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National Center for Healthy Housing

Healthy-housing research, policy and community implementation

Research time: ~20 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? NCHH researches how housing affects health and helps public agencies and community organizations put effective interventions into practice. Its portfolio includes asthma services, lead prevention, indoor air quality, home safety and policy advocacy. A finite judgment estimate prices asthma-service implementation enabled by technical assistance, charging full recipient costs and leaving other housing-health benefits unpriced.

Why we’re interested in this organization:

  • The underlying mechanisms are concrete: fewer asthma symptoms, safer homes and improved daily functioning, with randomized evidence for some interventions.

  • Research, technical assistance and advocacy can help public systems implement services at a scale beyond the charity's own budget.

  • Current financial disclosures distinguish the nonprofit from its commercial subsidiary, allowing a recipient-specific spending baseline.

Our main reservations:

  • The missing link is how much additional implementation an unrestricted gift causes; published technical-assistance and advocacy counts do not identify that counterfactual.

  • Effects differ by intervention and baseline housing risk, and not every reduction in environmental exposure has demonstrated a clinical or QALY benefit.

  • Public funding, partner effort, territorial reach and overlapping programs complicate attribution; a verified marginal funding opportunity was not found.

What do you get for your dollar? $95.2M per better life: ten additional quality-adjusted life years in USA. Judgment-based partial-health. Asthma implementation enabled by technical assistance; full recipient GAAP cost, other housing-health pathways unpriced..

20prospective opportunities*.15implementation change*50completed child-courses*.5funding response*.7nonreplacement=52.5 additional effective child-course-years before geography. Clinical transfer and timing are applied separately; trial symptom days are not automatically QALYs.

1. What do they do?

NCHH's 2026–2030 framework describes research, policy, community assistance and field development. This is an intermediary with several possible routes to better health. A new grant may finance staff time, research, tools, coaching, regranting or organizational capacity. The current asthma platform addresses reimbursement, workforce, referral systems and implementation, not just education for individual patients.

2. Monitoring and information sharing

NCHH's 2024 technical-assistance update reports approximately 78 partners across two initiatives, over $85,000 in mini-grants and scholarships, and renewed three-year EPA agreements. These are useful implementation outputs, jointly produced with RAMP; they are not 78 independently attributable health successes. Its impact sheet reports cumulative reach, including coalition members in Puerto Rico and Guam. It supplies no resident-weighted 50-states-plus-DC marginal allocation. I found no portfolio dashboard linking an additional unrestricted dollar to additional completed services and measured health.

3. Qualitative assessment

The most persuasive case is that skilled assistance can remove a financing or implementation bottleneck for an already effective service. A randomized King County childhood-asthma study found 2.10 additional symptom-free days per fortnight at follow-up and $707.04 incremental intervention cost in 2012 dollars; it tested a delivered home-visit program, not NCHH fundraising. NCHH's own CAPABLE evaluation found improved daily functioning, but site results varied and medical spending fell more in controls. A lead-hazard randomized trial reduced dust lead while overall blood-lead and most neurobehavioral changes were not significant. Thus a general 'healthy home' is not a uniform health unit. My best judgment gives this technical-assistance asthma pathway a finite expected health estimate, while recognizing that implementation and utility parameters—not financial arithmetic—dominate uncertainty. It is not a complete portfolio ranking.

4. What do you get for your dollar?

Recipient expenses in the FY2025 audit's consolidating schedule were $2,593,580: $2,353,962 program, $170,879 administration and $68,739 fundraising. A proportional $1,000 allocation is approximately $908/$66/$26, an accounting illustration rather than a marginal spending promise. These GAAP figures include donated services; the FY2024 audit and FY2024 Form 990 differ by $83,374 for that reason. We use a consistent recipient-only GAAP series, not consolidated subsidiary spending.

The CAPABLE demonstration reported $2,642 average intervention cost per client, with six occupational-therapy and four nursing visits at the median. This historical delivery cost is not a current NCHH price and does not include all research costs. No defensible homes-per-gift figure is available.

