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
  • Research — reviewed programs, finances and impact evidence.
  • Source audit — checked claims, assumptions and calculations.
  • Modeling — estimated costs, QALYs and uncertainty.

Published: 10 September 2026.

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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 potential in sharing equipment whose purchase cost can be difficult for an individual household to meet. The model's planned expense of $169,269 divided by inferred planning activity gives about $49 per client-equivalent. This is a forecast-based ratio, not the observed marginal cost of a completed loan or a safely fitted device. Source

Equipment can make walking, transfers or bathing easier when a recipient otherwise lacks a suitable aid. For adult mobility, the central model assumes a 0.03 health-utility improvement for a quarter of a year, or 0.0075 QALYs for someone gaining that benefit. It then adjusts for unmet access, safe use, unique recipients, realization of the plan and what extra cash changes.

The central result is about $1.73 million per 10 Bay Area QALYs. The mechanism is useful access and functioning, not the item count alone; a loan that replaces equivalent equipment or is not used does not earn the same modeled benefit. 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 are understandable, potentially valuable services. Our current model is less convincing as a guide to new donations because both cash-enabled expansion and health conversion are uncertain. We would first reconcile current resources with a concrete plan for additional useful loans. 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. Use planned whole-organization $169,269 expense and inferred 3,429 planning client-equivalents from 960/.28. The resulting $49.37 unit cost is not a historical actual or a funded marginal offer. Full 2024 expense of $104,000 is disclosed but not paired with newer output forecasts.

2. Monitoring and information sharing

Whole legal entity

2024 IRS self-report. $104,000 expenses, $193,488 cash/savings/investments and $195,635 net assets; no actual recipient count.

Our assessment. Not current unrestricted liquidity or donation marginality.

Adult and pediatric borrowers

Public grant applications and official instructions. Real repair/loan operations; reported 3,874 items in a recent 12-month period; newer forecast 960 district clients.

Our assessment. Items, visits, people and forecasts are not interchangeable.

Older emergency-department patients and COPD patients, not MELP borrowers

Controlled walking-aid trials and provision guidance. Some functional benefit but null quality-of-life findings; safe use and fit matter.

Our assessment. No MELP utility coefficient identified; no QALY mapping invented.

3. Qualitative assessment

Volunteers repair, clean and lend donated equipment, potentially bridging unmet mobility and self-care needs.

Key reservations

  • Whole-gift result is poor under stated priors; do not call this a high-EV recommendation.
  • Cash reserves and public grants may finance existing operations without the donor.
  • The denominator is inferred from a planning target and historical district share; actual unique users remain unknown.
  • All utility, duration, mix, use and causal access assumptions are judgments.
  • No delivery; first-come availability may exclude those most constrained.
  • Favorable tail dominates expected benefit despite small prior weight.
  • Complete donated equipment, volunteer, public partner and recipient resource costs are unpriced.

Benefits not included in our estimate

  • Retail replacement value and recipient financial savings
  • Waste and climate benefits
  • Caregiver time and health
  • Separate falls, mortality and hospitalization benefits on top of utility
  • Lifetime pediatric development or independence
  • Overseas benefits of redirected equipment

4. What do you get for your dollar?

Signed expected Bay cost: $3,009,665 per 10 QALYs

Calculate each joint scenario independently, subtract harms, then average QALYs using weights locked before execution. Divide the whole gift by expected net QALYs; do not average cost ratios or discard negative worlds.

A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

CENTRAL: U = (10000 / (169269 / (960/.28))) × .75 plan realization × .30 cash additionality × .80 unique fraction; QBay = U × [Σ(primary-needs share × unmet access × safe use × utility × finite years) − .00015 harm] × .95
U = 36.4593; Bay QALY = 0.05795308; cost/10 = $1,725,534

