{"edition":"los-angeles","organization":"Breathe Southern California","organizationId":"org:breathe-southern-california","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"la-breathe-judgment-partial-health-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":"BEAM LA+San Bernardino county eligibility requires exclusion of San Bernardino; g_LA=.5 is only a judgment scenario, varied .2-.9. Named 2026 purifier-event neighborhoods lie within LA County, so g_LA=1 can apply to those specifically verified households, not to all recipient activity or effects.","formula":"Q_LA(D)=(D/C)*N*b*(deltaSFD14/14)*deltaU*r*w*T*g/(1+d) + Q_filter_LA(D)+Q_policy_other_LA(D)-H_LA(D). C=2923727; central judgment N=100, b=.25, deltaSFD14=2.1, deltaU=.1, r=.5, w=.75, T=1, g=.5, d=.03. Filter skeleton: effective additional occupied-room person-days * health gain per reduced exposure-day; both unknown after alternative provision. Price=10*D/Q only for identified positive scope.","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.","nativeOutcomes":"Additional LA asthma-support patient-years and symptom-free patient-days; additional effective occupied-room exposure-days from purifier use; implementation-induced exposure reduction. Patients, devices, screenings, maps and public grants are not health outcomes.","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":0.5,"unit":"LA+Orange resident share of diagnostic BEAM benefit","basis":"judgment","rationale":"Equal-share scenario for two named counties, not observed distribution. San Bernardino excluded; Orange not listed eligible.","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_LA","value":null,"unit":"incremental LA 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_LA","value":null,"unit":"incremental LA 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":0.06826456310679611,"assumptions":"N = 100; b = 0.25; g = 0.5; 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":0.00013106796116504855,"assumptions":"N=30; b=.05; deltaSFD14=2.1; deltaU=.03; r=.2; w=.5; T=1; g=.2; 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":5.898058252427185,"assumptions":"N = 300; b = 0.75; g = 0.9; 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 LA 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":["At diagnostic clinical bridge, $1 million/10 QALYs requires full-recipient cost per additional LA course <=$546.1165048543688.","g=.2 or .9 yields 40% or 180% of diagnostic LA health. No population weighting claimed.","All unpriced pathways can dominate the BEAM component; adding a portfolio uplift without native evidence would manufacture value.","Public funding may enable private navigation rather than substitute completely; measure additional enrollment/use and time saved, not just grant totals.","FY 2025 costs versus a larger 2026 response require current marginal budget; cost cannot safely be inferred from an expired matching appeal."],"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":"2026-05-15","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":"2025-05-15","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":"2024-05-15","retrieved":"2026-09-14"}]}