{"edition":"los-angeles","organization":"Dayle McIntosh Center","organizationId":"org:dayle-mcintosh-center","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"la-dmc-home-access-v1","costScope":"Full annual recognized recipient cost; home-access partial health only, not full social or portfolio value. The full annual budget is a ratio normalization, not a requested donation or verified funding tranche. Applying the ratio to an ordinary small gift assumes locally proportional capacity response and the stated component allocation.","geographicAttribution":"98% LA/Orange benefit prior; Orange County eligibility supports high local share, but actual residence mix is unmeasured. Test .9–1.","formula":"N=C*f/k; Qall=N*a*b*q/1.03; QLA=Qall*g; price10=10*C/QLA. C=3729186,f=.2,k=5000,a=.5,b=.25,q=.01,g=.98. One year total health area, no recurrence.","counterfactual":"Public funders, other home-modification organizations, family resources and DMC's existing financed work continue. Only otherwise unavailable or earlier completed access enters a; ordinary donor capacity responsiveness enters b once.","attribution":"a is clinical service substitution, b financing substitution; no additional coalition multiplier. Do not double count transition, falls, mobility or personal-care benefit for the same person.","uncertainty":"All output and health-bridge parameters are explicit subjective priors. The source-grounded operations make the pathway plausible, not the exact allocation, cost or effect calibrated. Other portfolio outcomes remain unknown.","nativeOutcomes":"149.16744 modeled packages at f=.2 and k=5000, reduced to 18.64593 additional packages before geography. These are scenario quantities, not reported DMC clients.","inputs":[{"name":"C","value":3729186,"unit":"USD/year","basis":"observed","rationale":"Full recognized expense.","sourceIds":["9902025"]},{"name":"f","value":0.2,"unit":"fraction allocated to home-access packages","basis":"judgment","rationale":"Not reported spending share; test .05–.4.","sourceIds":["home-access"]},{"name":"k","value":5000,"unit":"USD per complete package","basis":"judgment","rationale":"Installation plus coordination planning cost; test2000–15000, not DMC quote or CAPABLE price.","sourceIds":["capable19"]},{"name":"a","value":0.5,"unit":"no-equivalent-service fraction","basis":"judgment","rationale":"Existing public or municipal alternatives; test .2–.8.","sourceIds":["home-access"]},{"name":"b","value":0.25,"unit":"ordinary-funding capacity response","basis":"judgment","rationale":"Replacement donors and contracts; test .05–.75.","sourceIds":["9902025"]},{"name":"q","value":0.01,"unit":"total first-year QALY per extra package","basis":"judgment","rationale":"Finite functional-health area, not trial QALY; test .001–.05 plus zero/harm. Treat this as expected net first-year health area, inclusive of competing mortality, intervention burden and benefit fade within the year; it is not a utility level maintained for every survivor.","sourceIds":["capable19"]},{"name":"g","value":0.98,"unit":"LA/Orange resident benefit fraction","basis":"judgment","rationale":"High local share but unmeasured; test .9–1.","sourceIds":["about"]}],"scenarios":[{"id":"central","label":"central","costUSD":3729186,"allPopulationQalys":0.18102844660194178,"editionQalys":0.17740787766990296,"assumptions":"f=0.2; k=5000 USD per installed home-access package including coordination; a=0.5; b=0.25; q=0.01 total first-year QALY; g=0.98; no later benefit. Every parameter except C is judgment."},{"id":"low","label":"low","costUSD":3729186,"allPopulationQalys":0.00012068563106796118,"editionQalys":0.00010861706796116505,"assumptions":"f=0.05; k=15000 USD per installed home-access package including coordination; a=0.2; b=0.05; q=0.001 total first-year QALY; g=0.9; no later benefit. Every parameter except C is judgment."},{"id":"high","label":"high","costUSD":3729186,"allPopulationQalys":21.723413592233015,"editionQalys":21.723413592233015,"assumptions":"f=0.4; k=2000 USD per installed home-access package including coordination; a=0.8; b=0.75; q=0.05 total first-year QALY; g=1; no later benefit. Every parameter except C is judgment."},{"id":"zero","label":"zero","costUSD":3729186,"allPopulationQalys":0,"editionQalys":0,"assumptions":"No net additional health or complete substitution."},{"id":"adverse","label":"adverse","costUSD":3729186,"allPopulationQalys":-1,"editionQalys":-1,"assumptions":"Illustrative one LA QALY net harm from unsafe or displaced care; not observed. This direct one-year local-harm stress assumes g=1 for the harmed population; it is not derived using the central geography fraction."},{"id":"portfolio-unknown","label":"portfolio-unknown","costUSD":3729186,"allPopulationQalys":null,"editionQalys":null,"assumptions":"Other independent-living pathways unpriced."}],"sensitivity":["Price varies inversely with f,a,b,q,g and directly with k; the full-budget normalization cancels only under the assumed proportional capacity model.","Use smaller first-year utility or higher modification cost for a less favorable price.","The 2025 post-hospital trial is meaningful counterevidence to universal transfer.","Add outside public resources and unrecognized donated equipment for social costing."],"missingInputs":["Current marginal spending allocation and actual unmet-project pipeline.","Full completed-package resource cost and which costs insurers pay.","Measured function-to-utility trajectory and adverse effects.","Public/municipal substitution and donor response.","Actual beneficiary residence and overlap across services."]},"sources":[{"id":"about","title":"Current identity and funding","url":"https://daylemc.org/about-us-2/","publisher":"Dayle McIntosh Center","published":null,"retrieved":"2026-09-14"},{"id":"services","title":"Current service portfolio","url":"https://daylemc.org/services/","publisher":"Dayle McIntosh Center","published":null,"retrieved":"2026-09-14"},{"id":"home-access","title":"Home access eligibility, financing and implementation","url":"https://daylemc.org/home-access/","publisher":"Dayle McIntosh Center","published":null,"retrieved":"2026-09-14"},{"id":"transitions","title":"Current community transition pathway","url":"https://daylemc.org/services/transition-services/community-transitions/","publisher":"Dayle McIntosh Center","published":null,"retrieved":"2026-09-14"},{"id":"9902023","title":"FY2023 original Form 990","url":"https://projects.propublica.org/nonprofits/organizations/953313707/202401669349300115/full","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"scheduleD2023","title":"FY2023 original Schedule D reconciliation","url":"https://projects.propublica.org/nonprofits/full_text/202401669349300115/IRS990ScheduleD","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"9902024","title":"FY2024 original Form 990","url":"https://projects.propublica.org/nonprofits/organizations/953313707/202501559349301605/full","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"scheduleD2024","title":"FY2024 original Schedule D reconciliation","url":"https://projects.propublica.org/nonprofits/full_text/202501559349301605/IRS990ScheduleD","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"9902025","title":"FY2025 original Form 990","url":"https://projects.propublica.org/nonprofits/organizations/953313707/202620869349300547/full","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"scheduleD2025","title":"FY2025 original Schedule D reconciliation","url":"https://projects.propublica.org/nonprofits/full_text/202620869349300547/IRS990ScheduleD","publisher":"DMC / IRS","published":null,"retrieved":"2026-09-14"},{"id":"capable19","title":"CAPABLE randomized functional-disability trial","url":"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2720136","publisher":"Szanton et al. / JAMA Internal Medicine","published":"2019-01-07","retrieved":"2026-09-14"},{"id":"capable25","title":"CAPABLE post-hospital randomized trial","url":"https://pubmed.ncbi.nlm.nih.gov/40990312/","publisher":"Szanton et al. / Journal of the American Geriatrics Society","published":null,"retrieved":"2026-09-14"}]}