September 19, 2022
President Joe Biden
The White House
1600 Pennsylvania Ave, N.W. Washington, DC 20500
Ambassador Susan Rice
Assistant to the President for Domestic Policy 1600 Pennsylvania Ave, N.W.
Washington, DC 20500
Dear President Biden and Ambassador Rice,
The National Diaper Bank Network thanks President Biden for making hunger, health, and nutrition a priority of the administration by hosting the upcoming White House Conference on Hunger, Nutrition, and Health. We strongly support the administration’s efforts to increase food access and improve the health of families and children.
The National Diaper Bank Network (NDBN) leads a nationwide movement to provide families, individuals, and children with the basic necessities they need to thrive, including clean, dry diapers, period products, and other basic necessities. NDBN works to create awareness, provide assistance, and build community to end diaper need in the U.S. Our network includes more than 225 diaper banks, diaper pantries, and food banks working to serve communities in all 50 states, Washington D.C., and Puerto Rico.
A recent study published in Health Equity by researchers from University of Vermont, The Greater Boston Food Bank, and University of Maryland Baltimore County found that diaper need is a recognized public health issue that is associated with poverty, food insecurity, and chronic illness. Overall, the study found that 56% of families who were food insecure also experienced diaper need.
The correlation between poverty and diaper need is not new. Even before the COVID-19 pandemic, one in three US families with young children struggled to afford enough diapers to keep their child clean, dry, and healthy. Without enough diapers each day, infants and toddlers are at risk of skin infections, open sores, urinary tract infections, and other conditions that may require medical attention. Additionally, almost all childcare providers require parents to provide a daily supply of disposable diapers to care for a child. Without diapers, parents cannot go to work or school and lose income and the opportunity to succeed. Parents struggling with diaper need report missing an average of four days of work per month. These factors, coupled with the complete absence of federal support for these basic necessities, help explain why mothers unable to diaper their children, are more likely to suffer from depression.
Unlike food, diapers are not covered by WIC or SNAP, so nonprofit diaper banks must fill the gap. Diaper Banks stretch limited resources to meet a small portion of the need in their respective communities. During the COVID-19 pandemic, diaper banks faced unprecedented demand for their services, reporting 200 to 600 percent increases in need for diapers from their communities. In response, and almost entirely through philanthropic support, diaper banks increased distribution by 86 percent. However, this tremendous effort from diaper banks will meet less than 10 percent of the estimated need.
As you work to address food insecurity, nutrition, and health, we ask that you also advocate for policies that will help families across the country secure the diapers and basic necessities they need to not only survive but thrive. Now is the time to work to provide families with diapers, as doing so protects the health of children and promotes the economic success of parents. A sufficient supply of diapers reduces instances of diaper dermatitis and urinary tract infections. As a result, children are healthier, and our health care system saves millions of dollars due to preventative care. Additionally, with a sufficient supply of diapers, parents avoid missing work and are able to pursue greater economic opportunities. These factors combine to provide more than $11 return on every $1 invested in providing diapers to families in need.
We have provided several policy proposals below that will support families facing diaper need:
1. Support the End Diaper Need Act
We request that your administration support the End Diaper Need Act of 2021 (H.R. 259). Introduced January 11, 2021 by Congresswoman Barbara Lee and Congresswoman Rosa DeLauro, the End Diaper Need Act of 2021 (H.R.259) would appropriate $100 million each fiscal year from 2021-2024 to fund the expansion and scaling of programs addressing diaper need and improving the health and wellbeing of infants, toddlers, and families across America. This bill also defines diapers as “medically necessary” so that families can purchase them through health savings accounts and HRAs.
2. Electronic Benefits Transfer Diaper Stipend
Pandemic EBT has proven that assistance through the EBT system is an efficient and effective method of supporting families. California currently provides families in the state’s welfare-to-work program with a monthly stipend for purchasing diapers through EBT. Creating a national monthly diaper stipend program — modeled on the successful Pandemic EBT and California diaper stipend — would deliver economic relief to families regardless of their proximity to a diaper bank. The National Diaper Bank Network and anti-hunger advocates support a diaper-specific program. We oppose suggestions to expand the Supplemental Nutrition Assistance Program (SNAP) or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to include diapers. A diaper-specific program will ensure that families are not forced to choose between using limited benefits for food or diapers. Rather they will be able to receive support for the basic necessities they need to thrive.
3. Expand Diaper Access Through Child Care
The inability to afford diapers frequently prevents parents from utilizing even subsidized child care. Most providers require parents to supply the diapers their child will need during the day. Child care providers frequently survive financially at the slimmest margins and cannot afford to provide diapers for children attending their programs. We encourage you to take executive action clarifying that child care providers who receive federal funding should not turn away families due to a lack of diapers. Those child care programs include the Child Care Development Block Grant, to purchase and provide diapers to children. Ensuring families can utilize child care by providing funding for diapers would benefit young children developmentally and stimulate the economy as parents can work and better provide for their families.
4. Include Diapers in Medicaid Coverage
Diapers are a basic necessity required to prevent diaper dermatitis, urinary tract infections, and other health issues for infants and children. Research in Connecticut showed that The Diaper Bank of Connecticut’s services saved the health care system millions of dollars by improving children’s health. Currently, Medicaid only allows coverage of incontinence products for adults and some children over the age of three. Including diapers in Medicaid coverage could potentially provide millions of dollars in savings by improving preventative infant health care.
5. Executive Order Enabling State Medicaid Coverage
Even without expanding Medicaid coverage through legislation, the administration could issue an executive order providing states with the necessary waivers to cover diapers through their Medicaid programs and encouraging them to do so. This would enable local advocates to push for policy changes at the state level now and leverage positive state outcomes to push for federal policy change in the future.
6. Executive Order for Cross-Agency Program Review on Diaper Need
From research conducted by the National Diaper Bank Network, we know that huge numbers of families cannot get the diapers they need for their child. We also see that diaper need forces parents to choose between purchasing diapers or other basic necessities such as food or transportation and can prevent families from participating in program requirements. Studying cross- agency programs that serve children and families, such as SNAP, TANF, child care, and other programs, to determine where families are being denied services because of barriers to participation caused by diaper need would illuminate previously unquantified aspects of diaper need. The review could then make recommendations to support parents in addressing diaper need and fully participating in these programs, thus improving families’ economic security, educational, and health outcomes.
These policies will build upon President Obama’s efforts to raise awareness regarding and address diaper need in 2016. President Obama recognized that diapers are a necessity for families and, in doing so, garnered national media attention. The legislative proposals above would provide unprecedented federal diaper resources to families, helping them survive the pandemic’s economic devastation and build the foundation for them to thrive in the years ahead.
Thank you for your time and consideration of these important policies and thank you for leading the White House Conference on Hunger, Nutrition, and Health. We ask that as you look into ways to alleviate hunger and food insecurity, that you do not forget about diaper need.
Joanne Samuel Goldblum, CEO
National Diaper Bank Network.