Where the money comes from — and where it doesn’t.
Most organizations show you a pie chart. We are going to show you our arithmetic, including the part that does not work.
The patient pays nothing. So who pays us?
Our neighbors are not our customers. The clinic already sees them on a sliding scale — for many, at no charge at all. We are never going to bill a Canal family for walking them to a door that was already open.
So we sell to the people who save money when a neighbor sees a doctor instead of an emergency room. That is not a metaphor. Every avoidable ER visit is a real cost sitting on somebody’s books — a health plan’s, a hospital’s. Prevent it and you have created measurable value. We intend to create it, measure it, and be paid a fraction of it.
That is an ordinary business. It is how most businesses work.
Four customers, one product
The health plan
Every avoidable emergency room visit by one of their members costs them money. Primary-care engagement saves them money. California’s Medi-Cal plans already contract with community organizations for exactly this kind of care management, paid per member, per month. [Rates are contract terms and not public. Pending.]
The clinic
A health center is funded per encounter and gets discounted medication for the patients it actually sees. Empty chairs help nobody. We are their demand channel — under a flat services contract at fair market value, never per patient, because paying for referrals is illegal and we will not do it.
The sponsor
$50 a month sponsors a navigator. Not a membership — care is already nearly free. You are funding the person who knocks, walks people in, does the forms, and drags them back for the second appointment. Marin is fifteen minutes from the Canal and among the wealthiest counties in America. The money is already here. We intend to go get it in person.
The hospital & the foundations
Nonprofit hospitals are required to spend on community health. Uncompensated emergency care for uninsured Canal residents is expensive; preventing it is worth real money to them. Marin Community Foundation and others fund what no contract will.
Why we publish no totals yet: health-plan rates are contract terms, not public numbers. Until we have them in writing, any figure here would be a guess dressed up as a fact. We would rather show you a blank.
We ask in person. And we ask about Rosa, not about you.
We are not putting a sick neighbor on the internet to raise money. Here is what we do instead.
We petition on the street, face to face.
Our people stand in Marin and ask Marin for money, on payroll, by the hour — never on commission, never on a quota. Fifteen minutes from the Canal is some of the greatest concentrated wealth in America, and most of it has never heard of this neighborhood. That is a distribution problem too, and we solve it the same way: in person.
The face on our ask is our navigator’s, not a patient’s.
“This is Rosa. She walks forty families to the clinic and does their forms in Spanish. Fifty dollars a month keeps her doing it.” Rosa works here. Rosa consents. Rosa’s story is hers to give. No neighbor’s illness is ever the pitch — not on a website, not on a clipboard, not to a donor’s face.
Nobody competes to be sick enough.
Donors do not browse people and pick the most sympathetic one. When money is raised on someone’s suffering, the money follows whoever tells the saddest story — not whoever needs it most. We pool it and we allocate it by need. That costs us donations, and we are doing it anyway.
Small and repeating beats big and once.
Fifty dollars a month, from a lot of people, forever. Micro-donations are how you fund a payroll rather than a moment. Your gift is not a rescue — it is a salary.
Your $50 buys an hour of somebody’s time and a tank of gas.
The barrier in this neighborhood was never medical. It was a ride, a form, and a phone call.
The navigator
Wages and health coverage for a Canal resident who knocks on doors, walks neighbors to the clinic, fills out the forms, and chases the second appointment. Most of your money is somebody’s paycheck. That is the point, not the overhead.
Getting there
Gas. A taxi. A bus pass. Parking at the hospital. The ride to chemotherapy that decides whether treatment gets finished or abandoned. Our founder watched patients in Atlanta lose cancer treatment over a car that would not start — not over medicine.
The month that went wrong
Rent when illness costs someone their shifts. Groceries. Childcare during treatment. Never a medical bill — a fund that pays medical bills is an insurance company, and we are not one. We pay for the things that make treatment possible.
