{"edition":"new-york-city","organization":"New York Lawyers for the Public Interest","organizationId":"org:new-york-lawyers-for-the-public-interest","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"nyc-nylpi-medical-legal-v1","costScope":"Whole annual gross recognized recipient resources; partial medical-legal health only, not full policy portfolio or comparative ranking.","geographicAttribution":"g=.85 subjective MSA residency of modeled health clients; statewide cases and detention outside MSA require residence tracing. Official22-county boundary, not CSA.","formula":"Qall=N*a*b*(p*u*t-h)/(1+d); QMSA=g*Qall; Price10=10*C/QMSA when positive.","counterfactual":"Existing public funding, ordinary legal/clinical partners, alternative care and established laws continue. No historical advocacy success automatically belongs to a new gift.","attribution":"p effective clinical change, a additional work versus alternatives, b financial response; each once. 44 medical evaluations and60 immigration cases not added to85 screened individuals.","uncertainty":"Very weak-confidence partial estimate; no claim that a small clinical slice captures policy upside. Zero and adverse included; scenarios are not confidence bounds.","nativeOutcomes":"Screened individuals -> effective-care changes beyond alternatives -> finite utility difference minus burden.","inputs":[{"name":"C","value":8609977,"unit":"USD annual gross recipient expense","basis":"observed","rationale":"Original financial reconstruction or specified testimony count; current-scale transfer is judgment.","sourceIds":["return2025","schedule2025"]},{"name":"N","value":85,"unit":"people screened per historical FY","basis":"observed","rationale":"Original financial reconstruction or specified testimony count; current-scale transfer is judgment.","sourceIds":["testimony","oregon"]},{"name":"p","value":0.25,"unit":"fraction","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"a","value":0.5,"unit":"fraction","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"b","value":0.5,"unit":"fraction","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"u","value":0.1,"unit":"health utility gain","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"t","value":0.5,"unit":"years","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"h","value":0.0005,"unit":"QALYs lost per attributable screened person","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"g","value":0.85,"unit":"fraction","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]},{"name":"d","value":0.03,"unit":"annual discount","basis":"judgment","rationale":"Explicit uncalibrated assumption, not source-measured yield.","sourceIds":["testimony","oregon"]}],"scenarios":[{"id":"central","label":"Partial medical-legal health, not policy portfolio","costUSD":8609977,"allPopulationQalys":0.24757281553398058,"editionQalys":0.21043689320388348,"assumptions":"{\"C\":8609977,\"N\":85,\"p\":0.25,\"a\":0.5,\"b\":0.5,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":0.85,\"d\":0.03}","pricePer10Qalys":409147695.96309114},{"id":"low","label":"Mostly information with little treatment change","costUSD":8609977,"allPopulationQalys":0.0015473300970873791,"editionQalys":0.0009283980582524274,"assumptions":"{\"C\":8609977,\"N\":85,\"p\":0.1,\"a\":0.25,\"b\":0.1,\"u\":0.05,\"t\":0.25,\"h\":0.0005,\"g\":0.6,\"d\":0.03}","pricePer10Qalys":92740144418.30063},{"id":"high","label":"Frequent consequential care access","costUSD":8609977,"allPopulationQalys":5.547178398058252,"editionQalys":5.269819478155339,"assumptions":"{\"C\":8609977,\"N\":85,\"p\":0.6,\"a\":0.75,\"b\":0.75,\"u\":0.2,\"t\":1,\"h\":0.0005,\"g\":0.95,\"d\":0.03}","pricePer10Qalys":16338276.929011347},{"id":"zero","label":"Complete donor replacement","costUSD":8609977,"allPopulationQalys":0,"editionQalys":0,"assumptions":"{\"C\":8609977,\"N\":85,\"p\":0.25,\"a\":0.5,\"b\":0,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":0.85,\"d\":0.03}","pricePer10Qalys":null},{"id":"adverse","label":"No effective care with process burden","costUSD":8609977,"allPopulationQalys":-0.02063106796116505,"editionQalys":-0.01753640776699029,"assumptions":"{\"C\":8609977,\"N\":85,\"p\":0,\"a\":0.5,\"b\":0.5,\"u\":0.1,\"t\":0.5,\"h\":0.001,\"g\":0.85,\"d\":0.03}","pricePer10Qalys":null},{"id":"clinical-cost","label":"Induced outside clinical resources","costUSD":8636539.5,"allPopulationQalys":0.24757281553398058,"editionQalys":0.21043689320388348,"assumptions":"{\"C\":8636539.5,\"N\":85,\"p\":0.25,\"a\":0.5,\"b\":0.5,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":0.85,\"d\":0.03}","pricePer10Qalys":410409950.8650519},{"id":"volunteer-cost","label":"Unrecognized