County’s safe syringe programs see a change as Harm Reduction Coalition loses funding

The Harm Reduction Coalition of Santa Cruz County gives away free syringes in nine sizes.
(Rachel Bluth / Kaiser Health News)

The Harm Reduction Coalition — which has officially partnered with Santa Cruz County’s Health Services Agency for two years — and its safe syringes and related programs didn’t receive funding for the year. Supervisors cited duplication of services with the county’s own efforts, but HRC leaders say they provide needed, additive options.

Safe syringe programs have become a vital resource for public health officials nationwide in recent years — but there isn’t always a great deal of funding put toward those programs. As such, some communities, including Santa Cruz County, have relied on partnerships with local nonprofits to address the issue head-on.

Santa Cruz has two programs that have worked in tandem: the Syringe Services Program, overseen by the county’s Health Services Agency (HSA), and the nonprofit program Harm Reduction Coalition of Santa Cruz County (HRC), overseen by the state. Now, though, that working relationship will change after the County Board of Supervisors unanimously rescinded HRC’s funding on June 7.

The funding cut came as a surprise to HRC.

“I think every proposal was cut by 3% or so, but we were the only group to have our funding completely cut,” said Dani Drysdale, HRC’s syringe services program coordinator.

“Our application was dynamite — it was in line with community values of equity and health and wellness and race and overdose prevention,” said Denise Elerick, the group’s founder. “I don’t know if our board of supervisors has a working knowledge of what evidence-based best practices are.”

The organization, in existence since April 2018, distributes clean syringes and safely disposes of used syringes countywide, while providing opioid overdose medication naloxone, wound-care supplies and educational materials. The group asked for $144,481 per year, which over three years would have sustained two staff positions.

Elerick and Drysdale say that without the funding, HRC will have to search for how to pay for those two key positions come July 1, 2023.

“Supervisor [Ryan] Coonerty and I felt strongly that HRC’s model, which was proposed for expansion into South County, was not in keeping with prior board direction and policy, which is to prioritize our county’s own Syringe Services Program,” Supervisor Bruce McPherson told Lookout via email.

Coonerty said one of the other main issues with HRC’s work is that he and McPherson consider the program to be “duplicative.” The county’s Syringe Services Program, according to Coonerty, focuses on getting as many clean needles into the community as possible, while also directly connecting individuals with county health services in downtown Santa Cruz and Watsonville.

“I’m proud of what the county program has made a very good effort to connect people to services,” Coonerty said. “It’s not a matter of the county versus the Harm Reduction Coalition, it’s the HRC versus child care, or the HRC versus groups that protect seniors from abuse. ... These are really difficult decisions we have to make, and we’re just trying our best to take too little resources and give them to places where they make the most impact.”

On June 7, the board heard from city and county staff on their Collective of Results and Evidence (CORE) recommendations, with staff including county Human Services Director Randy Morris citing HRC’s community impact. Based on the expert methodology, HRC received a score of 90 out of 100, with the CORE requiring a minimum 86.

Elerick pushed back against the supervisors’ comments.

“Ryan and Bruce will tell the community [the county has a] wonderful, robust program, but the [program’s budget and staffing is] decimated within an inch of its life. We talk regularly, we do hepatitis C testing together, we work side by side — but we do things the county cannot do,” she said. “Some of those elements include syringe home delivery, naloxone distribution and education, and tabling at public events. HRC also conducts mandated syringe sweeps, with the goal of mitigating syringe litter.”

Dani Drysdale (left) and Denise Elerick of the Harm Reduction Coalition of Santa Cruz County.
Dani Drysdale (left) and Denise Elerick of the Harm Reduction Coalition of Santa Cruz County.
(Kevin Painchaud / Lookout Santa Cruz)

She further noted: “The Health Services Agency needs to partner with nonprofits like us, and they want to, the county program wants to work with us. ... These are unprecedented times when we have an overdose crisis, and if your head is in a hole in the ground, we are in a public health crisis.”

The county’s syringe services program


Safe syringe programs have been in the county for less than a decade, but those in the field say they have had a substantive impact on the community’s need for needle exchange, safe needles and education.

The county established its program under the Health Services Agency in April 2013. The primary goal: working in partnership with community members to prevent infectious disease spread via injection and address improperly discarded syringes.

Per HSA Deputy Director Jen Herrera, a syringe services program in California can operate either under county or state authorization. The county’s program takes direction from the board of supervisors on a three-pronged approach, focusing on syringe distribution, syringe collection and referrals.

The state authorized the Harm Reduction Coalition program in 2020, to work alongside the county’s program.

“We both have that same expectation and baseline, as far as we do as a program, and we both have access to state resources,” Herrera said.

The programs differ in locations and hours of availability. The county’s operates at fixed locations at the Santa Cruz Health Center on Emeline Avenue and the Watsonville Health Center on Freedom Boulevard. It operates 12 hours per week in Santa Cruz, and five hours per week in Watsonville.

“We still have parameters around how we’re operating — there’s much to be desired in terms of our accessibility,” Herrera said.

If individuals come to the county program outside of its business hours, Herrera says her staff directs them to other options, including HRC: “As long as there’s another program like HRC providing syringe services and supporting the community, we’re going to do the best to partner with them, because there’s an absolute need in the community.”

Elerick says HRC provides home delivery four days a week throughout the county, with a direct phone line users can call or text for services.

HRC appealed the funding decision prior to the supervisors’ final determination June 28. On Tuesday, Elerick and Drysdale told Lookout that HRC’s appeal had been denied.

Said Elerick: “This is … very unfortunate for the community we serve, and will continue to serve. We’ll continue to work with the county’s HSA for the health and well-being of the county’s residents.”

Added Drysdale, “At the end of the day, I am beyond proud that an organization led by trans drug users and others directly impacted by the drug war received such high praise from the CORE team. Maybe one day we will have a board that listens to people like us and experts like that team.”

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