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.   

James leading a training during our mission statement retreat day.

Jason & Irina reviewing materials.

Nancie & Maurice leading the game of harm reduction Jeopardy during our mission statement retreat day.

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

HRTC Welcomes New Board Members

Deborah Borne

Deborah has worked in homeless, addiction, drug user health and HIV services for over 30 years as a social worker, researcher, educator, administrator, policy maker, Medical Director and provider. Deborah currently works for the San Francisco Department of Public Health in health planning for people experiencing homelessness and reproductive health justice for vulnerable populations. As a Street Medicine clinician, she sees patients on the street, at syringe exchanges, and in social service centers.

Deborah was the Medical Director of the Tom Waddell Health Center and then the SFDPH Transitions Division and Care Coordination Program. During the COVID-19 emergency, Deborah served as the San Francisco COVID Command Center Operations Deputy for Prevention, and Deputy of Equity and Neighborhood Health. Her local and national work has included medical integration into behavioral health centers; SF City Shelter Health legislation; HIV/STD prevention and treatment quality efforts for vulnerable communities; and development of San Francisco General Hospital’s Social Medicine consultation service.

Deborah has been a trainer for the National Health Care for the Homeless Council in Motivational Interviewing, Trauma Informed Care, STD/HIV Care, Quality Improvement, Shelter Health Care, Reproductive Health and Outreach. She is currently a Search Inside Yourself and Heart Math mindfulness trainer for the San Francisco Department of Public Health’s Trauma Informed Equitable Systems Initiative.

Anat Leonard-Wookey



Anat joined the HRTC board in October 2023. She brings over 20 years of experience across the homeless services system of care (e.g. shelter, transitional housing, permanent supportive housing and supported employment) serving multiple communities, including survivors of intimate partner violence, youth, families, seniors, persons living with HIV/AIDS, and persons with co-occurring mental health and substance use disorders. Anat was the Vice President of Programs for HomeRise and prior to moving to San Francisco she was the Deputy Executive Director of Housing Services at Bowery Residents’ Committee in New York City. She holds a Masters in Social Work from Columbia University, and licensure as a Clinical Social Worker in New York and California. She is passionate about harm reduction and social justice and believes deeply in the wisdom within each human. She has enjoyed supporting non-profits through Board Service in the past and most recently termed off the Board at Dolores Street Community Services. She is the mom to a toddler who keeps her on her toes and volunteers as a Crew Leader with Sutro Stewards to stay connected to nature.

State Proposition 1:

"Treatment not Tents"

These are the questions HRTC asked as we considered our position, and we are sharing them in case they can be of help to you before you vote:

• Would this proposition expand services?  Or does it move to cut already limited outpatient treatment programs in favor of inpatient, locked “beds?”
• Is this proposition attempting to speak to a housing crisis in California or a mental health and substance use crisis?  How much new housing will be created under this measure?  How many new services for mental health and substance use treatment be created?
• Does this proposition address the treatment needs of people whose drug use has become harmful who also have mental health issues?  Will this proposition expand access to dual diagnosis care?
• Locked, forced treatment beds are not the same as permanent housing.  What permanent housing will be provided under the proposition?  
• Is it possible that many people want treatment but aren’t able to access it?  Is it possible that many people would want treatment if it better met their treatment needs and goals?
• Most in-patient or residential treatment programs are 30-90 days.  If you are unhoused when you enter treatment, will you be unhoused when you leave treatment under Proposition 1?
• How will Proposition 1 be funded?  What will the impact be to existing funding for community mental health, substance use and housing programs?

Remember, voting day is Tuesday, March 5, 2024!

Abby McMorrow, ASW Community Based Therapist

After a hiatus due to the impact of COVID-19 and space challenges, the Harm Reduction Group is meeting on Thursday mornings in the Hospitality House drop-in center located at 169 6th Street. Our group provides a space to talk about substance use, mental health, or anything in between with no requirement of abstinence. We range from groups of six to groups of thirteen (we now know our ideal number is ten). Group members come as they are, stay as they’re able, and leave when they need.

How do we make and hold space for everyone to come as they are? Meaning inviting differing goals, differing identities, and different personalities. Holding a space that allows for the acceptance of all experiences is not without its challenges. People experiencing the chronic and complex trauma related to homelessness, stigma, and systemic violence may present with justified anger, pressing mental health symptoms, and challenging interpersonal skills. We are working on building cohesion in the group where someone experiencing psychosis and someone experiencing acute distress can find connection and create a shared reality.

The Harm Reduction Group opens our individual minds to new perspectives, realities, experiences. In essence, we are broadening the way we hear the stories of others and how they hear our own. We are expanding the ways we can hold individual goals and community goals. By building the capacity to expand instead of constrict when others share, we hold each other by giving support, building community, and reducing isolation. And by practicing healthy relationships in real time, we make a roadmap to building healthier relationships with ourselves and with our drugs. Does this go fluidly and flawlessly all the time? Absolutely not. There is big energy on 6th Street and that big energy finds its way into the group. We rupture and repair in the moment. Someone might have big feelings about someone’s view on drug use. Someone else might have big feelings about someone else’s involuntary movements. We try to bring those big feelings back to the group and have the group work these out together. Thus far no one has lunged across the group at someone else, so I’d call our attempts at de-escalation a success. And people keep coming back.

We are about ten weeks into the group and are in the early stages. We are building trust, testing boundaries, and setting group norms—which right now include a lot of talking, some listening, and a good dose of harm reduction.

Did you know that HRTC distributes over 400 harm reduction kits at our mobile sites every week? These include injectable naloxone kits for overdose reversal, fentanyl testing kits, safer use kits, all carefully tailored to encourage our community members to take control of and help manage their substance use and stay as healthy as possible, safe and alive. 

There are several reasons why this is an important part of our agency's practice:

1. Safer use kits help prevent both overdoses and the transmission of HIV, Hep-C and Covid.
2. Per the CDC, community members who seek out harm reduction materials are 5 times more likely to consider counseling and treatment to help manage their substance use.
3. Having harm reduction supplies at our mobile sites is a key tool in helping our therapists engage in conversations with our community members about their relationship with substances. 

In order to support this critical aspect of our outreach efforts, HRTC will be hosting quarterly volunteer events at our drop in center at 21 Merlin Street. We will be making a variety of harm reduction kits for use in our community programs.

Dates (2024):

March 2nd

June 1st

September 7th

December 7th

We hope to see you all there!