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>> Good morning come on everyone.

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I'm the chair of the Board of Legislative Committee on Health.

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Today is August 26th and we are commencing this meeting at 11:08

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a.m..

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Today's meeting topic is something

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that we have spoken about before early

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on when we spoke about implementing

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vending machines for public safety item, particularly

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Narcan.

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Are and I read a couple of recent articles that highlighted

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Staten Island where Miss Adrian --

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and we're so happy to have her join us today to speak about how

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they implemented it their.

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In fact, I believe it was from your weekly email

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list of news items that I read.

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There's also a program in Connecticut

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that we tried to get that to join us today To.

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But we really wanted to approach this again and see --

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learn how it was implemented in other places and see where we

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can possibly implement it here in Westchester County.

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Before I quiet and give Adrian the floor,

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I want to ask everybody at the table to introduce themselves

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and then we will have everybody who is virtual do the same.

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>> I'm the commissioner of the --

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I'm Doctor Dr. Sherlita Amler and I have the (Indiscernible).

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>> I'm Patrick Quinn and I also work with the Division

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of Health.

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>> I'm deputy commissioner of the Department of Community

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Mental Health.

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>> I'm the assistant commissioner of the Department

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of Community Mental Health.

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>> Thank you.

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And Adrian, we will start with you.

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>> Hi.

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Hello, I'm sorry I can't be there.

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I'm Adrian and I'm the executive director of partnerships

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for Community Wellness.

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>> Thank you.

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Deputy chief.

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You're muted.

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You're muted, deputy commissioner.

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>> Hi.

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I'm not deputy Commissioner, that's my boss.

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I'm sorry.

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That's okay.

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My name is Niall Salih and I'm the Department of Emergency

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Services and I oversee the public access defibrillation

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program for Westchester County.

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So that's probably why I am on this meeting.

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>> Thank you.

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And Mr. >> Good morning, everyone. the county

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Department of Emergency Services, EMS Division.

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And I'm here for the same reason.

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Thank you.

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>> Thank you.

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>> Good morning.

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I'm deputy commissioner for the Department

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of Emergency Services.

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We are here to help you guys.

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>> Yes, I love it.

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EMS is well- represented.

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I'll just educate that we are also

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joined on the screen with our other committee

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coordinator, Diana Gomez.

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And our director of legislation, James.

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Thank you to everyone for joining us today.

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Again, I'm going to turn the floor over to Adrienne Abbate

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so we can learn from their program.

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I'm really happy to have such a strong EMS presence.

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If you do want to speak about -- if this comes to fruition

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in the county, what areas in our county,

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what locations would be ideal where we are seeing the most

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occurrences.

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Adrian, again, thank you so much for joining us.

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Please, take the floor.

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>> We see your presentation but you are still muted.

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>> Thank you for letting me know that.

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You can see the presentation, wonderful.

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Okay.

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I'm gonna stop my video while I am presenting.

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I'm assuming we're gonna have some time

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at the end for questions.

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>> Absolutely.

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>> Fantastic.

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>> We won't even interrupt you.

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>> Please do.

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Okay great.

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I like a lively conversation.

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I introduced myself but just to give some background,

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I've been at partnerships for community Wellness

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for about 14 years.

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Before that, I worked at the New York City Department

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of Mental Health and Hygiene under Tom Frieden and Bloomberg

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where we did a lot of innovative public health strategies.

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And I decided to focus where I live

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and I became the founding director of partnerships

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for Community Wellness.

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We are a public health nonprofit.

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We work to address the systemic issues that

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contribute to poor health outcomes

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by serving as this bridge between systems and communities.

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When I say systems, we mean neighborhoods,

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hospitals, schools.

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And really, making sure that communities

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are informing the work in every single aspect

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from strategy to development to implementation.

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We do this -- these are our neighbors in the middle.

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Building coalitions, creating building spaces for partners

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to come together and understand issues.

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We do training and capacity building for community but also

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for organizational partners.

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We have an arm of work that works

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on research and evaluation.

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We have very strong advocacy committee --

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a very strong advocacy committee.

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This is a precursor to the work that we're

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doing in the public health and we

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work on sustainable development and act

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as a physical pastor for small organizations.

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We almost act like a little health

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department in our own right but we are a CD o,

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we do have a lot of government contracts.

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We are very vulnerable right now because our mission is not

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in alignment with other federal priorities, but we are scrapping

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and we are making it work.

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So we take a social justice approach to health.

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We focus on health equity.

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I talked about that.

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Really addressing root causes, so looking upstream.

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A lot of amazing work is happening,

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meeting people's immediate needs, which is critical.

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But that's downstream.

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But we like to really unpack the issues

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and think about the systemic issues that

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have contributed to these poor health outcomes and inequities.

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We focus on vulnerable populations and we really

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believe in community power -- so involving communities most

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impacted in the design implementation of the work.

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And that's also part of our public health story as well.

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These are the buckets of work.

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I'm not going to go into them in detail.

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I'll go into the behavioral health work

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but we also focus on maternal and child health and emerging

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public health issues.

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A lot of work around vaccines, both during COVID.

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And now we are seeing pediatric vaccines lowest among the city.

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Staten Island, I should give some context,

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for those not aware, is an outlier in terms

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of the bureau's.

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It's the smallest but it's 500,000 people so it's almost

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the size of Buffalo.

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So it's like we are the size of a small city

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but part of a large municipality.

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We are the only Republican district

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in terms of congressional representation.

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And I do like to say that we have

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a lot of bipartisan support in the behavioral health work

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that we've been doing.

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So what does behavioral health look like on Staten Island?

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I'm just talking about the collaboratives

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but we have a pretty strong infrastructure.

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We created the -- and then has evolved over the past decade

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and a half to incorporate mental health because we know that

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there's so many similar risk and protective factors.

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We work across the continuum.

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Many coalitions are just prevention coalitions

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but we've always had treatment, harm reduction,

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recovery as part of the coalition.

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We have work groups that align with the issue

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that we are seeing in our strategies.

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Our structure is a little bit scary.

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It is a beast but it's also something

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that has been operating with gas for a long time.

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Sometimes it's hard to keep these collaboratives

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and we've had some real wins.

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We were the first group to pilot Narcan with NYPD.

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And it started in a little workgroup at TYSA

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and then it became borough wide and city wide and then scale.

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Staten Island is a nice place to test strategies and potentially

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scale them.

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We have grasstops and grassroots so government partners

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at the table com a district attorney, heads of agencies, all

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of the OASAS/OMH providers.

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We also have grassroots groups and people most impacted.

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We are also the facilitator of our state opioid

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response regional network.

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I'm not sure if Westchester has a network

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but these were dollars that were brought in

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to make sure that there's no wrong door, that we have

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enhanced services for special populations,

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that we are addressing housing, vocational supports,

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making sure prevention is included in the conversations.

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We are part of the district attorney's Fentanyl Task Force.

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I know that Westchester has a similar type of hope program

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but we were at the table when the Hope program was formed,

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making sure that people with lived experience

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were at the table, thinking about,

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what does engagement look like?

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And just, really, I mean, I'm very proud of the work

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that we've been doing with our criminal justice partners

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but yes, it's a model for some other communities.

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I'm not going to go into detail, but this

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is a very innovative program.

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It's the Staten Island PPS performance provider system.

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It's a Hotspotting initiative and they

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are using data analytics to look at where overdoses are happening

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and then responding to provide intense wraparound services.

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And they have studied it and seen a 70% decrease

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in overdose deaths among their cohort

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when compared to another group that didn't receive it.

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It's some really interesting things

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that are being tested out.

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And this is where the public health end machine came up

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we were learning about it in TYSA.

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We learned that the city was already doing

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something in 2023 and 2024.

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We were not the first in New York City

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but we were not in that original cohort of machines.

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But we wanted to.

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Now, I'm going to talk a little bit

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about how we brought it to Staten Island

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and why we brought it here.

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I provided that prior slide to give you context,

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that there's a lot going on.

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And this is just one piece of the puzzle.

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And it's just complementing a lot

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of the other work that is happening and being provided

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by a lot of the partners.

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This strategy -- the public health initiative is supported

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by public health settlement funds that are provided to New

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York City.

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Is not part of the original abatement

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or any part of the Oasis procurement

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but it is through New York City's share.

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I'm going to talk more about that in a little bit.

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And I mentioned that it's part of a larger New York City

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Department of Health and Mental Hygiene Initiative.

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So they got the first funding.

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I think there are two of them in Brooklyn.

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And I'm sorry, I'm blanking on the locations of the other two

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but they started the program and then

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we scaled it to Staten Island this year.

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I'm sure I'm singing to the choir,

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but I'm going to define public health vending machines so

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that we're all on the same page.

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They are automated kiosks or vending machines

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that dispense free public health and wellness supplies to members

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of the community.

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We don't call them harm reduction vending machines

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because we supply lots of different supplies,

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just to support people in their wellness journey.

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They are accessible 24 hours a day

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and transactions are completely anonymous.

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So people only have to enter in their zip code,

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and then the code for whatever that item is.

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And you can see from the picture,

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each item is in a little packet so

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that we are thinking about children and how it looks.

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Some communities put them in in brown wrappers.

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We have them in little packets with labels on them

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and people punch the number in.

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And then that data is shared with the city health department

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so that they can be tracking the supplies that people

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are getting.

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And also, the zip codes where people are not accessing them,

266
00:14:00,190 --> 00:14:02,752
but where those people are from.

267
00:14:02,752 --> 00:14:04,792
So we have a sense of the communities

268
00:14:04,792 --> 00:14:07,792
that it's penetrating and reaching.

269
00:14:08,312 --> 00:14:11,246
>> So how do you know where they are from?

270
00:14:11,246 --> 00:14:12,806
>> They punch in their zip code.

271
00:14:12,806 --> 00:14:17,112
That's the only item -- that's the only information that is

272
00:14:17,112 --> 00:14:18,286
collected is the zip code.

273
00:14:18,286 --> 00:14:21,392
You punch in your zip code and then you put in 140

274
00:14:21,392 --> 00:14:23,623
and it's like, that's a naloxone kit.

275
00:14:23,623 --> 00:14:27,852
So we know and we can track the item and the zip code

276
00:14:27,852 --> 00:14:29,966
of where the person is from.

