrestricted gift in every scenario

  • central: SF donor: $18,309,818/10 QALYs. US/Bay/SF QALYs: 0.0574900076 / 0.0563402074 / 0.0546155072. US/Bay donor prices: $17,394,327 / $17,749,313 per 10 QALYs. Gross envelope $113,000; US/Bay/SF resource prices: $19,655,590 / $20,056,724 / $20,690,094 per 10 QALYs.
  • favorable joint: SF donor: $35,811/10 QALYs. US/Bay/SF QALYs: 28.4945019 / 28.4945019 / 27.9246119. US/Bay donor prices: $35,094 / $35,094 per 10 QALYs. Gross envelope $226,000; US/Bay/SF resource prices: $79,314 / $79,314 / $80,932 per 10 QALYs.
  • pessimistic: SF donor: $51,232,537,768/10 QALYs. US/Bay/SF QALYs: 0.0000216876063 / 0.000020603226 / 0.0000195188457. US/Bay donor prices: $46,109,283,991 / $48,536,088,412 per 10 QALYs. Gross envelope $100,850; US/Bay/SF resource prices: $46,501,212,905 / $48,948,645,163 / $51,668,014,339 per 10 QALYs.
  • no navigation allocation: SF donor: No finite positive ratio. US/Bay/SF QALYs: 0 / 0 / 0. US/Bay donor prices: No finite positive ratio / No finite positive ratio per 10 QALYs. Gross envelope $100,000; US/Bay/SF resource prices: No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • no funding additionality: SF donor: No finite positive ratio. US/Bay/SF QALYs: 0 / 0 / 0. US/Bay donor prices: No finite positive ratio / No finite positive ratio per 10 QALYs. Gross envelope $113,000; US/Bay/SF resource prices: No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • no extra cures: SF donor: No finite positive ratio. US/Bay/SF QALYs: 0 / 0 / 0. US/Bay donor prices: No finite positive ratio / No finite positive ratio per 10 QALYs. Gross envelope $113,000; US/Bay/SF resource prices: No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • immediate counterfactual cure: SF donor: No finite positive ratio. US/Bay/SF QALYs: 0 / 0 / 0. US/Bay donor prices: No finite positive ratio / No finite positive ratio per 10 QALYs. Gross envelope $113,000; US/Bay/SF resource prices: No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • independent harm: SF donor: No finite positive ratio. US/Bay/SF QALYs: -0.1 / -0.098 / -0.095. US/Bay donor prices: No finite positive ratio / No finite positive ratio per 10 QALYs. Gross envelope $113,000; US/Bay/SF resource prices: No finite positive ratio / No finite positive ratio / No finite positive ratio per 10 QALYs.
  • donor pays daa: SF donor: $40,281,600/10 QALYs. US/Bay/SF QALYs: 0.0261318216 / 0.0256091852 / 0.0248252306. US/Bay donor prices: $38,267,520 / $39,048,490 per 10 QALYs. Gross envelope $100,455; US/Bay/SF resource prices: $38,441,463 / $39,225,983 / $40,464,698 per 10 QALYs.
  • favorable one year catchup: SF donor: $364,248/10 QALYs. US/Bay/SF QALYs: 2.80141123 / 2.80141123 / 2.745383. US/Bay donor prices: $356,963 / $356,963 per 10 QALYs. Gross envelope $226,000; US/Bay/SF resource prices: $806,736 / $806,736 / $823,200 per 10 QALYs.

Uncertainty. The joint favorable scenario is not a confidence bound or measured offer. Its $35,811 SF donor result becomes $364,248 with universal counterfactual cure one year later; gross resources rise from $80,932 to $823,200 per 10 SF QALYs. Current navigator capacity is uncertain. Null allocation/activity/cures and immediate catch-up retain the full gift and no positive ratio; the independent-harm case is negative.

5. Funding and previous grants

Conditional research, not a verified funding recommendation: current navigation capacity and the unrestricted gift's additional clinical effect remain unverified.

Historical CHEP proposals/objectives contain inconsistent end dates, all before this review; no current extension or unfunded gap is inferred. FY2025 audit records EndHepCSF restricted funds, not a present discretionary tranche. March2026 public work names the initiative for community needs assessment, which receives no cure credit. Existing public clinical support and restricted philanthropy remain the baseline.

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. Official SFPHF 2024 Form 990; FY ended June2025. San Francisco Public Health Foundation. Primary document or provider disclosure; see evidence for transfer limits. Published: Prepared May12,2026; retrieved: September 8, 2026.
  2. SFPHF FY2025 audited statements. San Francisco Public Health Foundation; independent auditor. Primary document or provider disclosure; see evidence for transfer limits. Published: March30,2026; retrieved: September 8, 2026.
  3. End Hep C SF Community Navigator Program. End Hep C SF. Primary document or provider disclosure; see evidence for transfer limits. Published: Undated; retrieved: September 8, 2026.
  4. SFPHF intermediary role. San Francisco Public Health Foundation. Primary document or provider disclosure; see evidence for transfer limits. Published: Page metadata April15,2025; retrieved: September 8, 2026.
  5. May2024 proposed public funding including navigation. SF Department of Public Health. Primary document or provider disclosure; see evidence for transfer limits. Published: May7,2024; retrieved: September 8, 2026.
  6. October2024 BLA review: later proposed term and named subcontractors. SF Budget and Legislative Analyst. Primary public document indexed excerpt; access limits retained in date/description. Published: October23,2024; search-index primary excerpt only, direct fetch failed; retrieved: September 8, 2026.
  7. March2026 public proposal: End Hep C SF community needs assessment. SF Department of Public Health. Primary public document indexed excerpt; access limits retained in date/description. Published: March2,2026; primary indexed excerpt; retrieved: September 8, 2026.
  8. CTN-0064 randomized care facilitation. Metsch et al.; Open Forum Infectious Diseases. Primary document or provider disclosure; see evidence for transfer limits. Published: 2021; full primary page and outcome table read; retrieved: September 8, 2026.
  9. McEwan et al. incremental SVR benefits. McEwan et al.; PLOS ONE. Primary document or provider disclosure; see evidence for transfer limits. Published: 2015; primary methods/results read; retrieved: September 8, 2026.
  10. Accessible HCV care trial. Eckhardt et al.; JAMA Internal Medicine. Primary document or provider disclosure; see evidence for transfer limits. Published: 2022; primary results read; integrated-care efficacy NOT transferred; retrieved: September 8, 2026.
  11. FY25-26 CHEP program objectives. SF Department of Public Health. Primary document or provider disclosure; see evidence for transfer limits. Published: FY25-26 document; stale internal headers; retrieved: September 8, 2026.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): $14,469,637. Organization size is separate from the modeled cost-effectiveness of a donation.

San Francisco Public Health Foundation

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

Fiscal years ended June 30. Whole foundation expenses, including its other projects; not the End Hep C SF project budget.