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[0:22]
>> Good morning come on everyone.
[0:26]
I'm the chair of the Board of Legislative Committee on Health.
[0:32]
Today is August 26th and we are commencing this meeting at 11:08
[0:39]
a.m..
[0:41]
Today's meeting topic is something
[0:46]
that we have spoken about before early
[0:50]
on when we spoke about implementing
[0:56]
vending machines for public safety item, particularly
[1:02]
Narcan.
[1:03]
Are and I read a couple of recent articles that highlighted
[1:10]
Staten Island where Miss Adrian --
[1:18]
and we're so happy to have her join us today to speak about how
[1:23]
they implemented it their.
[1:25]
In fact, I believe it was from your weekly email
[1:32]
list of news items that I read.
[1:35]
There's also a program in Connecticut
[1:39]
that we tried to get that to join us today To.
[1:43]
But we really wanted to approach this again and see --
[1:53]
learn how it was implemented in other places and see where we
[1:57]
can possibly implement it here in Westchester County.
[2:01]
Before I quiet and give Adrian the floor,
[2:06]
I want to ask everybody at the table to introduce themselves
[2:10]
and then we will have everybody who is virtual do the same.
[2:18]
>> I'm the commissioner of the --
[2:22]
I'm Doctor Dr. Sherlita Amler and I have the (Indiscernible).
[2:31]
>> I'm Patrick Quinn and I also work with the Division
[2:35]
of Health.
[2:37]
>> I'm deputy commissioner of the Department of Community
[2:39]
Mental Health.
[2:41]
>> I'm the assistant commissioner of the Department
[2:43]
of Community Mental Health.
[2:46]
>> Thank you.
[2:47]
And Adrian, we will start with you.
[2:52]
>> Hi.
[2:53]
Hello, I'm sorry I can't be there.
[2:56]
I'm Adrian and I'm the executive director of partnerships
[2:58]
for Community Wellness.
[3:02]
>> Thank you.
[3:04]
Deputy chief.
[3:06]
You're muted.
[3:12]
You're muted, deputy commissioner.
[3:17]
>> Hi.
[3:18]
I'm not deputy Commissioner, that's my boss.
[3:21]
I'm sorry.
[3:23]
That's okay.
[3:24]
My name is Niall Salih and I'm the Department of Emergency
[3:28]
Services and I oversee the public access defibrillation
[3:32]
program for Westchester County.
[3:33]
So that's probably why I am on this meeting.
[3:39]
>> Thank you.
[3:40]
And Mr. >> Good morning, everyone. the county
[3:45]
Department of Emergency Services, EMS Division.
[3:48]
And I'm here for the same reason.
[3:51]
Thank you.
[3:53]
>> Thank you.
[4:01]
>> Good morning.
[4:02]
I'm deputy commissioner for the Department
[4:04]
of Emergency Services.
[4:05]
We are here to help you guys.
[4:08]
>> Yes, I love it.
[4:10]
EMS is well- represented.
[4:12]
I'll just educate that we are also
[4:15]
joined on the screen with our other committee
[4:20]
coordinator, Diana Gomez.
[4:22]
And our director of legislation, James.
[4:26]
Thank you to everyone for joining us today.
[4:29]
Again, I'm going to turn the floor over to Adrienne Abbate
[4:35]
so we can learn from their program.
[4:37]
I'm really happy to have such a strong EMS presence.
[4:40]
If you do want to speak about -- if this comes to fruition
[4:44]
in the county, what areas in our county,
[4:50]
what locations would be ideal where we are seeing the most
[4:56]
occurrences.
[4:57]
Adrian, again, thank you so much for joining us.
[5:01]
Please, take the floor.
[5:09]
>> We see your presentation but you are still muted.
[5:16]
>> Thank you for letting me know that.
[5:18]
You can see the presentation, wonderful.
[5:21]
Okay.
[5:22]
I'm gonna stop my video while I am presenting.
[5:26]
I'm assuming we're gonna have some time
[5:28]
at the end for questions.
[5:30]
>> Absolutely.
[5:32]
>> Fantastic.
[5:34]
>> We won't even interrupt you.
[5:36]
>> Please do.
[5:39]
Okay great.
[5:41]
I like a lively conversation.
[5:43]
I introduced myself but just to give some background,
[5:47]
I've been at partnerships for community Wellness
[5:49]
for about 14 years.
[5:51]
Before that, I worked at the New York City Department
[5:54]
of Mental Health and Hygiene under Tom Frieden and Bloomberg
[5:57]
where we did a lot of innovative public health strategies.
[6:00]
And I decided to focus where I live
[6:03]
and I became the founding director of partnerships
[6:06]
for Community Wellness.
[6:08]
We are a public health nonprofit.
[6:10]
We work to address the systemic issues that
[6:13]
contribute to poor health outcomes
[6:14]
by serving as this bridge between systems and communities.
[6:17]
When I say systems, we mean neighborhoods,
[6:21]
hospitals, schools.
[6:22]
And really, making sure that communities
[6:25]
are informing the work in every single aspect
[6:29]
from strategy to development to implementation.
[6:32]
We do this -- these are our neighbors in the middle.
[6:36]
Building coalitions, creating building spaces for partners
[6:39]
to come together and understand issues.
[6:41]
We do training and capacity building for community but also
[6:44]
for organizational partners.
[6:45]
We have an arm of work that works
[6:47]
on research and evaluation.
[6:49]
We have very strong advocacy committee --
[6:53]
a very strong advocacy committee.
[6:55]
This is a precursor to the work that we're
[6:57]
doing in the public health and we
[7:00]
work on sustainable development and act
[7:03]
as a physical pastor for small organizations.
[7:05]
We almost act like a little health
[7:07]
department in our own right but we are a CD o,
[7:10]
we do have a lot of government contracts.
[7:13]
We are very vulnerable right now because our mission is not
[7:16]
in alignment with other federal priorities, but we are scrapping
[7:20]
and we are making it work.
[7:21]
So we take a social justice approach to health.
[7:26]
We focus on health equity.
[7:27]
I talked about that.
[7:28]
Really addressing root causes, so looking upstream.
[7:31]
A lot of amazing work is happening,
[7:34]
meeting people's immediate needs, which is critical.
[7:37]
But that's downstream.
[7:38]
But we like to really unpack the issues
[7:40]
and think about the systemic issues that
[7:43]
have contributed to these poor health outcomes and inequities.
[7:46]
We focus on vulnerable populations and we really
[7:49]
believe in community power -- so involving communities most
[7:53]
impacted in the design implementation of the work.
[7:55]
And that's also part of our public health story as well.
[7:59]
These are the buckets of work.
[8:01]
I'm not going to go into them in detail.
[8:03]
I'll go into the behavioral health work
[8:05]
but we also focus on maternal and child health and emerging
[8:07]
public health issues.
[8:08]
A lot of work around vaccines, both during COVID.
[8:12]
And now we are seeing pediatric vaccines lowest among the city.
[8:17]
Staten Island, I should give some context,
[8:19]
for those not aware, is an outlier in terms
[8:22]
of the bureau's.
[8:23]
It's the smallest but it's 500,000 people so it's almost
[8:26]
the size of Buffalo.
[8:26]
So it's like we are the size of a small city
[8:29]
but part of a large municipality.
[8:31]
We are the only Republican district
[8:34]
in terms of congressional representation.
[8:37]
And I do like to say that we have
[8:39]
a lot of bipartisan support in the behavioral health work
[8:41]
that we've been doing.
[8:45]
So what does behavioral health look like on Staten Island?