277
00:14:29,966 --> 00:14:31,426
There are no cameras.

278
00:14:31,426 --> 00:14:32,886
I'll get into that as well.

279
00:14:32,886 --> 00:14:36,166
Any other questions before I move on?

280
00:14:36,166 --> 00:14:37,176
Okay.

281
00:14:37,176 --> 00:14:40,176
So why on Staten Island?

282
00:14:41,600 --> 00:14:44,270
We have long been impacted by the opioid epidemic.

283
00:14:44,270 --> 00:14:47,782
We outpaced the city for many years.

284
00:14:47,782 --> 00:14:51,146
The Citywide rate, we were neck and neck with the Bronx.

285
00:14:51,146 --> 00:14:53,352
And the lack of public health infrastructure,

286
00:14:53,352 --> 00:14:56,666
so we don't have a brick and mortar health and hospital

287
00:14:56,666 --> 00:14:57,726
public hospital.

288
00:14:57,726 --> 00:15:00,346
We don't have a local health department presence.

289
00:15:00,346 --> 00:15:04,726
So we really are good at working together and trying

290
00:15:04,726 --> 00:15:08,158
to scale programs from the city with other funding sources

291
00:15:08,158 --> 00:15:10,876
if it's not in the city budget.

292
00:15:10,876 --> 00:15:13,646
I didn't talk about the geography of Staten Island

293
00:15:13,646 --> 00:15:16,190
but our machines are on the North Shore.

294
00:15:16,190 --> 00:15:20,219
The North Shore is more ethnically diverse.

295
00:15:21,512 --> 00:15:25,112
It's disproportionately impacted by overdose deaths.

296
00:15:25,358 --> 00:15:27,486
It's a high poverty area.

297
00:15:27,486 --> 00:15:31,539
And I feel like this is not unusual,

298
00:15:31,539 --> 00:15:35,190
but the opioid epidemic has changed in how it looks

299
00:15:35,190 --> 00:15:38,320
and who it's impacting over the course of the years.

300
00:15:38,320 --> 00:15:42,878
And we are now -- where it was a very white to middle class issue

301
00:15:42,878 --> 00:15:46,918
on Staten Island when we formed, it has evolved.

302
00:15:46,918 --> 00:15:49,150
It's always been impacting communities of color

303
00:15:49,150 --> 00:15:52,126
but we are really drilling down and focusing in naming equity

304
00:15:52,126 --> 00:15:54,606
and investing in the North Shore neighborhoods,

305
00:15:54,606 --> 00:15:56,696
and this is where the overdoses are happening.

306
00:15:56,696 --> 00:15:58,952
And so we are putting the machines

307
00:15:58,952 --> 00:16:01,952
in the communities most impacted.

308
00:16:02,486 --> 00:16:04,326
>> Can we talk about that change?

309
00:16:04,326 --> 00:16:05,566
>> Sure.

310
00:16:05,566 --> 00:16:09,199
>> Because my understanding, and anybody can jump in and correct

311
00:16:09,199 --> 00:16:12,326
me if I'm wrong, my understanding is the opioid

312
00:16:12,326 --> 00:16:17,126
epidemic surge from people being prescribed pain medications,

313
00:16:17,574 --> 00:16:22,974
and then became addicted -- which is the meaning

314
00:16:24,898 --> 00:16:26,273
of addiction, they couldn't stop.

315
00:16:26,273 --> 00:16:30,631
And I know you've seen the stories, especially in Florida,

316
00:16:30,631 --> 00:16:34,360
these pop up locations where people could easily get

317
00:16:34,360 --> 00:16:36,436
fake prescriptions and opioids.

318
00:16:37,116 --> 00:16:42,516
So how did that change from upper- middle class

319
00:16:43,842 --> 00:16:49,842
people or an athlete to now, where it's so widespread.

320
00:16:55,248 --> 00:16:55,748
>> Sure.

321
00:16:55,748 --> 00:16:59,146
I'm happy to tell the story of Staten Island where

322
00:16:59,146 --> 00:17:01,366
we were seeing, when we were seeing early

323
00:17:01,366 --> 00:17:05,206
on in the coalition, and looking at data, that not only were we

324
00:17:05,206 --> 00:17:08,950
seeing high rates of use, but we were also looking

325
00:17:08,950 --> 00:17:10,486
at prescribing patterns.

326
00:17:10,486 --> 00:17:13,426
And our doctors were prescribing the highest dosages

327
00:17:13,426 --> 00:17:15,940
for the longest duration.

328
00:17:15,940 --> 00:17:19,206
So when we first started the coalition, we did a lot of work

329
00:17:19,206 --> 00:17:20,626
with the medical community.

330
00:17:20,626 --> 00:17:23,806
There were some bad apples like pill mills,

331
00:17:23,806 --> 00:17:29,134
where they were selling and operating them in bad faith.

332
00:17:29,134 --> 00:17:31,486
But there were also people who were instructed

333
00:17:31,486 --> 00:17:35,566
from pharmaceutical companies that this was a best practice.

334
00:17:35,566 --> 00:17:38,726
And, we are meeting the needs of their patients.

335
00:17:38,726 --> 00:17:41,942
So there was a lot of physician education that went on.

336
00:17:41,942 --> 00:17:44,780
The other thing about Staten Island that we thought

337
00:17:44,780 --> 00:17:45,996
was significant and contributed to it

338
00:17:45,996 --> 00:17:50,838
was that we have a lot of the sanitation,

339
00:17:50,838 --> 00:17:53,838
NYPD, live on Staten Island.

340
00:17:54,586 --> 00:17:57,886
These are people who have insurance, who sustain injuries.

341
00:17:57,886 --> 00:18:00,414
So these were local conditions.

342
00:18:00,414 --> 00:18:02,306
And I feel like that's always important,

343
00:18:02,306 --> 00:18:04,102
is to understand the local conditions that

344
00:18:04,102 --> 00:18:06,790
are contributing to the issue.

345
00:18:06,790 --> 00:18:09,126
So then we were also instrumental

346
00:18:09,126 --> 00:18:12,726
in passing legislation which is statewide,

347
00:18:12,986 --> 00:18:16,266
but it's basically the prescription drug monitoring

348
00:18:16,266 --> 00:18:20,466
program which makes it impossible for doctors

349
00:18:21,160 --> 00:18:23,952
to write scripts without it being entered into a system

350
00:18:23,952 --> 00:18:25,479
with a pharmacy that received it.

351
00:18:25,479 --> 00:18:27,966
There are a lot of checks and balances,

352
00:18:27,966 --> 00:18:29,446
making it more difficult for people

353
00:18:29,446 --> 00:18:32,126
to access pills for diversion.

354
00:18:32,126 --> 00:18:35,846
Which led to people, then, when you develop a dependency,

355
00:18:35,846 --> 00:18:38,294
and you can't get the pills, switching to heroin

356
00:18:38,294 --> 00:18:39,686
which was much cheaper.

357
00:18:39,686 --> 00:18:42,206
I mean, there's a whole evolution.

358
00:18:42,206 --> 00:18:45,942
Then, fentanyl was added, making it more dangerous.

359
00:18:45,942 --> 00:18:48,286
Now we have cytokines.

360
00:18:48,286 --> 00:18:51,192
There's always going to be something new added

361
00:18:51,192 --> 00:18:53,530
and it's important to be nimble and understand

362
00:18:53,530 --> 00:18:55,676
what is happening in the community and ways

363
00:18:55,676 --> 00:18:57,266
to respond to.

364
00:18:57,266 --> 00:19:01,246
And when we first went out and we were doing presentations,

365
00:19:01,246 --> 00:19:03,406
the members of the black community

366
00:19:03,406 --> 00:19:06,230
were like, where were you during the crack epidemic?

367
00:19:06,230 --> 00:19:10,346
And I had to say, I'm sorry but we are here now

368
00:19:10,346 --> 00:19:12,614
and we are working and we are trying

369
00:19:12,614 --> 00:19:14,531
to address the harms that have been happening.

370
00:19:14,531 --> 00:19:16,899
So that is kind of where we are at now.

371
00:19:16,899 --> 00:19:18,948
When we look at overdose deaths in New York City

372
00:19:18,948 --> 00:19:21,932
and on Staten Island, it's happening in an older and more

373
00:19:21,932 --> 00:19:23,916
socially isolated population.

374
00:19:23,916 --> 00:19:26,666
So that's why there's many strategies

375
00:19:26,666 --> 00:19:29,232
about getting naloxone mailed to people at home.

376
00:19:29,232 --> 00:19:31,226
And that's also why it's important to have

377
00:19:31,226 --> 00:19:33,860
public health vending machines because we

378
00:19:33,860 --> 00:19:39,860
know that with overdoses, 40% of them happen with a bystander.

379
00:19:39,166 --> 00:19:41,992
So if a person doesn't have a kit on them

380
00:19:41,992 --> 00:19:45,202
and they are in a situation, it's a missed opportunity.

381
00:19:45,202 --> 00:19:48,486
So I hope that was helpful.

382
00:19:48,486 --> 00:19:50,646
>> Yes, it definitely was.

383
00:19:50,646 --> 00:19:54,806
Deputy chief, do you want to jump in?

384
00:19:54,806 --> 00:19:57,806
Do you want to share?

385
00:19:58,446 --> 00:20:03,846
Is that the same type of evolution you've seen?

386
00:20:07,308 --> 00:20:09,766
>> I could tell you from just getting feedback from the EMS

387
00:20:09,766 --> 00:20:16,643
agencies in our area, they are not reporting in a large number

388
00:20:16,643 --> 00:20:17,594
of these events.

389
00:20:17,594 --> 00:20:19,190
I'm not saying they are not happening.

390
00:20:19,190 --> 00:20:21,726
It's just that they are not reporting

391
00:20:21,726 --> 00:20:24,390
that they are in weekly check ins

392
00:20:24,390 --> 00:20:26,406
and saying that they had a particularly heavy call

393
00:20:26,406 --> 00:20:27,886
volume this past weekend.

394
00:20:27,886 --> 00:20:29,154
There's none of that.

395
00:20:29,154 --> 00:20:32,542
One thing that I am curious about, just in general

396
00:20:32,542 --> 00:20:35,726
with this, with these public health vending machines,

397
00:20:35,726 --> 00:20:39,897
has there been any sort of a link to EMS?

