GiveBetter x Los Angeles

Lestonnac Free Clinic

Whole free-clinic, dental, vision and surgical-access portfolio

Research time: ~7 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

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Summary

What do they do? Lestonnac supplies free or low-cost medical, dental, vision and surgical care to underserved Southern California patients. Its main clinic and new surgery center are in Orange County, with satellite clinics both inside and outside the Los Angeles metro boundary. The estimate concerns an ordinary gift to the entire recipient and counts health benefits only for Los Angeles and Orange County residents.

Why we’re interested in this organization:

  • Direct treatment and functional correction create a clearer health mechanism than awareness or referral counts alone.

  • Volunteer clinicians and donated resources can allow private dollars to support more care, though they can also become bottlenecks.

  • Current expansion plans, original accounts and named clinic schedules permit concrete testing of funding and geography assumptions.

Our main reservations:

  • No controlled Lestonnac clinical evaluation or measured marginal patient yield was found; most of the numerical health bridge is judgment.

  • The 70% local beneficiary share is a schedule-informed prior, not a patient-residence measurement; mobile services and cross-county referrals could change it materially.

  • Large unrestricted net assets, public grants and partner-funded surgery mean a new donation need not translate proportionally into added care.

What do you get for your dollar? $2.8M per better life: ten additional quality-adjusted life years in Los Angeles.

Clinically consequential additional care patient-years, with visits and overlapping programs counted only once. The central scenario has 1,225 all-population effective patient-years at the annual-cost normalization, including 857.5 within LA and Orange counties before discounting health benefits. q = 0.02 is the net utility-year conversion. A patient-year represents the aggregate 12-month clinical package, not a separate year for each visit.

1. What do they do?

Lestonnac's programs include primary and specialty medicine, dental treatment, glasses, retinal care and referrals. The surgical program opened a dedicated Orange facility in May 2025; Hoag's July 2026 update confirms ongoing support for equipment, supplies and operations. An ordinary donation is not assumed to buy only the most beneficial surgery.

2. Monitoring and information sharing

The 2024 return reports over 10,000 patients and 20,000 visits. This is an organizational claim, not a controlled outcome or verified marginal capacity. The dental page reports 3,843 visits in 2024, including prevention and pain treatment. The vision page reports 2,374 glasses in 2023; neither count is added to the patient denominator because overlap and repeated care are unknown. Required improvements in measurement are unique patient residence, clinically completed care, sustained function or symptoms, adverse outcomes and what alternative care patients would receive.

3. Qualitative assessment

The model values completed useful care, not clinic visits. The Oregon insurance experiment's health mapping provides an external scale check, but comprehensive insurance and a free-clinic treatment package are different interventions. Its two-year clinical results found no significant improvement in measured physical biomarkers despite improvements in depression and access. Therefore the 0.02-QALY conditional patient-year gain is an explicit transfer judgment, not Lestonnac evidence. Benefits from glasses, dental relief and surgery are represented within the aggregate clinical mix, not separately stacked on top. Clinical harm, treatment failure and alternative care must reduce net yield.

4. What do you get for your dollar?

The proposed central is about $2.82 million per 10 Los Angeles/Orange County QALYs. It uses full-recipient gross annual cost of $4,695,553 ($4,655,295 Part IX plus $40,258 separately netted event costs), a 10,000-patient scale anchor, 35% clinically consequential access improvement versus alternative care, 35% marginal funding responsiveness, 0.02 QALY per effective patient-year and 70% local residence, with one year of benefit discounted 3%. These assumptions yield 23.786 all-population QALYs and 16.650 local QALYs per annual cost basis. This is a low-confidence whole-clinical-portfolio judgment model, not a measured return or a restriction to surgery. No lifetime gains, past cancer detections or every potential mobile-unit encounter are added. Wide stress scenarios and zero/harm are essential to interpretation. The consistently gross three-year costs are $3,429,350 (2022), $4,200,336 (2023) and $4,695,553 (2024), averaging $4,108,413. The 2022 amount is checked against its own original return, not only a subsequent prior-year summary.

Model, assumptions and sensitivity

Entire recipient annual gross accrual cost, including separately netted fundraising events: FY 2024 Part IX $4,655,295 plus Part VIII, line 8b $40,258 = $4,695,553. Not surgical program cost or donated-service sticker value. FY 2024 before the new center is a scale anchor; cost drift is stressed. Unrecognized volunteer opportunity cost, separately funded hospital costs and patient travel are outside private-donor denominator, so this is not a societal cost-effectiveness estimate.

