{"edition":"los-angeles","organization":"Human Options","organizationId":"org:human-options","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"la-human-options-survivor-health-v1","costScope":"Full recipient gross accrual Form 990 expense, including separately netted direct event costs. Not a restricted counseling or shelter denominator. The modeled health component covers counseling and post-shelter safety; prevention, legal rights and other portfolio outcomes remain unpriced. Additional external health-care, housing and volunteer opportunity costs are not comprehensively estimated.","geographicAttribution":"LA MSA consists of Los Angeles and Orange counties. Current direct services focus on Orange County. g = 0.95 is an explicit judgment for residence during benefit, allowing some survivors to move beyond the boundary; it is not measured and ranges from 0.85 to 1 in stress scenarios. Headquarters location alone does not establish allocation.","formula":"Q_all(D) = (D / C) × k × [Np × dp × rp × b × ep × up × Tp / (1 + d) + Ns × ds × rs × b × es × us × Ts / (1 + d)^2]. Q_LA(D) = g × Q_all(D); price per ten QALYs = 10 × D / Q_LA(D). C = 7595219; Np = 1200; dp = 0.5; rp = 0.5; b = 0.5; ep = 0.17; up = 0.15; Tp = 0.5; Ns = 498; ds = 0.5; rs = 0.5; es = 0.13; us = 0.10; Ts = 0.5; k = 0.8; g = 0.95; d = 0.03. Displayed normalization D = C is an annual scale comparison, not an assurance of linear expansion.","counterfactual":"Public grants, CalOptima, other domestic-violence providers, ordinary advocacy, family support and existing reserves continue. The external counseling effect is already relative to ordinary advocacy, and the safety effect is relative to post-shelter usual services. b reduces added throughput for financing/provider replacement; rp and rs separately reduce clinical transfer. Past housing exits and advocacy successes are not newly purchased benefits.","attribution":"dp discounts mixed ages, intensity and participant definitions before applying the adult psychological reference. ds translates mixed residential person/family records into adult index-person equivalents; no family-size multiplier is used. k reduces overlap between mental-health recovery and safety in the same survivors. No second physical-abuse or housing-first health effect is stacked on these terms.","uncertainty":"Explicit subjective conditional central for a substantial direct-service health component, not an empirically calibrated portfolio expectation. Current costs and reported scale are observed; marginal volume, intervention matching, clinical utility and LA share are not. Zero and adverse net effects remain possible. The endpoint-risk differences do not prove permanent prevention, remission or QALYs.","nativeOutcomes":"Central counseling branch: 600 distinct eligible/intensity-equivalent records; 300 are funding-responsive, and 25.5 additional depression-threshold improvements follow after transfer. Central residential branch: 249 adult equivalents; 8.0925 additional people avoid any repeat physical violence over the two-year reference endpoint after transfer and funding response. These are model outputs, not observed Human Options outcomes. Finite utility improvements and overlap then convert them to health.","inputs":[{"name":"C","value":7595219,"unit":"USD per recipient fiscal year","basis":"observed","rationale":"FY 2025 Part IX $7,312,028 plus Part VIII event cost $283,191; accrual accounting, all programs and overhead.","sourceIds":["ho-99025"]},{"name":"Np","value":1200,"unit":"reported people receiving broadly described healing support","basis":"observed","rationale":"Annual-report scale, not verified adult therapy completions or causal recovery.","sourceIds":["ho-report25"]},{"name":"dp","value":0.5,"unit":"distinct eligible and sufficiently intensive adult-equivalent records per participant","basis":"judgment","rationale":"Allows child/family mix, lighter support and repeated records. It is not an observed completion rate.","sourceIds":["ho-services","ho-report25"]},{"name":"rp","value":0.5,"unit":"external psychological effect retained","basis":"judgment","rationale":"Human Options treatment fidelity, intensity and usual-care context differ; the reference trial also had substantial attrition.","sourceIds":["path","ho-pep26"]},{"name":"ep","value":0.17,"unit":"external difference in depression-threshold prevalence at twelve months","basis":"observed","rationale":"46% minus 29% in PATH follow-up; not a