398
00:20:39,897 --> 00:20:42,358
Because I know it's all anonymous.

399
00:20:42,358 --> 00:20:44,494
And if somebody is dispensing something

400
00:20:44,494 --> 00:20:49,379
for potential use on a patient, there's not always a guarantee

401
00:20:49,379 --> 00:20:51,146
that one round of Narcan is going

402
00:20:51,146 --> 00:20:54,146
to achieve the desired results.

403
00:20:54,379 --> 00:20:57,870
Certainly, EMS would be more than warranted there.

404
00:20:57,870 --> 00:21:00,126
Is there some sort of way in Staten Island

405
00:21:00,126 --> 00:21:04,934
that EMS units are getting notified of the potential?

406
00:21:04,934 --> 00:21:08,110
And if they do, how would they know what area could potentially

407
00:21:08,110 --> 00:21:09,121
be utilized?

408
00:21:09,121 --> 00:21:12,246
I'm just curious if there's any correlation.

409
00:21:12,246 --> 00:21:13,746
>> Interesting question.

410
00:21:13,746 --> 00:21:15,994
We don't have a system set up.

411
00:21:15,994 --> 00:21:19,726
So when people take the kits, we are not there to train them.

412
00:21:19,726 --> 00:21:21,326
And if we do any kind of training,

413
00:21:21,326 --> 00:21:24,850
we also say to call 911 right away.

414
00:21:24,850 --> 00:21:25,813
That's one of the main things.

415
00:21:25,813 --> 00:21:28,650
Don't think that giving them a lock zone is enough,

416
00:21:28,650 --> 00:21:30,979
because they can come back and then nod off again.

417
00:21:30,979 --> 00:21:34,226
It's one of our main messaging points,

418
00:21:34,226 --> 00:21:39,626
but there's no way for us to know exactly.

419
00:21:39,846 --> 00:21:43,970
It's not like, if you use this kit, please call us and let

420
00:21:43,970 --> 00:21:44,586
us know so we can be tracking.

421
00:21:44,586 --> 00:21:48,906
There's a lot of unreported overdoses again that happen.

422
00:21:48,906 --> 00:21:53,106
And unfortunately, missed opportunities to engage people.

423
00:21:53,926 --> 00:21:59,326
>> I want to point out that I think (Indiscernible)

424
00:21:59,708 --> 00:22:03,908
because they've been providing naloxone and training

425
00:22:08,509 --> 00:22:09,176
(Indiscernible).

426
00:22:09,176 --> 00:22:10,468
Do you know what year that was?

427
00:22:10,468 --> 00:22:11,512
>> It was 2014.

428
00:22:11,512 --> 00:22:18,112
>> We've been doing this for 12 years and how many people have

429
00:22:18,471 --> 00:22:20,471
you (Indiscernible)?

430
00:22:21,401 --> 00:22:22,526
>> I don't know, thousands.

431
00:22:22,526 --> 00:22:24,766
Thousands of thousands of thousands.

432
00:22:24,766 --> 00:22:27,174
>> Thousands and thousands of thousands of people.

433
00:22:27,174 --> 00:22:34,374
I think that you can continue to try to educate the public.

434
00:22:34,686 --> 00:22:38,600
But sometimes it is around access.

435
00:22:38,600 --> 00:22:40,508
Luckily, the governor did make it

436
00:22:40,508 --> 00:22:42,854
so that you can get a prescription of an opioid

437
00:22:42,854 --> 00:22:48,446
and you have the ability to have Narcan filled at your pharmacy.

438
00:22:48,446 --> 00:22:51,339
I think that would help.

439
00:22:51,339 --> 00:22:57,939
A lot of things have been put in place and (Indiscernible)

440
00:22:58,280 --> 00:22:58,863
one more tool.

441
00:22:58,863 --> 00:23:00,530
There are many things that the community

442
00:23:00,530 --> 00:23:05,624
is doing to try to prevent overdose deaths in Westchester.

443
00:23:05,624 --> 00:23:10,926
And I found what you had to say very interesting about what's

444
00:23:10,926 --> 00:23:13,512
going on in Staten Island.

445
00:23:13,512 --> 00:23:16,642
I think some of the problems that you discussed

446
00:23:16,642 --> 00:23:19,246
are problems that we share.

447
00:23:19,246 --> 00:23:20,566
>> Yes.

448
00:23:20,566 --> 00:23:25,606
>> We are trying to address in our own way, here.

449
00:23:25,606 --> 00:23:30,366
>> I'd like to add on to what the question was asking about

450
00:23:30,366 --> 00:23:33,966
when people call 911 (Indiscernible) syringe exchange

451
00:23:38,920 --> 00:23:39,500
program and the Narcan.

452
00:23:39,500 --> 00:23:42,426
Almost 100% of the time, they don't call 911.

453
00:23:42,426 --> 00:23:48,460
But in the lockbox, we have a laminated miniature poster

454
00:23:48,460 --> 00:23:50,460
that shows a QR code.

455
00:23:50,460 --> 00:23:52,926
Which if you have a phone, you can go right there.

456
00:23:52,926 --> 00:23:57,446
Then it has a 52nd instruction on how to administer Narcan

457
00:23:57,446 --> 00:23:59,350
and call 911.

458
00:23:59,350 --> 00:24:02,350
And we discussed vending machines.

459
00:24:04,118 --> 00:24:08,918
We also wanted to include an information pack

460
00:24:10,926 --> 00:24:12,582
that mental health put together.

461
00:24:12,582 --> 00:24:16,782
It has food pantries and emergency information,

462
00:24:17,406 --> 00:24:18,952
contact information.

463
00:24:18,952 --> 00:24:21,639
But you're right, a lot of the times--

464
00:24:21,639 --> 00:24:25,276
>> I love that you're doing all that.

465
00:24:25,276 --> 00:24:27,514
We are trying to do that as well with the QR codes

466
00:24:27,514 --> 00:24:28,722
and the additional resources.

467
00:24:28,722 --> 00:24:32,846
We are all going through it and testing out what works.

468
00:24:32,846 --> 00:24:39,446
And to the earlier point, this is just one piece --

469
00:24:40,356 --> 00:24:41,886
one tool in the toolbox.

470
00:24:41,886 --> 00:24:43,126
Yes.

471
00:24:43,126 --> 00:24:46,788
>> I just wanted to add that one of the things that we are aware

472
00:24:46,788 --> 00:24:53,886
of as we try to be data-focused, we know that, for example,

473
00:24:53,886 --> 00:25:00,486
that the data we get on overdose deaths is pretty consistent

474
00:25:01,886 --> 00:25:07,886
and accurate, the actual number of overdoses are becoming harder

475
00:25:08,246 --> 00:25:10,766
and harder to track simply because of what we are

476
00:25:10,766 --> 00:25:11,982
discussing here.

477
00:25:11,982 --> 00:25:17,614
And when you add in -- we have talked for the last several

478
00:25:17,614 --> 00:25:19,766
years about safe use and that kind of stuff.

479
00:25:19,766 --> 00:25:23,912
You can't automatically assume that a naloxone kit being taken

480
00:25:23,912 --> 00:25:27,912
out of a vending machine is being used specifically

481
00:25:27,912 --> 00:25:29,912
for emergency purposes.

482
00:25:30,466 --> 00:25:34,660
There's also that issue of correlation.

483
00:25:34,726 --> 00:25:36,599
It's great that it's out there.

484
00:25:36,599 --> 00:25:40,306
We have no idea when and if it's actually being used.

485
00:25:40,306 --> 00:25:40,806
>> Yep.

486
00:25:40,806 --> 00:25:42,470
And we've been talking about that.

487
00:25:42,470 --> 00:25:46,266
One of our measures is just having the products

488
00:25:46,266 --> 00:25:47,622
circulating in the community.

489
00:25:47,622 --> 00:25:50,539
We are hoping that they will be used.

490
00:25:50,539 --> 00:25:53,798
But just getting it out there is an important piece of that.

491
00:25:53,798 --> 00:25:55,386
I'm going to go through this quickly.

492
00:25:55,386 --> 00:25:59,526
This is what we have in our machine -- naloxone,

493
00:25:59,526 --> 00:26:03,326
fentanyl and Xylazine test strips, wound care kits,

494
00:26:03,326 --> 00:26:07,516
safer sex supplies, COVID tests and masks, hygiene kits,

495
00:26:07,516 --> 00:26:09,992
feminine hygiene, we have plan B.

496
00:26:09,992 --> 00:26:13,346
We lost our Planned Parenthood clinic so we started to provide

497
00:26:13,346 --> 00:26:17,300
plan B. We have fit packs and then seasonal items like foil

498
00:26:17,300 --> 00:26:20,630
blankets in the winter, and socks.

499
00:26:21,493 --> 00:26:23,608
Socks have been very popular.

500
00:26:23,608 --> 00:26:27,946
But we did a lot of work, doing a needs assessment

501
00:26:27,946 --> 00:26:29,246
in the community.

502
00:26:29,246 --> 00:26:32,620
So street outreach, pushing into the treatment programs

503
00:26:32,620 --> 00:26:33,479
to learn about what are the things

504
00:26:33,479 --> 00:26:35,126
that they want in the machine.

505
00:26:35,126 --> 00:26:38,710
We have two machines and they were

506
00:26:38,710 --> 00:26:41,210
customized based on this needs assessment and feedback.

507
00:26:41,210 --> 00:26:43,488
I have to say that when you have the machine,

508
00:26:43,488 --> 00:26:45,366
you can't just make a quick change

509
00:26:45,366 --> 00:26:48,786
because each coil in the vending machine

510
00:26:48,786 --> 00:26:52,790
is designed for a certain size item.

511
00:26:52,790 --> 00:26:53,772
So sometimes there's some planning

512
00:26:53,772 --> 00:26:56,712
that has to go into what the products are.

513
00:26:56,712 --> 00:26:58,406
We do not have syringes.

514
00:26:58,406 --> 00:27:00,639
And we do not have smoking kits.

515
00:27:00,639 --> 00:27:03,233
This is something that has been one of the more controversial

516
00:27:03,233 --> 00:27:04,126
items.

517
00:27:04,126 --> 00:27:06,246
Some of the machines in the city have those.

518
00:27:06,246 --> 00:27:11,446
We do not have them on Staten Island at this point.

