{"edition":"los-angeles","organization":"Radiant Health Centers","organizationId":"org:radiant-health-centers","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"la-radiant-clinical-components-v1","costScope":"Full recipient gross expense, not selected clinical-program budget; unrecognized volunteer and outside care resources unknown.","geographicAttribution":"g=.98 judgment for Orange County-centered resident outcomes. No measured LA/Orange address fraction; sensitivity .9–1.","formula":"C=13585902+240092=13825994. A(T)=sum(y=1..T)(1.03^-y). QA=N*s*h*f*a*b*r*ta*qe/1.03; QP=N*s*p*f*a*b*i*ep*v*A(T)/1.03; QM=M*s*em*tm*b*qm/1.03. QLA=(QA+QP+QM)*z*g. Central QA=.1703883495, QP=.1635041709, QM=.5568567961 before overlap/geography; QLA=.7856408972. Price10=10*C/QLA. Qportfolio=QLA+Qother-H.","counterfactual":"Other clinics, insurance, Ryan White services, 340B financing and usual counseling continue. a limits ART/PrEP exposure to meaningful changes from alternatives. b applies separately to the ordinary gift's resource response. Mental transfer tm includes both modality/intensity and alternative counseling.","attribution":"ART and PrEP shares are mutually exclusive in one modeled year, with h+p<=1. Annual counts are not prescription-years. SMART r is a randomized-strategy follow-up-year rate, not a biological effect per extra medication year. Counseling effect is additional to usual care; z further reduces potential cross-branch overlap. No test, contact, housing count or secondary infection is credited again.","uncertainty":"Explicit conditional clinical estimate, not whole-portfolio return. Treatment shares and marginal responsiveness are subjective; broad scenarios, zero and harm are retained. Public fiscal-year counts lag current costs.","nativeOutcomes":"At s=1, the 1,872 clinic patients imply 748.8 assumed ART patients and 280.8 PrEP patients. Three-quarter-year exposure, .25 incremental strategy fraction and .25 funding response yield 35.1 ART strategy-follow-up years and 13.1625 additional PrEP person-years. The latter avert .1131975 infections at i=.01 and effectiveness .86. Counseling uses 322*.5*.25*.25=10.0625 transferred, donor-responsive CoBalT-equivalent offers. These fractional outputs are model expectations, not observed people.","inputs":[{"name":"C","value":13825994,"unit":"USD annual gross recipient expense","basis":"observed","rationale":"Audit total plus original-return event costs; drugs and recognized donated materials retained.","sourceIds":["audit25","99025","d25"]},{"name":"N","value":1872,"unit":"FY2024 clinic patients","basis":"observed","rationale":"Not diagnosis-specific or treatment person-years.","sourceIds":["impact"]},{"name":"M","value":322,"unit":"FY2024 unique counseling clients","basis":"observed","rationale":"Not completed courses or responders.","sourceIds":["impact"]},{"name":"s","value":1,"unit":"current capacity relative to FY2024 counts","basis":"judgment","rationale":"No FY2025 unique counts; test .5–1.5 without assuming cost growth proves volume growth.","sourceIds":["impact","99025"]},{"name":"h","value":0.4,"unit":"clinic share receiving modeled ART continuity support","basis":"judgment","rationale":"Actual medication mix unavailable; test .2–.6.","sourceIds":["art","audit25"]},{"name":"p","value":0.15,"unit":"clinic share receiving modeled PrEP","basis":"judgment","rationale":"Actual medication mix unavailable; test .05–.3; h+p never exceeds one.","sourceIds":["prep"]},{"name":"f","value":0.75,"unit":"strategy or PrEP follow-up years per annual patient","basis":"judgment","rationale":"Exposure and retention unavailable; cap at one year, test .25–1.","sourceIds":["impact"]},{"name":"a","value":0.25,"unit":"medication-strategy exposure additional to alternatives","basis":"judgment","rationale":"Meaningful interruption or absence of PrEP, not simply a few days faster; test .05–.6.","sourceIds":["art","billing"]},{"name":"b","value":0.25,"unit":"proportional marginal funding response","basis":"judgment","rationale":"Payer, collections and donor substitution; test .05–.75.","sourceIds":["audit25","billing"]},{"name":"r","value":0.02,"unit":"composite events per randomized ART-strategy follow-up year","basis":"observed","rationale":"SMART 3.3 minus 1.3 per100; not effect per extra ART year.","sourceIds":["smart"]},{"name":"ta","value":0.5,"unit":"ART strategy-effect transfer","basis":"judgment","rationale":"Modern care gaps differ from protocol interruption; test .1–1.","sourceIds":["smart"]},{"name":"qe","value":0.5,"unit":"finite