{"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":"2026-09-14","model":{"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."]},"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":"2026-09-14"},{"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":"2026-09-14"},{"id":"vacf-about","title":"About and impact graphic","url":"https://www.vacf.org/about","publisher":"VACF","published":null,"retrieved":"2026-09-14"},{"id":"vacf-programs","title":"Programs and services","url":"https://www.vacf.org/programs","publisher":"VACF","published":null,"retrieved":"2026-09-14"},{"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":"2026-09-14"},{"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":"2026-09-14"},{"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":"2026-09-14"}]}