{"edition":"new-york-city","organization":"St. Ann's Corner of Harm Reduction","organizationId":"org:st-ann-s-corner-of-harm-reduction","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"nyc-sachr-integrated-health-v1","costScope":"All recipient gross annual operating expense, including recognized noncash and separately netted events; external medical and volunteer resource sensitivities retained.","geographicAttribution":"g=.98 is a subjective local-residence share for a South Bronx/neighboring-borough cohort. NYC lies entirely within the official 22-county MSA; no headquarters-based statewide benefit assignment.","formula":"k=ln(1+d); F(v,t)=(1-exp(-v*t))/v; B=u*[F(m-delta+k,1)-F(m+k,1)+(exp(-(m-delta))-exp(-m))*exp(-k)*F(m+k,T-1)]; M=p*v*[z*F(m-delta+k,1)+(1-z)*F(m+k,1)]; Qall=N*f*a*b*(z*B+M)-h; QMSA=g*Qall; price10=10*C/QMSA when positive.","counterfactual":"Existing public grants, other harm-reduction services and medical care continue. a discounts replacement by alternative services; b separately discounts whether unrestricted funding changes the supported scale. Neither is reapplied per mechanism.","attribution":"One unique cohort and a combined mortality effect prevent repeat-rescue and overlapping-service lifetime double counting. Mortality and short-lived utility changes are distinct terms on the same survival curve.","uncertainty":"Reasoned integrated clinical scenario, not a measured program effect or comprehensive social return. No source-calibrated probability is claimed; broad alternatives, complete substitution and adverse outcomes are explicit.","nativeOutcomes":"Unique participants -> additional integrated harm-reduction/clinical engagement -> one-year mortality-hazard and utility changes -> finite survival-adjusted QALYs. Central annual normalization transfers 2,816 older participants to 2,252.8 current-equivalent participants; after care and funding additionality, 281.6 integrated-engagement equivalents remain, including 168.96 higher-risk equivalents. Whole-recipient cost per additional engagement is $18705.50 and per local equivalent $19087.25. These are judgment-based native units, not observed retained buprenorphine patients or additional rescues. Mortality and morbidity components contribute 1.9876 and 2.0022 all-population QALYs.","inputs":[{"name":"C","value":5267469,"unit":"USD annual gross resources","basis":"observed","rationale":"Latest original full-recipient cost plus event addback.","sourceIds":["return2025","schedule2025"]},{"name":"N","value":2816,"unit":"older unique participants","basis":"observed","rationale":"Older annual-impact unique-person count; f prevents presenting it as current observed capacity.","sourceIds":["impact","report"]},{"name":"f","value":0.8,"unit":"current reach transfer fraction","basis":"judgment","rationale":"Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude.","sourceIds":["programs","clinical","heal"]},{"name":"z","value":0.6,"unit":"higher-risk cohort fraction","basis":"judgment","rationale":"Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned 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resources increase cost 25%","costUSD":6584336.25,"allPopulationQalys":3.9897701715322205,"editionQalys":3.909974768101576,"pricePer10Qalys":16839843.325119246,"assumptions":"{\"C\":6584336.25,\"N\":2816,\"f\":0.8,\"z\":0.6,\"delta\":0.003,\"a\":0.5,\"b\":0.25,\"u\":0.7,\"m\":0.08,\"T\":10,\"p\":0.15,\"v\":0.05,\"g\":0.98,\"h\":0,\"d\":0.03}"},{"id":"referral-cost","label":"Additional medication and referral resources","costUSD":5830669,"allPopulationQalys":3.9897701715322205,"editionQalys":3.909974768101576,"pricePer10Qalys":14912293.16252336,"assumptions":"{\"C\":5830669,\"N\":2816,\"f\":0.8,\"z\":0.6,\"delta\":0.003,\"a\":0.5,\"b\":0.25,\"u\":0.7,\"m\":0.08,\"T\":10,\"p\":0.15,\"v\":0.05,\"g\":0.98,\"h\":0,\"d\":0.03}"}],"missingInputs":["Current unique participants and NYC-MSA residence distribution.","Buprenorphine enrollment, duration, discontinuation and alternative-provider substitution.","Incremental overdose mortality, infection outcomes and sustained clinical utility relative to comparable participants.","Unrestricted gift allocation, public renewal commitments and external medication/volunteer costs."],"sensitivity":["Small clinical effect and substantial substitution: 1542063818 USD per 10 MSA QALYs.","Stronger sustained clinical engagement: 756892 USD per 10 MSA QALYs.","Complete funding substitution: no finite positive-benefit price.","No clinical benefit and one net QALY lost: no finite positive-benefit price.","Unrecognized resources increase cost 25%: 16839843 USD per 10 MSA QALYs.","Additional medication and referral resources: 14912293 USD per 10 MSA QALYs."]},"sources":[{"id":"return2023","title":"FY2023 original IRS990","publisher":"St. Ann's Corner / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202421369349307717/IRS990","published":null,"retrieved":"2026-09-14"},{"id":"schedule2023","title":"FY2023 original IRS990ScheduleD","publisher":"St. Ann's Corner / 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implementation randomized trial","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa2401177","publisher":"HEALing Communities investigators / NEJM","published":"2024-06-16","retrieved":"2026-09-14"},{"id":"donate","title":"Ordinary donation route","url":"https://www.sachr.org/donate","publisher":"St. Ann's Corner","published":null,"retrieved":"2026-09-14"},{"id":"nyc-naloxone","title":"Public naloxone and program supply routes","publisher":"NYC Health","url":"https://www.nyc.gov/site/doh/health/health-topics/naloxone.page","published":null,"retrieved":"2026-09-14"},{"id":"nyc-mail","title":"May 2026 free naloxone mail campaign","publisher":"NYC Health","url":"https://www.nyc.gov/site/doh/about/press/pr2026/free-naloxone-by-mail-campaign.page","published":null,"retrieved":"2026-09-14"},{"id":"outreach-current","title":"Current South Bronx outreach scope","publisher":"SACHR","url":"https://www.sachr.org/outreach","published":null,"retrieved":"2026-09-14"}]}