519
00:27:11,446 --> 00:27:15,646
>> Forgive me, what is a fit pack?

520
00:27:17,860 --> 00:27:20,686
>> It's basically to dispose of syringes.

521
00:27:20,894 --> 00:27:23,126
It's a mini sharps container.

522
00:27:23,126 --> 00:27:26,216
And again, we've talked about this.

523
00:27:26,216 --> 00:27:28,990
It's a lot of insider baseball, but people

524
00:27:28,990 --> 00:27:31,440
who currently use drugs know it and they

525
00:27:31,440 --> 00:27:32,734
would be the ones accessing.

526
00:27:32,734 --> 00:27:34,991
So a community member who doesn't know it,

527
00:27:34,991 --> 00:27:37,116
maybe they might take it once and they might use it

528
00:27:37,116 --> 00:27:38,860
for their GLP one injectable.

529
00:27:38,860 --> 00:27:40,660
I don't know.

530
00:27:40,660 --> 00:27:44,726
So that is kind of how we are approaching it.

531
00:27:44,726 --> 00:27:49,560
I love that you brought up the idea of resources.

532
00:27:49,560 --> 00:27:50,681
In our kids, we are putting information

533
00:27:50,681 --> 00:27:53,126
in about services for treatment and recovery.

534
00:27:53,126 --> 00:27:55,262
And we have posted them at partner locations

535
00:27:55,262 --> 00:27:58,126
to make sure that people are connected to resources.

536
00:27:58,126 --> 00:28:03,494
This is our timeline, which is a little bit scary.

537
00:28:03,494 --> 00:28:05,918
I don't think it needs to take three years,

538
00:28:05,918 --> 00:28:07,770
but this is just our journey.

539
00:28:07,770 --> 00:28:10,346
It started in 2023 when we just did

540
00:28:10,346 --> 00:28:13,366
some guerrilla postering on Overdose Awareness Day, where

541
00:28:13,366 --> 00:28:15,126
we blanketed neighborhoods that we knew

542
00:28:15,126 --> 00:28:17,366
were high overdose rates.

543
00:28:17,366 --> 00:28:18,350
With posters.

544
00:28:18,350 --> 00:28:24,350
And we just attached test strips and some harm reduction

545
00:28:24,626 --> 00:28:25,406
supplies.

546
00:28:25,406 --> 00:28:29,419
We would go back and we would see that they were

547
00:28:29,419 --> 00:28:32,390
being taken on a daily basis.

548
00:28:32,390 --> 00:28:34,380
We blanketed the area.

549
00:28:34,380 --> 00:28:37,659
The posters kept getting taken down, we would put them back up.

550
00:28:37,659 --> 00:28:39,306
But it really showed that there was

551
00:28:39,306 --> 00:28:42,454
a appetite for this self-service harm reduction model.

552
00:28:42,454 --> 00:28:44,547
It was only started double it was only

553
00:28:44,547 --> 00:28:46,672
when we started to get fines from the of sanitation

554
00:28:46,672 --> 00:28:48,797
that we thought we should try a different strategy.

555
00:28:48,797 --> 00:28:53,581
But we certainly made a mark in terms of raising awareness

556
00:28:53,581 --> 00:28:55,581
around harm reduction.

557
00:28:55,786 --> 00:29:01,446
In 2024, when the city first got their opioid settlement funds,

558
00:29:01,446 --> 00:29:05,460
they were expanding and enhancing existing projects.

559
00:29:05,460 --> 00:29:08,326
None of those projects existed on Staten Island,

560
00:29:08,326 --> 00:29:11,182
again, going back to that public comment on infrastructure.

561
00:29:11,182 --> 00:29:12,792
We made a lot of noise.

562
00:29:12,792 --> 00:29:16,279
And this is the importance of having coalitions and activated

563
00:29:16,279 --> 00:29:16,779
groups.

564
00:29:16,779 --> 00:29:19,926
So we advocated to the mayor to say,

565
00:29:19,926 --> 00:29:22,966
we have been disproportionately impacted by this epidemic.

566
00:29:22,966 --> 00:29:24,790
We are not receiving a dime.

567
00:29:24,790 --> 00:29:26,986
City Hall heard us and they created an opportunity

568
00:29:26,986 --> 00:29:30,952
for Staten Island, for CBOs, to apply

569
00:29:30,952 --> 00:29:34,219
for funding to support services across the continuum.

570
00:29:34,219 --> 00:29:38,340
And partnerships, us, we decided to apply

571
00:29:38,340 --> 00:29:41,356
to get the public health vending machines.

572
00:29:41,356 --> 00:29:46,156
There were eight total -- seven other providers who were using

573
00:29:46,156 --> 00:29:48,940
their own funds in different ways.

574
00:29:48,940 --> 00:29:52,758
We decided to use ours for public health vending machines.

575
00:29:52,758 --> 00:29:55,726
In 2025, I mentioned the needs assessment.

576
00:29:55,726 --> 00:29:58,534
We did a lot of support building in the community

577
00:29:58,534 --> 00:30:02,310
and we presented at the District attorney's meeting.

578
00:30:02,310 --> 00:30:04,212
We went to community boards.

579
00:30:04,212 --> 00:30:05,679
We did town halls.

580
00:30:05,679 --> 00:30:10,479
It was really important to raise community awareness

581
00:30:10,586 --> 00:30:12,926
and build buy in.

582
00:30:12,926 --> 00:30:15,600
Not everybody was happy about it.

583
00:30:15,600 --> 00:30:17,262
But for the most part, a lot of the partners

584
00:30:17,262 --> 00:30:19,266
were like, this is really great.

585
00:30:19,266 --> 00:30:20,711
School based health clinics double

586
00:30:20,711 --> 00:30:23,860
Dutch we're excited about some of the reproductive health

587
00:30:23,860 --> 00:30:23,859
products.

588
00:30:23,859 --> 00:30:28,220
Just, different stakeholders responded to the different needs

589
00:30:28,220 --> 00:30:29,318
and items.

590
00:30:29,318 --> 00:30:33,326
We were also part of a cohort of other public health vending

591
00:30:33,326 --> 00:30:35,720
machine partners throughout the city.

592
00:30:35,720 --> 00:30:38,352
So we were learning some of the best practices.

593
00:30:38,352 --> 00:30:43,632
And then in 2026, it took a while to identify actual sites.

594
00:30:43,632 --> 00:30:45,606
It is hard to site programs.

595
00:30:45,606 --> 00:30:50,406
I would say that zoning laws around sidewalks

596
00:30:50,766 --> 00:30:52,266
were a challenge.

597
00:30:52,266 --> 00:30:55,136
Having sites that were not owned by the program

598
00:30:55,136 --> 00:30:57,860
was very difficult because landlords

599
00:30:57,860 --> 00:30:59,246
were pushing back against it.

600
00:30:59,246 --> 00:31:04,760
So we ended up going with two providers -- chance and light.

601
00:31:04,760 --> 00:31:06,718
And that's the picture with the ribbon cutting.

602
00:31:06,718 --> 00:31:09,694
You can see it's co-located next to food storage boxes.

603
00:31:09,694 --> 00:31:13,140
So there's a food pantry and community programing there.

604
00:31:13,140 --> 00:31:17,986
And then the other site on the right is down at --

605
00:31:17,986 --> 00:31:22,486
it's on Richmond Terrace which is the perimeter of North Shore.

606
00:31:22,486 --> 00:31:25,480
On the island, there's a food pantry next door.

607
00:31:25,480 --> 00:31:28,346
But we know there's a lot of sex work happening at night.

608
00:31:28,346 --> 00:31:30,286
It's pretty desolate.

609
00:31:30,286 --> 00:31:33,726
So placing them in one spot where there's more resources

610
00:31:33,726 --> 00:31:37,646
and programing and one where it's a little bit more desolate

611
00:31:37,646 --> 00:31:39,272
and where resources are needed.

612
00:31:39,272 --> 00:31:42,670
It launched at the end of June and we have already

613
00:31:42,670 --> 00:31:47,166
had 16 transactions to date across both of the sites.

614
00:31:47,166 --> 00:31:49,166
It's a lot.

615
00:31:51,766 --> 00:31:54,166
Here's my lessons learned.

616
00:31:54,766 --> 00:31:56,916
It's important to get the community buy in.

617
00:31:56,916 --> 00:32:00,660
It's instrumental in every program that you do.

618
00:32:00,660 --> 00:32:04,166
The idea -- challenges of the property.

619
00:32:04,166 --> 00:32:07,460
We also didn't anticipate the costs associated

620
00:32:07,460 --> 00:32:08,339
with installing them.

621
00:32:08,339 --> 00:32:11,518
We had to put in a concrete platform

622
00:32:11,518 --> 00:32:13,616
and have electricians do the wiring.

623
00:32:13,616 --> 00:32:14,676
There's Wi-Fi.

624
00:32:14,676 --> 00:32:17,839
There's some costs associated that we didn't necessarily

625
00:32:17,839 --> 00:32:21,726
focus on right away but we were able to figure out.

626
00:32:21,726 --> 00:32:23,506
Consider Co-locating where people

627
00:32:23,506 --> 00:32:25,686
can access wraparound services.

628
00:32:25,686 --> 00:32:27,726
And then in general, for other communities,

629
00:32:27,726 --> 00:32:31,606
to think through them, the main expenses apart

630
00:32:31,606 --> 00:32:35,563
from buying the machine or you can get machines

631
00:32:35,563 --> 00:32:37,654
from the other entities.

632
00:32:37,654 --> 00:32:42,540
There are a few organizations that provide machines for free.

633
00:32:42,540 --> 00:32:44,782
We bought ours because we're part of the city cohort.

634
00:32:44,782 --> 00:32:47,722
It was about $11,000 for our machines.

635
00:32:47,722 --> 00:32:51,273
And it was expensive for us to do --

636
00:32:51,273 --> 00:32:53,606
it's almost the same amount for us to do the contracting

637
00:32:53,606 --> 00:32:55,146
modifications for installation.

638
00:32:55,146 --> 00:32:58,146
So that's the upfront cost.

639
00:32:58,214 --> 00:33:01,814
And then the ongoing costs are basically labor.

640
00:33:01,814 --> 00:33:05,112
And then buying the public health supplies that we cannot

641
00:33:05,112 --> 00:33:05,912
give for free.