[8:48]
I'm just talking about the collaboratives
[8:50]
but we have a pretty strong infrastructure.
[8:54]
We created the -- and then has evolved over the past decade
[9:07]
and a half to incorporate mental health because we know that
[9:11]
there's so many similar risk and protective factors.
[9:14]
We work across the continuum.
[9:17]
Many coalitions are just prevention coalitions
[9:19]
but we've always had treatment, harm reduction,
[9:22]
recovery as part of the coalition.
[9:24]
We have work groups that align with the issue
[9:26]
that we are seeing in our strategies.
[9:28]
Our structure is a little bit scary.
[9:31]
It is a beast but it's also something
[9:35]
that has been operating with gas for a long time.
[9:39]
Sometimes it's hard to keep these collaboratives
[9:41]
and we've had some real wins.
[9:43]
We were the first group to pilot Narcan with NYPD.
[9:48]
And it started in a little workgroup at TYSA
[9:54]
and then it became borough wide and city wide and then scale.
[9:58]
Staten Island is a nice place to test strategies and potentially
[10:01]
scale them.
[10:02]
We have grasstops and grassroots so government partners
[10:05]
at the table com a district attorney, heads of agencies, all
[10:08]
of the OASAS/OMH providers.
[10:10]
We also have grassroots groups and people most impacted.
[10:14]
We are also the facilitator of our state opioid
[10:17]
response regional network.
[10:18]
I'm not sure if Westchester has a network
[10:22]
but these were dollars that were brought in
[10:25]
to make sure that there's no wrong door, that we have
[10:27]
enhanced services for special populations,
[10:29]
that we are addressing housing, vocational supports,
[10:33]
making sure prevention is included in the conversations.
[10:36]
We are part of the district attorney's Fentanyl Task Force.
[10:39]
I know that Westchester has a similar type of hope program
[10:42]
but we were at the table when the Hope program was formed,
[10:45]
making sure that people with lived experience
[10:47]
were at the table, thinking about,
[10:50]
what does engagement look like?
[10:52]
And just, really, I mean, I'm very proud of the work
[10:57]
that we've been doing with our criminal justice partners
[10:59]
but yes, it's a model for some other communities.
[11:02]
I'm not going to go into detail, but this
[11:05]
is a very innovative program.
[11:07]
It's the Staten Island PPS performance provider system.
[11:12]
It's a Hotspotting initiative and they
[11:14]
are using data analytics to look at where overdoses are happening
[11:17]
and then responding to provide intense wraparound services.
[11:22]
And they have studied it and seen a 70% decrease
[11:27]
in overdose deaths among their cohort
[11:30]
when compared to another group that didn't receive it.
[11:32]
It's some really interesting things
[11:34]
that are being tested out.
[11:36]
And this is where the public health end machine came up
[11:41]
we were learning about it in TYSA.
[11:46]
We learned that the city was already doing
[11:47]
something in 2023 and 2024.
[11:49]
We were not the first in New York City
[11:51]
but we were not in that original cohort of machines.
[11:53]
But we wanted to.
[11:55]
Now, I'm going to talk a little bit
[11:58]
about how we brought it to Staten Island
[12:00]
and why we brought it here.
[12:03]
I provided that prior slide to give you context,
[12:06]
that there's a lot going on.
[12:08]
And this is just one piece of the puzzle.
[12:11]
And it's just complementing a lot
[12:14]
of the other work that is happening and being provided
[12:17]
by a lot of the partners.
[12:19]
This strategy -- the public health initiative is supported
[12:22]
by public health settlement funds that are provided to New
[12:25]
York City.
[12:26]
Is not part of the original abatement
[12:28]
or any part of the Oasis procurement
[12:31]
but it is through New York City's share.
[12:33]
I'm going to talk more about that in a little bit.
[12:36]
And I mentioned that it's part of a larger New York City
[12:38]
Department of Health and Mental Hygiene Initiative.
[12:41]
So they got the first funding.
[12:44]
I think there are two of them in Brooklyn.
[12:48]
And I'm sorry, I'm blanking on the locations of the other two
[12:52]
but they started the program and then
[12:54]
we scaled it to Staten Island this year.
[12:56]
I'm sure I'm singing to the choir,
[13:00]
but I'm going to define public health vending machines so
[13:03]
that we're all on the same page.
[13:05]
They are automated kiosks or vending machines
[13:08]
that dispense free public health and wellness supplies to members
[13:11]
of the community.
[13:12]
We don't call them harm reduction vending machines
[13:14]
because we supply lots of different supplies,
[13:18]
just to support people in their wellness journey.
[13:21]
They are accessible 24 hours a day
[13:22]
and transactions are completely anonymous.
[13:24]
So people only have to enter in their zip code,
[13:29]
and then the code for whatever that item is.
[13:31]
And you can see from the picture,
[13:33]
each item is in a little packet so
[13:37]
that we are thinking about children and how it looks.
[13:41]
Some communities put them in in brown wrappers.
[13:44]
We have them in little packets with labels on them
[13:47]
and people punch the number in.
[13:48]
And then that data is shared with the city health department
[13:51]
so that they can be tracking the supplies that people
[13:54]
are getting.
[13:55]
And also, the zip codes where people are not accessing them,
[14:00]
but where those people are from.
[14:02]
So we have a sense of the communities
[14:04]
that it's penetrating and reaching.
[14:08]
>> So how do you know where they are from?
[14:11]
>> They punch in their zip code.
[14:12]
That's the only item -- that's the only information that is
[14:17]
collected is the zip code.
[14:18]
You punch in your zip code and then you put in 140
[14:21]
and it's like, that's a naloxone kit.
[14:23]
So we know and we can track the item and the zip code
[14:27]
of where the person is from.
[14:29]
There are no cameras.
[14:31]
I'll get into that as well.
[14:32]
Any other questions before I move on?
[14:36]
Okay.
[14:37]
So why on Staten Island?
[14:41]
We have long been impacted by the opioid epidemic.
[14:44]
We outpaced the city for many years.
[14:47]
The Citywide rate, we were neck and neck with the Bronx.
[14:51]
And the lack of public health infrastructure,
[14:53]
so we don't have a brick and mortar health and hospital
[14:56]
public hospital.
[14:57]
We don't have a local health department presence.
[15:00]
So we really are good at working together and trying
[15:04]
to scale programs from the city with other funding sources
[15:08]
if it's not in the city budget.
[15:10]
I didn't talk about the geography of Staten Island
[15:13]
but our machines are on the North Shore.
[15:16]
The North Shore is more ethnically diverse.
[15:21]
It's disproportionately impacted by overdose deaths.
[15:25]
It's a high poverty area.
[15:27]
And I feel like this is not unusual,
[15:31]
but the opioid epidemic has changed in how it looks
[15:35]
and who it's impacting over the course of the years.
[15:38]
And we are now -- where it was a very white to middle class issue
[15:42]
on Staten Island when we formed, it has evolved.
[15:46]
It's always been impacting communities of color
[15:49]
but we are really drilling down and focusing in naming equity
[15:52]
and investing in the North Shore neighborhoods,
[15:54]
and this is where the overdoses are happening.
[15:56]
And so we are putting the machines
[15:58]
in the communities most impacted.
[16:02]
>> Can we talk about that change?
[16:04]
>> Sure.
[16:05]
>> Because my understanding, and anybody can jump in and correct
[16:09]
me if I'm wrong, my understanding is the opioid
[16:12]
epidemic surge from people being prescribed pain medications,
[16:17]
and then became addicted -- which is the meaning
[16:24]
of addiction, they couldn't stop.
