{"edition":"new-york-city","organization":"New York Legal Assistance Group","organizationId":"org:new-york-legal-assistance-group","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"nyc-nylag-coverage-health-v1","costScope":"All annual gross NYLAG recognized resources, including donated legal services and event expense; only coverage-access health is priced, not all legal services or complete portfolio return.","geographicAttribution":"g=.95 is a subjective MSA-resident share for the modeled coverage clients. NYC, Long Island and Westchester facilities are within the official MSA; statewide work and nonresident patients are not automatically local.","formula":"v=ln(1+d)+rho; A=(1-exp(-v*T))/v; Qall=N*f*a*b*(p*u*A-h); QMSA=g*Qall; price10=10*costUSD/QMSA if positive. Cost-only sensitivities do not change outcomes.","counterfactual":"Existing public contracts, hospital social workers, legal aid, insurance enrollment and emergency/safety-net medical care continue. Historical eligibility success and current public contract are baseline. No all-care-versus-no-care assumption.","attribution":"f discounts transfer of 2024 eligibility volume to present legal and funding conditions; a is alternative-representation substitution; p is conversion to effective clinical care; b is ordinary private-funding response. Each applied once; hospital partnership outcomes are not separately added.","uncertainty":"Partial-health judgment model. Historical eligibility count is observed but future volume, treatment conversion, clinical utility, recurrence and private-gift effect are not. High, low, zero and harm scenarios are not confidence bounds. The short symptom horizon assumes survival through modeled follow-up and does not separately estimate competing death; no mortality-prevention credit is claimed. A longer clinical extrapolation would require explicit competing mortality.","nativeOutcomes":"Legal work -> additional Medicaid eligibility -> effective treatment beyond alternatives -> finite utility improvement minus process burden.","inputs":[{"name":"C","value":100312616,"unit":"USD annual gross recognized expense","basis":"observed","rationale":"Original FY2025 Part IX plus donated services, credit loss and separately netted event expense.","sourceIds":["return2025","schedule2025"]},{"name":"N","value":250,"unit":"historical annual people obtaining eligibility","basis":"observed","rationale":"2025 testimony reports 250 undocumented immigrants attaining Medicaid eligibility in 2024; not 250 clinical successes.","sourceIds":["testimony"]},{"name":"f","value":0.5,"unit":"current legal/volume transfer fraction","basis":"judgment","rationale":"Explicit halving of historical volume for current transfer uncertainty, not a measured legal change or forecast.","sourceIds":["health","contract","oregon"]},{"name":"p","value":0.5,"unit":"effective clinical care conversion fraction","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"a","value":0.5,"unit":"additional representation fraction","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"b","value":0.25,"unit":"ordinary private-funding response","basis":"judgment","rationale":"Public hospital contract and existing funding justify substantial substitution risk; .25 is a judgment, not contract-derived marginality.","sourceIds":["health","contract","oregon"]},{"name":"u","value":0.2,"unit":"utility gain conditional on effective care","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"rho","value":0.5,"unit":"annual recurrence/waning hazard","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"T","value":1,"unit":"maximum effect years","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"h","value":0.001,"unit":"QALY burden per additional eligibility case","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"g","value":0.95,"unit":"MSA fraction","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]},{"name":"d","value":0.03,"unit":"annual discount","basis":"judgment","rationale":"Explicit assumption, not a source-estimated NYLAG clinical or geographic rate.","sourceIds":["health","contract","oregon"]}],"scenarios":[{"id":"central","label":"Conditional coverage-to-effective-care health","costUSD":100312616,"allPopulationQalys":1.1974581838578398,"editionQalys":1.1375852746649477,"pricePer10Qalys":881803045.7500868,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0.5,\"a\":0.5,\"b\":0.25,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.001,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":100312616}"},{"id":"low","label":"Low conversion and high public replacement","costUSD":100312616,"allPopulationQalys":0.006070616084318259,"editionQalys":0.004856492867454608,"pricePer10Qalys":206553615412.9595,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.25,\"p\":0.25,\"a\":0.25,\"b\":0.1,\"u\":0.05,\"rho\":1,\"T\":0.5,\"h\":0.001,\"g\":0.8,\"d\":0.03,\"numeratorCostUSD\":100312616}"},{"id":"high","label":"Frequent consequential effective treatment","costUSD":100312616,"allPopulationQalys":45.01222569138405,"editionQalys":45.01222569138405,"pricePer10Qalys":22285637.837100152,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":1,\"p\":0.75,\"a\":0.75,\"b\":0.5,\"u\":0.4,\"rho\":0.2,\"T\":2,\"h\":0.001,\"g\":1,\"d\":0.03,\"numeratorCostUSD\":100312616}"},{"id":"zero","label":"Complete private-gift replacement","costUSD":100312616,"allPopulationQalys":0,"editionQalys":0,"pricePer10Qalys":null,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0.5,\"a\":0.5,\"b\":0,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.001,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":100312616}"},{"id":"adverse","label":"Eligibility