GiveBetter x SF

MELP/AbleCloset

Free loans of reused durable medical equipment for adults and children

Research time: ~22 min on GPT-6 Astra Lite + ~17 min on GPT-6.1 Sol
  • Research — reviewed programs, finances and impact evidence.
  • Source audit — checked claims, assumptions and calculations.
  • Modeling — estimated costs, QALYs and uncertainty.

Updated: 2026-10-01.

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Summary

What do they do? MELP provides free reused medical equipment to people who need it. AbleCloset also lends specialized equipment for children. The service involves obtaining, repairing and matching equipment so that it can support mobility and daily care. More

We include MELP / AbleCloset among our top-ten research candidates because of its:

  • Practical reuse-and-loan service that can reduce the cost of accessing useful equipment.
  • Specialized pediatric equipment pathway as well as adult mobility and bathing aids.
  • Public planning documents, financial reporting and current pickup arrangements that make operations inspectable.

Our main reservations about MELP / AbleCloset are:

  • The modeled client denominator is inferred from a planning document, not an observed count of unique recipients.
  • Existing reserves and public support make additional cash-funded expansion uncertain.
  • Appropriate fit, sustained use and health gains have not been measured locally, and evidence for some equipment pathways is mixed.

What do you get for your dollar?

GiveBetter sees promise in reusing equipment to improve mobility and daily care without requiring every household to buy a new device. Our conditional central estimate is about $360K per DALY in the Bay Area, combining health-access gains and net household resource savings. Planned organization expense divided by inferred planning activity is about $49 per client-equivalent, not an observed additional-loan price. Source

For someone who otherwise lacks timely equivalent equipment, an adult mobility aid may improve walking and independence. The central clinical judgment is a 0.03 utility improvement over an incremental 0.125-year bridge, before adjustments for unmet access, safe use and donor additionality. Pediatric benefit is a separate weaker assumption; administrative loan length does not establish clinical exposure.

For a disjoint group who would buy or rent equivalent equipment anyway, the model credits one-off net savings rather than additional equipment-access health. It assumes $40/$25/$100/$20 of net savings across mobility, bathing, pediatric and supply needs. Per illustrative donor budget, 0.02 health years plus 0.00 income-equivalent years give 0.02745621 Bay-attributed combined years. These resource and clinical assumptions are not locally measured. More

What information has MELP / AbleCloset shared about its program?

The organization shares equipment activity, pickup information and planning targets, including a reported 3,874 items over a recent twelve-month period. Items are not unique clients, and planned activity is not completed service. A deduplicated record of equipment type, actual use and alternative access would help test the model. More

What is GiveBetter’s qualitative assessment of MELP / AbleCloset?

Reuse and specialized pediatric lending address concrete needs with modest cash expenditure per planning episode. Current operations and original financial returns make the service inspectable. Donor-triggered capacity, recipient alternatives and net savings still need verification before treating the modeled ratio as an actionable funding opportunity. More

1. What do they do?

MELP lends standard adult mobility and safety equipment; AbleCloset handles specialized pediatric equipment. Both are within EIN 27-1212734. Free loans are available from San Carlos and South San Francisco, without a residence restriction.

Receive and prepare equipment

Volunteers inspect, repair, clean and inventory donations; not every incoming item is usable locally.

Match a recipient

Inventory is first-come and users arrange pickup. Multiple items or visits need not mean multiple people.

Enable finite additional use

Only otherwise-unmet, sustained safe health-improving use is credited; utility losses are subtracted separately.

Scope of this review. The estimate uses the coherent 2025–26 organization plan: $169,269 and 960 district client-equivalents divided by a 28% district share. The alternative expense table is $166,269. Neither denominator is an actual unique annual census. No device-stock reuse multiplier is added.

2. Monitoring and information sharing

MELP/AbleCloset, EIN 27-1212734

Original self-filed 990-EZ returns. FY2024 expenses $104,000 and revenue $189,551; FY2023 expenses $63,199 and revenue $100,156. The third latest original located is FY2013, before the April 2023 merger.

Our assessment. These returns and current loan instructions support organizational activity, not a verified marginal donation opportunity. FY2013 is not a comparable third recent year, so a latest-three-year mean is unavailable.

Adult and pediatric borrowers

Current official loan instructions and public grant plans. Adult pickup is first-come, with returns when ready; there is no universal numeric adult loan term. Pediatric loans are generally six months with possible extensions, and therapist sizing and safety are required.

Our assessment. Administrative loan length is not incremental health exposure. Trials or bridges to a borrower’s own device may be useful even when duration is short. Items, visits and unique people are not interchangeable.