642
00:33:05,912 --> 00:33:08,406
So right now, naloxone and test strips

643
00:33:08,406 --> 00:33:12,518
are made available by the state which is fantastic.

644
00:33:12,518 --> 00:33:16,566
But we purchased the plan B. We purchased the feminine hygiene

645
00:33:16,566 --> 00:33:19,588
supplies, we purchased the wound care kit --

646
00:33:19,588 --> 00:33:20,679
all of that stuff.

647
00:33:20,679 --> 00:33:23,460
And we're trying to do some innovative partnerships

648
00:33:23,460 --> 00:33:24,620
with entities.

649
00:33:24,620 --> 00:33:27,406
We might also do some diapers in there,

650
00:33:27,406 --> 00:33:30,726
trying to get things donated as much as we can to make sure

651
00:33:30,726 --> 00:33:33,126
that this is sustainable.

652
00:33:33,366 --> 00:33:36,719
And I think that's all I have for now.

653
00:33:36,719 --> 00:33:38,139
There's a lot.

654
00:33:38,139 --> 00:33:42,206
But I think you get the gist of it.

655
00:33:42,206 --> 00:33:44,606
>> That was extremely helpful.

656
00:33:46,286 --> 00:33:52,886
So now I'm gonna ask everybody to add whether you --

657
00:33:54,622 --> 00:33:58,486
whether and how you think this will work in Westchester County.

658
00:33:58,486 --> 00:34:04,182
Before I do that, I want to ask about the feminine products.

659
00:34:04,182 --> 00:34:08,382
You said you had 16 points of access.

660
00:34:09,109 --> 00:34:11,949
Were they for feminine products?

661
00:34:11,949 --> 00:34:14,766
Because every year I send out an annual letter.

662
00:34:14,766 --> 00:34:18,390
I should go out any day now, to our school districts.

663
00:34:18,390 --> 00:34:21,262
But I send them to remind them that they are required

664
00:34:21,262 --> 00:34:25,456
by state law to provide feminine products in the bathrooms

665
00:34:25,456 --> 00:34:29,926
so students don't have to go to the nurse's office.

666
00:34:29,926 --> 00:34:31,446
>> Yes.

667
00:34:31,446 --> 00:34:33,846
>> What were those 16 points?

668
00:34:35,460 --> 00:34:38,766
>> I think what I shared was that there were 1600 transaction

669
00:34:38,766 --> 00:34:41,166
across the two machines.

670
00:34:41,579 --> 00:34:43,579
1600 transactions.

671
00:34:45,606 --> 00:34:46,263
Yeah.

672
00:34:46,263 --> 00:34:53,374
Of the -- I mean, I don't want to share data because I'm not --

673
00:34:53,374 --> 00:34:56,341
but feminine hygiene products was in the top in terms

674
00:34:56,341 --> 00:35:00,246
of things that were being selected for.

675
00:35:00,246 --> 00:35:03,846
Wound care kits were pretty high.

676
00:35:04,206 --> 00:35:08,606
I mean, it is interesting to see across the sites what

677
00:35:08,606 --> 00:35:09,439
the differences are.

678
00:35:09,439 --> 00:35:13,962
But yes come on we've really been trying to do a lot --

679
00:35:13,962 --> 00:35:16,462
but yes, we've been trying to do a lot around period poverty

680
00:35:16,462 --> 00:35:19,882
and making sure people can access these products and not

681
00:35:19,882 --> 00:35:24,820
have to struggle and ask for them.

682
00:35:24,286 --> 00:35:26,166
>> Okay.

683
00:35:26,166 --> 00:35:29,845
>> Adrian, you said that you looked into matters.

684
00:35:29,845 --> 00:35:37,450
We had them do a presentation to our opioid response in April.

685
00:35:37,302 --> 00:35:39,846
And we are looking into them but you

686
00:35:39,846 --> 00:35:42,486
chose not to go with matters?

687
00:35:42,486 --> 00:35:45,526
>> Because I was part of the city cohort and we were all

688
00:35:45,526 --> 00:35:47,606
using the same machine.

689
00:35:47,606 --> 00:35:49,946
I don't know if it was also --

690
00:35:49,946 --> 00:35:53,406
I don't know how the data collection works with matters.

691
00:35:53,406 --> 00:35:59,406
The city wanted to have access to our data (Indiscernible).

692
00:36:02,294 --> 00:36:04,233
I don't know how the data collection

693
00:36:04,233 --> 00:36:04,238
and sharing works with matters.

694
00:36:04,238 --> 00:36:06,488
I know that they do provide the machine free of charge

695
00:36:06,488 --> 00:36:09,334
and they help with getting those free, statewide naloxone

696
00:36:09,334 --> 00:36:11,502
kits and the testing strips.

697
00:36:11,502 --> 00:36:15,222
I mean, yeah, we've heard good things.

698
00:36:15,222 --> 00:36:17,486
I'm just not quite sure about the data piece.

699
00:36:17,486 --> 00:36:22,886
That's the only one I'm not really there on.

700
00:36:33,774 --> 00:36:34,274
>> Okay.

701
00:36:34,274 --> 00:36:34,378
Since you just asked that, it sounds like this is already

702
00:36:34,378 --> 00:36:36,378
being considered?

703
00:36:36,819 --> 00:36:39,666
>> I was on a Zoom call at the beginning of the year when we

704
00:36:39,666 --> 00:36:43,242
heard about matters and that they were offering free vending

705
00:36:43,242 --> 00:36:43,798
machines.

706
00:36:43,798 --> 00:36:47,998
So I had them present in April.

707
00:36:50,922 --> 00:36:54,458
We learned that everything was free.

708
00:36:54,458 --> 00:36:59,246
Unless we wanted to provide those other supplies.

709
00:36:59,246 --> 00:37:02,926
And at the same time, the Department of Mental Health

710
00:37:02,926 --> 00:37:06,596
was looking into having supplies for the homeless population,

711
00:37:06,596 --> 00:37:09,766
some of the supplies that were mentioned.

712
00:37:09,766 --> 00:37:12,348
But New York, because it was free

713
00:37:12,348 --> 00:37:15,386
and it seemed like a good opportunity,

714
00:37:15,386 --> 00:37:19,474
it's similar to what the vending machines that Adrian

715
00:37:19,474 --> 00:37:20,638
was talking about.

716
00:37:20,638 --> 00:37:23,586
When you enter center code and your zip code,

717
00:37:23,586 --> 00:37:27,816
but I forget about how they collect the data.

718
00:37:27,816 --> 00:37:31,356
At a time, they had three vending machines

719
00:37:31,356 --> 00:37:33,600
that were available.

720
00:37:33,600 --> 00:37:35,966
It was unsure about the future of them

721
00:37:35,966 --> 00:37:40,366
but I was asked to reach out to them recently.

722
00:37:40,366 --> 00:37:43,856
And so I'm trying to find out if there is still funding.

723
00:37:43,856 --> 00:37:45,574
Do they have machines?

724
00:37:45,574 --> 00:37:48,486
I remember them saying if they didn't, they

725
00:37:48,486 --> 00:37:50,752
would take six months to build one.

726
00:37:50,752 --> 00:37:56,140
And if they don't, then they would consider settlement money.

727
00:37:56,140 --> 00:37:58,434
And we will be reaching out to you

728
00:37:58,434 --> 00:38:01,406
to find exactly who you ordered them from.

729
00:38:01,406 --> 00:38:04,232
But they seem to have it set up.

730
00:38:04,232 --> 00:38:09,726
I thought they had machines in the city, in the Bronx.

731
00:38:09,726 --> 00:38:11,326
>> Yes.

732
00:38:11,326 --> 00:38:13,574
>> They had them in Putnam, Dutchess.

733
00:38:13,574 --> 00:38:17,774
But they didn't have any in Westchester.

734
00:38:20,126 --> 00:38:22,126
>> Yeah.

735
00:38:22,566 --> 00:38:25,699
>> They had three Narcan vending machines.

736
00:38:25,699 --> 00:38:28,408
>> They said we'll also be provided with free Narcan.

737
00:38:28,408 --> 00:38:31,294
We get free Narcan through the state and we get testing strips.

738
00:38:31,294 --> 00:38:36,860
But matter will also provide the Narcan and the testing strips.

739
00:38:36,860 --> 00:38:40,886
>> And then we can get a grant (Indiscernible).

740
00:38:45,550 --> 00:38:47,133
>> I can forward you the presentation.

741
00:38:47,133 --> 00:38:51,802
>> (Indiscernible) can only put Narcan and testing strips

742
00:38:51,802 --> 00:38:52,302
in their?

743
00:38:52,302 --> 00:38:52,314
>> No, I think it helps the counties about what will be

744
00:38:52,314 --> 00:38:53,299
provided.

745
00:38:53,299 --> 00:38:58,990
>> They would provide the Narcan testing strips (Indiscernible).

746
00:39:03,846 --> 00:39:06,540
Or hygiene kits and things like that. (Indiscernible)

747
00:39:06,540 --> 00:39:08,540
to the county.

748
00:39:10,544 --> 00:39:12,944
But Narcan strips (Indiscernible)

749
00:39:14,774 --> 00:39:15,691
really replenish that.

750
00:39:15,691 --> 00:39:17,691
>> (Indiscernible) location.

751
00:39:21,663 --> 00:39:22,705
>> They are refrigerated.

752
00:39:22,705 --> 00:39:24,800
You have to have electric and you

753
00:39:24,800 --> 00:39:26,830
have to have access to Wi-Fi.

754
00:39:26,830 --> 00:39:28,959
>> It has to be on a flat surface.

755
00:39:28,959 --> 00:39:30,756
It could be on a sidewalk.

756
00:39:30,756 --> 00:39:33,756
If it was (Indiscernible) building,

757
00:39:37,938 --> 00:39:40,220
you would have to get acceptance from the landlord.

758
00:39:40,220 --> 00:39:41,720
You have to have access to electric.

759
00:39:41,720 --> 00:39:45,366
So what we did, myself, and we have a New York State fellow

760
00:39:45,366 --> 00:39:47,460
double Dutch we walked around.

761
00:39:47,460 --> 00:39:49,446
We were thinking about double Dutch we walked around.