[16:26]
And I know you've seen the stories, especially in Florida,
[16:30]
these pop up locations where people could easily get
[16:34]
fake prescriptions and opioids.
[16:37]
So how did that change from upper- middle class
[16:43]
people or an athlete to now, where it's so widespread.
[16:55]
>> Sure.
[16:55]
I'm happy to tell the story of Staten Island where
[16:59]
we were seeing, when we were seeing early
[17:01]
on in the coalition, and looking at data, that not only were we
[17:05]
seeing high rates of use, but we were also looking
[17:08]
at prescribing patterns.
[17:10]
And our doctors were prescribing the highest dosages
[17:13]
for the longest duration.
[17:15]
So when we first started the coalition, we did a lot of work
[17:19]
with the medical community.
[17:20]
There were some bad apples like pill mills,
[17:23]
where they were selling and operating them in bad faith.
[17:29]
But there were also people who were instructed
[17:31]
from pharmaceutical companies that this was a best practice.
[17:35]
And, we are meeting the needs of their patients.
[17:38]
So there was a lot of physician education that went on.
[17:41]
The other thing about Staten Island that we thought
[17:44]
was significant and contributed to it
[17:45]
was that we have a lot of the sanitation,
[17:50]
NYPD, live on Staten Island.
[17:54]
These are people who have insurance, who sustain injuries.
[17:57]
So these were local conditions.
[18:00]
And I feel like that's always important,
[18:02]
is to understand the local conditions that
[18:04]
are contributing to the issue.
[18:06]
So then we were also instrumental
[18:09]
in passing legislation which is statewide,
[18:12]
but it's basically the prescription drug monitoring
[18:16]
program which makes it impossible for doctors
[18:21]
to write scripts without it being entered into a system
[18:23]
with a pharmacy that received it.
[18:25]
There are a lot of checks and balances,
[18:27]
making it more difficult for people
[18:29]
to access pills for diversion.
[18:32]
Which led to people, then, when you develop a dependency,
[18:35]
and you can't get the pills, switching to heroin
[18:38]
which was much cheaper.
[18:39]
I mean, there's a whole evolution.
[18:42]
Then, fentanyl was added, making it more dangerous.
[18:45]
Now we have cytokines.
[18:48]
There's always going to be something new added
[18:51]
and it's important to be nimble and understand
[18:53]
what is happening in the community and ways
[18:55]
to respond to.
[18:57]
And when we first went out and we were doing presentations,
[19:01]
the members of the black community
[19:03]
were like, where were you during the crack epidemic?
[19:06]
And I had to say, I'm sorry but we are here now
[19:10]
and we are working and we are trying
[19:12]
to address the harms that have been happening.
[19:14]
So that is kind of where we are at now.
[19:16]
When we look at overdose deaths in New York City
[19:18]
and on Staten Island, it's happening in an older and more
[19:21]
socially isolated population.
[19:23]
So that's why there's many strategies
[19:26]
about getting naloxone mailed to people at home.
[19:29]
And that's also why it's important to have
[19:31]
public health vending machines because we
[19:33]
know that with overdoses, 40% of them happen with a bystander.
[19:39]
So if a person doesn't have a kit on them
[19:41]
and they are in a situation, it's a missed opportunity.
[19:45]
So I hope that was helpful.
[19:48]
>> Yes, it definitely was.
[19:50]
Deputy chief, do you want to jump in?
[19:54]
Do you want to share?
[19:58]
Is that the same type of evolution you've seen?
[20:07]
>> I could tell you from just getting feedback from the EMS
[20:09]
agencies in our area, they are not reporting in a large number
[20:16]
of these events.
[20:17]
I'm not saying they are not happening.
[20:19]
It's just that they are not reporting
[20:21]
that they are in weekly check ins
[20:24]
and saying that they had a particularly heavy call
[20:26]
volume this past weekend.
[20:27]
There's none of that.
[20:29]
One thing that I am curious about, just in general
[20:32]
with this, with these public health vending machines,
[20:35]
has there been any sort of a link to EMS?
[20:39]
Because I know it's all anonymous.
[20:42]
And if somebody is dispensing something
[20:44]
for potential use on a patient, there's not always a guarantee
[20:49]
that one round of Narcan is going
[20:51]
to achieve the desired results.
[20:54]
Certainly, EMS would be more than warranted there.
[20:57]
Is there some sort of way in Staten Island
[21:00]
that EMS units are getting notified of the potential?
[21:04]
And if they do, how would they know what area could potentially
[21:08]
be utilized?
[21:09]
I'm just curious if there's any correlation.
[21:12]
>> Interesting question.
[21:13]
We don't have a system set up.
[21:15]
So when people take the kits, we are not there to train them.
[21:19]
And if we do any kind of training,
[21:21]
we also say to call 911 right away.
[21:24]
That's one of the main things.
[21:25]
Don't think that giving them a lock zone is enough,
[21:28]
because they can come back and then nod off again.
[21:30]
It's one of our main messaging points,
[21:34]
but there's no way for us to know exactly.
[21:39]
It's not like, if you use this kit, please call us and let
[21:43]
us know so we can be tracking.
[21:44]
There's a lot of unreported overdoses again that happen.
[21:48]
And unfortunately, missed opportunities to engage people.
[21:53]
>> I want to point out that I think (Indiscernible)
[21:59]
because they've been providing naloxone and training
[22:08]
(Indiscernible).
[22:09]
Do you know what year that was?
[22:10]
>> It was 2014.
[22:11]
>> We've been doing this for 12 years and how many people have
[22:18]
you (Indiscernible)?
[22:21]
>> I don't know, thousands.
[22:22]
Thousands of thousands of thousands.
[22:24]
>> Thousands and thousands of thousands of people.
[22:27]
I think that you can continue to try to educate the public.
[22:34]
But sometimes it is around access.
[22:38]
Luckily, the governor did make it
[22:40]
so that you can get a prescription of an opioid
[22:42]
and you have the ability to have Narcan filled at your pharmacy.
[22:48]
I think that would help.
[22:51]
A lot of things have been put in place and (Indiscernible)
[22:58]
one more tool.
[22:58]
There are many things that the community
[23:00]
is doing to try to prevent overdose deaths in Westchester.
[23:05]
And I found what you had to say very interesting about what's
[23:10]
going on in Staten Island.
[23:13]
I think some of the problems that you discussed
[23:16]
are problems that we share.
[23:19]
>> Yes.
[23:20]
>> We are trying to address in our own way, here.
[23:25]
>> I'd like to add on to what the question was asking about
[23:30]
when people call 911 (Indiscernible) syringe exchange
[23:38]
program and the Narcan.
[23:39]
Almost 100% of the time, they don't call 911.
[23:42]
But in the lockbox, we have a laminated miniature poster
[23:48]
that shows a QR code.
[23:50]
Which if you have a phone, you can go right there.
[23:52]
Then it has a 52nd instruction on how to administer Narcan
[23:57]
and call 911.
[23:59]
And we discussed vending machines.
[24:04]
We also wanted to include an information pack
[24:10]
that mental health put together.
[24:12]
It has food pantries and emergency information,
[24:17]
contact information.
[24:18]
But you're right, a lot of the times--
[24:21]
>> I love that you're doing all that.
[24:25]
We are trying to do that as well with the QR codes
[24:27]
and the additional resources.
[24:28]
We are all going through it and testing out what works.
[24:32]
And to the earlier point, this is just one piece --
[24:40]
one tool in the toolbox.
[24:41]
Yes.