LA MSA includes Los Angeles and Orange counties; Inland Empire excluded. Listed weekly opening-hour proxy: Orange 54 + Los Alamitos 9 + Fullerton 12 + Norwalk 18 + Los Angeles~6 = ~99 local, versus San Bernardino 38 plus intermittent Inland Empire clinics~4.4 = ~141.4 total; about 70%. g=.70 is a judgment prior requiring similar patient throughput/clinical value per opening hour and predominantly local residence. Not weighted by population or assumed from headquarters. Mobile work, differing staffing, surgery and cross-county patients are unmeasured; g=.4–.9 stressed, not bounds.

For an ordinary gift D, additional effective patient-years = (D / E) × N × e × b. Q_all(D) = (D / E) × N × e × b × q / (1 + d); Q_LA(D) = g × Q_all(D). At the annual-cost normalization D = E, Q_all = N × e × b × q / (1 + d). Price per ten LA QALYs = 10 × E / Q_LA(E). Glasses, dental and surgical counts are not added separately to this aggregate clinical mix.

E
4695553 USD/year (observed). FY 2024 full recipient gross expense: original Part IX $4,655,295 plus separately netted Part VIII, line 8b event costs $40,258. [lest24]
N
10000 patient-scale anchor/year (observed). Conservative lower count from 2024 reported over 10000 patients; unique-person definition and repeat reporting should be verified. [lest24]
e
0.35 fraction with incremental consequential clinical care (judgment). Discounts alternative care, incomplete pathways and low-benefit encounters; not measured treatment success. [lest-programs] [oregon-clinical]
b
0.35 funding-to-throughput additionality (judgment). Ordinary-gift response reduced for public/partner funding, reserves and volunteer constraints. [lest24] [hoag26] [lest-volunteer]
q
0.02 QALY/effective patient-year (judgment). Aggregate clinical-mix prior below external Oregon 0.05 mapping; not validated transfer from insurance to free-clinic treatment. [oregon-value] [oregon-clinical]
g
0.7 LA+Orange resident health fraction (judgment). Approximately 70% schedule-informed clinic capacity proxy; not observed patient residence. [lest-locations]
d
0.03 annual discount rate (judgment). Only one 12-month benefit period, at year 1.
mobile_target
2000 exams/glasses per year target (observed). Prospective second-unit target only; excluded from achieved/central extra output. [lest-room]

Whole-clinical-portfolio judgment central: Cost: $4.7M; Los Angeles QALYs: 16.650485436893202; all-population QALYs: 23.78640776699029. N = 10,000; e = 0.35; b = 0.35; q = 0.02; g = 0.7; one year of benefit; d = 0.03.

Weak marginal treatment and funding stress: Cost: $5.9M; Los Angeles QALYs: 0.1941747572815534; all-population QALYs: 0.4854368932038835. e = 0.1; b = 0.1; q = 0.005; g = 0.4. Recipient costs are 25% above FY 2024. This is not a confidence bound.

Responsive capacity and effective clinical mix stress: Cost: $4.7M; Los Angeles QALYs: 183.49514563106797; all-population QALYs: 203.88349514563106. e = 0.6; b = 0.7; q = 0.05; g = 0.9. This is not an observed yield or confidence bound.

No marginal effective care: Cost: $4.7M; Los Angeles QALYs: 0; all-population QALYs: 0. b=0 or e=0; no favorable finite price.

Net adverse clinical effect stress: Cost: $4.7M; Los Angeles QALYs: -4.162621359223301; all-population QALYs: -5.946601941747573. q=-.005 stress only; not an observed harm finding.

Counterfactual: Other safety-net clinics, possible insurance coverage, emergency care, existing volunteers, Hoag and other grants, and reserves continue. e discounts care that is screening-only, incomplete, ineffective or otherwise available. b discounts marginal funding that only replaces existing support, builds unused capacity or cannot unlock volunteer appointments. Demand or a waiting list alone does not identify e or b.

Attribution: Direct clinical delivery avoids coalition attribution but not substitution. e concerns incremental effective care for a patient under expanded throughput; b concerns whether extra dollars expand throughput at all. g concerns beneficiary residence independently. q is conditional net health gain, not value of insurance, education scores or donated medical charges.