To meet $100,000 per better life, each dollar must generate 0.0001 additional USA QALYs; the $1 million threshold requires 0.00001. As an illustrative asthma bridge, maintaining the trial's 2.1/14 symptom-day improvement for a full year and assigning 0.05–0.20 utility to each recovered symptom-day gives 0.0075–0.030 QALYs per additional child-year. Those utility assumptions are judgments, not trial measurements. At those thresholds, additional attributable implementation would need to cost about $75–$300 or $750–$3,000 per effective USA child-year respectively. These prices concern NCHH's enabling contribution; downstream service delivery is a separate cost. This is a testable hurdle, not our forecast; downstream delivery funding is additional resource use.

The judgment central yields 0.272376 USA QALYs per $2,593,580 of full recipient GAAP spending, approximately $95.22 million per 10. It assumes20 annual asthma opportunities, .15 additional implementation probability,50 completed child-courses per success, .5 funding response and .7nonreplacement. These choices are modest-scale priors relative to a multi-year78-partner platform, not observed conversions. Half the trial clinical effect, three-quarter-year timing and .1symptom-day utility connect those services to finite health. The model charges all recipient research, advocacy and support cost; other pathway health is omitted. Downstream delivery is additional societal resource use: at the historical $707.04 per child-course alone, 52.5 additional course-years would imply about $37,120 before current-price adjustment. That historical benchmark is not a current price quote.

Model, assumptions and sensitivity

Ordinary unrestricted gift to NCHH nonprofit, including its full program and support portfolio. Annual comparison uses recipient-only GAAP expenses inclusive of donated services, excluding separate subsidiary spending. A societal model must additionally disclose implementation costs borne by public agencies, insurers, landlords and partners.

50 states plus DC only. National research and coalition reach is observed; Puerto Rico/Guam and international collaborators are explicitly outside this edition. Marginal resident-weighted share is unknown, not inferred from headquarters or population.

C=2593580 annual full recipient GAAP cost. Y=K*dp*N*b*s; Qall=Y*(delta/14)*e*w*u/1.03; QUSA=Qall*g. K annual asthma implementation opportunities, dp net probability change attributable to NCHH rather than partners, N completed child-courses per successful implementation, b funding responsiveness, s no equivalent replacement, e clinical transport, w within-year retained timing, u recovered symptom-day utility. One year only; no extra mortality/hospital or recurring cohort credit.

Illustrative gift G
100000 USD (judgment). Comparison scale only; not a restricted opportunity or minimum gift.
FY2025 recipient expense
2593580 USD/year (observed). NCHH column, consolidating statement, fiscal year ended September 30; full GAAP cost including in-kind. [nchh-audit25]
Asthma trial symptom-free-day increment
2.1 days/14 days (observed). Randomized delivered intervention benchmark; not NCHH organizational effect. [asthma-rct]
Asthma trial additional delivery cost
707.04 2012 USD/participant (observed). Historical intervention increment; excludes research/development and must not substitute for NCHH gift cost. [asthma-rct]
Recovered symptom-day utility range
[0.05,0.2] utility difference (judgment). Illustrative sensitivity only; symptom-free status is not a directly measured preference-weighted utility. Not measured trial utility; the central uses the separate explicit 0.10 judgment.
Asthma benefit duration for hurdle calculation
1 year (judgment). Assumes full-year persistence of follow-up difference; requires validation, not a measured area under curve. [asthma-rct]
K
20 see formula (judgment). 20annual asthma-focused opportunities is a planning judgment smaller than78reported partners across two initiatives and multiple years;78is not annual independently attributable success. [nchh-ta] [asthma-rct]
dp
0.15 see formula (judgment). .15additional implementation probability attributable to NCHH after RAMP/government/other assistance; not measured. [nchh-ta] [asthma-rct]
N
50 see formula (judgment). 50completed child-courses per successful local implementation is modest clinic-scale planning, not observed TA volume. [nchh-ta] [asthma-rct]
b
0.5 see formula (judgment). .5funding response after restricted grants and other donations; not a funded pipeline. [nchh-ta] [asthma-rct]
s
0.7 see formula (judgment). .7fraction not replaced by equivalent public or insurer services; technical assistance may enable existing budgets. [nchh-ta] [asthma-rct]
e
0.5 see formula (judgment). Half the trial symptom effect for differences in local delivery and case mix; not another trial adherence adjustment. [nchh-ta] [asthma-rct]
w
0.75 see formula (judgment). .75average retained benefit within the first year, then zero. [nchh-ta] [asthma-rct]
u
0.1 see formula (judgment). .1utility improvement on an avoided symptom day; explicit preference prior, not measured trial utility. [nchh-ta] [asthma-rct]
g
0.95 see formula (judgment). .95benefit within50states+DC; territorial activity excluded, no headquarters shortcut. [nchh-ta] [asthma-rct]
delta
2.1 see formula (observed). External randomized2.1additional symptom-free days per fortnight; not organizational causal yield. [nchh-ta] [asthma-rct]