one-year QALY area per composite event prevented","basis":"judgment","rationale":"Event mix unobserved; no remaining-lifetime multiplier; test .1–1.","sourceIds":["smart"]},{"name":"i","value":0.01,"unit":"annual HIV incidence absent PrEP in modeled group","basis":"judgment","rationale":"Not local measured risk; test .002–.03.","sourceIds":["proud"]},{"name":"ep","value":0.86,"unit":"PrEP relative incidence reduction","basis":"observed","rationale":"PROUD trial estimate, conditional on transferable delivery.","sourceIds":["proud"]},{"name":"v","value":0.1,"unit":"annual survival-adjusted utility difference after infection prevented","basis":"judgment","rationale":"Finite health-area assumption, includes survival once; test .03–.15.","sourceIds":[]},{"name":"T","value":20,"unit":"years after infection prevented","basis":"judgment","rationale":"No health area after year20; low scenario10.","sourceIds":[]},{"name":"em","value":0.5,"unit":"counseling share clinically compatible with depression benefit","basis":"judgment","rationale":"Not measured treatment-resistant depression; test .1–.7.","sourceIds":["mental","cobalt"]},{"name":"tm","value":0.25,"unit":"counseling effect transfer including alternatives","basis":"judgment","rationale":"Current mainly-group format is not CoBalT individual CBT; test .1–1.","sourceIds":["mental","cobalt"]},{"name":"qm","value":0.057,"unit":"QALY per randomized CoBalT offer over one year","basis":"observed","rationale":"External package versus usual care; not Radiant's observed effect.","sourceIds":["cobalt"]},{"name":"z","value":0.9,"unit":"cross-component non-overlap factor","basis":"judgment","rationale":"No extra housing/nutrition benefit added; residual shared health areas discounted; test .7–1.","sourceIds":[]},{"name":"g","value":0.98,"unit":"LA/Orange resident benefit share","basis":"judgment","rationale":"Orange County-focused services; exact residence unknown.","sourceIds":["current"]},{"name":"d","value":0.03,"unit":"annual discount","basis":"judgment","rationale":"Infection health area discounted by year and one initial event year; others one year.","sourceIds":[]},{"name":"Qother","value":null,"unit":"non-overlapping remaining portfolio health","basis":"unknown","rationale":"Primary/reproductive care, housing, food and other effects unpriced.","sourceIds":["current","audit25"]}],"scenarios":[{"id":"central","label":"Conditional selected clinical health","costUSD":13825994,"allPopulationQalys":0.8016743848994923,"editionQalys":0.7856408972015024,"assumptions":"s=1;h=0.4;p=0.15;f=0.75;a=0.25;b=0.25;ART transfer=0.5;Q/event=0.5;T=20;v=0.1;mental eligibility=0.5;mental transfer=0.25;z=0.9;g=0.98;incidence=0.01. Joint subjective stress test, not confidence bounds."},{"id":"low","label":"Weak delivery and transfer","costUSD":13825994,"allPopulationQalys":0.0031430507229117306,"editionQalys":0.0028287456506205576,"assumptions":"s=0.5;h=0.2;p=0.05;f=0.25;a=0.05;b=0.05;ART transfer=0.1;Q/event=0.1;T=10;v=0.03;mental eligibility=0.1;mental transfer=0.1;z=0.7;g=0.9;incidence=0.002. Joint subjective stress test, not confidence bounds."},{"id":"high","label":"Favorable delivery and transfer","costUSD":13825994,"allPopulationQalys":49.94448521193465,"editionQalys":49.94448521193465,"assumptions":"s=1.5;h=0.6;p=0.3;f=1;a=0.6;b=0.75;ART transfer=1;Q/event=1;T=20;v=0.15;mental eligibility=0.7;mental transfer=1;z=1;g=1;incidence=0.03. Joint subjective stress test, not confidence bounds."},{"id":"zero","label":"No additional clinical health","costUSD":13825994,"allPopulationQalys":0,"editionQalys":0,"assumptions":"b=0 or relevant causal effects are zero."},{"id":"adverse","label":"Illustrative net harm","costUSD":13825994,"allPopulationQalys":-1,"editionQalys":-1,"assumptions":"One LA QALY net loss from adverse effects, disruption or displaced care; not observed."},{"id":"portfolio-unknown","label":"Whole-portfolio return unestimated","costUSD":13825994,"allPopulationQalys":null,"editionQalys":null,"assumptions":"Other pathways cannot be assumed zero for ranking."