Older emergency-department patients, not MELP borrowers

Randomized walking-aid evidence. The 2025 trial reports mobility and fear-of-falling benefits. Its walking-aid-versus-control health VAS contrast is −1.17 (95% CI −7.34 to 4.99); the 5.24 contrast is telemonitoring-plus-aids versus aids, not versus control.

Our assessment. A 0–100 VAS is not a preference-weighted utility tariff. Neither uncontrolled improvement nor dividing the VAS by 100 identifies the loan’s QALYs. An older home-rollator COPD trial found no group quality-of-life difference; that does not prove every functional benefit is zero.

Older adults awaiting a major bathing adaptation

BATH-OUT-2 randomized expedited installed adaptations. The 2025 primary funder report’s expedited-versus-usual-wait analysis, excluding alternative participants, gives a 0.06 QALY difference (95% CI 0.032–0.082). Differential attrition and control-group catch-up complicate interpretation.

Our assessment. An installed level-access shower is not a portable chair loan. This supports plausibility of useful access, not our .02 utility coefficient or a direct imported effect size.

Potential equipment purchasers, not a measured MELP borrower sample

Commercial quotes and public coverage rules. A local retailer lists monthly rollator and standard-wheelchair rental prices of $89.99 and $124.99. Medicare Part B describes 20% coinsurance on the approved amount after the deductible for qualifying covered equipment.

Our assessment. Cash quotes are not Medicare allowances. Neither source measures MELP household savings; payer savings are not household income. Purchaser shares and net $40/$25/$100/$20 amounts remain explicit assumptions.

3. Qualitative assessment

Reuse can bridge a wait for mobility, bathing or pediatric equipment, while households who would otherwise buy equivalent equipment can retain resources.

Key reservations

  • The activity denominator is a forecast, not a same-period unique-recipient census.
  • Existing public support, historical reserves and lending capacity make the donation response uncertain.
  • Equipment utility, incremental duration, fit, use and household savings are not measured locally.
  • Pickup requirements and availability can exclude the most constrained recipients; induced attempts may impose costs.
  • Pediatric health and purchase savings are especially weakly identified and can be removed independently.
  • Donated equipment, labor and external costs are not fully priced; the headline is not a complete societal-cost estimate.

Benefits not included in our estimate

  • Donated retail replacement value and insurer/public-payer savings as household income
  • Waste or climate benefits
  • Unmeasured caregiver time, wages and health
  • Separate falls, mortality or hospitalization gains already overlapping functional utility
  • Lifetime pediatric development or independence
  • Overseas outcomes of redirected equipment

4. What do you get for your dollar?

About $360K per DALY in the Bay Area

Useful equipment may make walking, transfers or bathing easier when timely equivalent equipment is otherwise unavailable. For a different group who would have bought or rented equally useful equipment, free lending may instead save household resources. We keep these groups disjoint rather than awarding new access and an avoided purchase to every borrower. The current estimate is one transparent central planning judgment with unweighted diagnostics, not an average dominated by invented favorable-scenario probabilities.

DALY is our one-year comparison unit. QALY-based health gains and income-welfare equivalents retain their original assumptions; they are not measured clinical DALYs. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

Central health and household-resource ledger: V = (10,000 / 169,269) × (960 / .28) × .75 × .80; U = V × .30; Bay benefit = .95 × (health − device harms + household savings)
V = 121.53099 exposed planning episodes; U = 36.45930 additional episodes. Net health = 0.0247891795; income-equivalent years = 0.00; Bay combined years = 0.03. Cost per DALY = $364K.

