{"edition":"los-angeles","organization":"Vital Access Care Foundation (Vietnamese American Cancer Foundation)","organizationId":"org:vietnamese-american-cancer-foundation","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-10-05","display":{"metric":{"id":"daly-equivalent","years":1,"label":"DALY","priceLabel":"$ / DALY"},"priceUSD":2059820.7780573617,"canonicalPriceUSDPerTenEquivalentYears":20598207.780573618,"conversion":"display only; QALYs and income equivalents are not measured clinical DALYs"},"listDisplay":{"metric":{"id":"daly-equivalent","years":1,"label":"DALY","priceLabel":"$ / DALY"},"priceUSD":2059820.7780573617,"canonicalPriceUSDPerTenEquivalentYears":20598207.780573618,"conversion":"display only; QALYs and income equivalents are not measured clinical DALYs"},"model":{"version":"la-vacf-beta-v1","costScope":"Full annual recipient expenses / conditional incremental annual service capacity; partner clinical costs outside donor numerator and incompletely priced on social ledger.","geographicAttribution":"95% judged beneficiary residence in LA–Long Beach–Anaheim MSA, including Orange County; not allocated from office alone. All-population health separately serialized.","formula":"S=N*HBVshare*uniqueShare*capacityShare; Qall=(S*appropriateShare*additionalCare*clinicalTransfer*qRef − S*additionalUnmodeledHarm)/(1+r)^delay; QLA=g*Qall. Each disjoint household branch nets positiveOverlap*resourceGain−full costs BEFORE log; income=.5*persons*discounted finite years*log(1+net/baseline)*g. Price10=10*C/(QLA+signed income).","counterfactual":"Ordinary care and public programs may supply screening/treatment without this gift. additionalCare=.5 and capacityShare=.25 are distinct alternative-care and donor-capacity judgments. clinicalTransfer=.25 adjusts external offer evidence, not repeated funding attribution.","attribution":"s and d translate mixed reported outputs to candidate clinical opportunities; no multiplying 9% prevalence into a reference model that already includes infection prevalence. t is a joint transfer discount for older case mix and less complete care than reference; not an empirically calibrated completion probability. No independent cancer/food/navigation additions that could double-count the same people.","uncertainty":"Conditional reference, not calibrated posterior or complete portfolio EV. Unknown clinical/resource cases remain null; null clinical preserves signed resources.","nativeOutcomes":"Conditional annual capacity: 124.95 unique service participants and judged appropriate opportunities; 62.475 additional-care offers before external transfer; 15.61875 reference-offer equivalents. These are modeled counts, not observed completed treatment. LA clinical health1.2018628125 QALYs; signed resource welfare−0.13128035042786065 equivalents.","inputs":[{"name":"costUSD","value":2205208,"basis":"observed","unit":"USD annual recipient expense","sourceIds":["vacf-99024"],"rationale":"Original return field verified; activities are mixed, not unique completed treatment."},{"name":"activities","value":2499,"basis":"observed","unit":"mixed annual activities","sourceIds":["vacf-99024"],"rationale":"Original return field verified; activities are mixed, not unique completed treatment."},{"name":"hbvShare","value":0.25,"basis":"judgment","unit":"fraction of mixed activities assigned to HBV","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. 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See visible joint resource ledger."},{"name":"resourceGain","value":300,"basis":"judgment","unit":"USD net household resource relief before positive overlap","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"positiveOverlap","value":0.5,"basis":"judgment","unit":"independent positive resource fraction","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"disruption","value":200,"basis":"judgment","unit":"USD household treatment/work disruption cost","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. 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See visible joint resource ledger."},{"name":"delay","value":0,"basis":"judgment","unit":"years until incremental service","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"discount","value":0.03,"basis":"judgment","unit":"annual resource discount fraction","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"providerUnits","value":10,"basis":"judgment","unit":"disjoint provider owner welfare persons","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"providerMargin","value":0,"basis":"unknown","unit":"USD provider net margin per incremental service (stress only)","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. See visible joint resource ledger."