}],"sensitivity":["Central $175,983,633.86 per10 LA QALYs; favorable $2,768,272.40; weak $48,876,766,269.06.","No counseling transfer removes the largest central branch; this is a material assumption, not a robust HIV-only price.","The scenario stops ART-event and counseling benefits after one year and post-infection utility after20; ongoing future treatment cost is not borrowed to claim longer intervention exposure.","Halving b doubles the positive price; improvement in billing could either expand care or substitute for philanthropy.","Adding unrecognized volunteer and outside treatment resources increases social cost; recognized drugs and event goods are already retained.","FY2024 count versus FY2025 expense mismatch is explicit, tested through s, not hidden in a synthetic mean."],"missingInputs":["Current unique ART/PrEP patients, duration, adherence, viral suppression and counterfactual care gaps.","Local PrEP risk and persistence.","Counseling diagnoses, modality, completion and comparative utilities.","Unrestricted marginal allocation and payer/collection substitution.","Client-address geography and deduplication across clinical/social services.","Unrecognized volunteer resources and non-overlapping remaining health pathways."]},"sources":[{"id":"audit25","title":"FY2025 original audited statements; auditor date January 31, 2026","url":"https://projects.propublica.org/nonprofits/display_audit/2025-02-GSAFAC-0000401968","publisher":"Radiant / Stephens, Reidinger & Beller LLP","published":null,"retrieved":"2026-09-14"},{"id":"audit24","title":"FY2024 original audited statements","url":"https://projects.propublica.org/nonprofits/display_audit/2024-02-GSAFAC-0000359618","publisher":"Radiant / independent auditor","published":null,"retrieved":"2026-09-14"},{"id":"audit23","title":"FY2023 original audited statements and direct event costs","url":"https://projects.propublica.org/nonprofits/display_audit/2023-02-GSAFAC-0000402587","publisher":"Radiant / independent auditor","published":null,"retrieved":"2026-09-14"},{"id":"99025","title":"FY2025 original return and netted event cost","url":"https://projects.propublica.org/nonprofits/full_text/202630849349300343/IRS990","publisher":"Radiant / IRS","published":"2026-03-25","retrieved":"2026-09-14"},{"id":"99024","title":"FY2024 original return and netted event cost","url":"https://projects.propublica.org/nonprofits/full_text/202500159349302735/IRS990","publisher":"Radiant / IRS","published":"2025-01-15","retrieved":"2026-09-14"},{"id":"d25","title":"FY2025 audit-to-return expense reconciliation","url":"https://projects.propublica.org/nonprofits/full_text/202630849349300343/IRS990ScheduleD","publisher":"Radiant / IRS","published":"2026-03-25","retrieved":"2026-09-14"},{"id":"d24","title":"FY2024 audit-to-return expense reconciliation","url":"https://projects.propublica.org/nonprofits/full_text/202500159349302735/IRS990ScheduleD","publisher":"Radiant / IRS","published":"2025-01-15","retrieved":"2026-09-14"},{"id":"impact","title":"FY2024 annual report: clinical counts; financial table not used as authority","url":"https://www.radianthealthcenters.org/wp-content/uploads/2025/02/Radiant-Health-Centers-Annual-Report-2023-2024.pdf","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"current","title":"Current integrated Orange County services","url":"https://www.radianthealthcenters.org/","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"art","title":"Current Rapid ART delivery","url":"https://www.radianthealthcenters.org/lgbtq-medical-clinic/rapid-art-hiv-treatment","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"prep","title":"Current PrEP services","url":"https://www.radianthealthcenters.org/lgbtq-medical-clinic/prep","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"mental","title":"Current counseling format and scope","url":"https://www.radianthealthcenters.org/lgbtq-counseling","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"billing","title":"Insurance, FQHC status and sliding fees","url":"https://www.radianthealthcenters.org/lgbtq-medical-clinic/payment-billing","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"donate","title":"Ordinary recipient giving page","url":"https://www.radianthealthcenters.org/get-involved/donate","publisher":"Radiant","published":null,"retrieved":"2026-09-14"},{"id":"smart","title":"SMART randomized continuous versus interrupted ART strategies","url":"https://doi.org/10.1056/NEJMoa062360","publisher":"SMART Study Group / NEJM","published":null,"retrieved":"2026-09-14"},{"id":"proud","title":"PROUD randomized PrEP trial","url":"https://pubmed.ncbi.nlm.nih.gov/26364263/","publisher":"McCormack and colleagues / Lancet","published":"2015-09-09","retrieved":"2026-09-14"},{"id":"cobalt","title":"CoBalT randomized clinical and economic evaluation","url":"https://pubmed.ncbi.nlm.nih.gov/24824481/","publisher":"Wiles and colleagues / NIHR","published":null,"retrieved":"2026-09-14"}]}