762
00:39:49,446 --> 00:39:52,446
We were thinking about (Indiscernible)

763
00:39:57,916 --> 00:39:59,499
and we were trying to figure out which

764
00:39:59,499 --> 00:39:59,503
locations would be available.

765
00:39:59,503 --> 00:39:59,514
And so we thought maybe a good location would be 85

766
00:39:59,514 --> 00:39:59,716
Court Street.

767
00:39:59,716 --> 00:40:01,424
I'm not sure where we are in the building

768
00:40:01,424 --> 00:40:05,624
right now, just right across the street.

769
00:40:05,686 --> 00:40:12,286
My (Indiscernible) was able to take a picture of the location

770
00:40:14,680 --> 00:40:16,888
and put the vending machine to have a look at what it

771
00:40:16,888 --> 00:40:18,888
would look like.

772
00:40:20,860 --> 00:40:26,860
Again, we thought about a pilot project in White Plains

773
00:40:27,206 --> 00:40:30,221
was essentially located double Dutch centrally located.

774
00:40:30,221 --> 00:40:32,806
And probably similar to what was being said,

775
00:40:32,806 --> 00:40:35,540
you have software where you can remotely

776
00:40:35,540 --> 00:40:37,352
see what is being taken.

777
00:40:37,352 --> 00:40:42,800
And then you can go out when it needs to be resupplied.

778
00:40:42,800 --> 00:40:44,766
We had questions about vandalism.

779
00:40:44,766 --> 00:40:45,794
It was rare.

780
00:40:45,794 --> 00:40:47,486
I don't know if that happened.

781
00:40:47,486 --> 00:40:49,939
She said it was rare.

782
00:40:49,939 --> 00:40:54,552
And that, if they did, they would work with us and it really

783
00:40:54,552 --> 00:40:56,192
shouldn't be --

784
00:40:56,192 --> 00:41:00,166
>> But that was one of the main concerns that we heard from

785
00:41:00,166 --> 00:41:03,286
communities when we were talking about installation.

786
00:41:03,286 --> 00:41:04,878
They were worried about vandalism.

787
00:41:04,878 --> 00:41:09,780
We actually did an FAQ Mythbuster (Indiscernible)

788
00:41:16,811 --> 00:41:18,811
concerns and I'm happy to share it with you all.

789
00:41:18,811 --> 00:41:18,816
We are not seeing that.

790
00:41:18,816 --> 00:41:19,489
I mean, I think some of the machines in the city

791
00:41:19,489 --> 00:41:22,325
had some light vandalism like graffiti,

792
00:41:22,325 --> 00:41:24,646
but it was nothing that was major.

793
00:41:24,646 --> 00:41:26,982
And we haven't experienced anything yet.

794
00:41:26,982 --> 00:41:29,811
Also, people are worried about diversion.

795
00:41:29,811 --> 00:41:32,106
What if somebody clears out the machine?

796
00:41:32,106 --> 00:41:36,319
Our answer is, it's not like we are

797
00:41:36,319 --> 00:41:39,226
trying to think about language about leaving supplies

798
00:41:39,226 --> 00:41:40,646
for others.

799
00:41:40,646 --> 00:41:43,246
But as long as the stuff is getting circulated

800
00:41:43,246 --> 00:41:46,619
and out there, I don't know.

801
00:41:46,619 --> 00:41:49,646
We go back and forth about this.

802
00:41:49,646 --> 00:41:52,646
These are the pain points.

803
00:41:52,726 --> 00:41:56,899
>> I have a quick question when it comes to data collection.

804
00:41:56,899 --> 00:42:00,499
You're talking about some Hotspotting data.

805
00:42:00,757 --> 00:42:02,299
Where did you receive your data from?

806
00:42:02,299 --> 00:42:04,700
Did you get that from the communities?

807
00:42:04,700 --> 00:42:06,566
Did you get it from law enforcement?

808
00:42:06,566 --> 00:42:07,966
EMS.

809
00:42:07,966 --> 00:42:12,766
>> Our district attorney is really good about sharing

810
00:42:12,806 --> 00:42:17,460
the Hope initiative and keeping partners in the loop about

811
00:42:17,460 --> 00:42:18,310
overdose deaths.

812
00:42:18,310 --> 00:42:22,662
And then for the Hotspotting program with the,

813
00:42:22,662 --> 00:42:25,211
they are getting data from hospitals.

814
00:42:25,211 --> 00:42:28,598
I don't want to speak on behalf, because it's

815
00:42:28,598 --> 00:42:30,374
a whole proprietary.

816
00:42:30,374 --> 00:42:34,436
They worked with MIT to create some data analytic portal

817
00:42:34,436 --> 00:42:35,686
platform.

818
00:42:35,686 --> 00:42:40,126
But they are pulling data from multiple sources.

819
00:42:40,126 --> 00:42:43,130
>> To me, that would probably be the most important where you are

820
00:42:43,130 --> 00:42:45,499
going to concentrate your programs.

821
00:42:45,499 --> 00:42:49,334
Westchester, being what I usually say, is very unique.

822
00:42:49,334 --> 00:42:52,334
There's over 40 different police departments.

823
00:42:52,486 --> 00:42:56,860
There's 50-something fire departments, 45 EMS agencies.

824
00:42:57,606 --> 00:42:59,706
We have 13911 receiving hospitals.

825
00:42:59,706 --> 00:43:02,486
Getting that data, even if you're just

826
00:43:02,486 --> 00:43:06,506
looking at 911 dispatch data, is extremely difficult to.

827
00:43:06,506 --> 00:43:08,984
But that is kind of why I was looking at,

828
00:43:08,984 --> 00:43:11,580
what's the best way to get the data?

829
00:43:11,580 --> 00:43:13,266
So you are really treating the most appropriate areas

830
00:43:13,266 --> 00:43:16,432
in the population you need to.

831
00:43:16,432 --> 00:43:17,977
>> That's a great point.

832
00:43:17,977 --> 00:43:22,246
I mean, we did use that data to pinpoint the neighborhoods

833
00:43:22,246 --> 00:43:24,294
that we wanted to be in.

834
00:43:24,294 --> 00:43:25,200
It's interesting.

835
00:43:25,200 --> 00:43:28,486
The one area that I really wanted to be in, we couldn't be.

836
00:43:28,486 --> 00:43:30,446
It was one park in the neighborhood where we

837
00:43:30,446 --> 00:43:31,836
were seeing a lot of overdoses.

838
00:43:31,836 --> 00:43:35,318
Even though this was a city initiative,

839
00:43:35,318 --> 00:43:36,802
parks wasn't bought in.

840
00:43:36,802 --> 00:43:39,546
They said, we don't want that in our refurbished park.

841
00:43:39,546 --> 00:43:42,246
They said, we are doing a new comfort station,

842
00:43:42,246 --> 00:43:45,350
we're worried about condoms clogging the toilets.

843
00:43:45,350 --> 00:43:46,452
There was some interesting things.

844
00:43:46,452 --> 00:43:49,196
And it was like, o, okay.

845
00:43:49,196 --> 00:43:51,186
Libraries didn't want it.

846
00:43:51,186 --> 00:43:53,158
I'm giving you the CBO perspective

847
00:43:53,158 --> 00:43:55,878
but I'm kind of curious, I don't know

848
00:43:55,878 --> 00:43:57,598
what it's like in Westchester.

849
00:43:57,598 --> 00:44:00,270
But I'm curious about working with other county entities

850
00:44:00,270 --> 00:44:03,870
and how it will be received.

851
00:44:04,190 --> 00:44:04,947
>> Good point.

852
00:44:04,947 --> 00:44:06,947
Thank you.

853
00:44:07,126 --> 00:44:11,246
>> So if we had everything in place,

854
00:44:11,246 --> 00:44:15,446
how would you determine the best locations?

855
00:44:19,606 --> 00:44:22,699
>> Again, we could query the EMS agencies.

856
00:44:22,699 --> 00:44:25,219
Would probably be the same with law enforcement.

857
00:44:25,219 --> 00:44:27,486
The local communities would probably

858
00:44:27,486 --> 00:44:31,459
know best about areas of high overdose

859
00:44:31,459 --> 00:44:35,659
or the areas of high drug use.

860
00:44:35,779 --> 00:44:38,566
It may not be specific to overdose

861
00:44:38,566 --> 00:44:41,936
but locally, I think those local agencies can probably

862
00:44:41,936 --> 00:44:43,910
provide the best.

863
00:44:43,910 --> 00:44:46,516
And be it that in a more urban area or maybe

864
00:44:46,516 --> 00:44:47,702
a more suburban area.

865
00:44:47,702 --> 00:44:48,766
I'm not really sure.

866
00:44:48,766 --> 00:44:51,137
We don't get to see a lot of that data.

867
00:44:51,137 --> 00:44:53,591
But that was my point is that, what

868
00:44:53,591 --> 00:44:56,286
is the best way that we can look at getting accurate

869
00:44:56,286 --> 00:45:00,366
data to truly help the population in need?

870
00:45:00,366 --> 00:45:00,866
>> Right.

871
00:45:00,866 --> 00:45:03,460
I see you shaking your head.

872
00:45:03,460 --> 00:45:06,716
>> Yes, absolutely pure Mike this is in alignment with what I

873
00:45:06,716 --> 00:45:07,886
was saying earlier.

874
00:45:07,886 --> 00:45:10,426
I think if we reach out to the local agencies

875
00:45:10,426 --> 00:45:14,783
to see what they have to say, on a weekly basis,

876
00:45:14,783 --> 00:45:20,183
no specific agency is citing a really high volume

877
00:45:20,406 --> 00:45:22,140
of these situations.

878
00:45:22,140 --> 00:45:25,739
A lot of times, they may not even

879
00:45:25,739 --> 00:45:27,899
be getting into the 911 system.

880
00:45:27,899 --> 00:45:30,910
But I think if we check with them,

881
00:45:30,910 --> 00:45:32,918
I think it would be a really good starting point.

882
00:45:32,918 --> 00:45:36,426
And then, when and if a location is determined,

883
00:45:36,426 --> 00:45:39,158
that might be appropriate to put one of the units,

884
00:45:39,158 --> 00:45:41,718
I think for situational awareness,

885
00:45:41,718 --> 00:45:46,518
at a minimum, the primary EMS response agency,

886
00:45:46,826 --> 00:45:50,990
I can notify them just for situational awareness

887
00:45:50,990 --> 00:45:55,326
that, you know this is in your primary area, just in case.

