Harm Reduction Outreach with Syringe Exchange
Volunteer Management Guide
The Chicago Recovery Alliance

I. Philosophy

CRA operates a volunteer-based program of Harm Reduction Outreach with syringe exchange. Accordingly, the utmost attention is paid to the volunteer base of CRA. While CRA's Guidelines and Operating Procedures spells out the specifics of on-site work for volunteers, this Volunteer Orientation Guide describes the specific plans CRA has for recruiting, training, supporting and assisting the growth of CRA volunteers.

II. Program

Recruitment

An ongoing recruitment effort is crucial to replace volunteers who have retired or are less able to volunteer, to diversify the volunteer pool and bring new talents and collaborations to CRA's Harm Reduction Outreach with syringe exchange.

Site Organizers are primarily responsible for the process of recruitment of new volunteers to work their sites. If a Site Organizers efforts produce a volunteer who is able and interested in working under another Site Organizer then that person should be introduced to the other Site Organizer and the process of training and support collaborated between the Site Organizers involved.

Strategies used to recruit new volunteers have included:

•   Discussing volunteer opportunities amongst people:
- utilizing the outreach sites;
- encountered at recovery oriented groups;
- visiting :RA's informational exhibits at fairs and other gatherings;
- attending CRA's training events;
- who are co-workers, friends or family of current volunteers; and
- who live and or work in the neighborhood of the particular site.

•   Place ads in local papers such as the Reader, The Chicago Defender, New City, Streetwise, etc.

•   Contact volunteer facilitation offices or other appropriate personnel of local schools, social service agencies, and community groups.

•   Always keeping an eye open for potential volunteers in everyday activities.

CRA uses a mentorship program with objective quality control measures built in at various steps. Each volunteer is assessed individually as to their abilities, experiences and interests and their training course is based on this background and their completion of the objective measurements of knowledge and observed performance criteria. These phases of training for all volunteers are:

• Observation Phase - After expressing an initial interest in volunteer possibilities with CRA, potential volunteers are invited to come to one or more outreach sites to observe the outreach in action. This action serves as a low pressure opportunity to take in the activities of the outreach with no demands of involvement. CRA feels that under these circumstances a person can make the best choice as to their level of interest in further participation in CRA activities as a volunteer. Typically, observation of CRA's outreach produces an appreciation for the work and either a willingness to join the team or the insight that the person is not ready to join this work at this time. Potential volunteers are encouraged to connect with the visceral as well as the intellectual impact observing the outreach produces in them and these reactions are discussed with the Site Organizer during and at the end of the site.

Criteria: Discussion with Site Organizer as to both their intellectual and emotional reaction to observing the site in action. At this time a mutual decision is made to go one of three directions:

1) Plan for one or more further opportunities to observe the outreach in order to further process or experience one's reaction to the work (further readings about the philosophy or the "Guidelines and Operating Procedures" may also be offered);

2) State the desire to continue to the training phase of the outreach with the goal of becoming part of the outreach team, or

3) Decide that this is not the time to proceed with further contact with the outreach site.

• Training Phase - The training phase is a period of acquiring knowledge and skill at performing the functions required at the outreach sites. As well, this phase has objective quality control measures included allow volunteers to demonstrate the knowledge and other competencies to perform the HIV prevention outreach functions well. These competencies are of two categories:

- Harm Reduction Outreach Knowledge -

The informational aspects of CRA's outreach work are continuously being compiled in the "Harm Reduction Protocol" and the "Guidelines and Operating Procedures". A volunteers understanding of these two documents is essential in order to complete the training phase for working as a volunteer.

Volunteers in training are issued the latest versions of both the documents mentioned above and given time to review this material. Upon giving this paperwork to a volunteer the Site Organizer makes an appointment to sit down and go over this material with a focus on answering any questions the materials bring up for the volunteer. The Site Organizer also makes it dear that an objective test of comprehension will be conducted about both documents when the volunteer feels he or she is ready.

