{"edition":"usa","organization":"Green & Healthy Homes Initiative","organizationId":"org:green-and-healthy-homes-initiative","boundaryVersion":"USA-50-states-DC-v1","updated":"2026-09-14","model":{"version":"usa-ghhi-alpha-v1-judgment-20260914","costScope":"Full charitable recipient support; 2022–24 standalone expense series. Latest consolidated 2025 accounts disclosed separately. Conditional c includes allocated delivery/administration costs, f includes the ordinary-support portfolio share; partner repair costs must be added or explicitly attributed, not treated as free.","geographicAttribution":"USA-50-states-DC-v 1 residents. Operations are predominantly domestic; g=.99 is a judgment for this narrow direct-service probe, not an observed health-weighted share. Global climate spillovers excluded.","formula":"Q_USA=(G*b*f/c)*[s*e*(d1+d2/1.03)*u/365-h]*g + G*theta_other; G=10000 computational normalization only. d1=.81*365/14; d2=.59*365/14. theta_other is net USA QALYs per unrestricted dollar from non-overlapping remaining pathways. Cost per 10=10G/Q_USA when positive.","counterfactual":"b measures additional service spending rather than reserves or replacement funding; s is the fraction of asthma benefit absent without GHHI after landlord, public, insurer and other-provider alternatives. Both are currently judgmental rather than observed. h is incremental disruption or harm relative to the actual alternative. A different, less-disruptive option can deliver equivalent benefit while the extra repair adds harm; identical replacement repairs cancel shared burdens.","attribution":"f isolates completed asthma remediation from lead, energy, grants, education and policy. e discounts trial transport, adherence and delivery differences. Do not credit public grant face value, partner-financed activity or coalition outcomes in full.","uncertainty":"We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless. Zero and adverse outcomes remain possible; the quantified pathway is not a complete portfolio valuation.","nativeOutcomes":"Completed and sustained hazard remediations; child symptom-free days; serious falls/injuries; measured exposure changes. Visits, homes, members, grants and dollars saved are not QALYs.","inputs":[{"name":"G","value":10000,"unit":"USD normalization","basis":"judgment","rationale":"Arithmetic disclosure, not suggested gift size.","sourceIds":[]},{"name":"C2024","value":17630687,"unit":"USD recipient annual expense","basis":"observed","rationale":"Part IX total; all recipient functions retained.","sourceIds":["ghhi-tax24"]},{"name":"c","value":8000,"unit":"USD per completed asthma intervention","basis":"judgment","rationale":"Illustrative full delivery/allocated support cost; not derived by dividing mixed services or old trial costs.","sourceIds":["ghhi-tax24","kattan-cost"]},{"name":"b","value":0.5,"unit":"fraction","basis":"judgment","rationale":"Additional spending after funding substitution/reserves; unresolved.","sourceIds":["ghhi-tax24","ghhi-audit25"]},{"name":"f","value":0.2,"unit":"fraction","basis":"judgment","rationale":"Share of ordinary marginal support reaching completed asthma work; unresolved.","sourceIds":["ghhi-tax24","ghhi-audit25"]},{"name":"s","value":0.7,"unit":"fraction","basis":"judgment","rationale":"Health gain not supplied by household/public/insurance alternatives.","sourceIds":["ghhi-tax24","ghhi-audit25"]},{"name":"e","value":0.75,"unit":"fraction","basis":"judgment","rationale":"Transport differences from the trial's delivered intervention and population only; randomized symptom differences already include trial-level nonadherence, which must not be discounted again.","sourceIds":["morgan-asthma"]},{"name":"u","value":0.1,"unit":"utility difference on symptom day","basis":"judgment","rationale":"Generic utility loss per symptomatic day; not measured by the trial.","sourceIds":["morgan-asthma"]},{"name":"h","value":0.0005,"unit":"QALYs harm per completed intervention","basis":"judgment","rationale":"Incremental temporary disruption, unsafe repair and downside relative to actual alternative care; not observed incidence. Shared burden cancels under identical