Low-confidence judgment-based central with source-grounded cost and scale but no organization-specific causal calibration. All e, b, q, g are subjective. Benefit beyond one year excluded; harmful care or reduced alternative access could yield net negative health. Source patient-count definitions and new-center cost dynamics remain material.

Sensitivity

  • Price scales inversely with e, b, q, g. The clinical transfer and cash-response priors dominate geographic fine-tuning.
  • At q=.02 and 3% discount, $1 million/10 requires 2418.209795 incremental local effective patient-years on the corrected gross cost basis, compared with 857.5 central; $100 thousand/10 requires 24182.09795.
  • If every central health gain is outside LA/Orange, local value is zero; clinic geography must eventually be replaced by beneficiary residence.
  • No repeated lifetime benefit for glasses replacements or repeat chronic-care visits. New surgery could increase durable benefit and cost; current procedure mix and completed cases are unknown.
  • The 75%-funded mobile unit does not imply an automatic fourfold match, known remaining gap or ordinary-gift deployment.

Unresolved inputs

  • Unique patient geography and actual per-site/mobile throughput, especially LA/Orange versus Riverside/San Bernardino.
  • Marginal ordinary-donation budget and the specific clinician/equipment/supply bottleneck it would relax.
  • Current 2025–26 costs and completed procedures since surgery-center opening; independent clinical outcomes and complications.
  • Clinical treatment mix, completion/adherence, alternative care and sustained utility outcomes.
  • Reconciliation of Part III service revenue with Part VIII and explanation of functional accounting classifications.

5. Funding and previous grants

The 2024 original return reports $6,388,245 revenue, $802,500 government grants and $9,587,829 unrestricted net assets. Functional expense is $3,698,845 program and $956,450 management, with zero reported fundraising in Part IX but $40,258 of direct event costs separately netted in Part VIII. Those event costs are added to the model numerator; directory allocations are not used. Part III's $175,447 program revenue is inconsistent with blank Part VIII service revenue, so it is not interpreted as reimbursement. 2023 accounts supply prior expenses. The 2026 room campaign says 75% of a second mobile-vision unit is funded and targets 2,000 annual exams/glasses. It does not disclose a remaining-dollar gap or ordinary-gift allocation, and a target is not realized additional treatment. Volunteer onboarding, partner funding and existing reserves may be more limiting than new cash.

Annual expenses

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

  • FY 2022: $3.4M; St Jeanne De Lestonnac Free Clinic (EIN95-3499011), 12-month period, Form 990 gross recipient expenses: Part IX plus separately netted direct fundraising event costs. Source
  • FY 2023: $4.2M; St Jeanne De Lestonnac Free Clinic (EIN95-3499011), 12-month period, Form 990 gross recipient expenses: Part IX plus separately netted direct fundraising event costs. Source
  • FY 2024: $4.7M; St Jeanne De Lestonnac Free Clinic (EIN95-3499011), 12-month period, Form 990 gross recipient expenses: Part IX plus separately netted direct fundraising event costs. Source

6. Sources

  1. 2024 Form990, original PartsI,III,VIII–X. St Jeanne De Lestonnac Free Clinic / IRS. Published: 2025-10-27; retrieved: 2026-09-14.
  2. 2023 Form 990, original Parts VIII and IX. St Jeanne De Lestonnac Free Clinic / IRS. Published: 2024-10-31; retrieved: 2026-09-14.
  3. Programs. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  4. Current locations and opening schedules. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  5. Vision programs. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  6. Dental programs. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  7. Surgery days and new surgery center. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  8. Surgery center volunteer onboarding. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  9. Adopt A Room2026: second mobile vision unit. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  10. How Hoag and Lestonnac Free Clinic are Expanding Free Surgical Care in Orange County. Hoag Hospital Foundation. Published: 2026-07-03; retrieved: 2026-09-14.
  11. The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment. Finkelstein, Hendren and Luttmer / Journal of Political Economy. Published: not stated; retrieved: 2026-09-14.
  12. The Oregon Experiment—Effects of Medicaid on Clinical Outcomes. Baicker and colleagues / New England Journal of Medicine. Published: 2013-05-02; retrieved: 2026-09-14.
  13. Official donation page. Lestonnac Free Clinic. Published: not stated; retrieved: 2026-09-14.
  14. 2022 Form 990, original Parts VIII and IX. St Jeanne De Lestonnac Free Clinic / IRS. Published: 2023-11-14; retrieved: 2026-09-14.