Strategies for Utilizing Consumers in the Development of Harm Reduction Services Jason Farrell, Harm Reduction Consulting Services, Inc. - EQUS Conference, Brussels 15 – 17 June 2011

Presentation Overview Presentation will highlight how consumers can be recruited as board members, advisory group participants, service providers, and most importantly to become empowered by offering opportunities to participate in the design of standards for the provision of harm reduction and substance use related services, ultimately allowing their recommendations to not only be heard but put into action

Effective Harm Reduction Services Prevent infections Provide education and support Provide interventions: improve health, reduce/eliminate risks, adherence to treatments, and mange drug use Provide risk assessments, triage and diagnostic care Provide access to medical care and drug treatment Referrals to other social services: mental health, housing, etc. Provided in a user friendly safe nurturing environment

Consumers Contributions Provision of services Location of services Service delivery models Operational guidelines Program development Collaborative outcomes and community benefits

Overcoming Barriers Trust: for many years consumers have been told we listen and care when if fact many times suggestions fall by the waist side Accountability: recommendations must be taken into consideration and put into action. Consumers must be allowed to not only identify problematic issues but as a group recommend resolutions Commitment: from board members to the volunteers, top down, all must be committed to involving consumers with development, guidance and provision of program services Incentives: offering consumers incentives who participate on advisory committees can lead to consistent attendance and participation. Such fringe benefits can range from metro travel support, attending trainings and travelling to conferences

Organizational Chart

How it Works PAC meeting minutes are given to the executive director to review. Executive director will meet with or provide written response to consumers recommendations and issues identified. Furthermore PAC may be asked to provide suggested resolution to issues they identified. PAC chair person being board member will present meeting minutes at NGO board of director meetings. Based upon funding and feasibility, plans or time line will be developed to implement recommendations. If funding is needed then PAC recommendations will be used to solicit funding for such services from donors

Provision of Services Hours: when best to engage target risk groups Type of services: based upon need and request Staffing: rapport, training, quality Insight on trends of drug use and risk behaviours Strategic planning of services based upon disclosed needs

Location of Services Locations where outreach should be conducted: drugs sold; drug users congregate, sex work areas Due to police actions many of these locations change rapidly Despite infection rates provided by government and police reports of drug use/dealing, drug users can help identify trends of new locations where services are needed and where new infections are likely to occur

Service Delivery Models Fixed location: offices Outreach: various locations Street based: table, fixed site; and foot, walking Mobile: car, van, motor bike Peer Based Peer Delivered

Operational Guidelines Drop in centre rules Self policing/regulating drop in centre and area near centre Prevent drug dealing, using and selling stolen property Contain problematic participants The centre or NGO becomes the consumers centre Gain a sense of ownership

Program Development Board Membership Advisory Committees/Boards Focus Groups Funding Applications

Board Membership It is important to have equal representation on boards Including drug users, people living with HIV/HCV and other infectious diseases the NGO targets All genders, sexual orientations, race, and nationalities

Consumer Advisory Committees Consumer or participant advisory committees are made up of program participants, to provide input and guidance on program policies and operations. Responsible for identifying potential problems in program operation and for proposing solutions to these potential problems. Incentives such as funds for metro travel, meals at each meeting, and ability to attend conferences, i.e. travel representing the organization can help with membership retention.

Advisory Committee Membership Potential members should state reasons wanting to participate, and what skills or personal experience they offer to improve the services of the NGO or program. Membership process should clearly define committee members terms, allowing rotation of membership, to avoid burnout. The selection process should also allow for alternate members as a way to train new members, fill vacancies, and to ensure maximum participation in the event of illness or other absence.

Advisory Committee Outcomes The advisory committee should have a purpose statement outlining direction towards improving program services for clients, and to regularly assess its success in achieving this purpose. What has been helpful is to establish measurable goals for not only improving client satisfaction with services, but how satisfaction has been attributable towards enrollment, retention and achieving NGOs overall goals and objectives. To ensure participant advisory committee recommendations are taken into consideration chair persons should be members of the NGOs board of directors.

Focus Groups Anonymous consumer satisfaction surveys Random interviews Ideally focus groups should be facilitated by non NGO staff or affiliates Best results are when a non threatening space is created where focus group members can freely discuss concerns without fear of retribution or adverse consequences for speaking badly about staff or services

Sustaining Consumer Collaboration Leadership within the harm reduction community and donors to ensure consumers are involved with service development, guidance and delivery Mechanisms or policies should be mandated by donors requiring sustained collaborations and accountability between consumers, NGO developers and policy makers Accountability, without it NGOs can provide fabricated lists of consumers involved in development or advisory groups Documentation or minutes from advisory committee meetings and board meetings can be furnished with each monthly report prior to reimbursement from donor. When funding is subjected to these requirements accountability will become evident Consumers can provide invaluable information, insight and leadership when treated with respect and dignity as colleagues

Contact Information Thank you – Dank U – Merci – Danke Jason Farrell Harm Reduction Consulting Services, Inc. +31 (0)