San Francisco has tech billionaires and Google buses, famous landmarks and crowds of European tourists. It also has an income disparity comparable to that of Rwanda. And while many low- and middle-income people have been pushed outside the city limits, the city’s poorest families often don’t have the resources to leave and remain stuck in one of America’s most expensive cities.

Now city officials are trying to address the needs of its most vulnerable by subsidizing disposable diapers and becoming the first major U.S. municipality to do so, it is believed.

San Francisco plans to spend about $479,000 annually to distribute diapers monthly to families in need. Still in its pilot phase serving 257 families with a child under the age of one, the city says that the diaper program will be operating at full capacity by Nov. 1, at which point it will serve roughly 1,300 families with children under three years old.

Sheree Guthrie is one of those receiving assistance through the scheme. The 35 year old has lived in San Francisco for 23 years and has one baby, Tristan, with another one on the way. In the past, the mother explained, she sometimes couldn’t afford to change Tristan’s soggy diaper. But she recently received her supply of diapers through the pilot program.

“They don’t really give you enough [money] here in San Francisco to pay rent and to buy food and to buy the diapers,” she said. “You’re kind of left without any options towards the end of the month. So the diapers have been a really nice option.”

The idea for subsidized diapers came from Dan Kelly, director of planning at the San Francisco Human Services Agency, after hearing an NPR story about a diaper bank in Connecticut.

Shortly afterward, he heard that the price of diapers at the corner grocery stores around public housing developments could run as high as 50 cents each. It compares unfavorably to the price of diapers at bigger retailers such as Walmart, at which they can cost as little as 17 cents. And with a newborn going through up to 12 diapers a day, the costs can rack up.

“That's the high cost of poverty,” said Kelly. “When you’re very poor, you don't get the break of shopping around and having a lot of shopping choices. You're vulnerable to being exploited. And your ability to plan and research your economic choices is really limited because you’re just trying to get through day to day.”

A single parent working full-time at the San Francisco minimum wage of $11.05 per hour with two young children will spend an estimated 8 percent of that person’s annual income, or about $1,872 year, on diapers, according to a report done for the San Francisco Human Services Agency.

Operating through the SF-HSA, the diapers are provided to families that are already receiving CalWORKs assistance — California’s welfare program. The diapers are distributed through a network of family resource centers that also provide other services to low-income families.

The diaper plan was intentionally designed to try to increase CalWORKs participation. Currently only 46 percent of eligible San Francisco families with a child under the age of three have enrolled in CalWORKs, according to a report presented to SF-HSA in May.

“It is hoped that the added incentive of free diapers might spread word of mouth about the benefits of CalWORKs. SF-HSA plans to use the diaper pick-up days as an opportunity to conduct CalWORKs outreach,” the report reads.

CalWORKs provides a single parent with two kids living in San Francisco an average of $704 a month in cash benefits.

To use the program, people present their EBT card as identification — also used for food stamps and cash assistance — and their diaper pickup is electronically recorded in a database.

It “will be the first of its kind in the country,” said Lisa Truong, founder and executive director of Help a Mother Out, the Bay Area diaper bank selected to run the city’s program. “So that's a pretty huge thing.”

Though there are hundreds of diaper banks across the country, San Francisco has developed the first city-government subsidized program of its kind in the U.S.

“That's kind of San Francisco’s role,” said Kelly. “We're always innovating and doing new things that often become standards for the national government.”

Sharon Bechtol works as the volunteer and donations coordinator at the Homeless Prenatal Program in San Francisco, one of the four family resource centers running the pilot program. She said the need for assistance has only been increasing.

“When I started six years ago, we were seeing 2,400 families. We’re now up to 4,000 families. The need just keeps growing and growing. … The funding has not kept up with the demand for services,” Bechtol said.

The Homeless Prenatal Program saw families having to choose between buying diapers or buying food. If children are kept in soiled diapers for too long, they can develop rashes and infections.

Carrie Hamilton, a case manager at the Homeless Prenatal Program, understands the importance of a diaper bank on a personal level. She qualified for the diaper pilot program for her 10 month-old-baby, Abigail, after some financial setbacks last year.



“It’s been a big help,” Hamilton said. “Being able to feel confident that you have diapers, because when you don’t, you start to worry and stress, and you start feeling like you’re a bad mom. And that can cause all sorts of mental health issues.”