[24:43]
>> I just wanted to add that one of the things that we are aware
[24:46]
of as we try to be data-focused, we know that, for example,
[24:53]
that the data we get on overdose deaths is pretty consistent
[25:01]
and accurate, the actual number of overdoses are becoming harder
[25:08]
and harder to track simply because of what we are
[25:10]
discussing here.
[25:11]
And when you add in -- we have talked for the last several
[25:17]
years about safe use and that kind of stuff.
[25:19]
You can't automatically assume that a naloxone kit being taken
[25:23]
out of a vending machine is being used specifically
[25:27]
for emergency purposes.
[25:30]
There's also that issue of correlation.
[25:34]
It's great that it's out there.
[25:36]
We have no idea when and if it's actually being used.
[25:40]
>> Yep.
[25:40]
And we've been talking about that.
[25:42]
One of our measures is just having the products
[25:46]
circulating in the community.
[25:47]
We are hoping that they will be used.
[25:50]
But just getting it out there is an important piece of that.
[25:53]
I'm going to go through this quickly.
[25:55]
This is what we have in our machine -- naloxone,
[25:59]
fentanyl and Xylazine test strips, wound care kits,
[26:03]
safer sex supplies, COVID tests and masks, hygiene kits,
[26:07]
feminine hygiene, we have plan B.
[26:09]
We lost our Planned Parenthood clinic so we started to provide
[26:13]
plan B. We have fit packs and then seasonal items like foil
[26:17]
blankets in the winter, and socks.
[26:21]
Socks have been very popular.
[26:23]
But we did a lot of work, doing a needs assessment
[26:27]
in the community.
[26:29]
So street outreach, pushing into the treatment programs
[26:32]
to learn about what are the things
[26:33]
that they want in the machine.
[26:35]
We have two machines and they were
[26:38]
customized based on this needs assessment and feedback.
[26:41]
I have to say that when you have the machine,
[26:43]
you can't just make a quick change
[26:45]
because each coil in the vending machine
[26:48]
is designed for a certain size item.
[26:52]
So sometimes there's some planning
[26:53]
that has to go into what the products are.
[26:56]
We do not have syringes.
[26:58]
And we do not have smoking kits.
[27:00]
This is something that has been one of the more controversial
[27:03]
items.
[27:04]
Some of the machines in the city have those.
[27:06]
We do not have them on Staten Island at this point.
[27:11]
>> Forgive me, what is a fit pack?
[27:17]
>> It's basically to dispose of syringes.
[27:20]
It's a mini sharps container.
[27:23]
And again, we've talked about this.
[27:26]
It's a lot of insider baseball, but people
[27:28]
who currently use drugs know it and they
[27:31]
would be the ones accessing.
[27:32]
So a community member who doesn't know it,
[27:34]
maybe they might take it once and they might use it
[27:37]
for their GLP one injectable.
[27:38]
I don't know.
[27:40]
So that is kind of how we are approaching it.
[27:44]
I love that you brought up the idea of resources.
[27:49]
In our kids, we are putting information
[27:50]
in about services for treatment and recovery.
[27:53]
And we have posted them at partner locations
[27:55]
to make sure that people are connected to resources.
[27:58]
This is our timeline, which is a little bit scary.
[28:03]
I don't think it needs to take three years,
[28:05]
but this is just our journey.
[28:07]
It started in 2023 when we just did
[28:10]
some guerrilla postering on Overdose Awareness Day, where
[28:13]
we blanketed neighborhoods that we knew
[28:15]
were high overdose rates.
[28:17]
With posters.
[28:18]
And we just attached test strips and some harm reduction
[28:24]
supplies.
[28:25]
We would go back and we would see that they were
[28:29]
being taken on a daily basis.
[28:32]
We blanketed the area.
[28:34]
The posters kept getting taken down, we would put them back up.
[28:37]
But it really showed that there was
[28:39]
a appetite for this self-service harm reduction model.
[28:42]
It was only started double it was only
[28:44]
when we started to get fines from the of sanitation
[28:46]
that we thought we should try a different strategy.
[28:48]
But we certainly made a mark in terms of raising awareness
[28:53]
around harm reduction.
[28:55]
In 2024, when the city first got their opioid settlement funds,
[29:01]
they were expanding and enhancing existing projects.
[29:05]
None of those projects existed on Staten Island,
[29:08]
again, going back to that public comment on infrastructure.
[29:11]
We made a lot of noise.
[29:12]
And this is the importance of having coalitions and activated
[29:16]
groups.
[29:16]
So we advocated to the mayor to say,
[29:19]
we have been disproportionately impacted by this epidemic.
[29:22]
We are not receiving a dime.
[29:24]
City Hall heard us and they created an opportunity
[29:26]
for Staten Island, for CBOs, to apply
[29:30]
for funding to support services across the continuum.
[29:34]
And partnerships, us, we decided to apply
[29:38]
to get the public health vending machines.
[29:41]
There were eight total -- seven other providers who were using
[29:46]
their own funds in different ways.
[29:48]
We decided to use ours for public health vending machines.
[29:52]
In 2025, I mentioned the needs assessment.
[29:55]
We did a lot of support building in the community
[29:58]
and we presented at the District attorney's meeting.
[30:02]
We went to community boards.
[30:04]
We did town halls.
[30:05]
It was really important to raise community awareness
[30:10]
and build buy in.
[30:12]
Not everybody was happy about it.
[30:15]
But for the most part, a lot of the partners
[30:17]
were like, this is really great.
[30:19]
School based health clinics double
[30:20]
Dutch we're excited about some of the reproductive health
[30:23]
products.
[30:23]
Just, different stakeholders responded to the different needs
[30:28]
and items.
[30:29]
We were also part of a cohort of other public health vending
[30:33]
machine partners throughout the city.
[30:35]
So we were learning some of the best practices.
[30:38]
And then in 2026, it took a while to identify actual sites.
[30:43]
It is hard to site programs.
[30:45]
I would say that zoning laws around sidewalks
[30:50]
were a challenge.
[30:52]
Having sites that were not owned by the program
[30:55]
was very difficult because landlords
[30:57]
were pushing back against it.
[30:59]
So we ended up going with two providers -- chance and light.
[31:04]
And that's the picture with the ribbon cutting.
[31:06]
You can see it's co-located next to food storage boxes.
[31:09]
So there's a food pantry and community programing there.
[31:13]
And then the other site on the right is down at --
[31:17]
it's on Richmond Terrace which is the perimeter of North Shore.
[31:22]
On the island, there's a food pantry next door.
[31:25]
But we know there's a lot of sex work happening at night.
[31:28]
It's pretty desolate.
[31:30]
So placing them in one spot where there's more resources
[31:33]
and programing and one where it's a little bit more desolate
[31:37]
and where resources are needed.
[31:39]
It launched at the end of June and we have already
[31:42]
had 16 transactions to date across both of the sites.
[31:47]
It's a lot.
[31:51]
Here's my lessons learned.
[31:54]
It's important to get the community buy in.
[31:56]
It's instrumental in every program that you do.
[32:00]
The idea -- challenges of the property.
[32:04]
We also didn't anticipate the costs associated
[32:07]
with installing them.
[32:08]
We had to put in a concrete platform
[32:11]
and have electricians do the wiring.
[32:13]
There's Wi-Fi.
[32:14]
There's some costs associated that we didn't necessarily
[32:17]
focus on right away but we were able to figure out.
[32:21]
Consider Co-locating where people
[32:23]
can access wraparound services.
[32:25]
And then in general, for other communities,
[32:27]
to think through them, the main expenses apart
[32:31]
from buying the machine or you can get machines
[32:35]
from the other entities.
[32:37]
There are a few organizations that provide machines for free.
