State of the Agency February 2024

HRTC’s current team of twenty–made up primarily of clinicians and a harm reduction service coordinator, logistics coordinator, MSW intern and two administrative support staff–kicked off 2024 by re-examining our mission and vision statements. Gathered together in our comfy community space at 21 Merlin St., we brainstormed, wrote and rewrote, discussed and debated and then took a break to play some harm reduction jeopardy. Here is what we came up with: HRTC exists to transform substance use treatment by providing low-barrier, person-centered, integrated mental healthcare, as well as clinical harm reduction training, to people and organizations most impacted by the War on Drugs. Rooted in values of diversity, equity, inclusion, social justice and the firm belief that everyone matters, we are committed to offering Harm Reduction Therapy to anyone who uses drugs, regardless of the complexity of their drug use, the multiplicity of their intersecting issues and circumstances, or their goals. Our vision is that Harm Reduction Therapy will someday be available to everyone who has problems with alcohol or other drugs and that the humane, compassionate and pragmatic principles of harm reduction will guide all treatment.

Guided by this re-centering around our shared purpose, HRTC is better prepared to weather the increasingly harm-reduction-hostile storms that are now ever-present locally. The move to prioritize the criminalization of people who use drugs over proven life-saving measures (such as housing, safer use practices, treatment on demand) or investment in quality, accessible treatment is beyond troubling. As Michael Botticelli, Director of the Office of Drug Control Policy under President Obama recently said in the New Yorker “Addiction treatment is the only area of healthcare in which we consider saving someone’s life to be an unacceptable outcome.” Criminalization and coercive treatment is a waste of taxpayer funds; these policies re-traumatize, dismiss and further push vulnerable people to the margins. These policies failed us in the 1980s and 1990s and yet they are being exhumed in San Francisco, the impact landing disproportionally on people living in poverty and communities of color. San Francisco is home to many smart, talented, caring people who can and MUST do better than enabling another War on Drugs. If current policies are allowed to continue unchecked we will lose more people to overdose and the harshness of life on the streets while placing undue burdens on the next generation. We need affordable, quality housing AND accessible, affordable, quality treatment when people need it.

2023 Highlights

In 2023, with the help of funding and community support from Hospitality House, Homeless Youth Alliance, the San Francisco Department of Public Health & many of you, HRTC clinicians brought Harm Reduction Therapy to 19 different service sites to reach unhoused people with multiple complex needs who also use drugs. We were joined at many sites by service partners: Care Through Touch Institute (our roommates at 21 Merlin Street!), DPH Street Medicine and RAMS – Peer Division. We enhanced our training services in the Bay Area, nationally and internationally. Our longtime partners at Blanket the Homeless became an official program of HRTC, expanding our ability to offer much-needed basic needs to people living on the streets. We welcomed new Board members and continued our intra-agency work of learning to be HRTC without our agency founders. [see “HRTC Welcomes New Board Members”]

We succeeded in not only re-opening our main offices after experiencing severe flooding, but were also able to develop the site into a warm, welcoming center where we provide on-demand treatment and milieu services to approximately 30 people daily. We did all of this while continuing to center conversations of diversity, equity, inclusion and social justice (DEIJ) to help map our agency focus and goals.

Challenges & Future Goals

While we will continue to build on our successes of 2023, we know that 2024 brings many challenges. In addition to local and state moves away from life-saving harm reduction services and possible funding shifts, we must attend to the needs of our team, many of whom have not stopped to regroup following the intense demands of the COVID-19 pandemic. We know that more will be needed from us to collaborate and advocate for the needs of marginalized people who use drugs and that working collectively with leaders in the harm reduction and anti-poverty movements will be key to any success. HRTC is proud to continue to provide quality, person-centered, compassionate, collaborative, integrated substance use and mental health treatment options to people most marginalized in San Francisco and are committed to doing so, despite political and funding challenges.

For 2024, we will deepen our focus on DEIJ goals to include increasing our community-based treatment advocacy work, expanding harm reduction clinical training services, and attend to agency funding diversification and structural needs so that we can adequately support skilled staff. We will focus any expansion of services toward training and our brick & mortar, low-threshold, integrated substance use and mental health community space at 21 Merlin St. In order to do this we will need to ensure responsiveness to the needs of unhoused people who use drugs by centering these voices in our work.

We continue to thank all of you for your ongoing support and belief in HRTC and Harm Reduction Therapy. We thank you for joining us in our dedication to compassionately centering the needs of vulnerable people who use drugs in our communities.

Thank you,

Anna Berg, Nancie Jann, Maurice Byrd, Celia Sampayo Perez

HRTC’s Leadership Team

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