volunteer-resource stress","costUSD":10762471.25,"allPopulationQalys":0.24757281553398058,"editionQalys":0.21043689320388348,"assumptions":"{\"C\":10762471.25,\"N\":85,\"p\":0.25,\"a\":0.5,\"b\":0.5,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":0.85,\"d\":0.03}","pricePer10Qalys":511434619.9538639}],"missingInputs":["Deduplicated care changes attributable to legal work and client residence.","Public funding displacement and ordinary-gift case response.","Health effects of disability, environmental and policy work outside the priced component."],"sensitivity":["Mostly information with little treatment change: 92,740,144,418 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.","Frequent consequential care access: 16,338,277 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.","Complete donor replacement: no finite positive-benefit price. Scenario assumptions are judgments, not statistical confidence limits.","No effective care with process burden: no finite positive-benefit price. Scenario assumptions are judgments, not statistical confidence limits.","Induced outside clinical resources: 410,409,951 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits.","Unrecognized volunteer-resource stress: 511,434,620 USD per 10 MSA QALYs. Scenario assumptions are judgments, not statistical confidence limits."],"nativeCosts":"Whole annual expense / 85 historical screened people = $101,293.85 per screened person, a portfolio accounting ratio. Central effective additional care equivalents = 85*0.25*0.5*0.5 = 5.3125 before the 85% residency allocation; full expense / local equivalent = about $1.91 million. These are judgment-based additional-care units, not documented clinical successes."},"sources":[{"id":"return2023","title":"FY2023 original Form990","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202421039349302012/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2023","title":"FY2023 original ScheduleD reconciliation","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202421039349302012/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"return2024","title":"FY2024 original Form990","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202541019349301504/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2024","title":"FY2024 original ScheduleD reconciliation","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202541019349301504/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"return2025","title":"FY2025 original Form990","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202621059349300347/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2025","title":"FY2025 original ScheduleD reconciliation","publisher":"NYLPI / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202621059349300347/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"health","title":"Health Justice portfolio","publisher":"NYLPI","url":"https://www.nylpi.org/our-work/health-justice/","published":null,"retrieved":"2026-09-14"},{"id":"testimony","title":"FY27 medical-legal delivery and funding testimony","publisher":"NYLPI","url":"https://www.nylpi.org/resource/camilla-samuelsson-testimony-to-the-committees-on-mental-health-and-substance-use-joint-with-the-committee-on-health-and-the-committee-on-disabilities-march-19-2026/","published":"2026-03-19","retrieved":"2026-09-14"},{"id":"training","title":"Current medical-records review training","publisher":"NYLPI","url":"https://www.nylpi.org/event-recap-medical-providers-network-training-medical-records-review-2/","published":"2026-02-09","retrieved":"2026-09-14"},{"id":"policy","title":"Current citywide disability/environment implementation proposals","publisher":"NYLPI","url":"https://www.nylpi.org/nylpi-offers-proposals-to-advance-disability-and-environmental-justice-in-nyc-via-the-mayors-commission-on-government-efficiency/","published":"2026-07-06","retrieved":"2026-09-14"},{"id":"waste","title":"Current commercial waste-zone implementation advocacy","publisher":"NYLPI","url":"https://www.nylpi.org/resource/justin-wood-comments-regarding-dsny-proposed-commercial-waste-zones-implementation-rule/","published":"2026-03-06","retrieved":"2026-09-14"},{"id":"oregon","title":"Randomized insurance-access clinical outcomes","publisher":"Baicker et al., NEJM","url":"https://pubmed.ncbi.nlm.nih.gov/23635051/","published":"2013-05-02","retrieved":"2026-09-14"},{"id":"donate","title":"Official donation route","publisher":"NYLPI","url":"https://www.nylpi.org/donate","published":null,"retrieved":"2026-09-14"}]}