Human Options success rate or QALY measurement.","sourceIds":["path"]},{"name":"up","value":0.15,"unit":"utility improvement per modeled depression-threshold improvement","basis":"judgment","rationale":"Hypothetical mean health gain; crossing a questionnaire threshold does not itself establish remission or this utility difference.","sourceIds":[]},{"name":"Tp","value":0.5,"unit":"years of psychological utility improvement","basis":"judgment","rationale":"Half-year finite benefit, discounted with a one-year delay. No future recurrence-free lifetime assumed.","sourceIds":[]},{"name":"Ns","value":498,"unit":"reported residential survivors/families","basis":"observed","rationale":"Mixed-unit annual-report language; not directly a count of adult women completing intensive advocacy.","sourceIds":["ho-report25"]},{"name":"ds","value":0.5,"unit":"adult index-person equivalents per reported residential record","basis":"judgment","rationale":"Conservative mixed-unit, age and overlap allowance; no observed adult fraction is claimed.","sourceIds":[]},{"name":"rs","value":0.5,"unit":"external post-shelter safety effect retained","basis":"judgment","rationale":"Older intensive advocacy trial does not match all residential pathways or modern alternative services.","sourceIds":["cap99","ho-services"]},{"name":"es","value":0.13,"unit":"external difference in no repeat physical violence over two years","basis":"observed","rationale":"Original paper page 49 reports 24% versus 11% without further physical violence by 24 months. This is a person-level cumulative risk difference, not episodes per year.","sourceIds":["cap99"]},{"name":"us","value":0.1,"unit":"utility difference per modeled avoided-repeat-violence outcome","basis":"judgment","rationale":"Includes the finite health contribution of safety; not avoided homicide or the full welfare value of being safe.","sourceIds":[]},{"name":"Ts","value":0.5,"unit":"years of credited safety-related utility improvement","basis":"judgment","rationale":"At most half a year, with a two-year delay. No annual re-credit for the same survivor.","sourceIds":[]},{"name":"b","value":0.5,"unit":"ordinary-funding responsiveness after replacement","basis":"judgment","rationale":"No verified marginal queue; existing public contracts, alternative providers and resources reduce direct gift-to-volume proportionality.","sourceIds":["ho-99025","ho-services","ho-pep26"]},{"name":"k","value":0.8,"unit":"nonoverlapping health retained across branches","basis":"judgment","rationale":"Cross-program unique clients and overlapping symptoms are unmeasured; do not add all branch health without a reduction.","sourceIds":[]},{"name":"g","value":0.95,"unit":"LA/Orange resident benefit fraction","basis":"judgment","rationale":"Orange County-focused services, with allowance for relocation outside the MSA during benefits.","sourceIds":["ho-services"]},{"name":"d","value":0.03,"unit":"annual discount rate","basis":"judgment","rationale":"Psychological outcome delayed one year and cumulative safety endpoint delayed two years.","sourceIds":[]}],"scenarios":[{"id":"central","label":"Conditional counseling and safety health component","costUSD":7595219,"allPopulationQalys":1.79055518899048,"editionQalys":1.701027429540956,"assumptions":"Central inputs; entire recipient costs; unpriced portfolio is not zero."},{"id":"weak","label":"Weak intensity, transfer and funding response","costUSD":7595219,"allPopulationQalys":0.004354340654161561,"editionQalys":0.003701189556037327,"assumptions":"dp = 0.25; rp = 0.1; b = 0.1; up = 0.05; Tp = 0.25; ds = 0.35; rs = 0.1; us = 0.02; Ts = 0.25; k = 0.6; g = 0.85. External benchmarks and delays unchanged; not a confidence bound."},{"id":"strong","label":"Strong service match and sustained finite benefit","costUSD":7595219,"allPopulationQalys":40.2874917522858,"editionQalys":40.2874917522858,"assumptions":"dp = 0.9; rp = 1; b = 0.75; up = 0.25; Tp = 1; ds = 0.75; rs = 1; us = 0.2; Ts = 1; k = 1; g = 1. External benchmarks and delays unchanged; not a confidence bound."},{"id":"zero","label":"No additional service or clinical benefit","costUSD":7595219,"allPopulationQalys":0,"editionQalys":0,"assumptions":"Complete replacement or no effective intervention transfer; no finite positive price."},{"id":"downside","label":"Adverse net effect remains unquantified","costUSD":7595219,"allPopulationQalys":null,"editionQalys":null,"assumptions":"Retaliation, unsafe transitions, ineffective treatment or lost alternative services may outweigh health gains; no fabricated negative bound."