repairs.","sourceIds":["ghhi-tax24","ghhi-audit25"]},{"name":"g","value":0.99,"unit":"fraction","basis":"judgment","rationale":"Domestic health share for the narrow probe, not location-count ratio.","sourceIds":["ghhi-tax24","ghhi-audit25"]},{"name":"d1","value":21.117857142857144,"unit":"symptom days avoided first year","basis":"observed","rationale":"Annualization of randomized 0.81/14-day difference; assumes measured intervals represent the year.","sourceIds":["morgan-asthma"]},{"name":"d2","value":15.382142857142856,"unit":"symptom days avoided second year","basis":"observed","rationale":"Annualization of randomized 0.59/14-day difference; discounted 3% in model.","sourceIds":["morgan-asthma"]},{"name":"theta_other","value":0,"unit":"net USA QALYs per unrestricted USD","basis":"judgment","rationale":"We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless.","sourceIds":[]}],"scenarios":[{"id":"central","label":"Best estimate — explicit judgment","costUSD":10000,"allPopulationQalys":0.0005856947815533981,"editionQalys":0.000579837833737864,"assumptions":"{\"c\":8000,\"b\":0.5,\"f\":0.2,\"s\":0.7,\"e\":0.75,\"u\":0.1,\"h\":0.0005,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value. We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless."},{"id":"conditional-asthma","label":"Conditional asthma symptom pathway","costUSD":10000,"allPopulationQalys":0.0005856947815533981,"editionQalys":0.000579837833737864,"assumptions":"{\"c\":8000,\"b\":0.5,\"f\":0.2,\"s\":0.7,\"e\":0.75,\"u\":0.1,\"h\":0.0005,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value."},{"id":"favorable-asthma","label":"Favorable asthma assumptions, not a bound","costUSD":10000,"allPopulationQalys":0.028446490984743417,"editionQalys":0.02816202607489598,"assumptions":"{\"c\":3000,\"b\":0.8,\"f\":0.6,\"s\":0.9,\"e\":1,\"u\":0.2,\"h\":0,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value."},{"id":"poor-asthma","label":"Poor implementation and adverse net health","costUSD":10000,"allPopulationQalys":-0.0000018826716366158114,"editionQalys":-0.0000018638449202496532,"assumptions":"{\"c\":20000,\"b\":0.1,\"f\":0.05,\"s\":0.2,\"e\":0.25,\"u\":0.05,\"h\":0.001,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value."},{"id":"no-expansion","label":"No additional work","costUSD":10000,"allPopulationQalys":0,"editionQalys":0,"assumptions":"{\"c\":8000,\"b\":0,\"f\":0.2,\"s\":0.7,\"e\":0.75,\"u\":0.1,\"h\":0.0005,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value."},{"id":"equivalent-alternative","label":"Equivalent benefit available otherwise; retain harm","costUSD":10000,"allPopulationQalys":-0.0000625,"editionQalys":-0.000061875,"assumptions":"{\"c\":8000,\"b\":0.5,\"f\":0.2,\"s\":0,\"e\":0.75,\"u\":0.1,\"h\":0.0005,\"g\":0.99,\"d1\":21.117857142857144,\"d2\":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value. Equivalent symptom benefit comes from a different, less-disruptive alternative; this extra repair adds burden. Identical replacement repairs instead have incremental h=0."}],"sensitivity":["Conditional net asthma gain is 0.0046856 QALY per completed intervention. At b=.5, f=.2, c=$8,000 and g=.99, reaching $1 m per 10 requires 0.8081 QALY per intervention; $100 k requires 8.0808. These are ~172 and ~1,725 times the symptom-only probe.","Holding narrow probe fixed, theta_other must add 0.0000099420 USA QALY/USD to reach $1 m per 10, or 0.0000999420 for $100 k per 10. This is an explicit missing portfolio yield, not a claim it exists.","At the $17.63 m annual recipient cost scale, the $1 m threshold needs about 176.31 net USA QALYs per year and the $100 k threshold about 1,763.07, before any marginal scaling assumption.","Public-funding leverage could improve the donor ratio but requires evidence of additional appropriations or completed repairs, donor causal share and added public resource costs; crowd-out can instead reduce b toward zero.","Do not add avoided hospital bills to QALYs, convert IQ into health without a defensible mapping, or count fall-rate reduction as equivalent mortality reduction."],"missingInputs":["Current recipient-only financial reconciliation excluding subsidiary and 501(c)(4) spending.","Next-dollar allocation to each program; committed grant coverage; unrestricted gap and contractor/referral bottlenecks.","Completed unique asthma households with all payer costs, severity, sustained repairs and credible comparison care.","Lead exposure reductions by age and baseline level, causal health rather than earnings/IQ bridge, duration and double counting.","Serious injury outcome data and attributable implementation in the 461-member payer pilot; results beyond a before-after ROI forecast.","Environmental subaward and policy portfolio implementation probabilities, causal health exposure changes, geographic health shares and marginal GHHI attribution."]