GiveBetter x Los Angeles

Bienestar Human Services

HIV care and prevention, behavioral health, harm reduction and community support

Research time: 12 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

Donate

Summary

What do they do? Bienestar provides culturally focused health care and social support for Latinx, LGBTQ+ and other underserved people in greater Los Angeles. The numerical estimate prices a clinical component covering depression treatment, ART continuity and PrEP while charging the full recipient cost. It also offers harm reduction, community education and help accessing services.

Why we’re interested in this organization:

  • An original audit separates clinical resources and reconciles to the latest return.

  • Local randomized research includes a meaningful usual-service comparator.

  • Current services include sustained therapy and medication access, not only awareness.

Our main reservations:

  • Unit costs, clinical mix and donation responsiveness are subjective priors.

  • A local trial increased testing but did not show a PrEP-use effect.

  • Substantial contracts, pharmacy revenue and liquid assets may replace new gifts; omitted pathways prevent a portfolio ranking.

What do you get for your dollar? $98.6M per better life: ten additional quality-adjusted life years in Los Angeles. Conditional clinical-component estimate charging full recipient expenses; other program effects are not estimated.

Central budget equivalents: 152.537 depression offers, 129.8348 ART strategy-year resource equivalents, 86.55653333333333 PrEP coverage-year equivalents before eligibility and funding. All-population QALYs: depression 1.055170995145631, ART 0.03939162621359223, PrEP 0.13440032498305424. These are modeled expectations, not observed patients.

1. What do they do?

This report covers Bienestar Human Services Inc., EIN 95-4505737, rather than similarly named organizations. Its portfolio combines clinical care with education and social support. Current therapy includes bilingual individual and family sessions over three to six months. HIV care and PrEP services address medication access.

The harm-reduction program includes syringe services, naloxone and mobile outreach. Listed sites are in LA County, but residence is not measured. The model assigns 95% of clinical benefits to LA/Orange residents as a judgment. Current service pages mark the Long Beach center closed, unlike the generic organizational description; this does not imply that all Long Beach mobile outreach ended.

2. Monitoring and information sharing

The 500 clinic patients and 16,000 wider clients on the about page belong to its early-2020 timeline. The latest audit describes over 5,000 annual clients but does not identify current unique clinical courses. Neither count is converted into health benefit. Useful missing data are unique treatment offers, medication coverage, counterfactual treatment interruptions, diagnoses, residence and payer replacement.

The local Siempre Seguiré trial randomized 289 immigrant Latino gay/bisexual men to an eight-session intervention or standard wellness support. It found improved testing, but not PrEP use. Its online delivery cost was $982 per attending participant, not per all randomized participants; that unit is not imported as the cost of an ART year or depression course.

3. Qualitative assessment

The full local trial is important counterevidence against equating outreach with prevention. Follow-up PrEP use was similar between groups; the study did not establish an infection reduction. A separate adherence pilot had an imprecise electronically monitored effect. These findings support neither zero value for clinical medication access nor automatic credit for every contact.

For depression, CoBalT reports 0.057 incremental QALY over a year for adjunctive CBT in treatment-resistant UK adults. Different diagnosis, treatment and usual-care conditions require a 50% transfer judgment, limited to an assumed compatible budget fraction. The SMART trial compared continuous with interrupted ART: its two-per-100 strategy-year difference concerns opportunistic disease or death together, not deaths alone. Only a fraction of modeled coverage is treated as interruption-sensitive.

PROUD supports an 86% relative HIV reduction in a high-incidence PrEP population. The model instead assumes 1% annual untreated incidence locally and explicitly discounts replacement care. Each avoided infection receives a finite 20-year health trajectory, not a lifetime mortality multiplier. These three branches are a conditional clinical component. Housing, food, substance-use treatment, naloxone, syringe services and broader community benefits remain unpriced. Adding them later requires overlap checks.

4. What do you get for your dollar?

FY2025 recognized gross recipient expense is $11,511,459, identical in the original audit and return. No separately netted event, inventory, rental or gaming expense was shown. FY2024 and FY2023 Form 990 expenses were $9,460,690 and $7,388,764; the three-year mean is $9,453,637.67. All three returns identify accrual accounting. The audit records recognized resources, not a verified valuation of every unrecognized volunteer service; blank Schedule D reconciliation does not prove that no such resources exist.