How you will know if we are real
Not testimonials. Not photographs. Not how many doors we knocked on.
Avoidable emergency room visits prevented.
That is the number that decides whether this enterprise deserves to exist. It is measurable, it is auditable, and it is the same number our customers care about — which is exactly why this can be a business instead of a plea.
We will also count: neighbors who saw a primary care doctor for the first time · Medi-Cal renewals saved (those are permanent) · medication assistance approvals · second-appointment show rate, which is where everyone quietly drops out and where most of our value will actually be created.
If emergency room use does not move, this does not work, and we will say so here.
Where philanthropy comes in
Two jobs. Both are things no contract will ever pay for.
1. The neighbors with no payer
Since January 2026, adults without satisfactory immigration status cannot newly enroll in full-scope Medi-Cal. There is no plan to bill, no code to submit, no market price for a patient with no payer. Every hour we spend with them is an hour nobody reimburses. That is not a gap in our model. That is the reason we exist. Donations pay for it, and nothing else will.
2. The cost of getting to the starting line
Contracts pay you for work you are already able to do. Someone has to pay for becoming able — hiring the first cohort, training them to certification, building the systems that let us bill at all. California built a $1.85 billion fund to do exactly this for organizations like ours. It is closing. See below. Philanthropy is now that bridge.
The state capacity fund, and where it stands
California’s Providing Access and Transforming Health (PATH) initiative is a five-year, $1.85 billion program whose entire purpose was helping community organizations build the staff, training, and billing infrastructure needed to contract with Medi-Cal plans. It is the single best-fitting funding source that has ever existed for what we are building.
We missed it. That is not a worry — it is confirmed. As of July 1, 2026, the state is no longer accepting applications for the program. The final round of capacity grants was awarded in November 2025 — roughly $145.5 million to 153 organizations — and those funds are limited to a single year, 2026, to spend down existing awards. The state intends to sunset PATH as part of the broader Medi-Cal renewal; the current authorization runs through December 31, 2026.
The door closed two weeks before we wrote this page. We are not going to pretend otherwise.
What we are doing about it:
- Watching for a successor, not waiting for one. The Medi-Cal renewal is still being negotiated. If something replaces PATH, we will apply the week it opens and say so here. We are not building a plan on the hope that it does.
- Renting capacity instead of building it. If there is no capacity grant, we do not need to construct our own billing infrastructure. We can deliver as a subcontractor under an established provider who already has it. Slower, smaller, and entirely possible without capital.
- Asking philanthropy to be the bridge. The state built a fund for this exact gap and it is closing before we could reach it. Foundations and individual donors are now the only thing standing between a workforce that could exist and one that does not.
We could have written this page without mentioning any of that. We think an organization asking you to trust it with money should tell you when its best funding source just closed.
What happens, in what order
No dates we cannot keep. Each step gates the next.
Renewal help, on foot
Volunteers, clipboards, and the deadline that is quietly taking people’s coverage away. No funding, no software, no permission required. It saves people this month and it teaches us the real workflow.
Rates and partners in writing
Our regional Medi-Cal plan for care-management contracting and rates. A community clinic partner for the clinical home and discounted medication. A county behavioral health conversation for peer support. Until these are written down, every number on this site stays blank.
Bridge funding
Foundations, individual donors, and hospital community-benefit programs — to hire and train the first cohort. This is the gap the state fund would have covered. Our 501(c)(3) and state charitable registration must be complete before we accept a dollar.
First cohort, employed and insured
Residents hired W-2 with health coverage from day one, training toward certification, hours accruing. Delivered under a partner’s contract if we do not yet have our own.
Contracted revenue
Certification reached, care-management contract active, group classes running. Revenue starts carrying wages. Margin funds cohort two.
Philanthropy never leaves
Even at full contract revenue, the neighbors with no payer are never billable. Donations carry them permanently. Any organization that tells you it will eventually stop needing donations is either not serving those people or not telling you the truth.