HHS Found $96 Million for Eight Cities' Street Outreach While SAMHSA Stops Paying for Test Strips

Kimberly Douglas founded Black Moms Against Overdose after her 17-year-old son died of an overdose. This spring she told the Associated Press what she believes is behind the national drop in deaths: “We are starting to see overdoses go down in some places and that’s because of harm reduction.”

Months later, HHS announced it was spending $96 million on a different theory of what keeps unhoused people with addiction alive.

A government can fund a person’s housing, psychiatric care and crisis line and still defund the strip that tells them what is in the dose, and that is a choice about which part of a person’s day counts as care.

On October 2, Secretary Robert F. Kennedy Jr. named the eight communities that will share the new STREETS program, run through SAMHSA, in Ohio, Oklahoma, Michigan, Texas, West Virginia, Florida, North Carolina and Louisiana. Each gets up to $3 million a year for four years, which is where the $96 million comes from. The money is meant to build coordinated systems of outreach, psychiatric care, medical stabilization and crisis intervention for people experiencing homelessness who also have a substance use disorder, serious mental illness, or both, and to bring local government, health and housing providers, law enforcement and courts onto the same page. Arizona, which saw overdose deaths rise 18 percent last year (we covered the data here), is not on the list.

Coordinated care for people sleeping outside is the right thing to build. Nobody who has watched a person fall between a hospital discharge and a shelter intake would argue otherwise. The question is what the outreach worker carries in the bag. The AP reported this spring that SAMHSA notified federal grant recipients it would stop paying for test strips and kits that detect highly lethal additives in drugs, while also cutting overdose-prevention programs including clean syringe services and drug-use hotlines. The STREETS description we reviewed lists outreach, stabilization and crisis response. It does not mention drug-checking supplies. We do not know whether the awardees can buy them with these dollars, and that is the first question to ask.

If you work at one of the eight, ask your lead applicant in writing how outreach staff will be supplied with naloxone and drug-checking strips under the award, and what you will do if the answer is that you can’t use grant funds for them. Raise it at the first kickoff meeting, not the first audit.

Whatever any of this costs, naloxone still reverses a fentanyl overdose within minutes, and a pharmacist can tell you where to get it near you. That is still yours.

Douglas’s sentence is the one to carry into every budget meeting. She did not say overdoses fell because of coordination. She said harm reduction.