GiveBetter x New York City

St. Ann's Corner of Harm Reduction

Whole recipient; integrated drug-user health-hub scenario

Research time: 4 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

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Summary

What do they do? St. Ann's Corner operates a South Bronx health hub combining overdose prevention, sterile supplies, buprenorphine access and ongoing care coordination. Behavioral care, food, hygiene and outreach support the same vulnerable participants rather than forming independent pools of health gains. The estimate prices a conditional integrated clinical effect with the whole recipient's cost and explicitly uncertain current reach and additionality.

Why we’re interested in this organization:

  • The principal health pathways address high-risk drug use and barriers to treatment.

  • Original filings allow full operating and event-cost reconciliation.

  • A unique-person survival model avoids counting every repeat overdose rescue as another lifetime saved.

Our main reservations:

  • No current retained-treatment cohort or causal organization outcome is reported.

  • The integrated mortality and morbidity effects are subjective, not measured local rates.

  • Public grants and alternative services could substantially replace ordinary donations.

What do you get for your dollar? $13.5M per better life: ten additional quality-adjusted life years in New York City. Whole-recipient cost for a judgment-based integrated clinical health-hub pathway among MSA residents. Not measured portfolio return: long-term HIV/HCV transmission and non-health benefits are unpriced; external medication, public-stock and volunteer resources are incompletely valued..

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.

1. What do they do?

The charitable recipient is St. Ann's Corner of Harm Reduction Inc., EIN 13-3724008. Its current portfolio includes naloxone, buprenorphine services, syringe access, HIV/HCV testing and linkage, Ryan White support, behavioral care, outreach, food and hygiene. These are connected services for overlapping people, not additive client cohorts. Programs

2. Monitoring and information sharing

The annual-impact page reports 2,816 unique participants alongside a linked 2023 report. The original image-only report was inspected: it presents roughly 2,800 participants, 851,689 services and 2,648 medical services, not 2,648 treatment successes. The report's abbreviated financial overview does not reconcile to the original annual return, so the latter supplies the cost denominator. No current buprenorphine retention, viral suppression, overdose follow-up or unique additional-patient series was found. A current-scale factor explicitly discounts the older reach count. Impact page Original report Current outreach information continues to list South Bronx wound care, HIV/HCV testing and treatment, supplies and referrals. This supports operational continuity, not a claim of current retained-treatment volume.

3. Qualitative assessment

The most plausible material health mechanism is the combined health hub: timely overdose reversal plus engagement in effective treatment and ongoing care. Buprenorphine cohort evidence shows lower mortality during treatment, but confounding, treatment cycling and the older drug environment limit transfer. The HEALing Communities randomized bundled implementation trial found a mortality rate ratio of 0.91 with a 95% confidence interval of 0.76–1.09; a service package is not guaranteed to lower mortality. Clinical evidence Contemporary counterevidence

The central scenario therefore uses one modest combined mortality-hazard reduction for higher-risk participants, not separate additive deaths from naloxone, buprenorphine and care coordination. A small one-year utility improvement represents the remaining clinical and stabilization work among the same participants. It is not evidence that acupuncture or every social activity improves health. Long-term infection transmission, income, dignity and policy benefits remain unpriced; these omissions are explicit, but the model is not restricted to a tiny convenient program.

4. What do you get for your dollar?

The conditional integrated health-hub price is approximately $13.47 million per 10 MSA QALYs, not a measured total portfolio return.

The model charges the entire recipient's latest gross operating cost. Older unique reach is transferred at 80%; 60% of that cohort is assumed to face relevant drug-use mortality risk. The combined clinical package is assumed to reduce that subgroup's annual mortality hazard by 0.003 for one year, before a 50% alternative-service adjustment and 25% ordinary funding response. These are explicit judgment inputs, not observed SACHR treatment rates. All survivors revert to the same competing mortality hazard after the service year; additional survival is capped at ten years. A 15% chance of a 0.05 utility improvement for one year represents the broader clinical and stabilization pathway, without assigning it another mortality benefit.

