{"edition":"california","organization":"Vision To Learn","organizationId":"ein:45-3457853","boundaryVersion":"US-CA-state-v1","updated":"2026-09-13","model":{"version":"ca-vtl-whole-recipient-conditional-v1","costScope":"Full ordinary national-recipient gift G retained; f allocates modeled delivery without shrinking denominator. Donated inputs/public leverage disclosed separately. Reuses prior data/us/vision-to-learn-v2.json structure, with fresh original accounts and independently scoped California allocation. Course cost covers core delivery; the 20% outside that allocation covers other recipient activities/support, avoiding a second charge for the same overhead.","geographicAttribution":"g is the share of marginal net health benefit accruing to California residents, not office location, cumulative pairs or restricted-program scope. Central .4, favorable .6, adverse .2 are judgment scenarios. Actual g may be 0–1.","formula":"N=G*f/c. D(T)=[1-(1+r)^(-T)]/ln(1+r). Q_all=N*a*[p*w*u*D(T)-h]*(1+r)^(-d). Q_CA=g*Q_all. Price10=10*G/Q_CA for Q_CA>0. Full resources=G+N*inkind+M. If genuinely extra public M funds only CA courses: Q_CA_match=Q_CA+(M/c)*a*[p*w*u*D(T)-h]*(1+r)^(-d); do not multiply that addition by g again.","counterfactual":"Other donors or reimbursement may fund the same capacity (a); children may obtain adequate correction elsewhere even if the gift adds capacity (p). The finite period ends the modeled advantage over alternative care. These are distinct funding and patient-care counterfactuals.","attribution":"Count unique additional delivered child courses, not screenings, exams, multiple pairs or lifetime educational stories. Wear enters once as effective corrected time. No automatic Medicaid matching or causally unmeasured education QALYs.","uncertainty":"Conditional model with explicitly judgment-based joint scenarios, not empirically bounded confidence interval. Child utility, marginal California mix and funding additionality dominate. Zero/negative net benefit cannot be ruled out.","nativeOutcomes":"Additional unique children receiving a needed correction course; Additional effectively corrected child-years versus alternative care; Measured visual acuity change, distinct from preference-weighted health utility.","inputs":[{"name":"G","value":100000,"unit":"USD","basis":"judgment","rationale":"Calculation normalization, not recommended gift.","sourceIds":[]},{"name":"f","value":0.8,"unit":"core delivery cash allocation fraction","basis":"judgment","rationale":"Remaining 20% retained in full gift denominator for support/other activity; not a restricted gift.","sourceIds":["99025"]},{"name":"c","value":225,"unit":"cash USD per delivered unique-child care course","basis":"judgment","rationale":"Not advertised $150 nor accounting expense per pair. Includes delivery/follow-up assumption; $150–400 scenarios.","sourceIds":["home","99025"]},{"name":"a","value":0.5,"unit":"financial additionality fraction","basis":"judgment","rationale":"Half of financed capacity additional after substitute donors/public funding, not measured.","sourceIds":["mosfaq"]},{"name":"p","value":0.6,"unit":"fraction with counterfactual correction gap","basis":"judgment","rationale":"Absent adequate alternative correction during horizon; historical Medicaid nonuse is not this probability.","sourceIds":["mos"]},{"name":"w","value":0.6,"unit":"fraction of correction time used effectively","basis":"judgment","rationale":"Wear, breakage and actual use combined; not directly measured in California.","sourceIds":["wear"]},{"name":"u","value":0.02,"unit":"utility gain during effective correction","basis":"judgment","rationale":"Preference-weighted child utility is missing; 0.005–0.04 sensitivity, not clinical bounds.","sourceIds":["acuity"]},{"name":"T","value":1,"unit":"years","basis":"judgment","rationale":"Finite incremental correction period before alternative care/refractive change; no lifetime tail.","sourceIds":["rct"]},{"name":"r","value":0.03,"unit":"annual discount rate","basis":"judgment","rationale":"Continuous integral using ln(1+r).","sourceIds":[]},{"name":"d","value":0.125,"unit":"years before dispensing","basis":"judgment","rationale":"Six-week illustrative funding-to-benefit delay.","sourceIds":[]},{"name":"h","value":0.00005,"unit":"QALYs lost per additional course","basis":"judgment","rationale":"Small allowance for burden/inappropriate correction; could be wrong.","sourceIds":[]},{"name":"g","value":0.4,"unit":"California share of marginal net health benefit","basis":"judgment","rationale":"Cumulative California glasses share about44% is context, not marginal evidence. 20–60% cases are analyst scenarios, not bounds.","sourceIds":["annual25"]},{"name":"inkind","value":40,"unit":"additional donated-resource USD per course","basis":"judgment","rationale":"Separate gross resource sensitivity, not deducted from gift.","sourceIds":["annual25"]},{"name":"M","value":0,"unit":"incremental public USD","basis":"judgment","rationale":"No automatic match for ordinary donation; approved/claimable extra match unverified. Financing may be incremental while delivery still displaces other service: a separately discounts that delivery substitution.","sourceIds":["mosdonor"]}],"scenarios":[{"id":"central","label":"Conditional central judgment","costUSD":100000,"allPopulationQalys":1.2477596896818608,"editionQalys":0.49910387587274435,"assumptions":"G100000,f.8,c225,a.5,p.6,w.6,u.02,T1,r.03,d.125,h.00005,g.4. Not an empirical estimate."