},{"name":"clinicalHarmPerService","value":0,"basis":"judgment","unit":"additional clinical QALY harm per service (adverse stress only)","sourceIds":["vacf-programs","vacf-99024"],"rationale":"Explicit conditional reference or stress prior; unknown neutral counterparty anchors are not observed zeros. 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Participant branches are disjoint; counterparty stress cohorts are separate.","counterfactual":"Existing care and public assistance without the additional ordinary-gift capacity; costs persist when clinical benefit fails. No survivor earnings.","sourceIds":["vacf-programs","vacf-99024","hbv-model"]}],"allPopulationQalys":1.26511875,"editionQalys":1.2018628125,"incomeUnknown":false,"incomeEquivalent":-0.8790257200702997,"totalEquivalent":0.32283709242970027,"price10":68307144.73988758,"assumptions":"Conditional judgment-led reference; resource branches are mutually exclusive household-year outcomes, not observed patient cohorts.","incomeEquivalentYears":-0.8790257200702997,"combinedEquivalentYears":0.32283709242970027,"costPer10Qalys":68307144.73988758}],"sensitivity":[{"id":"clinical-null","editionQalys":0,"incomeEquivalent":-0.13128035042786065,"price10":null},{"id":"financial-only","editionQalys":0,"incomeEquivalent":-0.13128035042786065,"price10":null},{"id":"complete-unknown","editionQalys":null,"incomeEquivalent":null,"price10":null},{"id":"income-unknown","editionQalys":1.2018628125,"incomeEquivalent":null,"price10":null},{"id":"zero-expansion","editionQalys":0,"incomeEquivalent":0,"price10":null},{"id":"no-additional-care","editionQalys":0,"incomeEquivalent":-0.11888451421071926,"price10":null},{"id":"low-clinical","editionQalys":0.022772137500000005,"incomeEquivalent":-0.01184991464077484,"price10":2019010258.6465995},{"id":"high-clinical","editionQalys":27.041913281249997,"incomeEquivalent":-0.6873913426821568,"price10":836747.4868792235},{"id":"financial-gain","editionQalys":1.2018628125,"incomeEquivalent":-0.020456453558158852,"price10":18665956.74984478},{"id":"high-burden","editionQalys":1.2018628125,"incomeEquivalent":-0.7129813525877466,"price10":45107212.70542354},{"id":"zero-resource-gain","editionQalys":1.2018628125,"incomeEquivalent":-0.16859261474315734,"price10":21342026.5559517},{"id":"no-positive-overlap","editionQalys":1.2018628125,"incomeEquivalent":-0.09415480381282228,"price10":19907845.59383611},{"id":"all-positive-overlap","editionQalys":1.2018628125,"incomeEquivalent":-0.16859261474315734,"price10":21342026.5559517},{"id":"poor-households","editionQalys":1.2018628125,"incomeEquivalent":-0.26298972012814914,"price10":23487817.66052151},{"id":"higher-baseline","editionQalys":1.2018628125,"incomeEquivalent":-0.07871698124567456,"price10":19634209.01039388},{"id":"delay-two-years","editionQalys":1.1328709704024886,"incomeEquivalent":-0.12374432126294721,"price10":21852638.63441055},{"id":"three-year-resource-stress","editionQalys":1.2018628125,"incomeEquivalent":-0.38248132259164347,"price10":26913080.502302304},{"id":"false-alarm-20pct","editionQalys":1.2018628125,"incomeEquivalent":-0.1909300710667864,"price10":21813597.57795208},{"id":"clinical-adverse","editionQalys":-0.5935125,"incomeEquivalent":-0.13128035042786065,"price10":null},{"id":"provider-margin-stress","editionQalys":1.2018628125,"incomeEquivalent":-0.10661481483140375,"price10":20134325.784608822},{"id":"provider-loss-stress","editionQalys":1.2018628125,"incomeEquivalent":-0.15607463670476843,"price10":21086564.669973727},{"id":"unique-half","editionQalys":0.7511642578125,"incomeEquivalent":-0.08205021901741291,"price10":32957132.44891779},{"id":"half-appropriate","editionQalys":0.60093140625,"incomeEquivalent":-0.13128035042786065,"price10":46954179.54804152},{"id":"three-year-mean-cost","editionQalys":1.2018628125,"incomeEquivalent":-0.13128035042786065,"price10":14300751.110475117},{"id":"no-resource-care","editionQalys":1.2018628125,"incomeEquivalent":-0.11888451421071926,"price10":20362439.42730378},{"id":"vaccination-only-clinical","editionQalys":0.1038646875,"incomeEquivalent":-0.13128035042786065,"price10":null},{"id":"refugee-clinical","editionQalys":1.2908896874999998,"incomeEquivalent":-0.13128035042786065,"price10":19016818.246461},{"id":"partner-cost-1459-stress","editionQalys":1.2018628125,"incomeEquivalent":-0.34825885656879285,"price10":25834088.334259316},{"id":"partner-cost-5000-stress","editionQalys":1.2018628125,"incomeEquivalent":-0.8790257200702997,"price10":68307144.73988758}],"missingInputs":["Current