[32:42]
We bought ours because we're part of the city cohort.
[32:44]
It was about $11,000 for our machines.
[32:47]
And it was expensive for us to do --
[32:51]
it's almost the same amount for us to do the contracting
[32:53]
modifications for installation.
[32:55]
So that's the upfront cost.
[32:58]
And then the ongoing costs are basically labor.
[33:01]
And then buying the public health supplies that we cannot
[33:05]
give for free.
[33:05]
So right now, naloxone and test strips
[33:08]
are made available by the state which is fantastic.
[33:12]
But we purchased the plan B. We purchased the feminine hygiene
[33:16]
supplies, we purchased the wound care kit --
[33:19]
all of that stuff.
[33:20]
And we're trying to do some innovative partnerships
[33:23]
with entities.
[33:24]
We might also do some diapers in there,
[33:27]
trying to get things donated as much as we can to make sure
[33:30]
that this is sustainable.
[33:33]
And I think that's all I have for now.
[33:36]
There's a lot.
[33:38]
But I think you get the gist of it.
[33:42]
>> That was extremely helpful.
[33:46]
So now I'm gonna ask everybody to add whether you --
[33:54]
whether and how you think this will work in Westchester County.
[33:58]
Before I do that, I want to ask about the feminine products.
[34:04]
You said you had 16 points of access.
[34:09]
Were they for feminine products?
[34:11]
Because every year I send out an annual letter.
[34:14]
I should go out any day now, to our school districts.
[34:18]
But I send them to remind them that they are required
[34:21]
by state law to provide feminine products in the bathrooms
[34:25]
so students don't have to go to the nurse's office.
[34:29]
>> Yes.
[34:31]
>> What were those 16 points?
[34:35]
>> I think what I shared was that there were 1600 transaction
[34:38]
across the two machines.
[34:41]
1600 transactions.
[34:45]
Yeah.
[34:46]
Of the -- I mean, I don't want to share data because I'm not --
[34:53]
but feminine hygiene products was in the top in terms
[34:56]
of things that were being selected for.
[35:00]
Wound care kits were pretty high.
[35:04]
I mean, it is interesting to see across the sites what
[35:08]
the differences are.
[35:09]
But yes come on we've really been trying to do a lot --
[35:13]
but yes, we've been trying to do a lot around period poverty
[35:16]
and making sure people can access these products and not
[35:19]
have to struggle and ask for them.
[35:24]
>> Okay.
[35:26]
>> Adrian, you said that you looked into matters.
[35:29]
We had them do a presentation to our opioid response in April.
[35:37]
And we are looking into them but you
[35:39]
chose not to go with matters?
[35:42]
>> Because I was part of the city cohort and we were all
[35:45]
using the same machine.
[35:47]
I don't know if it was also --
[35:49]
I don't know how the data collection works with matters.
[35:53]
The city wanted to have access to our data (Indiscernible).
[36:02]
I don't know how the data collection
[36:04]
and sharing works with matters.
[36:04]
I know that they do provide the machine free of charge
[36:06]
and they help with getting those free, statewide naloxone
[36:09]
kits and the testing strips.
[36:11]
I mean, yeah, we've heard good things.
[36:15]
I'm just not quite sure about the data piece.
[36:17]
That's the only one I'm not really there on.
[36:33]
>> Okay.
[36:34]
Since you just asked that, it sounds like this is already
[36:34]
being considered?
[36:36]
>> I was on a Zoom call at the beginning of the year when we
[36:39]
heard about matters and that they were offering free vending
[36:43]
machines.
[36:43]
So I had them present in April.
[36:50]
We learned that everything was free.
[36:54]
Unless we wanted to provide those other supplies.
[36:59]
And at the same time, the Department of Mental Health
[37:02]
was looking into having supplies for the homeless population,
[37:06]
some of the supplies that were mentioned.
[37:09]
But New York, because it was free
[37:12]
and it seemed like a good opportunity,
[37:15]
it's similar to what the vending machines that Adrian
[37:19]
was talking about.
[37:20]
When you enter center code and your zip code,
[37:23]
but I forget about how they collect the data.
[37:27]
At a time, they had three vending machines
[37:31]
that were available.
[37:33]
It was unsure about the future of them
[37:35]
but I was asked to reach out to them recently.
[37:40]
And so I'm trying to find out if there is still funding.
[37:43]
Do they have machines?
[37:45]
I remember them saying if they didn't, they
[37:48]
would take six months to build one.
[37:50]
And if they don't, then they would consider settlement money.
[37:56]
And we will be reaching out to you
[37:58]
to find exactly who you ordered them from.
[38:01]
But they seem to have it set up.
[38:04]
I thought they had machines in the city, in the Bronx.
[38:09]
>> Yes.
[38:11]
>> They had them in Putnam, Dutchess.
[38:13]
But they didn't have any in Westchester.
[38:20]
>> Yeah.
[38:22]
>> They had three Narcan vending machines.
[38:25]
>> They said we'll also be provided with free Narcan.
[38:28]
We get free Narcan through the state and we get testing strips.
[38:31]
But matter will also provide the Narcan and the testing strips.
[38:36]
>> And then we can get a grant (Indiscernible).
[38:45]
>> I can forward you the presentation.
[38:47]
>> (Indiscernible) can only put Narcan and testing strips
[38:51]
in their?
[38:52]
>> No, I think it helps the counties about what will be
[38:52]
provided.
[38:53]
>> They would provide the Narcan testing strips (Indiscernible).
[39:03]
Or hygiene kits and things like that. (Indiscernible)
[39:06]
to the county.
[39:10]
But Narcan strips (Indiscernible)
[39:14]
really replenish that.
[39:15]
>> (Indiscernible) location.
[39:21]
>> They are refrigerated.
[39:22]
You have to have electric and you
[39:24]
have to have access to Wi-Fi.
[39:26]
>> It has to be on a flat surface.
[39:28]
It could be on a sidewalk.
[39:30]
If it was (Indiscernible) building,
[39:37]
you would have to get acceptance from the landlord.
[39:40]
You have to have access to electric.
[39:41]
So what we did, myself, and we have a New York State fellow
[39:45]
double Dutch we walked around.
[39:47]
We were thinking about double Dutch we walked around.
[39:49]
We were thinking about (Indiscernible)
[39:57]
and we were trying to figure out which
[39:59]
locations would be available.
[39:59]
And so we thought maybe a good location would be 85
[39:59]
Court Street.
[39:59]
I'm not sure where we are in the building
[40:01]
right now, just right across the street.
[40:05]
My (Indiscernible) was able to take a picture of the location
[40:14]
and put the vending machine to have a look at what it
[40:16]
would look like.
[40:20]
Again, we thought about a pilot project in White Plains
[40:27]
was essentially located double Dutch centrally located.
[40:30]
And probably similar to what was being said,
[40:32]
you have software where you can remotely
[40:35]
see what is being taken.
[40:37]
And then you can go out when it needs to be resupplied.
[40:42]
We had questions about vandalism.
[40:44]
It was rare.
[40:45]
I don't know if that happened.
[40:47]
She said it was rare.
[40:49]
And that, if they did, they would work with us and it really
[40:54]
shouldn't be --
[40:56]
>> But that was one of the main concerns that we heard from
[41:00]
communities when we were talking about installation.
[41:03]
They were worried about vandalism.
[41:04]
We actually did an FAQ Mythbuster (Indiscernible)
[41:16]
concerns and I'm happy to share it with you all.
[41:18]
We are not seeing that.
[41:18]
I mean, I think some of the machines in the city
[41:19]
had some light vandalism like graffiti,
[41:22]
but it was nothing that was major.