The audit allocates $1,525,370 to behavioral services, $3,813,121 to primary care, $1,628,775 to education, $2,456,505 to other programs and $2,087,688 to support. Primary care includes $2,596,696 of medicine. These disjoint budget pools build the delivery model; the denominator remains the entire $11.51 million recipient. Pharmacy revenue is not subtracted from expense.

The conditional component yields 1.168 LA QALYs, approximately $98.60 million per 10. Joint positive stress cases span $3.64 million to $16.36 billion, not confidence limits. This is not a whole-portfolio ranking or a restricted-program purchase price. Reaching $1 million per 10 across the portfolio requires 115.11459 net LA QALYs; $100,000 requires 1,151.1459. Outside clinical costs and participant time are additional social resources not quantified here.

Model, assumptions and sensitivity

Full recipient cost; only an explicitly limited clinical component is priced.

g=.95 is a resident-share judgment for LA/Orange, not an observed geographic split.

ND=B*e/u; NA=M*h*a/ua; NP=M*h*(1-a)/up; A(T)=sum(y=1..T)(1.03^-y). QD=ND*q*t*b/1.03; QA=NA*ea*ta*b*.02*qe/1.03; QP=NP*ep*b*i*.86*v*A(T)/1.03. QLA=(QD+QA+QP)*g; Price10=10*C/QLA. Portfolio Q=QLA+Qother-H; Qother unknown.

C
11511459 USD full annual recipient expense (observed). Audit and Part IX agree. [audit25] [99025]
B
1525370 USD behavioral service expense (observed). Audit functional allocation. [audit25]
M
2596696 USD primary-care medicine expense (observed). Audit medicine column; not all primary-care cost. [audit25]
e
0.3 compatible depression budget fraction (judgment). No observed diagnosis/course mix; test .1–.6. [mental]
u
3000 USD behavioral resources per compatible offer (judgment). Planning assumption, not a measured unit cost; test 1500–6000. [mental] [audit25]
q
0.057 QALY per randomized depression offer over 12 months (observed). CoBalT effect, not local effectiveness. [cobalt]
t
0.5 depression effect transfer (judgment). Different service and population; test .1–1. [mental] [cobalt]
b
0.25 proportional funding responsiveness (judgment). After public payer, reserve and donor replacement; test .05–.75. [audit25] [award]
g
0.95 LA/Orange resident share (judgment). LA sites support concentration, not an exact share; test .8–1. [mental] [harm]
h
0.8 HIV-related share of medicine budget (judgment). Actual drug mix unobserved. [hiv] [prep] [audit25]
a
0.75 ART share of HIV medicine budget (judgment). Complement .25 goes to PrEP; actual mix unobserved. [hiv] [prep]
ua
12000 medicine USD per ART strategy-year resource equivalent (judgment). Not full treatment cost; all staffing remains in C; test 6000–12000. [audit25]
up
6000 medicine USD per PrEP coverage-year equivalent (judgment). Not observed 340B acquisition cost; test 3000–6000. [audit25]
ea
0.25 ART equivalents exposed to relevant interruption counterfactual (judgment). Most medication spending does not imply an otherwise interrupted patient; test .05–.5. [smart] [hiv]
ta
0.5 ART strategy effect transfer (judgment). 2006 interruption trial differs from modern care gaps. [smart]
deltaA
0.02 composite opportunistic-disease-or-death events per strategy follow-up year (observed). SMART 3.3 versus 1.3 per 100; not a mortality rate or per additional ART year. [smart]
qe
0.5 QALY per composite event prevented (judgment). Finite one-year area, no lifetime extrapolation; event mix unobserved. [smart]
ep
0.5 PrEP equivalents otherwise uncovered (judgment). Prior care substitution distinct from funding response; test .1–.8. [siempre] [prep]
i
0.01 annual HIV incidence without PrEP in modeled risk group (judgment). Not Bienestar observed incidence; below PROUD high-risk population; test .002–.03. [proud]
rP
0.86 relative HIV reduction (observed). PROUD offer-based effect; no extra completion multiplier. [proud]
v
0.1 survival-adjusted utility difference per year after infection prevented (judgment). Finite health-area assumption includes survival differences; no separate life-years added; test .03–.15.
T
20 years of post-infection health area (judgment). No value after year 20; low scenario 10.
d
0.03 annual discount rate (judgment). One-year delivery delay plus explicit HIV trajectory discount.
Qother
null non-overlapping additional LA QALYs (unknown). Harm reduction, housing, education and other pathways unpriced. [harm] [about]

