{"edition":"california","organization":"Breathe Southern California","organizationId":"org:breathe-southern-california","boundaryVersion":"US-CA-state-v1","updated":"2026-09-14","model":{"version":"ca-breathe-beam-judgment-v2","costScope":"Ordinary gift/full recipient annual cost normalization, not a restricted BEAM or emergency-purifier gift. Latest annual cost is historical and predates 2026 response; insurer/public resources not subtracted.","geographicAttribution":"Both named BEAM eligibility counties are in California; g_CA=1 conditional on compliance. A .95 sensitivity allows eligibility/movement leakage. This is independently scoped, not a copy of the LA model's .5 county-share judgment.","formula":"QCA=(D/C)*N*b*(deltaSFD14/14)*deltaU*r*w*T*gCA/(1+d); C=2923727,N=100,b=.25,deltaSFD14=2.1,deltaU=.1,r=.5,w=.75,T=1,gCA=1,d=.03. Price10=10*D/QCA. Purifier and policy health unpriced; no automatic portfolio uplift.","counterfactual":"Medi-Cal asthma preventive services/Community Supports, alternative providers, existing purifiers, AQMD funded distribution, donors and partner resources continue absent a new gift. A gift cannot retroactively change June smoke exposure, past distributions or an expired match.","attribution":"b is a subjective marginal responsiveness factor combining recipient allocation/capacity and substitution; clinical r and within-year w are separate. Do not apply both BEAM multimodal symptom gains and filtration gains to the same patient's same symptoms. Policy benefits need coalition counterfactual and geographic exposure allocation.","uncertainty":"Finite judgment best estimate with broad joint scenarios, zero and harm. Unknown observed marginal inputs do not require suppressing the priced asthma pathway. The central is partial health at full gift cost, not a measured unrestricted-portfolio expectation. The utility prior represents expected net health area over the stated finite horizon, including treatment burden, within-horizon fade and competing mortality; it is not an endpoint score held indefinitely. No survival extension is credited.","nativeOutcomes":"100 annual course opportunities is a judgment, not observed run-rate. After b=.25,25 additional California reference courses; each yields .005461165049 discounted QALYs under the subjective clinical bridge, total .136529126214. Other portfolio outcomes unpriced.","inputs":[{"name":"C","value":2923727,"unit":"USD annual recipient expenses","basis":"observed","rationale":"FY 2025 original accrual return; predates 2026 response.","sourceIds":["990-25"]},{"name":"N","value":100,"unit":"annual BEAM courses, diagnostic","basis":"judgment","rationale":"300-plus cumulative patients over 2024–2026 divided by three calendar-year labels; not an observed annual run-rate.","sourceIds":["home"]},{"name":"b","value":0.25,"unit":"marginal funding responsiveness","basis":"judgment","rationale":"Possible navigation/capacity margin after payer/provider substitution; no verified gap.","sourceIds":["beam","chw"]},{"name":"g","value":1,"unit":"California share of eligible BEAM benefit","basis":"judgment","rationale":"Both Los Angeles and San Bernardino counties are in California. Conditional on residence eligibility; .95–1 test, not all-portfolio attribution.","sourceIds":["beam"]},{"name":"deltaSFD14","value":2.1,"unit":"symptom-free days per fortnight","basis":"observed","rationale":"External childhood RCT benchmark; not BEAM.","sourceIds":["rct"]},{"name":"deltaU","value":0.1,"unit":"utility difference on extra symptom-free day","basis":"judgment","rationale":"Preference-weight bridge not measured for BEAM.","sourceIds":[]},{"name":"r","value":0.5,"unit":"trial effect retained","basis":"judgment","rationale":"Adult/child mix, visit intensity and modern usual care differ.","sourceIds":["rct","adult"]},{"name":"w","value":0.75,"unit":"within-year effect timing retained","basis":"judgment","rationale":"Avoid full endpoint effect credited before treatment.","sourceIds":[]},{"name":"T","value":1,"unit":"years","basis":"judgment","rationale":"No later years or asthma cure credited.","sourceIds":[]},{"name":"d","value":0.03,"unit":"annual discount rate","basis":"judgment","rationale":"One-year discount on finite morbidity benefit.","sourceIds":[]},{"name":"Q_filter_CA","value":null,"unit":"incremental California