Model inputs and assumptions
Full annual cost boundary
$169,269 planned; $104,000 historical (range: $166,269 alternative budget table). Actual full legal-entity expense is disclosed separately from the newer planning budget. No overhead is excluded. Verified historical accounting; uncertain planning.
Client-equivalent planning denominator
960 / .28 = 3,428.57 (range: Explicitly inferred). Projected district clients divided by a reported historical district share. This is not an actual annual unique census. Central plan realization is 75%; unique fraction is 80%. Low: inferred planning quantity.
Cash additionality
30% central (range: 0–50%). Accounts for other donors, public funding, reserves and operational capacity. Separate unmet-access factors address recipients' alternatives. Subjective judgment.
Exclusive dominant-need shares
45/30/10/15% (range: See saved scenario matrix). Adult mobility, bathing/transfer, pediatric adaptive equipment and consumables. Shares are unmeasured and mutually exclusive; no device stacking. Subjective judgment.
Utility and finite years
.03× .25 / .02× .25 / .02× .5 / .002× .05 (range: Zero clinical effect in null/harm; maximum duration .75 year). No clinical study supplies these coefficients for MELP. Years means incremental useful health-improving time before alternative access, need resolution, discontinuation or device failure ends the advantage—not the physical life of the equipment. The favorable pediatric .75-year horizon is an explicit extension assumption beyond AbleCloset’s usual six-month pediatric loan limit (extensions can be requested), not established pediatric evidence. No lifetime, developmental, mortality or caregiver credit is added. Unvalidated analyst bridge.
Resident benefit allocation
95% Bay / 3% SF (range: 90–98% Bay; 2–5% SF). Historical county participation supports local presence, not current Bay/SF shares. PHCD share and opening hours are not residence allocation rules. Subjective residence allocation.
Joint scenario weights
40/15/15/15/12/3% (range: Cash null / clinical null / harm / cautious / central / favorable). Weights were locked before execution. The cautious world becomes net negative after independent harms and is retained. Uncalibrated joint scenario judgments.

Bounded $10,000 check gift only

  • cash_neutral_null: No positive net benefit per 10 Bay QALYs. Subjective weight 40%; 0.00 additional unique recipients; 0.000000 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • clinical_null: No positive net benefit per 10 Bay QALYs. Subjective weight 15%; 36.46 additional unique recipients; 0.000000 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • harm: No positive net benefit per 10 Bay QALYs. Subjective weight 15%; 15.19 additional unique recipients; -0.027344 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • cautious_positive: No positive net benefit per 10 Bay QALYs. Subjective weight 15%; 9.11 additional unique recipients; -0.000748 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • central: $1,725,534 per 10 Bay QALYs. Subjective weight 12%; 36.46 additional unique recipients; 0.057953 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • favorable: $98,406 per 10 Bay QALYs. Subjective weight 3%; 96.21 additional unique recipients; 1.016194 signed Bay QALYs. Negative and zero outcomes retain the whole gift cost.
  • Shared clinical priors: central scenario only: MELP weighted $2,117,236; central $572,533. Diagnostic replacement of adult mobility, bathing and supply utility/duration with ReCARES central values. Other factors and pediatric pathway are unchanged. Not a replacement forecast.
  • Shared clinical priors: all three benefit-pathway worlds: MELP weighted $1,317,403; central $572,533. Corresponding ReCARES utility/duration values replace only three matched categories in cautious, central and favorable worlds. Null/harm worlds, weights, costs, mix, additionality, geography and pediatric inputs remain unchanged.
  • Reverse clinical comparison: ReCARES weighted $507,197 with MELP matched clinical values. Central-only reverse swap gives $250,711 weighted and $455,104 central. Swapping all three benefit-pathway worlds gives $507,197 weighted. Neither family is empirically established; these comparisons do not prove organizational superiority.

Uncertainty. The lower utility and duration assumptions used here are not established MELP-specific differences from ReCARES. Shared clinical-prior diagnostics materially change both estimates: MELP is $1.32 million per 10 Bay QALYs with matched ReCARES values, while the reverse swap raises ReCARES to $507,197. These are sensitivity checks, not preferred estimates or clinical calibration. With the base priors unchanged, removing and renormalizing away MELP's favorable world gives $35,395,501 per 10 Bay QALYs. The favorable world alone creates the 3% subjective mass below both thresholds; its $98,406 result is close to $100,000 and does not merit empirical precision.

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.

Verify a small priced cash-triggered expansion or service-preservation plan, current reserve restrictions, unique recipients, device-class mix and actual use before recommending a gift.

No verified marginal offer. Historical cash of $193,488 is not current unrestricted cash. PHCD's $50,000 award in 2024–25 and Sequoia's $25,000 award in 2026–27 support a funded baseline; different periods are not summed. Complete societal resources are 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: Currentundated; retrieved: 2026-09-11.
  8. Frequently Asked Questions. MELP. Primary source. Published: Currentundated; retrieved: 2026-09-11.
  9. About Us. AbleCloset. Primary source. Published: Currentundated; 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.

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.