Harm Reduction Sisters

What it reported doing in 2025

Harm reduction sisters (hrs) provides safer injection and smoking supplies, narcan, non-medical HIV case management, harm reduction education, drug checking, and more - all at no cost. Our harm reduction services include the distribution of sterile injection supplies, overdose education, and naloxone to communities in northern Minnesota. Our peer navigators provide mobile rapid HIV testing by appointment in duluth and the surrounding areas. Outreach HIV case management - harm reduction sisters' outreach HIV case manager works with people who have received a reactive HIV test. The outreach case manager meets clients in environments that work for them to:- complete an initial, rapid, client-centered assessment of service needs- collaboratively develop an individualized care plan- make timely and coordinated referrals and assistance accessing appropriate health and support services based on client-identified priorities- provide ongoing client support to assess progress towards goals and emerging needs for support, including client-specific advocacy to support service access- deliver client-tailored education regarding HIV care and treatment, risk reduction and other areas to support optimal health outcomes- reassess client needs and regularly update care planpeer advocacy & linkage - our outreach team provides linkage to regional services and programming, including housing, insurance navigation, and health services.in 2025, harm reduction sisters continued to expand community services, utilizing our mobile unit to conduct outreach across duluth and the surrounding region. We established new partnerships with the northeast regional corrections center, center for alcohol and drug treatment, behavioral health group, umn/umd, union gospel mission, and the duluth public library to deliver essential services, including wound and foot care, sti testing and education, mobile health outreach, and syringe service program (ssp) services. The mobile unit was instrumental in extending the reach of these services throughout the year.hrs also grew its team to strengthen organizational capacity across both urban and rural service areas, resulting in increased participation across several programs, including community drug checking, community education events, sti education and prevention, and broader community engagement efforts.hrs closed out 2025 with two significant research partnerships. Hrs was selected as one of eight sites nationally to participate in the bistro study, which examines low-barrier buprenorphine inductions within ssps. We were also selected to take part in the project access study, focused on opt-out HIV and hepatitis c testing within ssps.hrs served 1,792 clients in 2025, which was an increase from 1,083 clients the previous year. We also distributed nearly 13,723 doses of narcan/naloxone.

Financial Efficiency

• Mission deployment rate: 80.7%; rating input score 81
• Program expense ratio: 87.7%; rating input score 88
• Fundraising efficiency: $32.83 raised per $1 spent on fundraising; rating input score 67; 67th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: Limited
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 64th percentile among comparable filings
• Governance controls: 6 of 8 controls in place; rating input score 75
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Fail
  • Document-retention policy: Fail
  • CEO compensation review process: Pass
  • Other executive compensation review process: NotApplicable
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 7.9%; rating input score 52; 52nd percentile among comparable filings
• Total-asset coverage ratio: 0.34; rating input score 17; 17th percentile among comparable filings
• Liabilities to assets ratio: 0.41; rating input score 15; 15th percentile among comparable filings
• Officer compensation ratio: 7.8%; rating input score 43; 43rd percentile among comparable filings

Growth

• Program expense growth: 52.6% per year; rating input score 100; 95th percentile among comparable filings
• Revenue growth: 48.2% per year; rating input score 100; 95th percentile among comparable filings
• Asset growth: 45.4% per year; rating input score 100; 94th percentile among comparable filings