Conditional clinical component: Cost: $11.5M; Los Angeles QALYs: 1.1675147990251635; all-population QALYs: 1.2289629463422775. {"e":0.3,"u":3000,"q":0.057,"t":0.5,"b":0.25,"g":0.95,"h":0.8,"a":0.75,"ua":12000,"up":6000,"ea":0.25,"ta":0.5,"qe":0.5,"ep":0.5,"i":0.01,"v":0.1,"T":20} C=11511459; B=1525370; M=2596696; deltaA=.02; rP=.86; d=.03. Joint judgment scenario, not a portfolio bound.

Weak delivery and transfer: Cost: $11.5M; Los Angeles QALYs: 0.007036066372687242; all-population QALYs: 0.008795082965859052. {"e":0.1,"u":6000,"q":0.057,"t":0.1,"b":0.05,"g":0.8,"h":0.8,"a":0.75,"ua":12000,"up":6000,"ea":0.05,"ta":0.5,"qe":0.5,"ep":0.1,"i":0.002,"v":0.03,"T":10} C=11511459; B=1525370; M=2596696; deltaA=.02; rP=.86; d=.03. Joint judgment scenario, not a portfolio bound.

Favorable delivery and transfer: Cost: $11.5M; Los Angeles QALYs: 31.602897437326195; all-population QALYs: 31.602897437326195. {"e":0.6,"u":1500,"q":0.057,"t":1,"b":0.75,"g":1,"h":0.8,"a":0.75,"ua":6000,"up":3000,"ea":0.5,"ta":0.5,"qe":0.5,"ep":0.8,"i":0.03,"v":0.15,"T":20} C=11511459; B=1525370; M=2596696; deltaA=.02; rP=.86; d=.03. Joint judgment scenario, not a portfolio bound.

Complete substitution or no clinical effect: Cost: $11.5M; Los Angeles QALYs: 0; all-population QALYs: 0. b=0.

Illustrative net harm: Cost: $11.5M; Los Angeles QALYs: -1; all-population QALYs: -1. One LA QALY lost is a stress test, not observed harm.

Whole-portfolio return unestimated: Cost: $11.5M; Los Angeles QALYs: unknown; all-population QALYs: unknown. Omitted pathways and overlap remain unresolved.

Counterfactual: Existing public contracts, pharmacy coverage, ordinary wellness support and alternative care remain. Depression uses a usual-care treatment contrast; ART credit only concerns interruption-sensitive strategy equivalents; PrEP credit only concerns otherwise uncovered risk. Funding responsiveness is additional to clinical compatibility, not a second completion adjustment.

Attribution: Behavioral and medication budgets are disjoint. No HIV-testing count, PrEP enrollment count, therapy-session count or all-client count becomes an outcome. ART and PrEP pools are mutually exclusive; depression/HIV quality areas may still overlap, so totals require validation.

Subjective conditional best estimate, not empirically calibrated delivery rates or a complete portfolio estimate. Joint stress scenarios are not probability bounds. Zero, adverse effects and omitted health gains remain possible.

Sensitivity

  • Central price 98597970.7461669; low 16360645835.697964; favorable 3642532.7844793783 USD per 10 LA QALYs.
  • Depression contributes about 86% of central clinical QALYs; its compatibility and course cost dominate.
  • Setting ART and PrEP benefits to zero leaves the depression component; setting depression transfer to zero removes most of the estimated benefit.
  • Doubling funding responsiveness halves the positive component price; budget unit costs, diagnosis mix and untreated incidence are priorities for data collection.
  • Finite health trajectories avoid repeated lifetime credit; additional public or participant costs would worsen a social-cost price.

Unresolved inputs

  • Unique eligible depression offers and actual resource cost.
  • Medicine mix, acquisition costs, coverage duration and true alternative coverage.
  • LA/Orange residence and health outcomes.
  • Marginal unrestricted funding bottleneck and current contract renewal.
  • Non-overlapping health effects of harm reduction, MOUD, housing, education and community support.