Criteria: The volunteer must complete an examination of the "Guidelines and Operating Procedures" by responding with an 85% accuracy rate to thirty question tests of their comprehension of both of these documents. The test questions are composed and asked in a meeting between the Site Organizer and the potential volunteer with the breakdown of questions being as follows:

I. Sections of Guidelines and Operating Procedures (# of questions):

CRA Background (3 questions)

Harm Reduction Principles (3 questions) Outreach's Impact and Goals (4 questions) Staffing and Operations (6 questions) Site Job Descriptions (10 questions) Operational Guidelines (4 questions)

II. Harm Reduction Protocol (# of questions)

History and Definitions (4 questions)

General Process Guides for a Harm Reduction. Approach

- Introducing Harm Reduction and Refining Our Roles (4 questions) - Collaborative Assessment (4 questions)

Harm Reduction Options - Take Away Messages - Safer Sex (3 questions)

- Safer Injection (3 questions)

- Better Vein Care (3 questions)

- Abscess Prevention (3 questions)

- Overdose Prevention (3 questions)

- Other Harm Reduction Messages (3 questions)

If the test is not completed at the 85% level or above then the Site Organizer and potential volunteer will discuss the deficiencies and make a plan to remediate them and take another test. This process can continue until the 85% proficiency is obtained on both documents. Successful completion of these tests completes the initial informational training of a new volunteer.

Ongoing. dissemination of new or updated information pertinent to the practice of harm reduction outreach or to the operation of CRA's outreach is accomplished through the Site Organizers to all volunteers.

- Effective Outreach Skills -

In addition to the knowledge needed for effective outreach, as described and evaluated above, CRA's Site Organizers also perform a skills-based training of all volunteers which is evaluated with observational criteria. The criteria (listed below) are evaluated when both the Site Organizer and the volunteer in training believe they have mastered the components of effective outreach skills.

The portion of the training where the Site Organizer mentors the volunteer involves,

1) performing the tasks required under at least two of the outreach jobs described in the Guidelines and Operating Procedures;

Criteria: Demonstrates the functions described in the Guidelines and Operating Procedures for at least two of the site jobs. A volunteer should not perform a specific site job until they have been checked out on the tasks. involved by the Site Organizer. The Site Organizer and the volunteer in training will discuss the performance of each site job practiced at an appropriate time.

2) the application of harm reduction philosophy in initiating and engaging in a respectful and collaborative encounter,

Criteria: Demonstrates ten instances of initiation of contact and discussion which a) maintains a respectful posture with a person utilizing the outreach and b) joins with the person in a collaborative risk reduction direction. And, conducts two contacts with people who are openly hostile and/or belligerent while maintaining his/her cool and respectful stance. The quality of these 12 contacts will be judged by the site organizer and discussed with the volunteer at an appropriate time. At each instance of discussion the Site Organizer will provide feedback regarding their impression of the observed encounters.

3) delivery of HIV prevention messages in risk reduction contacts; and

Criteria: Demonstrates 20 instances of delivering HIV prevention messages as described in the Harm Reduction Protocol. At least half of these messages must pertain to safer sex and the other half to safer injection practices. The quality of these 20 contacts will be judged by the site organizer and discussed with the volunteer at an appropriate time. At each instance of discussion the Site Organizer will include both the accuracy or the message and the quality of the encounter.

4) listening for and following through with an effective referral.

Criteria: Demonstrates five instances of listening for, inquiring about or otherwise fielding a referral request from a person utilizing the outreach. Prior to this evaluation the volunteer in training will confer with the Site Organizer and discuss the appropriate channels for making a referral given the volunteers background and experience. Some volunteers may be very competent with some types of referrals and not other types. As well, some volunteers may be able to make self-referrals to their own programs while others will be better advised to pull in the Site Organizer for referrals outside their expertise. The quality of these 5 referrals will be judged by the site organizer in keeping with CRA's Treatment and Other Referral Expediting Service guidelines and discussed with the volunteer.

Once these skills are demonstrated at the quality and quantity described above, the skills based volunteer training phase is completed. Signing a copy of the current Guidelines and Operating Procedures is required of all volunteers successfully completing the training phase.

As an ongoing part of effective harm reduction outreach, the outreach team will provide feedback concerning each others performance at the end of each site.