activity without care gain","costUSD":100312616,"allPopulationQalys":-0.15625,"editionQalys":-0.1484375,"pricePer10Qalys":null,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0,\"a\":0.5,\"b\":0.25,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.01,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":100312616}"},{"id":"medical-cost","label":"Added induced medical resources","costUSD":100468866,"allPopulationQalys":1.1974581838578398,"editionQalys":1.1375852746649477,"pricePer10Qalys":883176569.1551434,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0.5,\"a\":0.5,\"b\":0.25,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.001,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":100468866}"},{"id":"recognized-services","label":"Higher opportunity cost of donated services","costUSD":110905556.25,"allPopulationQalys":1.1974581838578398,"editionQalys":1.1375852746649477,"pricePer10Qalys":974920814.4652271,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0.5,\"a\":0.5,\"b\":0.25,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.001,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":110905556.25}"},{"id":"exclude-credit-loss","label":"Exclude non-resource credit loss","costUSD":99969946,"allPopulationQalys":1.1974581838578398,"editionQalys":1.1375852746649477,"pricePer10Qalys":878790788.0527382,"assumptions":"{\"C\":100312616,\"N\":250,\"f\":0.5,\"p\":0.5,\"a\":0.5,\"b\":0.25,\"u\":0.2,\"rho\":0.5,\"T\":1,\"h\":0.001,\"g\":0.95,\"d\":0.03,\"numeratorCostUSD\":99969946}"}],"missingInputs":["Current annual additional eligibility outcomes under changing rules, with residence.","Treatment received after eligibility and counterfactual hospital/charity care.","Funding allocation and marginal cases beyond the seven-year H+H contract.","Health utility and persistence by condition, including adverse burdens.","Complete health and non-health value of housing, immigration, family, public-benefit and policy work."],"sensitivity":["Low conversion and high public replacement: 206553615413 USD per 10 MSA QALYs.","Frequent consequential effective treatment: 22285638 USD per 10 MSA QALYs.","Complete private-gift replacement: no finite positive-benefit price.","Eligibility activity without care gain: no finite positive-benefit price.","Added induced medical resources: 883176569 USD per 10 MSA QALYs.","Higher opportunity cost of donated services: 974920814 USD per 10 MSA QALYs.","Exclude non-resource credit loss: 878790788 USD per 10 MSA QALYs."],"nativeCosts":"Whole annual expense / 250 historical eligibility gains = $401250.46, not marginal price per case. Central additional eligibility equivalents=250*0.5*0.5*0.25=15.625; effective local care equivalents=15.625*0.5*0.95=7.421875. Full expense / local care equivalent = $13515805.10 before finite utility and burden. Eligibility does not itself establish effective treatment."},"sources":[{"id":"return2023","title":"FY2023 original IRS990","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202431369349301218/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2023","title":"FY2023 original IRS990ScheduleD","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202431369349301218/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"return2024","title":"FY2024 original IRS990","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202541349349307214/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2024","title":"FY2024 original IRS990ScheduleD","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202541349349307214/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"return2025","title":"FY2025 original IRS990","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202641329349300449/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2025","title":"FY2025 original IRS990ScheduleD","publisher":"NYLAG / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202641329349300449/IRS990ScheduleD","published":null,"retrieved":"2026-09-14"},{"id":"testimony","title":"Original health budget testimony and 2024 coverage output","publisher":"NYLAG","url":"https://nylag.org/wp-content/uploads/2025/02/NYLAG-FY-25-26-Budget-Testimony-Joint-Legislative-Health-Hearing-Final.pdf","published":"2025-02-11","retrieved":"2026-09-14"},{"id":"contract","title":"Seven-year LegalHealth contract and 2025 reach","publisher":"NYC Health + Hospitals","url":"https://www.nychealthandhospitals.org/pressrelease/nyc-health-hospitals-commits-23-7-million-to-new-york-legal-assistance-groups-legalhealth-unit-for-free-legal-services-for-patients/","published":"2026-08-11","retrieved":"2026-09-14"},{"id":"health","title":"Current LegalHealth division and service model","publisher":"NYLAG LegalHealth","url":"https://legalhealth.org/","published":null,"retrieved":"2026-09-14"},{"id":"sites","title":"Patient services and geography","publisher":"NYLAG","url":"https://nylag.org/gethelp/","published":null,"retrieved":"2026-09-14"},{"id":"current","title":"Current Medicaid administration and access work","publisher":"NYLAG / NY Health Access","url":"https://nyhealthaccess.org/entry/257/","published":"2025-11-10","retrieved":"2026-09-14"},{"id":"oregon","title":"Randomized coverage access and health 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 ordinary-gift route","publisher":"NYLAG","url":"https://nylag.org/donate-now/","published":null,"retrieved":"2026-09-14"}]}