Model inputs and assumptions
Organization cost and activity
$169,269; 960 / .28 client-equivalents (range: $166,269 alternative expense). Public 2025–26 plan, not actual delivered service. FY2024 actual expense of $104,000 is not paired with later output forecasts. The full cost allocation is about $49.37 per planning client-equivalent. Analyst judgment unless explicitly identified as accounting or public planning.
Realization, deduplication and donation response
75%, 80%, 30% (range: Donation response 0–50%). The 80% factor converts repeat visits or multiple items into exclusive primary person/need episodes. Cash response concerns other funding and capacity; unmet equipment access concerns recipient alternatives. These are distinct counterfactuals. Analyst judgment unless explicitly identified as accounting or public planning.
Exclusive primary need
45% mobility, 30% bathing, 10% pediatric, 15% supplies (range: Unmeasured category composition). No person receives several complete health credits merely because they borrow several items. Analyst judgment unless explicitly identified as accounting or public planning.
Unmet access, safe use and clinical judgment
Unmet .40/.35/.40/.25; safe .80/.80/.80/.85; utility .03/.02/.01/.002 (range: Lower utility family .01/.01/.01/.001; health null). Adult utility priors match the current ReCARES family. They are not measured MELP effects. Pediatric .01 is a separately weak judgment, not an adult-study transfer. Device harm is .00015 years per additional episode, not reduced by safe-use or positive-utility factors. Analyst judgment unless explicitly identified as accounting or public planning.
Conditional incremental exposure
.125/.125/.25/.025 years (range: Zero benefit; favorable doubled duration). Adult exposure is an assumed approximately 46-day bridge, not an official deadline. Pediatric exposure is half the generally six-month administrative loan, not a measured clinical duration. Benefits end at substitute access or need resolution; discounting is 3% at the clinical midpoint. Analyst judgment unless explicitly identified as accounting or public planning.
Counterfactual purchasers and one-off net savings
Purchasers .30/.35/.15/.60; net savings $40/$25/$100/$20 (range: Zero savings; baseline $25K–$100K). Per category, unmet access plus equivalent-equipment purchasers cannot exceed 100%. Savings already deduct normal pickup costs. Commercial rental quotes establish a possible mechanism, not actual borrower savings. The pediatric $100 assumption is especially weak. Analyst judgment unless explicitly identified as accounting or public planning.
Household-resource comparison
$50,000 annual baseline; 0.5 × ln(1 + saving / baseline) (range: Income-only and no-income cases). Coefficient Giving comparison weight is normative. Each one-off saving enters one annual resource window, discounted by 3% for an assumed .125-year receipt delay. No recurring wages, staff payroll, retail donation value or insurer savings are credited. Analyst judgment unless explicitly identified as accounting or public planning.
Residence and shared-credit allocation
95% Bay; 3% SF; portfolio assignment 100% (range: Zero local attribution; reduce shared-credit assignment). Health and income have separately adjustable nested geographic shares. SF is included within Bay, never added to it. Assignment discounts every effect once when another portfolio claims the same episode; donor cost stays unchanged. Analyst judgment unless explicitly identified as accounting or public planning.

Sensitivity checks, not probabilities

  • Central: $364K. Ten combined Bay health and income-equivalent years. All recipient and causal coefficients remain judgments.
  • Lower utility family: $881K. Use .01/.01/.01/.001 utility while keeping other central inputs.
  • No household savings: $425K. Health and device harms retained, purchase/rental savings set to zero.
  • Household savings only: $2.6M. Positive health and device harm both set to zero; household savings remain.
  • Half donation response: $728K. Donation response 15% rather than 30%; do not call public funding automatically additional.
  • Alternative budget table: $358K. Use $166,269, not a cheap historical expense with a newer output forecast.
  • Favorable joint stress: $100K. Donation response 50%, doubled incremental duration and doubled net savings. No invented probability or recommendation based on this case alone.
  • Funding replacement: No additional modeled benefit. No additional equipment or gift-induced applicant exposure. The donor still incurs the gift cost.
  • Unsuccessful additional access attempts: Net harm; no positive price. No additional completed equipment episodes, but induced applicant exposure with a $20 extra burden; Bay signed benefit −0.02301033 years. Unchanged baseline pickup is not charged to this gift.
  • Health and savings null, device harm retained: Net harm; no positive price. Bay signed benefit −0.00519545 years. Harms are not clipped when benefits fail.

Uncertainty. The roughly $360K headline replaces the frozen prior-weighted $301K and its $173K unweighted central diagnostic. The change reflects shorter conditional exposure, a weaker pediatric bridge, explicit discounting, disjoint household savings and removal of unsupported probability weights. It is not a measured deterioration in the organization. Zero or negative combined benefit has no meaningful positive cost-effectiveness ratio.

Health and income effects

Health gross is U times the sum of each category’s mix × initially unmet access × safe use × utility × incremental years / 1.03^(years/2). Gross health is 0.0302580739 years; independent device harm is 0.0054688944, leaving 0.0247891795. Utility judgments summarize access/function; no separate falls, mortality or caregiver-health benefit is stacked on top.

Income-equivalent years are U times the sum of mix × counterfactual-purchaser share × 0.5 × ln(1 + net saving / 50,000) / 1.03^.125, totaling 0.0041120899. An initially unmet recipient gets access credit, not an invented purchase they could not afford; an equivalent-equipment purchaser gets net resources, not duplicate access credit. Wage and caregiver earnings could matter, but no identified increment supports positive central credit.

Additional applicant costs have an independent signed exposure ledger. Applicant episodes A = (net donor budget / planned expense) × (960 / .28) × applicant realization × .80 × induced applicant exposure × portfolio assignment. Burden J = A × 0.5 × ln(1 − extra burden / baseline) / 1.03^.125. Applicant realization is separately adjustable from completed-loan realization; both happen to be .75 centrally. Central extra burden is zero because normal pickup is already deducted from net savings, not because travel is costless. A gift-induced failed access attempt can have costs without completed loans; pure funding replacement with no changed exposure cannot.