Best estimate — explicit partial-health judgment: Cost: $2.6M; USA QALYs: 0.2723756067961165; all-population QALYs: 0.2867111650485437. {"K":20,"dp":0.15,"N":50,"b":0.5,"s":0.7,"e":0.5,"w":0.75,"u":0.1,"g":0.95,"delta":2.1}. Finite prospective judgment, not observed throughput or confidence limits.

Weak joint judgment stress: Cost: $2.6M; USA QALYs: 0.00007372572815533982; all-population QALYs: 0.00008191747572815535. {"K":5,"dp":0.03,"N":20,"b":0.1,"s":0.3,"e":0.25,"w":0.5,"u":0.05,"g":0.9,"delta":2.1}. Finite prospective judgment, not observed throughput or confidence limits.

Favorable joint judgment stress: Cost: $2.6M; USA QALYs: 21.02067961165049; all-population QALYs: 21.233009708737868. {"K":40,"dp":0.3,"N":100,"b":0.75,"s":0.9,"e":0.9,"w":1,"u":0.2,"g":0.99,"delta":2.1}. Finite prospective judgment, not observed throughput or confidence limits.

No additional net health: Cost: $2.6M; USA QALYs: 0; all-population QALYs: 0. No incremental implementation or no clinical benefit; no incremental harm.

Illustrative net health loss: Cost: $2.6M; USA QALYs: -1; all-population QALYs: -1. One net USA QALY lost through disruption, displaced care or adverse substitution; stress test, not an observed estimate.

Remaining portfolio health unpriced: Cost: $2.6M; USA QALYs: unknown; all-population QALYs: unknown. Other non-overlapping pathways could add or subtract health; no invented portfolio uplift.

Counterfactual: Without this gift, government contracts, other nonprofits, coalition members and payers continue working. Count only earlier or additional implemented services, not the total size of a restored appropriation or everyone served by a partner. Flexible gifts may replace other unrestricted funds or protect reserves; neither is automatically zero impact, but timing and additionality must be specified.

Attribution: The most uncertain variables are the gift's allocation and its causal effect on implementation. RAMP, local health departments, clinicians, landlords, other advocates and governments share production. Do not add asthma, falls and lead benefits for the same person without checking overlapping quality-of-life losses; do not add medical savings as QALYs.

Implementation volume and additionality are explicitly judgmental; the source establishes a TA platform, not these yields. A finite partial-health central is useful despite weak parameters. All remaining lead, falls, policy and indoor-air effects are unpriced, not zero-valued.

Sensitivity

  • At G=$100,000, T=$100,000 per 10 requires 10 USA QALYs; T=$1,000,000 per 10 requires 1. With q=0.0075–0.030 per effective child-year, required additional USA child-years are 333–1,333 or 33–133 respectively.
  • If an apparent gross service increase is only 10% attributable after coalition contribution/substitution, the necessary gross child-years are 10 times larger. If USA share is 90%, required all-population benefit is 11.1% larger; 90% is a diagnostic assumption, not observed allocation.
  • At the FY2025 full recipient budget, thresholds are 259.358 and 25.9358 USA QALYs annually. This is an institutional annual-benefit hurdle, not an estimate of marginal-gift productivity.
  • A fivefold change in persistent benefit or implementation yield changes the modeled price fivefold; zero net implementation gives no finite favorable price. Full societal costs rise when public downstream expenditures are counted.
  • Lead-related earnings or IQ cannot be monetized and silently relabeled QALYs. CAPABLE ADL gains require a validated utility and duration bridge; national policy gains require implementation and displacement evidence.