The model uses whole-recipient resources, including public and donated resources, and is not a prediction of unrestricted cash leverage. Positive alternatives are broad; zero replacement and a net-harm case are retained. A 25% resource-cost stress and an added $2,000 per funding-attributable participant test unmeasured volunteer, medication and referral resources. The 98% local share is a residence prior based on Bronx/neighboring-borough service, not a verified address count.

Native bridge: at the annual normalization there are 281.6 modeled additional integrated-engagement equivalents, including 168.96 higher-risk equivalents, not that many documented treatment completions. Whole-recipient cost is approximately $18,706 per additional engagement and $19,087 per local engagement. The 0.08 annual mortality input is a continuous hazard (about 7.7% one-year risk), not an observed SACHR mortality rate. It is also applied to the lower-risk utility cohort for simplicity; differentiated mortality and observed retention are missing. The adverse allowance h is already a net, funding-attributable QALY loss on this normalization, not an unadjusted population harm to multiply again.

Model, assumptions and sensitivity

All recipient gross annual operating expense, including recognized noncash and separately netted events; external medical and volunteer resource sensitivities retained.

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.

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.

C
5267469 USD annual gross resources (observed). Latest original full-recipient cost plus event addback. [return2025] [schedule2025]
N
2816 older unique participants (observed). Older annual-impact unique-person count; f prevents presenting it as current observed capacity. [impact] [report]
f
0.8 current reach transfer fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
z
0.6 higher-risk cohort fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
delta
0.003 one-year combined mortality-hazard reduction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
a
0.5 service additionality fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
b
0.25 funding-response fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
u
0.7 baseline health utility (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
m
0.08 annual competing mortality hazard (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
T
10 maximum survival years (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
p
0.15 clinical utility response fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
v
0.05 one-year utility gain among responders (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
g
0.98 MSA residence fraction (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
h
0 net adverse QALYs (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]
d
0.03 annual discount rate (judgment). Explicit prior, not a measured local rate; clinical evidence supports mechanism, not the assigned magnitude. [programs] [clinical] [heal]

Integrated health-hub conditional scenario: Cost: $5.3M; New York City QALYs: 3.909974768101576; all-population QALYs: 3.9897701715322205. {"C":5267469,"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}

Small clinical effect and substantial substitution: Cost: $5.3M; New York City QALYs: 0.03415856683028092; all-population QALYs: 0.03485568043906217. {"C":5267469,"N":2816,"f":0.5,"z":0.4,"delta":0.0005,"a":0.2,"b":0.1,"u":0.7,"m":0.08,"T":3,"p":0.05,"v":0.02,"g":0.98,"h":0,"d":0.03}

Stronger sustained clinical engagement: Cost: $5.3M; New York City QALYs: 69.59342501127992; all-population QALYs: 71.01369899110196. {"C":5267469,"N":2816,"f":1,"z":0.8,"delta":0.01,"a":0.75,"b":0.5,"u":0.7,"m":0.08,"T":15,"p":0.3,"v":0.1,"g":0.98,"h":0,"d":0.03}

Complete funding substitution: Cost: $5.3M; New York City QALYs: 0; all-population QALYs: 0. {"C":5267469,"N":2816,"f":0.8,"z":0.6,"delta":0.003,"a":0.5,"b":0,"u":0.7,"m":0.08,"T":10,"p":0.15,"v":0.05,"g":0.98,"h":0,"d":0.03}

No clinical benefit and one net QALY lost: Cost: $5.3M; New York City QALYs: -0.98; all-population QALYs: -1. {"C":5267469,"N":2816,"f":0.8,"z":0.6,"delta":0,"a":0.5,"b":0.25,"u":0.7,"m":0.08,"T":10,"p":0,"v":0.05,"g":0.98,"h":1,"d":0.03}

Unrecognized resources increase cost 25%: Cost: $6.6M; New York City QALYs: 3.909974768101576; all-population QALYs: 3.9897701715322205. {"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}

Additional medication and referral resources: Cost: $5.8M; New York City QALYs: 3.909974768101576; all-population QALYs: 3.9897701715322205. {"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}

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.