},{"id":"favorable","label":"Favorable joint assumptions","costUSD":100000,"allPopulationQalys":26.771002951157175,"editionQalys":16.062601770694304,"assumptions":"f.9,c150,a.8,p.9,w.8,u.04,T2,d1/12,h.00002,g.6,r.03. Sustained correction/replacement included in cost assumption; not a bound."},{"id":"adverse","label":"Adverse positive joint assumptions","costUSD":100000,"allPopulationQalys":0.005592249927240656,"editionQalys":0.0011184499854481314,"assumptions":"f.65,c400,a.2,p.3,w.3,u.005,T.5,d.25,h.00005,g.2,r.03. Not a lower bound."},{"id":"null","label":"Full substitution","costUSD":100000,"allPopulationQalys":0,"editionQalys":0,"assumptions":"a=0; all funded capacity would occur anyway. Harm-dominant cases can be negative."},{"id":"public-match-diagnostic","label":"Hypothetical approved incremental California public funding","costUSD":100000,"allPopulationQalys":1.7468635655546052,"editionQalys":0.9982077517454887,"assumptions":"M32000 purchases142.222 extra CA courses at central parameters, giving extra.499104Q. No verified match offer; gross resources151911.11 including inkind40 per all497.778courses."}],"sensitivity":["g alone at .2 or .6 changes central price to about $4.01m or $1.34m; cumulative reach does not resolve it.","p, w and u multiply; sustained correction and child utility dominate alongside funding additionality.","Holding remaining central values, one-year break-even utility for $1m/10Q is approximately .040 and for $100k/10Q approximately .398; solve exact formula including h.","If two pairs per child inflate output counts, inferred unit costs must rise; the model's c is per unique child course.","No public leverage in central. Public payments, donated lenses and shared school resources must not be claimed as free full-resource cost."],"missingInputs":["Actual next-dollar recipient allocation and California delivery mix.","Current core delivery cash cost per unique additional child, including replacements and referral completion, reconciled with separately charged support costs.","Funding substitution, restricted-grant capacity and qualified incremental MOS claims.","Current counterfactual correction gap and observed effective wear over finite follow-up.","Child preference-weighted utility by severity; not adult impairment utility or test-score conversion.","Latest original audit findings and remediation: attempted ProPublica audit download returned security HTML, so no audit conclusion asserted."]},"sources":[{"id":"home","title":"Current program and advertised contribution","publisher":"Vision To Learn","url":"https://visiontolearn.org/","published":null,"retrieved":"2026-09-13"},{"id":"donate","title":"Ordinary donation route","publisher":"Vision To Learn","url":"https://visiontolearn.org/donate/","published":null,"retrieved":"2026-09-13"},{"id":"annual25","title":"2024–2025 Annual Report","publisher":"Vision To Learn","url":"https://visiontolearn.org/wp-content/uploads/VTL_AnnualReport_2025_20-ocr.pdf","published":null,"retrieved":"2026-09-13"},{"id":"99025","title":"Original FY June 2025 Form 990","publisher":"Vision To Learn / IRS via ProPublica","url":"https://projects.propublica.org/nonprofits/organizations/453457853/202621359349308582/full","published":null,"retrieved":"2026-09-13"},{"id":"99024","title":"Original FY June 2024 Form 990 and 2023 comparative","publisher":"Vision To Learn / IRS via ProPublica","url":"https://projects.propublica.org/nonprofits/organizations/453457853/202511289349304146/full","published":null,"retrieved":"2026-09-13"},{"id":"mos","title":"Mobile Optometric Services program","publisher":"California DHCS","url":"https://www.dhcs.ca.gov/services/medi-cal-resources/medi-cal-eligibility-division/mobile-optometric-services-mos-program/","published":null,"retrieved":"2026-09-13"},{"id":"mosfaq","title":"MOS funding and provider requirements","publisher":"California DHCS","url":"https://www.dhcs.ca.gov/services/medi-cal-resources/medi-cal-eligibility-division/frequently-asked-questions-mos-faqs/","published":null,"retrieved":"2026-09-13"},{"id":"mosdonor","title":"MOS donor approval process","publisher":"California DHCS","url":"https://www.dhcs.ca.gov/services/medi-cal-resources/medi-cal-eligibility-division/how-do-i-become-a-donor/","published":null,"retrieved":"2026-09-13"},{"id":"acuity","title":"Visual acuity and refractive findings in children prescribed glasses","publisher":"Guo et al., American Journal of Ophthalmology / Harvard","url":"https://eye.hms.harvard.edu/publications/visual-acuity-and-refractive-findings-children-prescribed-glasses-school-based","published":null,"retrieved":"2026-09-13"},{"id":"rct","title":"Cluster randomized school vision program academic outcomes","publisher":"Neitzel et al., JAMA Ophthalmology","url":"https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2783867","published":null,"retrieved":"2026-09-13"},{"id":"wear","title":"Free glasses and teacher-incentive cluster randomized trial","publisher":"Yi et al., American Journal of Ophthalmology","url":"https://pubmed.ncbi.nlm.nih.gov/26275472/","published":null,"retrieved":"2026-09-13"}]}