Thread by @SyringeAccess

🧵(1/19) Yesterday, we hosted a panel at the National Harm Reduction Conference to try and answer a direct, but complicated as hell question:

“How do we get money in the hands of drug user health organizations that actually care about people who use drugs?”

#HarmRed2022

(2/19) To try and answer this question we got myself, @ChristineRdrgz of @AIDS_United, Rafi Torruella of Intercambios Puerto Rico, Philomena Kebec of the Bad River Tribe, & Maya Doe-Simkins of @RemedyAlliance together to talk about federal & private harm reduction funding.

(3/19) We talked about the way things are with harm reduction funding, but also about the way things ought to be, outlining how governments need to change how they structure their grantmaking & reporting, & outlining ways we can game the system & support one another.

(4/19) We touched on a lot of topics, but throughout the session several issues came up over & over again. Let’s go through some of them.

First off: Most federal grantmaking for harm reduction organizations is a nightmare…and it doesn’t have to be.

(5/19) Most of the US harm reduction orgs that do the best work & are most connected with community are small-to-medium in size & have haphazard organizational structures.

Our work & movement is rooted in underground service provision & lived/living experience, not bureaucracy.

(6/19) Unfortunately, many government funding opportunities—like the American Rescue Plan Act harm reduction money through SAMHSA—still utilize needlessly complex & cumbersome application processes that value fidelity to the process over the ability to actual provide services.

(7/19) The things that make for a good harm reduction org—leading from community, prioritization of low barrier service provision, flexibility to emerging needs of clients, valuing subject matter knowledge over formal education—can be detriments to applying for federal grants.

(8/19) The current system prioritizes orgs with good grant writers over orgs with good programs.

You can’t just describe how you’re helping PWUD. You have to address Indicator 4(a)(ii) in the Indicator 4(a)(ii) section & regurgitate the right buzzwords in the right order.

(9/19) And even for the harm reduction orgs that are capable of writing good grants, the reporting requirements and strings attached often dissuade them pursuing federal money.

Do y'all know how bad requirements have to be for a starving org to turn down money? Like, bad bad.

(10/19) On the panel, Rafi Torruella of Intercambios talked about how they are intentional about what federal opportunities they go for because the work is often not worth the reward.

For many harm reduction orgs, federal funding requirements aren't compatible with their work.

(11/19) Another issue that we discussed at great length was how we, as harm reductionists, market ourselves & profit from our work & our expertise.

To a fault, harm reductionists are willing to do what it takes to provide care for their community—including working for peanuts.

(12/19) Our passion for this work & those we serve is often weaponized against us by governments & large non-profits.

If you’re a harm reductionist, ask yourself how many times a health department or health center has asked for your help without pay? How often did you say yes?

(13/19) Philomena Kebec was adamant at our panel that we need to start demanding compensation & appreciation in line with our abilities.

It’s time for us to “trick the system”, she said, instead of letting it exploit us. We need to own our expertise & build funding streams.

(14/19) In her work with @RemedyAlliance, Maya Doe-Simkins shows how even the most ambitious harm reduction initiatives can not only survive without being subsumed by larger institutions, but thrive. When we operationalize & monetize our unique skill sets, we can upend systems.

(15/19) The last takeaway from the session, & maybe the most important, was that there is an intense need for harm reduction organizations to stop being competitors,& start being collaborators & co-conspirators.

We cannot end the war on drugs if we’re at war with ourselves.

(16/19) Solidarity is essential, particularly when it comes to bigger orgs supporting smaller ones.

Intercambios intentionally wrote in 2 smaller Puerto Rico harm reduction orgs into 1 of their grants because they didn’t have the bandwidth to it on their own. That’s solidarity.

(17/19) And if larger health centers, HIV service orgs, or SUD treatment/recovery orgs want to get involved in harm reduction and syringe services, they need to make sure existing harm reduction orgs are at the center of what you are doing & you need to follow their lead.

(18/19) Any major health care provider that comes into a community where grassroots harm reduction orgs are already operating & opens up their own program without their blessing & active, equitable participation is committing an act of violence against people who use drugs.

(19/19) Trying to divorce SSPs from the communities that birthed them inevitably turns them into hollow husks of their former selves.

We cannot corporatize harm reduction, but we can monetize existing structures to make sure our people get paid.