QALYs","basis":"unknown","rationale":"Need unique effective use, additionality relative to AQMD and existing stock, pollutant exposure and duration; not filter count.","sourceIds":["events26","palos","hepa-rct"]},{"name":"Q_policy_other_CA","value":null,"unit":"incremental California QALYs","basis":"unknown","rationale":"Need finite implementation/dose/coalition bridge.","sourceIds":["advocacy"]},{"name":"publicPurifierFunding","value":5000000,"unit":"USD additional approved funding ceiling","basis":"observed","rationale":"AQMD program, not Breathe funding or actual expenditures; substitution context only.","sourceIds":["palos"]}],"scenarios":[{"id":"central","label":"Judgment best estimate: BEAM health at full recipient cost","costUSD":2923727,"allPopulationQalys":0.13652912621359223,"editionQalys":0.13652912621359223,"assumptions":"N = 100; b = 0.25; gCA = 1; deltaSFD14 = 2.1; deltaU = 0.1; r = 0.5; w = 0.75; T = 1; d = 0.03."},{"id":"low","label":"Weak annual delivery, responsiveness and health transfer","costUSD":2923727,"allPopulationQalys":0.0006553398058252427,"editionQalys":0.0006225728155339806,"assumptions":"N=30; b=.05; deltaSFD14=2.1; deltaU=.03; r=.2; w=.5; T=1; gCA=.95; d=.03. Joint judgment stress case, not confidence limits."},{"id":"high","label":"Strong asthma margin and local share; not confidence bound","costUSD":2923727,"allPopulationQalys":6.553398058252427,"editionQalys":6.553398058252427,"assumptions":"N = 300; b = 0.75; gCA = 1; deltaU = 0.2; r = 1; w = 1. Other clinical assumptions are unchanged."},{"id":"zero","label":"Full substitution or no health improvement","costUSD":2923727,"allPopulationQalys":0,"editionQalys":0,"assumptions":"No additional health beyond existing payer/public/private provision."},{"id":"downside","label":"Unquantified adverse net effect remains possible","costUSD":2923727,"allPopulationQalys":null,"editionQalys":null,"assumptions":"Ineffective use, exposure substitution and harmful policy trade-offs not assigned a fabricated negative bound."},{"id":"adverse","label":"Illustrative net harm, not a measured bound","costUSD":2923727,"allPopulationQalys":-0.1,"editionQalys":-0.1,"assumptions":"A net .1 California QALY loss from displaced care or adverse effects; explicit stress test, not observed."},{"id":"portfolio-unknown","label":"Unpriced remaining portfolio pathways","costUSD":2923727,"allPopulationQalys":null,"editionQalys":null,"assumptions":"Purifier response and policy may add or subtract health; no invented amount is added to the BEAM estimate."}],"sensitivity":["Central partial-health price $214,146,759.82222223 per10 California QALYs; low/high joint scenarios are subjective, not confidence bounds.","The California denominator includes eligible San Bernardino residents excluded in LA. The same underlying benefits must not be summed across editions.","100 annual courses is weakly anchored to 300-plus cumulative patients across three calendar labels; actual annual throughput may differ.","Clinical transfer, within-year timing, utility and funding response dominate; no trial completion or payer substitution multiplier is added twice.","No lifetime asthma cure, overlapping purifier symptom benefit or unpriced policy uplift."],"missingInputs":["Current unrestricted allocation, grant restrictions and costed unmet queue across asthma and purifier response.","Unique annual BEAM courses by county, completed service intensity and alternative payer/provider response.","Purifier households not already covered by AQMD, effective operating time, clean-air delivery, pollutant-specific exposure and health benefit.","Current post-September 4 appeal status; no active match established.","Finite policy health and geography model, avoiding attribution of all California burden to one coalition member."]