}],"sensitivity":["The central price is approximately $44.7 million per ten LA QALYs. Halving ordinary-funding responsiveness doubles this price.","At current recipient cost, $1 million per ten QALYs requires 75.95219 additional LA QALYs; $100,000 requires 759.5219. These requirements exceed the modeled component but do not price the omitted portfolio.","Removing the post-shelter safety branch leaves the psychological component; no mortality or separate housing-first uplift replaces it.","External outcome thresholds are imperfect clinical summaries. If they do not imply a utility difference, that branch contributes no QALYs even if its legal or social outcome improves.","Primary financials include recognized noncash contributions; unrecognized volunteer time, survivor travel and external provider costs would require a separate societal analysis."],"missingInputs":["Distinct current participants by age, program and county; whether the reported 498 counts people, families or mixed records.","Counseling intensity, clinical fidelity, engagement and outcomes versus usual services; no proof that PEP is PATH.","Ordinary-donation allocation, restrictions, replacement finance and a costed unmet service queue.","Repeat-violence follow-up, safety harms, residence after relocation and cross-branch client overlap.","Preference-based utility and finite duration; prevention, child, legal and broader portfolio effects without double counting.","Accessible audit reconciliation, recognition of donated services and current resource costs beyond the 2025 return."]},"sources":[{"id":"ho-home","title":"Current operations","url":"https://humanoptions.org/","publisher":"Human Options","published":null,"retrieved":"2026-09-14"},{"id":"ho-services","title":"Current services and eligibility","url":"https://humanoptions.org/get-help/","publisher":"Human Options","published":null,"retrieved":"2026-09-14"},{"id":"ho-report25","title":"Annual Report 2024–2025","url":"https://humanoptions.org/wp-content/uploads/2025/12/Human-Options-Annual-Report-2024-2025_FINAL-1.pdf","publisher":"Human Options","published":null,"retrieved":"2026-09-14"},{"id":"ho-99025","title":"Original Form 990, year ended June 30, 2025","url":"https://projects.propublica.org/nonprofits/organizations/953667817/202513089349302841/full","publisher":"Human Options / IRS, hosted by ProPublica","published":"2025-11-04","retrieved":"2026-09-14"},{"id":"ho-99024","title":"Original Form 990, year ended June 30, 2024","url":"https://projects.propublica.org/nonprofits/organizations/953667817/202402999349301655/full","publisher":"Human Options / IRS, hosted by ProPublica","published":"2024-10-25","retrieved":"2026-09-14"},{"id":"ho-99023","title":"Original Form 990, year ended June 30, 2023","url":"https://projects.propublica.org/nonprofits/organizations/953667817/202343139349304879/full","publisher":"Human Options / IRS, hosted by ProPublica","published":"2023-11-09","retrieved":"2026-09-14"},{"id":"ho-index","title":"Current filing and audit index","url":"https://projects.propublica.org/nonprofits/organizations/953667817","publisher":"ProPublica","published":null,"retrieved":"2026-09-14"},{"id":"ho-pep26","title":"Personal Empowerment Program, updated January 12, 2026","url":"https://humanoptions.org/wp-content/uploads/2026/01/updated-PEP-flyer-2026.pdf","publisher":"Human Options","published":"2026-01-12","retrieved":"2026-09-14"},{"id":"ho-donate","title":"Donate","url":"https://humanoptions.org/donate/","publisher":"Human Options","published":null,"retrieved":"2026-09-14"},{"id":"path","title":"Psychological advocacy towards healing: randomized trial","url":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205485","publisher":"Ferrari et al. / PLOS ONE","published":"2018-11-27","retrieved":"2026-09-14"},{"id":"cap99","title":"Reducing Violence Using Community-Based Advocacy for Women With Abusive Partners","url":"https://cap.vaw.msu.edu/wp-content/uploads/2014/05/Two-year-followup-CAP-JCCP.pdf","publisher":"Sullivan and Bybee / Journal of Consulting and Clinical Psychology","published":null,"retrieved":"2026-09-14"},{"id":"dvhf23","title":"Domestic Violence Housing First and survivors' outcomes over two years","url":"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806371","publisher":"Sullivan et al. / JAMA Network Open","published":"2023-06-26","retrieved":"2026-09-14"}]}