deduplicated hepatitis screening and completed-care cascade","Marginal unrestricted-gift service queue and reserve drawdown plan","Controlled cancer-stage/treatment health effects","Net patient bills, benefits, foregone work and false-alarm incidence","Private-provider margin, insurer/public-payer net costs, nonlocal incidence and unmodeled portfolio outcomes"],"historicalAlphaModel":{"version":"la-vacf-alpha-v1","costScope":"Full recipient annual 2024 Part IX expense, all programs/overhead; no selected-program denominator. Output denominator prices only HBV screening/care contribution. External clinical costs excluded and discussed separately.","geographicAttribution":"LA MSA comprises Los Angeles and Orange counties. Historical study events were in both and current service focus is Orange County. g=.95 is judgment allowing nonresident beneficiaries, range .9–1, not measured residence share. National research spillovers are unpriced.","formula":"Q_all=N*s*d*a*b*t*q_ref; Q_LA=g*Q_all; price=10*C/Q_LA. N=2499 mixed screening/vaccination activities; s=.25 HBV-related screening opportunities; d=.8 unique appropriate people; a=.5 incremental versus other care; b=.25 ordinary-funding responsiveness; t=.25 age/cascade transfer; q_ref=23.861−23.780=.081 discounted lifetime QALY per API screening-program offer from Chahal et al. Central Q_all=1.26511875 and Q_LA=1.2018628125. One annual-budget cohort only; never repeat lifetime benefit each year.","counterfactual":"Without additional ordinary funding, existing grants/reserves and public/clinical providers continue. a removes HBV care that would occur anyway; b removes non-marginal funding or displacement. The reference model's no-intervention comparator is more favorable than contemporary care, so it is not copied directly.","attribution":"s and d translate mixed reported outputs to candidate clinical opportunities; no multiplying 9% prevalence into a reference model that already includes infection prevalence. t is a joint transfer discount for older case mix and less complete care than reference; not an empirically calibrated completion probability. No independent cancer/food/navigation additions that could double-count the same people.","uncertainty":"All organization-specific conversion factors are explicit subjective scenarios, not measured rates or confidence intervals. Partial component only. Low/high combine assumptions rather than statistical bounds; zero and small adverse effects remain possible.","nativeOutcomes":"Central 624.75 candidate HBV activities, 499.8 unique appropriate opportunities, 249.9 incremental opportunities before funding, 62.475 funding-responsive opportunities and 15.61875 reference-program-equivalent offers. These fractional expected quantities are model constructs, not observed diagnoses, cures or beneficiaries.","inputs":[{"name":"C","value":2205208,"unit":"USD/year","basis":"observed","rationale":"Original full recipient expense.","sourceIds":["vacf-99024"]},{"name":"N","value":2499,"unit":"mixed screening/vaccination activities/year","basis":"observed","rationale":"Return does not split diseases or vaccines.","sourceIds":["vacf-99024"]},{"name":"s","value":0.25,"unit":"HBV opportunity fraction","basis":"judgment","rationale":"Hepatitis is established but current share unknown; .1–.5 scenarios.","sourceIds":["vacf-programs"]},{"name":"d","value":0.8,"unit":"unique appropriate fraction","basis":"judgment","rationale":"Historical study had to remove duplicate participants; current dedup unknown.","sourceIds":["vacf-hbv"]},{"name":"a","value":0.5,"unit":"incremental-care fraction","basis":"judgment","rationale":"Other medical care, prior diagnoses and contemporary screening reduce additionality.","sourceIds":["cdc-hbv"]},{"name":"b","value":0.25,"unit":"ordinary-funding responsiveness","basis":"judgment","rationale":"Substantial surplus/reserves; no verified immediate cash