Unresolved inputs

  • A current marginal unrestricted-funding plan separating research, coaching/regranting, advocacy and support, with costs and funded versus unfunded capacity.
  • Number and size of implementations caused or accelerated by incremental NCHH assistance versus no gift, including unsuccessful attempts and partner contributions.
  • For each implemented service: actual treatment completion, baseline risk, causal health effect, preference-based utility, duration and attrition.
  • Recipient-residence allocation excluding territories and non-USA spillovers, plus overlap between pathways.
  • Public/private replacement, displaced services and additional implementation costs; a completed policy win is insufficient evidence of future gift effect.

5. Funding and previous grants

The Healthy Housing Transformation Fund provides an ordinary online donation route and describes flexible community support. It does not publish a costed unfunded queue or an asthma-only restriction. The FY2025 audited recipient schedule shows a $288,029 decline in net assets. That is not a cash-flow measure or proof of an unfunded expansion opportunity; current unrestricted balances and a marginal spending plan remain necessary.

NCHH reports that New York restored approximately $1.45 million annually for Healthy Neighborhoods in 2026. Several advocates and officials contributed. A new gift cannot claim a completed restoration, all government spending, or all beneficiaries; a prospective model needs the probability that its work changes a future decision and whether services would otherwise be replaced by Medicaid or local funding.

Annual expenses

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

  • FY 2023: $2.8M; National Center for Healthy Housing, Inc. (recipient only), 12-month period, US GAAP recipient column of audited consolidating schedule; includes donated services. Source
  • FY 2024: $3.5M; National Center for Healthy Housing, Inc. (recipient only), 12-month period, US GAAP recipient column of audited consolidating schedule; includes donated services. Source
  • FY 2025: $2.6M; National Center for Healthy Housing, Inc. (recipient only), 12-month period, US GAAP recipient column of audited consolidating schedule; includes donated services. Source

6. Sources

  1. NCHH Strategic Framework 2026–2030. NCHH. Published: not stated; retrieved: 2026-09-13.
  2. Building Systems to Sustain Home-Based Asthma Services. NCHH. Published: 2026-05-05; retrieved: 2026-09-13.
  3. Technical Assistance to Improve Indoor Air Quality. NCHH. Published: 2024-10-17; retrieved: 2026-09-13.
  4. Our Impact fact sheet. NCHH. Published: not stated; retrieved: 2026-09-13.
  5. Financial statements FY2025 and 2024: recipient schedule p20, notes pp14,17. NCHH / Grandizio, Wilkins, Little & Matthews LLP. Published: 2026-05-26; retrieved: 2026-09-13.
  6. Financial statements FY2024 and 2023: recipient schedule p31. NCHH / Grandizio, Wilkins, Little & Matthews LLP. Published: 2025-02-17; retrieved: 2026-09-13.
  7. NCHH FY2024 Form 990, tax year 2023. NCHH / IRS. Published: not stated; retrieved: 2026-09-13.
  8. Community Health Worker Home Visits for Medicaid-Enrolled Children With Asthma: Effects on Asthma Outcomes and Costs. Campbell et al., American Journal of Public Health / PMC. Published: 2015-08-13; retrieved: 2026-09-13.
  9. Aging Gracefully in Place: Evaluation of the CAPABLE Approach. NCHH / HUD. Published: 2020-05-18; retrieved: 2026-09-13.
  10. Effect of Residential Lead-Hazard Interventions on Childhood Blood Lead Concentrations and Neurobehavioral Outcomes. Braun et al., JAMA Pediatrics / PMC. Published: 2018-08-27; retrieved: 2026-09-13.
  11. Healthy Housing Transformation Fund. NCHH. Published: 2024-08-05; retrieved: 2026-09-13.
  12. Saved: New York State's Healthy Neighborhoods Program. NCHH. Published: 2026-06-09; retrieved: 2026-09-13.