5. Funding and previous grants

The FY2025 return records $4,590,114 of federal contracts, $4,522,776 of state/private grants and $3,754,614 of 340B pharmacy income within program revenue. A blank government-contributions line does not mean no public funding. Revenue was $13,458,867; unrestricted net assets were $10,912,092. The audit identifies $11,963,872 of financial assets available within one year. Those reserves do not prove there is no unmet need, but they weaken an automatic assumption that a gift immediately adds treatment.

The CDC award runs through September 30, 2026 and records a June 2026 supplement. Planned service targets are not delivered outcomes or a verified renewal gap. The local research article describes termination of a particular research grant; it does not establish that all clinical funding ended.

The central model assumes a 25% proportional service response after reserve, payer and donor substitution. Separate clinical eligibility factors distinguish already-covered medication from care genuinely changed by the recipient. Both are judgments. A documented uncovered staffing or medication-access bottleneck could substantially change the result. No gift or outreach occurred.

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $7.4M; Bienestar Human Services Inc., EIN 95-4505737, 12-month period, June-ending Form 990 gross accrual recipient expense; no separately netted event or inventory expense shown. Latest audited recognized expense agrees; unrecognized volunteer resources are not quantified.. Source
  • FY 2024: $9.5M; Bienestar Human Services Inc., EIN 95-4505737, 12-month period, June-ending Form 990 gross accrual recipient expense; no separately netted event or inventory expense shown. Latest audited recognized expense agrees; unrecognized volunteer resources are not quantified.. Source
  • FY 2025: $11.5M; Bienestar Human Services Inc., EIN 95-4505737, 12-month period, June-ending Form 990 gross accrual recipient expense; no separately netted event or inventory expense shown. Latest audited recognized expense agrees; unrecognized volunteer resources are not quantified.. Source

6. Sources

  1. FY2025 audited statements, audit dated February 9, 2026; functional table visually verified. Bienestar / Federal Audit Clearinghouse. Published: not stated; retrieved: 2026-09-14.
  2. FY2025 original Form 990; submission date. Bienestar / IRS. Published: 2026-04-02; retrieved: 2026-09-14.
  3. FY2024 original Form 990; submission date. Bienestar / IRS. Published: 2025-03-04; retrieved: 2026-09-14.
  4. FY2023 original Form 990; submission date. Bienestar / IRS. Published: 2024-01-12; retrieved: 2026-09-14.
  5. Recipient scope and historical timeline. Bienestar. Published: not stated; retrieved: 2026-09-14.
  6. Current bilingual mental-health treatment and locations. Bienestar. Published: not stated; retrieved: 2026-09-14.
  7. Current HIV clinical care. Bienestar. Published: not stated; retrieved: 2026-09-14.
  8. Current PrEP prescriptions and access support. Bienestar. Published: not stated; retrieved: 2026-09-14.
  9. Current syringe services, naloxone and mobile geography. Bienestar. Published: not stated; retrieved: 2026-09-14.
  10. Siempre Seguiré randomized trial. Siempre Seguiré investigators / AIDS and Behavior. Published: not stated; retrieved: 2026-09-14.
  11. Original full-text trial, costs and counterevidence. Trial investigators / Europe PMC. Published: not stated; retrieved: 2026-09-14.
  12. Pilot randomized stigma and ART-adherence trial. Trial investigators. Published: not stated; retrieved: 2026-09-14.
  13. ARTAS case-management randomized trial. Gardner and colleagues / AIDS. Published: 2005-03-04; retrieved: 2026-09-14.
  14. Bienestar Por Vida current CDC award and June 2026 supplement. US HHS. Published: not stated; retrieved: 2026-09-14.
  15. CoBalT randomized clinical and economic evaluation. Wiles and colleagues / NIHR. Published: not stated; retrieved: 2026-09-14.
  16. SMART randomized continuous versus interrupted ART strategies. SMART Study Group / NEJM. Published: not stated; retrieved: 2026-09-14.
  17. PROUD daily PrEP randomized trial. McCormack and colleagues / Lancet. Published: not stated; retrieved: 2026-09-14.