bottleneck.","sourceIds":["vacf-99024"]},{"name":"t","value":0.25,"unit":"reference transfer factor","basis":"judgment","rationale":"Reference starts age 30; VACF serves many older residents and lacks completion follow-up.","sourceIds":["hbv-model"]},{"name":"q_ref","value":0.081,"unit":"discounted lifetime QALY/program offer","basis":"observed","rationale":"Published modeled (not empirical) API inclusive 23.861 minus no intervention 23.780; includes imperfect uptake, avoids inflating per actual test.","sourceIds":["hbv-model"]},{"name":"g","value":0.95,"unit":"LA+Orange beneficiary share","basis":"judgment","rationale":"Local service focus with nonresident allowance; not office-location allocation.","sourceIds":["vacf-about"]}],"scenarios":[{"id":"central","label":"Conditional HBV component; not portfolio return","costUSD":2205208,"allPopulationQalys":1.26511875,"editionQalys":1.2018628125,"assumptions":"s=0.25; d=0.8; a=0.5; b=0.25; t=0.25; g=0.95; q_ref=.081. All conversion factors subjective."},{"id":"low","label":"low component scenario","costUSD":2205208,"allPopulationQalys":0.025302375000000005,"editionQalys":0.022772137500000005,"assumptions":"s=0.1; d=0.5; a=0.25; b=0.1; t=0.1; g=0.9; q_ref=.081. All conversion factors subjective."},{"id":"high","label":"high component scenario","costUSD":2205208,"allPopulationQalys":27.041913281249997,"editionQalys":27.041913281249997,"assumptions":"s=0.5; d=0.95; a=0.75; b=0.5; t=0.75; g=1; q_ref=.081. All conversion factors subjective."},{"id":"zero","label":"zero component scenario","costUSD":2205208,"allPopulationQalys":0,"editionQalys":0,"assumptions":"s=0.25; d=0.8; a=0.5; b=0; t=0.25; g=0.95; q_ref=.081. All conversion factors subjective."}],"sensitivity":["Positive low/high prices span about $968.38m to $815,478 per 10 LA QALYs; zero incremental funding or completed care makes price nonfinite.","At $1m/10, full annual cost needs 22.05208 LA QALYs; at $100k/10 it needs 220.5208. Central component supplies 1.20186, so unpriced benefits or better conversion would have to close a large gap.","q_ref embeds finite survival, disease recurrence/progression, treatment discontinuation and 3% annual discount in the source model. It is not 0.081 QALYs per year and receives no extra lifetime multiplier.","A societal-cost sensitivity must add actual incremental antiviral/vaccine/monitoring resources, not copy the source's outdated $798/month branded tenofovir cost. No current payer cost is estimated here.","Using all 3,750 ambiguously year-labeled website activities as 2025 outputs would raise scale 50%, but cannot establish HBV mix or 2025 costs; not the central case."],"missingInputs":["Current unique HBV triple-panel tests, excluding repeat tests and other diseases/vaccines.","HBV treatment eligibility, newly identified proportion, completed linkage, treatment retention and vaccination series completion, compared with otherwise available care.","Age-specific clinical trajectories and residence of beneficiaries.","Budget-linked marginal expansion plan and reserve commitments.","Quantified causal benefits of the larger non-HBV portfolio; the component is not an estimate of their absence."]},"inputEvidence":[{"name":"costUSD","value":2205208,"basis":"source","unit":"USD annual recipient expense","sourceIds":["vacf-99024"]},{"name":"activities","value":2499,"basis":"source","unit":"mixed annual activities","sourceIds":["vacf-99024"]},{"name":"hbvShare","value":0.25,"basis":"judgment","unit":"fraction of mixed activities assigned to HBV","sourceIds":[]},{"name":"uniqueShare","value":0.8,"basis":"judgment","unit":"unique screening people per HBV activity","sourceIds":[]},{"name":"appropriateShare","value":1,"basis":"judgment","unit":"appropriate clinical opportunities per service participant","sourceIds":[]},{"name":"additionalCare","value":0.5,"basis":"judgment","unit":"incremental clinical opportunity fraction","sourceIds":[]},{"name":"capacityShare","value":0.25,"basis":"judgment","unit":"ordinary-donation capacity response fraction","sourceIds":[]},{"name":"clinicalTransfer","value":0.25,"basis":"judgment","unit":"external lifetime clinical model transfer fraction","sourceIds":[]},{"name":"qRef","value":0.081,"basis":"source","unit":"modeled discounted lifetime QALY per offer","sourceIds":["hbv-model"]},{"name":"localShare","value":0.95,"basis":"judgment","unit":"beneficiary welfare share in LA