888
00:45:55,326 --> 00:45:56,859
>> Okay.

889
00:45:56,859 --> 00:45:58,854
>> It's gonna be difficult to figure out,

890
00:45:58,854 --> 00:46:02,366
because over the years, with the data that gets collected,

891
00:46:02,366 --> 00:46:05,542
occasionally we get clusters from the state.

892
00:46:05,542 --> 00:46:07,359
It might be in this area or this area.

893
00:46:07,359 --> 00:46:09,182
But there are some other counties,

894
00:46:09,182 --> 00:46:11,710
where I don't know if we have a specific area where

895
00:46:11,710 --> 00:46:13,152
there might be more overdoses.

896
00:46:13,152 --> 00:46:17,352
And so if we were thinking, start

897
00:46:17,422 --> 00:46:20,126
with a pilot project that is centrally located

898
00:46:20,126 --> 00:46:22,720
in an urban area like White Plains.

899
00:46:22,720 --> 00:46:28,672
And if that was successful, we could scale and offer it

900
00:46:28,819 --> 00:46:30,459
in Mount Vernon.

901
00:46:30,459 --> 00:46:32,856
They might have a better idea.

902
00:46:32,856 --> 00:46:37,174
Over the years, I haven't seen of any specific areas

903
00:46:37,174 --> 00:46:39,518
that I would highlight other than the areas

904
00:46:39,518 --> 00:46:42,518
that we were thinking about.

905
00:46:42,726 --> 00:46:45,436
>> But I think that's also the importance of doing

906
00:46:45,436 --> 00:46:49,566
the engagement with the programs and people who are receiving,

907
00:46:49,566 --> 00:46:52,373
who are in recovery and in treatment, to say,

908
00:46:52,373 --> 00:46:54,256
where would you have wanted support?

909
00:46:54,256 --> 00:46:57,152
Are there areas that you think we should be going into?

910
00:46:57,152 --> 00:47:00,806
Kind of layering the hotspot data with some qualitative data

911
00:47:00,806 --> 00:47:03,806
collection from people receiving services.

912
00:47:04,299 --> 00:47:06,880
>> It's interesting because if you look at the map

913
00:47:06,880 --> 00:47:10,166
on the website, from one of New York State,

914
00:47:10,166 --> 00:47:13,286
you see that they have the vending machines located

915
00:47:13,286 --> 00:47:15,406
specifically in two places.

916
00:47:15,406 --> 00:47:18,576
One is urban areas, and the other is out in the rural areas.

917
00:47:18,576 --> 00:47:21,662
You can understand from that perspective, the rural areas

918
00:47:21,662 --> 00:47:24,966
as well, because there are many folks in rural areas

919
00:47:24,966 --> 00:47:29,166
where that machine becomes their only option.

920
00:47:29,206 --> 00:47:31,206
>> Their lifeline, yes.

921
00:47:31,966 --> 00:47:34,966
>> (Indiscernible) legislative who represents Westchester,

922
00:47:44,910 --> 00:47:47,910
she would agree with this.

923
00:47:53,957 --> 00:47:56,124
>> (Indiscernible) people using Narcan on their own,

924
00:47:56,124 --> 00:47:59,124
what they've reported (Indiscernible) ems.

925
00:48:03,693 --> 00:48:07,293
>> Especially if just one shot works.

926
00:48:15,957 --> 00:48:17,707
>> (Indiscernible) become less data on it.

927
00:48:17,707 --> 00:48:17,715
>> We would never really had good data.

928
00:48:17,715 --> 00:48:17,722
We've done the trainings and we've always

929
00:48:17,722 --> 00:48:17,728
asked people to use the kit.

930
00:48:17,728 --> 00:48:17,732
Please let us know.

931
00:48:17,732 --> 00:48:19,315
Nobody ever lets us or the state know.

932
00:48:19,315 --> 00:48:20,866
They're afraid.

933
00:48:20,866 --> 00:48:24,676
I get that and I understand that.

934
00:48:24,676 --> 00:48:28,166
So really, we don't have any viable data

935
00:48:28,166 --> 00:48:31,206
we are the most Narcan is used.

936
00:48:31,206 --> 00:48:37,806
We just >> But I do think that we are seeing decreases

937
00:48:45,522 --> 00:48:46,605
in overdose deaths, right?

938
00:48:46,605 --> 00:48:46,616
And I think that the flooding of the communities with naloxone

939
00:48:46,616 --> 00:48:46,621
is contributing to that piece.

940
00:48:46,621 --> 00:48:48,204
People are not dying at the same rate.

941
00:48:48,204 --> 00:48:50,111
They might be overdosing and coming back.

942
00:48:50,111 --> 00:48:52,486
>> We've seen that since the very beginning when we first

943
00:48:52,486 --> 00:48:53,672
started this.

944
00:48:53,672 --> 00:48:59,190
They may not be willing to report to us and address,

945
00:48:59,190 --> 00:49:04,196
but they could call and say, I used it and it was successful.

946
00:49:04,196 --> 00:49:07,574
We know the program is working.

947
00:49:07,574 --> 00:49:09,806
And I think the measure of that was

948
00:49:09,806 --> 00:49:13,446
the fact that more and more people wanted the training.

949
00:49:13,446 --> 00:49:17,120
Patrick and I thought that we would do --

950
00:49:17,120 --> 00:49:21,714
we trained 50 or 100 people and we'd call it a day and be done.

951
00:49:21,714 --> 00:49:24,554
And 12 years later, we are still doing this.

952
00:49:24,554 --> 00:49:27,872
And in fact, it used to just be a sideline

953
00:49:27,872 --> 00:49:31,286
and now it's what he does.

954
00:49:31,286 --> 00:49:37,460
So we are a product of the success of the program which

955
00:49:37,460 --> 00:49:38,262
is great and wonderful.

956
00:49:38,262 --> 00:49:42,726
I would say that I think that through this program,

957
00:49:42,726 --> 00:49:46,146
we've probably saved more lives than I ever saved being a doctor

958
00:49:46,146 --> 00:49:50,346
and actually seeing people treated for diseases.

959
00:50:08,364 --> 00:50:11,824
Yeah that's an important and true statement.

960
00:50:11,824 --> 00:50:13,184
It's an important program.

961
00:50:13,184 --> 00:50:15,116
We give people a second chance or sometimes

962
00:50:15,116 --> 00:50:22,316
a third or fourth chance to turn their lives around and stay

963
00:50:22,580 --> 00:50:23,348
alive.

964
00:50:23,348 --> 00:50:27,438
Because you know, you can't improve your life --

965
00:50:27,438 --> 00:50:31,936
if we can keep people alive, they have the opportunity to get

966
00:50:31,936 --> 00:50:33,394
their lives back on track.

967
00:50:33,394 --> 00:50:37,594
And that's our goal and our hope.

968
00:50:37,684 --> 00:50:38,604
>> Absolutely.

969
00:50:38,604 --> 00:50:41,304
And that's how we respond to people.

970
00:50:41,304 --> 00:50:43,604
Like oh, you're just encouraging drug use.

971
00:50:43,604 --> 00:50:47,804
We are encouraging people to stay alive.

972
00:50:48,570 --> 00:50:51,516
>> To stay alive and hoping that at some point they will engage

973
00:50:51,516 --> 00:50:55,610
with -- something will make them willing to say, listen,

974
00:50:55,610 --> 00:50:56,737
this is not the life I want.

975
00:50:56,737 --> 00:50:57,484
You know?

976
00:50:57,484 --> 00:51:00,161
I really would like to get my life back together.

977
00:51:00,161 --> 00:51:04,524
And you can't do that if you're dead.

978
00:51:04,524 --> 00:51:05,675
>> Nope.

979
00:51:05,675 --> 00:51:09,956
Would West, would you all have other materials in addition

980
00:51:09,956 --> 00:51:12,836
to the naloxone and test strips?

981
00:51:12,836 --> 00:51:15,718
Like this concept of having more --

982
00:51:15,718 --> 00:51:18,972
have it be public health where there's some items that

983
00:51:18,972 --> 00:51:20,972
the community needs?

984
00:51:21,884 --> 00:51:24,284
>> We are public health.

985
00:51:25,844 --> 00:51:28,844
That speaks to our heart.

986
00:51:29,444 --> 00:51:33,724
We haven't really given that a lot of thought at this point.

987
00:51:33,724 --> 00:51:38,550
But I like the idea of -- we want to meet every need that we

988
00:51:38,550 --> 00:51:39,954
have the ability to address.

989
00:51:39,954 --> 00:51:45,404
That's the whole point of what we do, what mental health does.

990
00:51:45,404 --> 00:51:49,284
We want people to live longer, healthier and happier lives.

991
00:51:49,284 --> 00:51:50,660
That is our goal.

992
00:51:50,660 --> 00:51:52,864
Longer, healthier and happier lives.

993
00:51:52,864 --> 00:51:55,364
And whatever we can do to make that happen for our residents

994
00:51:55,364 --> 00:51:56,910
is what we want.

995
00:51:56,910 --> 00:51:59,310
>> I love that aspect.

996
00:53:23,832 --> 00:53:28,368
>> -- Or where do they feel that the benefit of a vending machine

997
00:53:28,368 --> 00:53:29,108
would be helpful?

998
00:53:29,108 --> 00:53:30,816
And where would that be in the community?

999
00:53:30,816 --> 00:53:37,760
Just some >> We've been doing a lot of work around meeting

1000
00:53:37,760 --> 00:53:41,442
people's social needs -- the health-related social needs.

1001
00:53:41,442 --> 00:53:45,420
We have part of the 1115 waiver.

1002
00:53:45,280 --> 00:53:49,626
Everybody is at this moment where Medicaid managed

1003
00:53:49,626 --> 00:53:53,116
care is connecting people with these enhanced services

1004
00:53:53,116 --> 00:53:58,501
and food has been the number one need in our community

1005
00:53:58,501 --> 00:53:59,471
and housing.

1006
00:53:59,471 --> 00:54:02,109
In right now many of our behavioral health

1007
00:54:02,109 --> 00:54:06,376
providers are part of this social care of the 1115 waiver

1008
00:54:06,376 --> 00:54:06,896
work.