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.

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.

Unresolved inputs

  • 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.

5. Funding and previous grants

Original accrual returns give FY2023 gross expense $4,348,379 = Part IX $4,274,533 + $73,846 event costs; FY2024 $5,106,419 = $4,991,072 + $115,347; FY2025 $5,267,469 = $5,171,588 + $95,881. Schedule D reports audit expense equal to Part IX with no additional donated-service reconciliation. Noncash contributions of $94,661, $95,182 and $109,444 are not added again merely because they are noncash; any omitted volunteer or public-stock resource is tested separately. The reports do not provide a complete external-resource inventory. FY2025 original Reconciliation

FY2025 reports $4,469,690 government grants and $2,113,536 net assets without donor restrictions, after a $342,951 deficit. This supports attention to continuity, not an inference that each new dollar buys new treatment. Existing grants, free supplies, other harm-reduction providers and medical reimbursement remain in the counterfactual. Donate

FY2025 Part IX allocates $4,384,865 to programs, $602,749 to management and $183,974 to fundraising; $95,881 of separately netted event expense is additional. No program share is multiplied into the whole-recipient numerator. NYC publicly supplies naloxone and fentanyl strips to registered overdose-prevention programs, and its May 2026 campaign offers residents free mailed naloxone. Those existing routes strengthen the need to measure high-risk delivery and engagement beyond supplies alone; this review does not assume every distributed kit was purchased with a new gift. NYC supply routes Current mail program

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $4.3M; St. Ann's Corner of Harm Reduction Inc., EIN 13-3724008, 12-month period, Accrual Form 990 gross expense plus separately netted event cost; no additional Schedule D donated-service adjustment.. Source
  • FY 2024: $5.1M; St. Ann's Corner of Harm Reduction Inc., EIN 13-3724008, 12-month period, Accrual Form 990 gross expense plus separately netted event cost; no additional Schedule D donated-service adjustment.. Source
  • FY 2025: $5.3M; St. Ann's Corner of Harm Reduction Inc., EIN 13-3724008, 12-month period, Accrual Form 990 gross expense plus separately netted event cost; no additional Schedule D donated-service adjustment.. Source

6. Sources

  1. FY2023 original IRS990. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  2. FY2023 original IRS990ScheduleD. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  3. FY2024 original IRS990. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  4. FY2024 original IRS990ScheduleD. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  5. FY2025 original IRS990. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  6. FY2025 original IRS990ScheduleD. St. Ann's Corner / IRS. Published: not stated; retrieved: 2026-09-14.
  7. Current health-hub programs. St. Ann's Corner. Published: not stated; retrieved: 2026-09-14.
  8. Annual participant scale, linked to 2023 report. St. Ann's Corner. Published: not stated; retrieved: 2026-09-14.
  9. 2023 annual report; image-only original visually inspected. St. Ann's Corner. Published: not stated; retrieved: 2026-09-14.
  10. Mortality during and after opioid substitution treatment. Sordo et al. / BMJ. Published: 2017-04-26; retrieved: 2026-09-14.
  11. Community overdose-prevention implementation randomized trial. HEALing Communities investigators / NEJM. Published: 2024-06-16; retrieved: 2026-09-14.
  12. Ordinary donation route. St. Ann's Corner. Published: not stated; retrieved: 2026-09-14.
  13. Public naloxone and program supply routes. NYC Health. Published: not stated; retrieved: 2026-09-14.
  14. May 2026 free naloxone mail campaign. NYC Health. Published: not stated; retrieved: 2026-09-14.
  15. Current South Bronx outreach scope. SACHR. Published: not stated; retrieved: 2026-09-14.