    5. Funding and previous grants

    Current pickup sites and reviewed filings support ongoing operations. Historical reserves, public support, unique recipients and appropriate sustained equipment use need reconciliation with a costed additional-capacity plan. The modeled price is not a verified funding offer.

    A priced additional service plan, current reserve restrictions and recipient follow-up would make the donation estimate more actionable.

    No binding donor-triggered capacity offer was located. FY2024 cash/savings/investments of $193,488 are historical, not current unrestricted liquidity. The PHCD 2026 $43,154 recommendation is not a paid award; Sequoia lists a 2026–27 $25,000 award. Different fiscal periods are not summed into a private funding gap. The illustrative calculation is bounded to a $10,000 donor budget and does not establish that a larger gift scales linearly. Complete societal equipment, volunteer and recipient-resource costs remain unknown.

    This review does not establish a verified marginal funding offer or a complete history of grants.

    Donate

    Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.

    6. Sources

    1. 2024 Form 990-EZ and Schedule O. MELP/AbleCloset / IRS, mirrored by ProPublica. Primary source. Published: Filed 2025-02-13; retrieved: 2026-09-11.
    2. 2025–26 Community Grants Program applicant packet, PDFp34. Peninsula Health Care District. Primary source. Published: 2025 grant cycle packet; retrieved: 2026-09-11.
    3. November 18, 2024 full applications, PDF p. 24. Peninsula Health Care District. Primary source. Published: 2024-11-18; retrieved: 2026-09-11.
    4. July 21, 2025 award-expenditure packet, PDFp14. Peninsula Health Care District. Primary source. Published: 2025-07-21; retrieved: 2026-09-11.
    5. Caring Community Grants. Sequoia Healthcare District. Primary source. Published: Current 2026–27 listing; retrieved: 2026-09-11.
    6. Passed Measure K resolution 24-599. San Mateo County. Primary source. Published: 2024-08-13; retrieved: 2026-09-11.
    7. Program and giving instructions. MELP. Primary source. Published: Current, undated; retrieved: 2026-09-11.
    8. Frequently Asked Questions. MELP. Primary source. Published: Current, undated; retrieved: 2026-09-11.
    9. About Us. AbleCloset. Primary source. Published: Current, undated; retrieved: 2026-09-11.
    10. Medical Equipment Loan Program grantee account. Community Foundation of San Carlos. Primary source. Published: 2024-11-27; retrieved: 2026-09-11.
    11. Walking Aids and Locomotion Training RCT. Polesel etal., JAMA Network Open. Primary source. Published: 2025-11-21; retrieved: 2026-09-11.
    12. Rollator use and qualityoflife inCOPD RCT. Gupta etal., Chest. Primary source. Published: 2006; retrieved: 2026-09-11.
    13. Wheelchair provision guidelines. World Health Organization. Primary source. Published: 2023-06-05; retrieved: 2026-09-11.
    14. How it works: pediatric loan periods and extensions. AbleCloset. Primary source. Published: Updated 2024-04-25; retrieved: 2026-09-11.
    15. Original FY2024 Form 990-EZ. MELP/AbleCloset / IRS, mirrored by ProPublica. Self-filed original return. Published: Filed 2025-02-13; retrieved: 2026-10-01.
    16. Original FY2023 Form 990-EZ. MELP/AbleCloset / IRS, mirrored by ProPublica. Self-filed original return. Published: Filed 2024-06-13; retrieved: 2026-10-01.
    17. Original FY2013 Form 990-EZ. MELP/AbleCloset / IRS, mirrored by ProPublica. Self-filed original return. Published: Filed 2014-11-17; retrieved: 2026-10-01.
    18. IRS-derived organization index. projects.propublica.org. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    19. PHCD 2026 grant recommendations. www.peninsulahealthcaredistrict.org. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    20. PHCD December 2025 board packet. www.peninsulahealthcaredistrict.org. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    21. BATH-OUT-2 primary findings and economic evaluation. sscr.nihr.ac.uk. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    22. Official program or research source. www.who.int. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    23. Medicare durable medical equipment coverage. www.medicare.gov. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    24. Local medical equipment rental quotes. www.gomedicalmarket.com. Original program, public-funder or research source. Published: Period and limitations stated in report; retrieved: 2026-10-01.
    25. Cost-effectiveness comparison methodology. Coefficient Giving. Normative comparison framework. Published: Current methodology; retrieved: 2026-10-01.

    Annual expenses: years and sources

    Average annual expenses (three consecutive fiscal years): Not available. Organization size is separate from the modeled cost-effectiveness of a donation.

    AbleCloset / MELP

    Whole-entity Form 990-EZ actual expenses. Only two consecutive recent years verified.

    Three consecutive full-year expense totals are not verified.

    Planned budgets are excluded. Pediatric AbleCloset joined MELP in 2023.