[41:24]
And we haven't experienced anything yet.
[41:26]
Also, people are worried about diversion.
[41:29]
What if somebody clears out the machine?
[41:32]
Our answer is, it's not like we are
[41:36]
trying to think about language about leaving supplies
[41:39]
for others.
[41:40]
But as long as the stuff is getting circulated
[41:43]
and out there, I don't know.
[41:46]
We go back and forth about this.
[41:49]
These are the pain points.
[41:52]
>> I have a quick question when it comes to data collection.
[41:56]
You're talking about some Hotspotting data.
[42:00]
Where did you receive your data from?
[42:02]
Did you get that from the communities?
[42:04]
Did you get it from law enforcement?
[42:06]
EMS.
[42:07]
>> Our district attorney is really good about sharing
[42:12]
the Hope initiative and keeping partners in the loop about
[42:17]
overdose deaths.
[42:18]
And then for the Hotspotting program with the,
[42:22]
they are getting data from hospitals.
[42:25]
I don't want to speak on behalf, because it's
[42:28]
a whole proprietary.
[42:30]
They worked with MIT to create some data analytic portal
[42:34]
platform.
[42:35]
But they are pulling data from multiple sources.
[42:40]
>> To me, that would probably be the most important where you are
[42:43]
going to concentrate your programs.
[42:45]
Westchester, being what I usually say, is very unique.
[42:49]
There's over 40 different police departments.
[42:52]
There's 50-something fire departments, 45 EMS agencies.
[42:57]
We have 13911 receiving hospitals.
[42:59]
Getting that data, even if you're just
[43:02]
looking at 911 dispatch data, is extremely difficult to.
[43:06]
But that is kind of why I was looking at,
[43:08]
what's the best way to get the data?
[43:11]
So you are really treating the most appropriate areas
[43:13]
in the population you need to.
[43:16]
>> That's a great point.
[43:17]
I mean, we did use that data to pinpoint the neighborhoods
[43:22]
that we wanted to be in.
[43:24]
It's interesting.
[43:25]
The one area that I really wanted to be in, we couldn't be.
[43:28]
It was one park in the neighborhood where we
[43:30]
were seeing a lot of overdoses.
[43:31]
Even though this was a city initiative,
[43:35]
parks wasn't bought in.
[43:36]
They said, we don't want that in our refurbished park.
[43:39]
They said, we are doing a new comfort station,
[43:42]
we're worried about condoms clogging the toilets.
[43:45]
There was some interesting things.
[43:46]
And it was like, o, okay.
[43:49]
Libraries didn't want it.
[43:51]
I'm giving you the CBO perspective
[43:53]
but I'm kind of curious, I don't know
[43:55]
what it's like in Westchester.
[43:57]
But I'm curious about working with other county entities
[44:00]
and how it will be received.
[44:04]
>> Good point.
[44:04]
Thank you.
[44:07]
>> So if we had everything in place,
[44:11]
how would you determine the best locations?
[44:19]
>> Again, we could query the EMS agencies.
[44:22]
Would probably be the same with law enforcement.
[44:25]
The local communities would probably
[44:27]
know best about areas of high overdose
[44:31]
or the areas of high drug use.
[44:35]
It may not be specific to overdose
[44:38]
but locally, I think those local agencies can probably
[44:41]
provide the best.
[44:43]
And be it that in a more urban area or maybe
[44:46]
a more suburban area.
[44:47]
I'm not really sure.
[44:48]
We don't get to see a lot of that data.
[44:51]
But that was my point is that, what
[44:53]
is the best way that we can look at getting accurate
[44:56]
data to truly help the population in need?
[45:00]
>> Right.
[45:00]
I see you shaking your head.
[45:03]
>> Yes, absolutely pure Mike this is in alignment with what I
[45:06]
was saying earlier.
[45:07]
I think if we reach out to the local agencies
[45:10]
to see what they have to say, on a weekly basis,
[45:14]
no specific agency is citing a really high volume
[45:20]
of these situations.
[45:22]
A lot of times, they may not even
[45:25]
be getting into the 911 system.
[45:27]
But I think if we check with them,
[45:30]
I think it would be a really good starting point.
[45:32]
And then, when and if a location is determined,
[45:36]
that might be appropriate to put one of the units,
[45:39]
I think for situational awareness,
[45:41]
at a minimum, the primary EMS response agency,
[45:46]
I can notify them just for situational awareness
[45:50]
that, you know this is in your primary area, just in case.
[45:55]
>> Okay.
[45:56]
>> It's gonna be difficult to figure out,
[45:58]
because over the years, with the data that gets collected,
[46:02]
occasionally we get clusters from the state.
[46:05]
It might be in this area or this area.
[46:07]
But there are some other counties,
[46:09]
where I don't know if we have a specific area where
[46:11]
there might be more overdoses.
[46:13]
And so if we were thinking, start
[46:17]
with a pilot project that is centrally located
[46:20]
in an urban area like White Plains.
[46:22]
And if that was successful, we could scale and offer it
[46:28]
in Mount Vernon.
[46:30]
They might have a better idea.
[46:32]
Over the years, I haven't seen of any specific areas
[46:37]
that I would highlight other than the areas
[46:39]
that we were thinking about.
[46:42]
>> But I think that's also the importance of doing
[46:45]
the engagement with the programs and people who are receiving,
[46:49]
who are in recovery and in treatment, to say,
[46:52]
where would you have wanted support?
[46:54]
Are there areas that you think we should be going into?
[46:57]
Kind of layering the hotspot data with some qualitative data
[47:00]
collection from people receiving services.
[47:04]
>> It's interesting because if you look at the map
[47:06]
on the website, from one of New York State,
[47:10]
you see that they have the vending machines located
[47:13]
specifically in two places.
[47:15]
One is urban areas, and the other is out in the rural areas.
[47:18]
You can understand from that perspective, the rural areas
[47:21]
as well, because there are many folks in rural areas
[47:24]
where that machine becomes their only option.
[47:29]
>> Their lifeline, yes.
[47:31]
>> (Indiscernible) legislative who represents Westchester,
[47:44]
she would agree with this.
[47:53]
>> (Indiscernible) people using Narcan on their own,
[47:56]
what they've reported (Indiscernible) ems.
[48:03]
>> Especially if just one shot works.
[48:15]
>> (Indiscernible) become less data on it.
[48:17]
>> We would never really had good data.
[48:17]
We've done the trainings and we've always
[48:17]
asked people to use the kit.
[48:17]
Please let us know.
[48:17]
Nobody ever lets us or the state know.
[48:19]
They're afraid.
[48:20]
I get that and I understand that.
[48:24]
So really, we don't have any viable data
[48:28]
we are the most Narcan is used.
[48:31]
We just >> But I do think that we are seeing decreases
[48:45]
in overdose deaths, right?
[48:46]
And I think that the flooding of the communities with naloxone
[48:46]
is contributing to that piece.
[48:46]
People are not dying at the same rate.
[48:48]
They might be overdosing and coming back.
[48:50]
>> We've seen that since the very beginning when we first
[48:52]
started this.
[48:53]
They may not be willing to report to us and address,
[48:59]
but they could call and say, I used it and it was successful.
[49:04]
We know the program is working.
[49:07]
And I think the measure of that was
[49:09]
the fact that more and more people wanted the training.
[49:13]
Patrick and I thought that we would do --
[49:17]
we trained 50 or 100 people and we'd call it a day and be done.
[49:21]
And 12 years later, we are still doing this.
[49:24]
And in fact, it used to just be a sideline
[49:27]
and now it's what he does.
