Governance policies dictate how an organization is run: who can make what decisions, when those decisions can be made, how many people must make them, and so on. Some examples of governance policies include agency bylaws and board-related policies (such as officer elections, meeting quorums, codes of conduct, personal contributions, confidentiality etc.).
Fiscal policies govern how an organization handles money and fiscal matters. Examples include policies about using credit cards, reimbursement requests, investments, check signing, bank account management etc.
Service Provision and Operations Policies
Service provision and operations policies are the policies that impact services: how services are provided, how they can be accessed, limitations on services, who can receive services, how information about services is communicated, how conflict is handled and so on.
Personnel policies, discussed in depth in the next section, primarily impact paid staff but often also impact agency volunteers and board members.
In addition to the essential foundations for harm reduction policies – ethics, experience, and evidence – there are several other outside influences that place limitations or expectations on the policy choices that SSPs make. These include:
Funders – funders will occasionally have expectations about an agency’s policies. Read grant offers carefully and ask questions.
Insurers – insurers may decline coverage in the presence or absence of certain policies.
The Law – though harm reductionists have famously thwarted it, civil, criminal, and regulatory laws govern many aspects of the policies that harm reduction organizations must have in place.
In harm reduction programs there are usually three components for creating policies, procedures, and programs – ethics, experience, and evidence.
To build policies, procedures, and programs in line with harm reduction best practices and ethics, they must always be grounded in the principles of harm reduction. These principles were developed over a period of about four years in the 1990s amid much debate among early harm reductionists who came to consensus on these enduring principles:
Principles of Harm Reduction
1997 Harm Reduction Coalition (Initially acting as the Harm Reduction Working Group)
Accepts, for better and for worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence and acknowledges that some ways of using drugs are clearly safer than others.
Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies.
Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
Ensures that people who use drugs and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
Affirms people who use drugs themselves as the primary agents of reducing the harms of their drug use and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.
From these principles, harm reduction leaders can address some of the more ethically challenging aspects of providing services to vulnerable, stigmatized populations who have historically been the recipients of “services” that actually reinforce the structural violence they face.
Leaders in harm reduction report testing policies and procedures against the Principles of Harm Reduction as a way to avoid reinforcing structural violence and to build programs in line with harm reduction best practices. As a part of these principles, ensuring that people who use drugs and others receiving services are included in decisions is essential for policy creation in harm reduction.
After checking for alignment with the Principles of Harm Reduction, the next most important test of any potential policy or procedure is its basis in the practical experiences of folks working on the ground and the lives of participants. Policies should never be created that would exclude them from services, undermine the value they get from services, or cause undue hardship for those directly providing services because of the practical realities of service provision or participants’ lives.
Finally, the best policies and procedures in harm reduction rely on peer-reviewed evidence. Peer-reviewed evidence means that something has been evaluated and critiqued by researchers and experts in the same field before the information is published.
In harm reduction, of course, practice has always preceded research. Activists whose intuition told them that reducing harm was better than letting people die were handing out syringes before the research caught up to them. At the same time, harm reduction has also always followed research – abandoning practices such as bleaching syringes that have not shown strong peer reviewed evidence of utility. Evidence from within the agency, in the form of program evaluation, is also used by harm reductionists to edit and improve programs and policies.
In addition to traditional Boards of Directors, many harm reduction agencies have other bodies for democratic control of various aspects of an organization. These include both advisory boards and cooperative boards.
Advisory boards are usually one of two types – community or participant.
Community Advisory Boards (CABs) may be made up of both participants and other close community members like the family members of participants or others the organization would like to involve in decision-making. “Community Advisory Board” is also a name sometimes used to describe an internal governance and advice board in fiscally sponsored projects. These boards often make recommendations to the BoD and may, in certain cases, directly control aspects of the organization.
Participant Advisory Boards (PABs) are, as the name implies, advisory boards consisting of people who use agency services. Like CABs, PABs often have the capacity to make recommendations to the BoD and may, in certain cases, directly control aspects of the organization.
Cooperative boards or committees are governing arms of cooperatively run organizations and may control every aspect of the organization with the (legally necessary) BoD merely rubber-stamping their decisions.
There is often a large difference between where leaders would like their Boards to be and where they actually are. In order to make boards more functional, organizations need to put time into board development.
To do this, harm reduction leaders recommended other leaders to:
Think about what style of board you want and need – first, think about what you’d actually like to get your board to do – is it fundraising? community relations? basic governance? decide what you need and then…
Recruit strategically – pick people for your board who you believe will bring skills or contacts that benefit your participants.
Be smart about size – try to pick a number of people for your board that is “right sized”- remember that more people do not always get more done.
Do not take people just because you are friends or you respect their work.
Do not be intimidated to vet – many harm reduction leaders expressed the importance of vetting people you might ask to put on the board and not simply taking anyone who volunteers. This may even include a formal application and interview process.
Express expectations and needs – be clear about the time commitment and let potential board members know exactly what the agency needs.
Feel free to say “no, thank you” – it is better to gracefully refuse someone before they have started than to wait until problems arise.
Organization leaders should always:
Expect to train board members – about the agency, its history, bylaws, and finances.
Seek out development opportunities for board members.
It is especially important to support board members who come from marginalized backgrounds to ensure that they are represented at the table and routinely have a real voice in decision making for organizations that provide them with services.
Legally, an organization’s bylaws govern the internal mechanics of democratic decision making in organizations. This includes the following:
Term limits – how long members can serve.
Quorum – how many members must be present for a binding decision to be made.
Qualifications for membership – who can serve on the board. This may include specifications for credentials, lived experience, etc.
Qualifications for discharge from membership – reasons a member might be discharged from service.