MSA","sourceIds":[]},{"name":"members","value":1,"basis":"judgment","unit":"modeled welfare persons per participant household","sourceIds":[]},{"name":"baseline","value":30000,"basis":"judgment","unit":"USD disposable household resources per year","sourceIds":[]},{"name":"commonCost","value":50,"basis":"judgment","unit":"USD time/travel cost per incremental participant household","sourceIds":[]},{"name":"resourceCareShare","value":0.25,"basis":"judgment","unit":"resource-care fraction of incremental clinical opportunities","sourceIds":[]},{"name":"resourceGain","value":300,"basis":"judgment","unit":"USD net household resource relief before positive overlap","sourceIds":[]},{"name":"positiveOverlap","value":0.5,"basis":"judgment","unit":"independent positive resource fraction","sourceIds":[]},{"name":"disruption","value":200,"basis":"judgment","unit":"USD household treatment/work disruption cost","sourceIds":[]},{"name":"falseAlarmShare","value":0.05,"basis":"judgment","unit":"disjoint false-alarm participant fraction","sourceIds":[]},{"name":"falseAlarmCost","value":200,"basis":"judgment","unit":"USD additional false-alarm household cost","sourceIds":[]},{"name":"resourceYears","value":1,"basis":"judgment","unit":"finite household resource years","sourceIds":[]},{"name":"delay","value":0,"basis":"judgment","unit":"years until incremental service","sourceIds":[]},{"name":"discount","value":0.03,"basis":"judgment","unit":"annual resource discount fraction","sourceIds":[]},{"name":"providerUnits","value":10,"basis":"judgment","unit":"disjoint provider owner welfare persons","sourceIds":[]},{"name":"providerMargin","value":0,"basis":"judgment","unit":"USD provider net margin per incremental service (stress only)","sourceIds":[]},{"name":"clinicalHarmPerService","value":0,"basis":"judgment","unit":"additional clinical QALY harm per service (adverse stress only)","sourceIds":[]},{"name":"payerCostPerOffer","value":0,"basis":"judgment","unit":"USD external clinical fiscal opportunity cost per reference offer (stress only)","sourceIds":[]},{"name":"payerPeople","value":100,"basis":"judgment","unit":"disjoint payer welfare persons","sourceIds":[]}]},"sources":[{"id":"vacf-99024","title":"Original 2024 Form 990","url":"https://projects.propublica.org/nonprofits/organizations/912170415/202523219349307047/full","publisher":"Vital Access Care Foundation / IRS; ProPublica host","published":"2025-11-17","retrieved":"2026-10-05"},{"id":"vacf-99023","title":"Original 2023 Form 990","url":"https://projects.propublica.org/nonprofits/organizations/912170415/202443189349302739/full","publisher":"Vital Access Care Foundation / IRS; ProPublica host","published":"2024-11-13","retrieved":"2026-10-05"},{"id":"vacf-about","title":"About and impact graphic","url":"https://www.vacf.org/about","publisher":"VACF","published":null,"retrieved":"2026-10-05"},{"id":"vacf-programs","title":"Programs and services","url":"https://www.vacf.org/programs","publisher":"VACF","published":null,"retrieved":"2026-10-05"},{"id":"vacf-hbv","title":"VACF community HBV screening study","url":"https://www.vacf.org/_files/ugd/dd68d6_5174bf64856744a4af4985d3f0c2c316.pdf","publisher":"Lee et al., BMJ Open","published":"2019-08-26","retrieved":"2026-09-14"},{"id":"vacf-hcv","title":"VACF HCV community screening study","url":"https://www.vacf.org/_files/ugd/dd68d6_8c64704520f24bcbbe6755c0eaa7115e.pdf","publisher":"Lee et al., PLOS ONE","published":"2022-09-27","retrieved":"2026-09-14"},{"id":"hbv-model","title":"HBV screening, treatment and vaccination economic model","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC6346293/","publisher":"Chahal et al., Open Forum Infectious Diseases","published":"2018-12-26","retrieved":"2026-10-05"},{"id":"cdc-hbv","title":"CDC 2023 HBV screening recommendations","url":"https://www.cdc.gov/mmwr/volumes/72/rr/rr7201a1.htm","publisher":"CDC","published":"2023-03-10","retrieved":"2026-10-05"},{"id":"vacf-99022","title":"Original 2022 Form 990","url":"https://projects.propublica.org/nonprofits/organizations/912170415/202343199349312164/full","publisher":"Vital Access Care Foundation / IRS; ProPublica host","published":"2023-11-15","retrieved":"2026-10-05"},{"id":"dhcs-ewc","title":"Every Woman Counts current public screening alternative","url":"https://www.dhcs.ca.gov/services/every-woman-counts/","publisher":"California DHCS","retrieved":"2026-10-05","published":null}]}