},"sources":[{"id":"home","title":"Current portfolio and cumulative service counts","url":"https://www.breathesocal.org/","publisher":"Breathe Southern California","published":null,"retrieved":"2026-09-14"},{"id":"beam","title":"BEAM services, eligibility, counties and managed-care contracts","url":"https://www.breathesocal.org/beam","publisher":"Breathe Southern California","published":null,"retrieved":"2026-09-14"},{"id":"lungpower","title":"Lung Power education workshops","url":"https://www.breathesocal.org/lungpower","publisher":"Breathe Southern California","published":null,"retrieved":"2026-09-13"},{"id":"advocacy","title":"Current advocacy portfolio and historical campaigns","url":"https://www.breathesocal.org/advocacy","publisher":"Breathe Southern California","published":null,"retrieved":"2026-09-13"},{"id":"donate","title":"Ordinary donation route","url":"https://www.zeffy.com/en-US/donation-form/bdb976f8-efe3-4d31-adc7-ab563a43a43e","publisher":"Breathe Southern California via Zeffy","published":null,"retrieved":"2026-09-13"},{"id":"rct","title":"Randomized Medicaid childhood-asthma home-visit outcomes and costs","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC4605150/","publisher":"Campbell et al., American Journal of Public Health","published":null,"retrieved":"2026-09-13"},{"id":"adult","title":"HomeBASE randomized adult asthma trial","url":"https://pubmed.ncbi.nlm.nih.gov/25419871/","publisher":"Krieger et al., JAMA Internal Medicine","published":null,"retrieved":"2026-09-13"},{"id":"dhcs","title":"Final asthma-remediation definitions and January 2026 benefit separation","url":"https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-February-2025-Service-Definition-Updates.pdf","publisher":"California DHCS","published":null,"retrieved":"2026-09-13"},{"id":"chw","title":"Current CHW and asthma provider enrollment resources","url":"https://www.dhcs.ca.gov/providers-partners/community-health-workers/","publisher":"California DHCS","published":null,"retrieved":"2026-09-13"},{"id":"ab1003","title":"Chaptered AB 1003 text","url":"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260AB1003","publisher":"California Legislature","published":"2025-10-13","retrieved":"2026-09-13"},{"id":"990-25","title":"Original Form 990, fiscal year ending June 2025","url":"https://projects.propublica.org/nonprofits/organizations/951641451/202611359349315411/full","publisher":"Breathe Southern California / IRS via ProPublica","published":null,"retrieved":"2026-09-14"},{"id":"990-24","title":"Original Form 990, fiscal year ending June 2024 with 2023 comparative totals","url":"https://projects.propublica.org/nonprofits/organizations/951641451/202501359349311575/full","publisher":"Breathe Southern California / IRS via ProPublica","published":null,"retrieved":"2026-09-14"},{"id":"events26","title":"Official 2026 community events and purifier eligibility","publisher":"Breathe Southern California","url":"https://www.breathesocal.org/events","published":null,"retrieved":"2026-09-14"},{"id":"buildings","title":"Building-decarbonization support","publisher":"Breathe Southern California","url":"https://www.breathesocal.org/buildings","published":null,"retrieved":"2026-09-14"},{"id":"bluesky","title":"BlueSky LA programs","publisher":"Breathe Southern California","url":"https://www.breathesocal.org/bluesky-la","published":null,"retrieved":"2026-09-14"},{"id":"palos","title":"2026 Palos Fire / Lineage Cleanup and Recovery; public purifier funding","publisher":"South Coast AQMD","url":"https://www.aqmd.gov/palos","published":null,"retrieved":"2026-09-14"},{"id":"social","title":"Organization-authored purifier response and past matching appeal; post date unverified","publisher":"Breathe Southern California via LinkedIn","url":"https://www.linkedin.com/company/breathesocal","published":null,"retrieved":"2026-09-14"},{"id":"rabbit","title":"AAFA 2026 certified-partner community response","publisher":"AAFA / Asthma & Allergy Friendly","url":"https://asthmaandallergyfriendly.com/USA/aafas-2026-asthma-capitals-report-highlights-certified-partners-driving-community-impact/","published":null,"retrieved":"2026-09-14"},{"id":"hepa-rct","title":"HEPA air cleaners: randomized asthma visit and symptom outcomes","publisher":"Lanphear et al.; Pediatrics","url":"https://pubmed.ncbi.nlm.nih.gov/21149427","published":"2010-12-13","retrieved":"2026-09-14"},{"id":"index-fresh","title":"Current IRS filing index, freshness check","publisher":"ProPublica Nonprofit Explorer","url":"https://projects.propublica.org/nonprofits/organizations/951641451","published":null,"retrieved":"2026-09-14"},{"id":"original-990-23","title":"Original FY2023 Form 990; accrual and netted-cost rows independently reopened","url":"https://projects.propublica.org/nonprofits/full_text/202401369349317700/IRS990","publisher":"Breathe Southern California / IRS","published":null,"retrieved":"2026-09-14"}]}