Meeting guidelines – this includes the meeting times, dates, and locations (for example “meetings will take place on the third Wednesday of the month at 6pm at the offices of Generic SSP”).
Community agreements about behavior in meetings.
Boards legally must maintain three core officers:
President – responsible for board function
Treasurer – responsible for financial oversight of the organization
Secretary – responsible for records of board activities and decisions, maintained in accordance with the law
Board members are legally and financially liable for the organization and can be sued for the activities of the organization. Because of this, officers must abide by the following duties:
Duty of Care – Board members must give the same care and concern to board responsibilities as “any prudent and ordinary person” would. This means board members should be actively participating in board meetings and on committees. It also means that they should be actively working with other board directors to advance the organization’s mission and goals.
Duty of Loyalty & Duty to Recuse – Board members must place the interests of the organization ahead of their own interests. It also means publicly disclosing any conflicts of interests and not using board service as a means for personal or commercial gain by recusing themselves from decisions that may benefit them, which is also known as the duty to recuse.
Duty of Obedience – Board members agree to abide by all applicable criminal and civil laws and other regulations, and to ensure that the organization doesn’t engage in illegal or unauthorized activities.
Duty of Transparency – More recently courts and other legal arbiters have increasingly cited what amounts to the “duty of transparency” of boards of Non-Profit Organizations (NPOs). This means that their activities and decisions, and the finances of the organization, should be readily available. This is a legal requirement in most jurisdictions.
In addition, and because of these duties, board members of nonprofits are also legally required to:
Maintain and uphold the bylaws.
Only make decisions in accordance with the quorum (number of members enfranchised to vote) required by the bylaws.
Keep meeting minutes, which must include records of:
Audited financial statements (the Board is responsible for making sure the ED or fiscal staff gets all required audits)
There are many styles of Boards of Directors, ranging from very involved to very uninvolved. Some styles include:
Rubber Stamp – these are boards that simply follow the lead of the executive. They are generally very hands-off and leave decisions to the executive director or, in the case of cooperative or hybrid organizations, other decision-making bodies stipulated in the organization’s bylaws.
Governance Board – a governance board completes all of the most essential tasks of a BoD but leaves most decisions and planning to the organization’s managers.
Program Board – program boards are generally made up of people who are experts or are interested in the day-to-day program operations at an organization. These boards tend to be very hands-on, and members often volunteer to provide agency services.
Operations Board – operations boards are generally more hands-on in the operations and planning of the organization, including supporting the executive director or managers and defining long term organizational goals.
Donor Board – donor boards almost exclusively work toward building the organization’s donor base and soliciting funds. Donor boards often have a requirement that members donate a specific amount each year. Although rare in harm reduction organizations, donor boards are common in the arts.
So, how does a time-strapped leader make time for something they really do not want to do? First of all…
Do Not Be Embarrassed
Here is an open secret – nearly everyone in harm reduction is behind on some form of documentation or filing. For many folks this can become a real source of anxiety. Relax, you are in good company.
Don’t Reinvent the Wheel
There are a variety of resources for templates and examples of spreadsheets, forms, and checklists to help you track critical information about everything from passwords to outreach logs. Check the Hacks database and learn to use tools like Google Advanced Search to get to specific formats (such as .docx,.xlxs, .txt etc.) that you can modify for your needs.
Set Aside Time/ Choose A Day
Make filing and documentation a priority by setting aside time for it. For some people this can mean setting aside time each day, week, every two weeks or even monthly. Write it into your schedule and block off time for it. You need to treat documentation and filing as you would any other meeting or obligation on your calendar.
Don’t Get Overwhelmed, Make it Incremental
Do not overwhelm yourself by deciding that you are going to do nothing but documentation for a full day or a week. For some lucky few this may be a relaxing task but for most of us, especially those of us who thrive on the chaos of harm reduction, it is as boring as watching paint dry. And, if we’re being honest, tantamount to admitting we will never do it.
Instead, pick an incremental and sustainable amount of time (like 30 minutes) and commit to doing it on a schedule. If 30 minutes sounds like a lot, try for ten. As with all things harm reduction, BETTER IS BETTER, and some change is better than none. Like any habit change, over time it will become less overwhelming and, best of all, there will actually be less of it to do.
Set a Timer
Use a timer to help you manage your time while you are filing and documenting. One evidence-based method for this is the Pomodoro method, which has lots of apps and other tools available to use for free.
If you have people you are working with, delegate some of your documentation to them if you can. This may mean telling someone information while they write or type it (doing a verbal download), or simply showing someone where the information is that needs to be transcribed. It is important to take advantage of your team; not only does it lighten your workload, it also increases transparency, builds trust, and eases change.
DO IT ANYWAY
Documentation and filing are not fun for most of us, and it is easy to let it slip to the very bottom of the to-do list somewhere under “do a full Google Earth deep dive on the country Paraguay”. Do not fall into this trap. Documentation is a gift to your future self and your agency’s well-being, and it is essential for successful organizations.
The hacks on this site are shared with you under a Creative Commons Attribution-ShareAlike 4.0 International licence. This allows you (with attribution) to adapt content for your own use, although we do ask you to then also allow others to have equal access to anything you develop. More details of this licence can be found on the Creative Commons website.
We do not claim that this is an exhaustive set of strategies, shortcuts, or tips for running an SSP. What we do suggest is that Harm Reduction Hacks offers down-to-earth, practical information for being a better leader, starting and running an SSP, and providing syringe access services. We feel we can say this with confidence because the Hacks are based on interviews with, and the experiences of, literally generations of people who have been doing harm reduction work.
Please note that nothing in this guide should be construed as legal advice. Please consult an attorney local to your area to ensure your program is in compliance with all local, state and federal regulations that apply to your situation.