[49:31]
So we are a product of the success of the program which
[49:37]
is great and wonderful.
[49:38]
I would say that I think that through this program,
[49:42]
we've probably saved more lives than I ever saved being a doctor
[49:46]
and actually seeing people treated for diseases.
[50:08]
Yeah that's an important and true statement.
[50:11]
It's an important program.
[50:13]
We give people a second chance or sometimes
[50:15]
a third or fourth chance to turn their lives around and stay
[50:22]
alive.
[50:23]
Because you know, you can't improve your life --
[50:27]
if we can keep people alive, they have the opportunity to get
[50:31]
their lives back on track.
[50:33]
And that's our goal and our hope.
[50:37]
>> Absolutely.
[50:38]
And that's how we respond to people.
[50:41]
Like oh, you're just encouraging drug use.
[50:43]
We are encouraging people to stay alive.
[50:48]
>> To stay alive and hoping that at some point they will engage
[50:51]
with -- something will make them willing to say, listen,
[50:55]
this is not the life I want.
[50:56]
You know?
[50:57]
I really would like to get my life back together.
[51:00]
And you can't do that if you're dead.
[51:04]
>> Nope.
[51:05]
Would West, would you all have other materials in addition
[51:09]
to the naloxone and test strips?
[51:12]
Like this concept of having more --
[51:15]
have it be public health where there's some items that
[51:18]
the community needs?
[51:21]
>> We are public health.
[51:25]
That speaks to our heart.
[51:29]
We haven't really given that a lot of thought at this point.
[51:33]
But I like the idea of -- we want to meet every need that we
[51:38]
have the ability to address.
[51:39]
That's the whole point of what we do, what mental health does.
[51:45]
We want people to live longer, healthier and happier lives.
[51:49]
That is our goal.
[51:50]
Longer, healthier and happier lives.
[51:52]
And whatever we can do to make that happen for our residents
[51:55]
is what we want.
[51:56]
>> I love that aspect.
[53:23]
>> -- Or where do they feel that the benefit of a vending machine
[53:28]
would be helpful?
[53:29]
And where would that be in the community?
[53:30]
Just some >> We've been doing a lot of work around meeting
[53:37]
people's social needs -- the health-related social needs.
[53:41]
We have part of the 1115 waiver.
[53:45]
Everybody is at this moment where Medicaid managed
[53:49]
care is connecting people with these enhanced services
[53:53]
and food has been the number one need in our community
[53:58]
and housing.
[53:59]
In right now many of our behavioral health
[54:02]
providers are part of this social care of the 1115 waiver
[54:06]
work.
[54:06]
So they are being connected and talking
[54:09]
about social needs and food insecurity and behavioral health
[54:12]
if somebody is unhoused, they're not
[54:15]
going to be able to maintain recovery or get treatments.
[54:18]
So, really thinking holistically about this work.
[54:22]
The recipients of services at those partner locations
[54:26]
do give a lot of feedback.
[54:27]
And a lot of them are people who access the food pantry
[54:30]
on a regular basis and have a sense of what
[54:32]
the community does.
[54:33]
So that brings in some of those other products that we
[54:40]
(Indiscernible).
[54:41]
>> Thank you.
[54:47]
>> Okay.
[54:48]
Will this work?
[54:50]
>> Will this work?
[54:53]
Uhm, interesting question.
[54:55]
Obviously the need has to be more clearly defined.
[54:59]
I mean, we have folks at EMS (Indiscernible)
[55:04]
we would have to dive a little bit deeper
[55:06]
to figure out exactly where the issue (Indiscernible)
[55:09]
and of course, there's the other big question
[55:12]
that we would have to look at is, how do we
[55:15]
go about a siting process?
[55:18]
If we're going to do this, this will be a community effort,
[55:22]
requiring the community.
[55:24]
Can you talk a little bit about that?
[55:28]
What did it take for you all to get the community buy in
[55:31]
to go forward?
[55:33]
>> We did a lot of presentations.
[55:36]
>> By the way, it's the hardest part of the work right getting
[55:42]
funding the hardest part of the work is siting the programs.
[55:45]
You get the funding and you get the green light
[55:47]
and you've got to get the support of the community.
[55:50]
And if you want it to succeed, at least.
[55:52]
So we went out, we did presentations.
[55:55]
We were already --
[55:58]
I was featured in the paper a couple of times.
[56:01]
So there's definitely information about the program
[56:03]
out there.
[56:04]
But right before we were about to do
[56:07]
the installation, the ribbon cutting,
[56:09]
the city wanted me to meet with my elected officials.
[56:13]
And I was like, but they've already heard about it.
[56:16]
No, you need a specific briefing with them
[56:18]
where they can ask questions and raise concerns.
[56:21]
So I think that we were very careful about making sure
[56:25]
that people knew about it and that people had an opportunity
[56:28]
to weigh in.
[56:30]
Town halls, smaller intimate conversations.
[56:35]
We did FAQs and flyering at different program sites so that
[56:41]
people built -- there was awareness being built.
[56:44]
But it was really tough.
[56:46]
None of the elected officials came out
[56:49]
against us, which was a real win.
[56:51]
But they were pretty quiet in their support.
[56:53]
I believe people were afraid of taking a public stand on it.
[56:57]
In terms of siting, I mentioned the issue.
[57:01]
Sometimes we would have partners --
[57:03]
that site that I wanted to place it in, Tappan Park,
[57:07]
we had some health care (Indiscernible) that said, yes,
[57:12]
but you have to talk to the landlord.
[57:14]
And the landlord said absolutely not.
[57:16]
The library said absolutely not.
[57:18]
The Parks department said no.
[57:19]
The methadone clinic said yes but their sidewalk
[57:21]
was too narrow.
[57:22]
So there's always these challenges
[57:25]
in actually placing the machines in
[57:28]
these particular neighborhoods.
[57:29]
So now, we went to our second --
[57:32]
I want to get back to 10304, that's
[57:35]
our zip code, because there's such a need there.
[57:37]
But with the limitations of the two,
[57:39]
we had to switch gears and pivot a little bit
[57:43]
and put it in locations with high overdose rates
[57:46]
but not the highest, not the one that I really
[57:49]
wanted to get it to.
[57:50]
>> What were the biggest concerns expressed
[57:52]
by the public?
[57:54]
>> Vandalism.
[57:56]
Crime.
[57:56]
You know, not wanting to have those people
[58:00]
in their neighborhoods.
[58:02]
I'm already cleaning up all the time, now what?
[58:05]
Because we were also going to do sharps containers
[58:08]
next to the machines.
[58:09]
We haven't had to do that.
[58:13]
I'm forgetting the reason why but we made a decision
[58:17]
not to do it at this point.
[58:19]
But that was in response.
[58:21]
We're not giving out syringes but if people have syringes
[58:24]
and want to dispose of them, maybe we
[58:26]
can have sharps containers so that we are anticipating
[58:29]
any kind of litter or situation that the community would
[58:32]
be upset about.
[58:36]
>> Did you find a different level of concern when you talked
[58:40]
about the Narcan and test strips versus some of the other
[58:43]
products that you were going to put in?
[58:46]
>> I was afraid about the plan B part.
[58:49]
The main concern was about safety and children
[58:53]
being able to access some of the medications
[58:55]
because it's all free.
[58:56]
That's also why we have them in the patches. -- pouches.
[59:01]
And then we also put some of those products up on the top.
[59:04]
We don't care if they are high school or young adults accessing
[59:07]
it, but we don't want children accidentally taking something.