},"sources":[{"id":"ghhi-tax24","title":"2024 Form 990, Parts III, VIII, IX and X","publisher":"Green & Healthy Homes Initiative / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202543189349314709/IRS990","published":"2025-11-14","retrieved":"2026-09-13"},{"id":"ghhi-tax23","title":"2023 Form 990","publisher":"Green & Healthy Homes Initiative / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202443139349304109/IRS990","published":"2024-11-08","retrieved":"2026-09-13"},{"id":"ghhi-tax22","title":"2022 Form 990","publisher":"Green & Healthy Homes Initiative / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202323199349321857/IRS990","published":"2023-11-15","retrieved":"2026-09-13"},{"id":"ghhi-audit25","title":"2025 consolidated financial statements and federal audit","publisher":"Mitchell Titus / Green & Healthy Homes Initiative","url":"https://projects.propublica.org/nonprofits/display_audit/2025-12-GSAFAC-0000426133","published":"2026-08-12","retrieved":"2026-09-13"},{"id":"ghhi-audit24","title":"2024 consolidated financial statements","publisher":"Mitchell Titus / Green & Healthy Homes Initiative","url":"https://projects.propublica.org/nonprofits/display_audit/2024-12-GSAFAC-0000378589","published":null,"retrieved":"2026-09-13"},{"id":"ghhi-direct","title":"Maryland direct services","publisher":"Green & Healthy Homes Initiative","url":"https://www.greenandhealthyhomes.org/services/maryland-direct-services/","published":null,"retrieved":"2026-09-13"},{"id":"ghhi-thriving","title":"Thriving Communities grantmaking program","publisher":"Green & Healthy Homes Initiative","url":"https://www.greenandhealthyhomes.org/thrivingcommunities/","published":null,"retrieved":"2026-09-13"},{"id":"ghhi-study","title":"Integrated housing intervention, Baltimore before-after study","publisher":"Norton and Brown / Environmental Justice","url":"https://www.greenandhealthyhomes.org/wp-content/uploads/GHHI-Improving-Health-Economic-and-Social-Outcomes-through-Integrated-Housing-Intervention-Environmental-Justice.pdf","published":null,"retrieved":"2026-09-13"},{"id":"morgan-asthma","title":"Results of a home-based environmental intervention among urban children with asthma","publisher":"Morgan et al. / New England Journal of Medicine","url":"https://pubmed.ncbi.nlm.nih.gov/15356304/","published":"2004-09-09","retrieved":"2026-09-13"},{"id":"kattan-cost","title":"Cost-effectiveness of a home-based environmental intervention","publisher":"Kattan et al. / Journal of Allergy and Clinical Immunology","url":"https://pubmed.ncbi.nlm.nih.gov/16275376/","published":"2005-10-03","retrieved":"2026-09-13"},{"id":"braun-lead","title":"Residential lead-hazard intervention randomized trial","publisher":"Braun et al. / JAMA Pediatrics","url":"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2696978","published":null,"retrieved":"2026-09-13"},{"id":"stark-falls","title":"Home hazard removal randomized trial","publisher":"Stark et al. / JAMA Network Open","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC8408671/","published":"2021-08-31","retrieved":"2026-09-13"},{"id":"bcbs-falls","title":"Blue Cross NC and GHHI fall-prevention pilot","publisher":"Blue Cross NC","url":"https://mediacenter.bcbsnc.com/news/blue-cross-nc-and-green-healthy-homes-initiative-team-up-to-reduce-home-injuries-for-leading-cause-of-er-visits-this-fall-season","published":null,"retrieved":"2026-09-13"},{"id":"ghhi-donate","title":"Official donation page","publisher":"Green & Healthy Homes Initiative","url":"https://www.greenandhealthyhomes.org/donate/","published":null,"retrieved":"2026-09-14"}]}