[59:13]
But that was one of the main things
[59:14]
that we were hearing from the community
[59:16]
was worry about people accessing it and unintentionally
[59:20]
getting sick.
[59:22]
So we tried to place it, we have it in the packets.
[59:25]
And that's helpful.
[59:27]
But yeah.
[59:29]
Oh yeah, the smoking kits were very controversial.
[59:34]
And that's also why we were talking about phasing
[59:39]
in supplies as we go along.
[59:43]
So maybe, reengaging the community to talk about these
[59:47]
and needs.
[59:48]
There's a birthday party going on in the hallway.
[59:52]
But yes, about implementing them at a later time.
[59:56]
But for the launch, we decided not
[59:58]
to put some of those materials in there.
[1:00:02]
>> On the timeline, it was from 2023 to 2026?
[1:00:08]
>> I would say, once you get the money, a year and a half.
[1:00:13]
In terms of building community support, getting the machines.
[1:00:17]
I mean, that was the precursor of us
[1:00:20]
testing out concepts and raising awareness around harm reduction.
[1:00:23]
But yes, we got the funding in 2025.
[1:00:29]
And that's when we were doing the needs assessment
[1:00:31]
and building the support.
[1:00:32]
And we actually didn't get them plugged in until June of 2026.
[1:00:36]
So a lot of -- we have somebody who's interested.
[1:00:43]
But then, no, we can't move forward for whatever reason.
[1:00:47]
So we were very excited, even on our own property
[1:00:50]
when we couldn't put it in, because it's
[1:00:53]
owned by a hospital system that couldn't get the approval.
[1:00:57]
So that's why we went with partner organizations.
[1:01:00]
There were a lot of challenges.
[1:01:04]
>> Since June , Any of the concerns that people have had
[1:01:11]
come I have they come to fruition?
[1:01:13]
>> Not at all.
[1:01:15]
Not at all.
[1:01:16]
No.
[1:01:50]
>> Thank you for sharing this information with us.
[1:01:52]
What were the library's main concern?
[1:02:01]
>> I have to go back.
[1:02:02]
We were partnering with the libraries for a while
[1:02:04]
and it was central.
[1:02:05]
So I library manager might be in support of doing --
[1:02:10]
partnering with us on some of our projects.
[1:02:12]
But the central office, there was a barrier.
[1:02:17]
I don't know if it was liability serving young families,
[1:02:25]
they were worried about safety and security.
[1:02:27]
I have to go back.
[1:02:28]
But they were just not interested.
[1:02:31]
>> (Indiscernible) about libraries.
[1:02:34]
This library right there (Indiscernible) overdoses.
[1:02:38]
>> A lot of overdoses happen in library bathrooms.
[1:02:41]
Go ahead.
[1:02:43]
>> We have a great relationship with some of these libraries.
[1:02:45]
And I think they would be on board.
[1:02:49]
I don't know if they have to get approval from the city.
[1:02:53]
But that area right there, there's overdoses that happen.
[1:02:57]
That's an area where there are overdoses.
[1:03:00]
>> Why so many?
[1:03:03]
>> When people use drugs, when they get them,
[1:03:06]
use them as quickly as possible.
[1:03:08]
If they're by a library, they're going
[1:03:09]
to go to the restroom they're. (Indiscernible)
[1:03:12]
many of these libraries.
[1:03:13]
They are staying there.
[1:03:15]
So there's a lot of substance use.
[1:03:17]
Not only that, there was an arrest
[1:03:21]
that was made a few years back in one
[1:03:23]
of these libraries for heroin.
[1:03:24]
Selling heroin out of it.
[1:03:28]
>> Gas stations.
[1:03:30]
People use very close to where they buy.
[1:03:37]
>> So we've done a lot of work.
[1:03:38]
And I'm sure that West Chester has
[1:03:40]
to, just working with restaurant owners and training them
[1:03:44]
and everybody having a naloxone kit behind the bar.
[1:03:47]
Coupled that now with our CPR training
[1:03:50]
so that people who are CPR trained
[1:03:53]
are also training in naloxone.
[1:03:56]
But yes, anywhere where you can get
[1:03:59]
into a bathroom, a private space, yep.
[1:04:06]
>> Did you want to say anything?
[1:04:07]
>> I was just thinking about something that was mentioned
[1:04:10]
previously that's an alternative to that.
[1:04:14]
But the idea of the lock boxes that we have put in the shelters
[1:04:20]
that we may be able to incorporate
[1:04:23]
in expansion of those as well.
[1:04:27]
>> That's a good point because matters, if they still do them,
[1:04:32]
they were distributing free naloxone.
[1:04:35]
But we purchased them in the past (Indiscernible)
[1:04:39]
into the shelters (Indiscernible)
[1:04:42]
schools. (Indiscernible) research.
[1:04:49]
>> In the back of my mind, I'm thinking about how the library
[1:04:52]
doesn't want this but they may be willing to accept that
[1:04:55]
because (Indiscernible) isn't going to go away.
[1:05:02]
This is more of a reality check.
[1:05:06]
>> Kind of ease them into it.
[1:05:08]
Exactly.
[1:05:09]
>> We should have a meeting at the library.
[1:05:11]
>> Sure.
[1:05:13]
>> So I'm thinking that and first,
[1:05:15]
I really want to thank Adrian.
[1:05:17]
He was a nice distraction which we really appreciate.
[1:05:21]
And we wish you all the success.
[1:05:26]
Our hope is that (Indiscernible).
[1:05:32]
>> Are no longer needed, yes.
[1:05:34]
I will say that naloxone is not a top thing that (Indiscernible)
[1:05:40]
from our machines.
[1:05:40]
That's why I was inquiring, if you're
[1:05:42]
going to have other products.
[1:05:44]
Because I think we've done such a good job
[1:05:46]
of getting naloxone out there.
[1:05:48]
I think that maybe there would be a higher demand for it.
[1:05:56]
I think we're trying to do targeted promotion
[1:05:58]
in different communities.
[1:06:00]
It's I know it's very early and I
[1:06:02]
don't know if we should be sharing this
[1:06:04]
because I want to be careful about what we share.
[1:06:06]
But this is one of the things that we are noticing.
[1:06:10]
It's more of the wound care and hygiene kits
[1:06:11]
that the people are gravitating towards.
[1:06:16]
>> I'm not surprised about that.
[1:06:18]
>> That's a sign of the times.
[1:06:23]
>> Again, thank you so much.
[1:06:24]
>> It was my pleasure.
[1:06:25]
If you have any more questions, I'm
[1:06:27]
happy to Zoom back into a room with you all. (Laughs).
[1:06:33]
>> I'll give you her contact information so you have it.
[1:06:37]
Thank you very much.
[1:06:40]
I'm thinking along with having a meeting with the library system
[1:06:46]
that maybe we could attend -- you hold meetings with all
[1:06:52]
of the municipalities, right?
[1:06:56]
>> Not necessarily.
[1:06:57]
We do have regular communications with emergency
[1:07:00]
services personnel but not really the municipal leadership.
[1:07:08]
>> Maybe we can go into one of those meetings and get them
[1:07:11]
to start thinking about or share with us locations.
[1:08:04]
>> (Indiscernible).
[1:08:06]
Thank you so very much.
[1:08:08]
I really appreciate you.
[1:08:10]
Let's talk about next steps.
[1:08:16]
>> Thank you.
[1:08:17]
>> We are officially adjourning at 12:15 p.m..
[1:08:24]
>> (Indiscernible) wound kits (Indiscernible).
[1:08:30]
>> (Indiscernible) in the lock boxes.
[1:08:34]
>> (Indiscernible) all right let's get (Indiscernible).