1009
00:54:06,896 --> 00:54:09,468
So they are being connected and talking

1010
00:54:09,468 --> 00:54:12,896
about social needs and food insecurity and behavioral health

1011
00:54:12,896 --> 00:54:15,440
if somebody is unhoused, they're not

1012
00:54:15,440 --> 00:54:18,888
going to be able to maintain recovery or get treatments.

1013
00:54:18,888 --> 00:54:22,496
So, really thinking holistically about this work.

1014
00:54:22,496 --> 00:54:26,196
The recipients of services at those partner locations

1015
00:54:26,196 --> 00:54:27,784
do give a lot of feedback.

1016
00:54:27,784 --> 00:54:30,756
And a lot of them are people who access the food pantry

1017
00:54:30,756 --> 00:54:32,789
on a regular basis and have a sense of what

1018
00:54:32,789 --> 00:54:33,912
the community does.

1019
00:54:33,912 --> 00:54:40,267
So that brings in some of those other products that we

1020
00:54:40,267 --> 00:54:41,136
(Indiscernible).

1021
00:54:41,136 --> 00:54:43,136
>> Thank you.

1022
00:54:47,794 --> 00:54:48,294
>> Okay.

1023
00:54:48,294 --> 00:54:50,294
Will this work?

1024
00:54:50,496 --> 00:54:52,496
>> Will this work?

1025
00:54:53,811 --> 00:54:55,736
Uhm, interesting question.

1026
00:54:55,736 --> 00:54:59,880
Obviously the need has to be more clearly defined.

1027
00:54:59,880 --> 00:55:04,359
I mean, we have folks at EMS (Indiscernible)

1028
00:55:04,359 --> 00:55:06,670
we would have to dive a little bit deeper

1029
00:55:06,670 --> 00:55:09,276
to figure out exactly where the issue (Indiscernible)

1030
00:55:09,276 --> 00:55:12,176
and of course, there's the other big question

1031
00:55:12,176 --> 00:55:15,546
that we would have to look at is, how do we

1032
00:55:15,546 --> 00:55:18,546
go about a siting process?

1033
00:55:18,760 --> 00:55:22,916
If we're going to do this, this will be a community effort,

1034
00:55:22,916 --> 00:55:24,176
requiring the community.

1035
00:55:24,176 --> 00:55:28,192
Can you talk a little bit about that?

1036
00:55:28,192 --> 00:55:31,620
What did it take for you all to get the community buy in

1037
00:55:31,620 --> 00:55:33,620
to go forward?

1038
00:55:33,136 --> 00:55:36,656
>> We did a lot of presentations.

1039
00:55:36,656 --> 00:55:42,895
>> By the way, it's the hardest part of the work right getting

1040
00:55:42,895 --> 00:55:45,538
funding the hardest part of the work is siting the programs.

1041
00:55:45,538 --> 00:55:47,496
You get the funding and you get the green light

1042
00:55:47,496 --> 00:55:50,116
and you've got to get the support of the community.

1043
00:55:50,116 --> 00:55:52,701
And if you want it to succeed, at least.

1044
00:55:52,701 --> 00:55:55,676
So we went out, we did presentations.

1045
00:55:55,676 --> 00:55:58,760
We were already --

1046
00:55:58,876 --> 00:56:01,384
I was featured in the paper a couple of times.

1047
00:56:01,384 --> 00:56:03,939
So there's definitely information about the program

1048
00:56:03,939 --> 00:56:04,764
out there.

1049
00:56:04,764 --> 00:56:07,256
But right before we were about to do

1050
00:56:07,256 --> 00:56:09,456
the installation, the ribbon cutting,

1051
00:56:09,456 --> 00:56:13,104
the city wanted me to meet with my elected officials.

1052
00:56:13,104 --> 00:56:16,238
And I was like, but they've already heard about it.

1053
00:56:16,238 --> 00:56:18,736
No, you need a specific briefing with them

1054
00:56:18,736 --> 00:56:21,756
where they can ask questions and raise concerns.

1055
00:56:21,756 --> 00:56:25,823
So I think that we were very careful about making sure

1056
00:56:25,823 --> 00:56:28,960
that people knew about it and that people had an opportunity

1057
00:56:28,960 --> 00:56:30,456
to weigh in.

1058
00:56:30,456 --> 00:56:33,456
Town halls, smaller intimate conversations.

1059
00:56:35,116 --> 00:56:41,120
We did FAQs and flyering at different program sites so that

1060
00:56:41,120 --> 00:56:44,796
people built -- there was awareness being built.

1061
00:56:44,796 --> 00:56:46,904
But it was really tough.

1062
00:56:46,904 --> 00:56:49,240
None of the elected officials came out

1063
00:56:49,240 --> 00:56:51,881
against us, which was a real win.

1064
00:56:51,881 --> 00:56:53,872
But they were pretty quiet in their support.

1065
00:56:53,872 --> 00:56:57,886
I believe people were afraid of taking a public stand on it.

1066
00:56:57,886 --> 00:57:01,616
In terms of siting, I mentioned the issue.

1067
00:57:01,616 --> 00:57:03,429
Sometimes we would have partners --

1068
00:57:03,429 --> 00:57:07,442
that site that I wanted to place it in, Tappan Park,

1069
00:57:07,442 --> 00:57:12,336
we had some health care (Indiscernible) that said, yes,

1070
00:57:12,336 --> 00:57:14,560
but you have to talk to the landlord.

1071
00:57:14,560 --> 00:57:16,216
And the landlord said absolutely not.

1072
00:57:16,216 --> 00:57:18,208
The library said absolutely not.

1073
00:57:18,208 --> 00:57:19,416
The Parks department said no.

1074
00:57:19,416 --> 00:57:21,688
The methadone clinic said yes but their sidewalk

1075
00:57:21,688 --> 00:57:22,786
was too narrow.

1076
00:57:22,786 --> 00:57:25,776
So there's always these challenges

1077
00:57:25,776 --> 00:57:28,320
in actually placing the machines in

1078
00:57:28,320 --> 00:57:29,709
these particular neighborhoods.

1079
00:57:29,709 --> 00:57:32,576
So now, we went to our second --

1080
00:57:32,576 --> 00:57:35,800
I want to get back to 10304, that's

1081
00:57:35,800 --> 00:57:37,749
our zip code, because there's such a need there.

1082
00:57:37,749 --> 00:57:39,622
But with the limitations of the two,

1083
00:57:39,622 --> 00:57:43,170
we had to switch gears and pivot a little bit

1084
00:57:43,170 --> 00:57:46,904
and put it in locations with high overdose rates

1085
00:57:46,904 --> 00:57:49,276
but not the highest, not the one that I really

1086
00:57:49,276 --> 00:57:50,684
wanted to get it to.

1087
00:57:50,684 --> 00:57:52,476
>> What were the biggest concerns expressed

1088
00:57:52,476 --> 00:57:54,476
by the public?

1089
00:57:54,736 --> 00:57:56,176
>> Vandalism.

1090
00:57:56,176 --> 00:57:56,896
Crime.

1091
00:57:56,896 --> 00:58:00,406
You know, not wanting to have those people

1092
00:58:00,406 --> 00:58:02,406
in their neighborhoods.

1093
00:58:02,816 --> 00:58:05,762
I'm already cleaning up all the time, now what?

1094
00:58:05,762 --> 00:58:08,426
Because we were also going to do sharps containers

1095
00:58:08,426 --> 00:58:09,802
next to the machines.

1096
00:58:09,802 --> 00:58:13,206
We haven't had to do that.

1097
00:58:13,206 --> 00:58:17,347
I'm forgetting the reason why but we made a decision

1098
00:58:17,347 --> 00:58:19,240
not to do it at this point.

1099
00:58:19,240 --> 00:58:21,120
But that was in response.

1100
00:58:21,120 --> 00:58:24,544
We're not giving out syringes but if people have syringes

1101
00:58:24,544 --> 00:58:26,602
and want to dispose of them, maybe we

1102
00:58:26,602 --> 00:58:29,640
can have sharps containers so that we are anticipating

1103
00:58:29,640 --> 00:58:32,756
any kind of litter or situation that the community would

1104
00:58:32,756 --> 00:58:34,756
be upset about.

1105
00:58:36,296 --> 00:58:40,112
>> Did you find a different level of concern when you talked

1106
00:58:40,112 --> 00:58:43,144
about the Narcan and test strips versus some of the other

1107
00:58:43,144 --> 00:58:46,296
products that you were going to put in?

1108
00:58:46,296 --> 00:58:49,536
>> I was afraid about the plan B part.

1109
00:58:49,536 --> 00:58:53,713
The main concern was about safety and children

1110
00:58:53,713 --> 00:58:55,546
being able to access some of the medications

1111
00:58:55,546 --> 00:58:56,673
because it's all free.

1112
00:58:56,673 --> 00:59:01,256
That's also why we have them in the patches. -- pouches.

1113
00:59:01,256 --> 00:59:04,376
And then we also put some of those products up on the top.

1114
00:59:04,376 --> 00:59:07,328
We don't care if they are high school or young adults accessing

1115
00:59:07,328 --> 00:59:12,728
it, but we don't want children accidentally taking something.

1116
00:59:13,374 --> 00:59:14,832
But that was one of the main things

1117
00:59:14,832 --> 00:59:16,496
that we were hearing from the community

1118
00:59:16,496 --> 00:59:20,696
was worry about people accessing it and unintentionally

1119
00:59:20,696 --> 00:59:22,560
getting sick.

1120
00:59:22,560 --> 00:59:25,709
So we tried to place it, we have it in the packets.

1121
00:59:25,709 --> 00:59:27,650
And that's helpful.

1122
00:59:27,650 --> 00:59:29,164
But yeah.

1123
00:59:29,164 --> 00:59:33,964
Oh yeah, the smoking kits were very controversial.

1124
00:59:34,456 --> 00:59:39,529
And that's also why we were talking about phasing

1125
00:59:39,529 --> 00:59:43,610
in supplies as we go along.

1126
00:59:43,610 --> 00:59:47,648
So maybe, reengaging the community to talk about these

1127
00:59:47,648 --> 00:59:48,832
and needs.

1128
00:59:48,832 --> 00:59:52,166
There's a birthday party going on in the hallway.

1129
00:59:52,166 --> 00:59:56,996
But yes, about implementing them at a later time.

1130
00:59:56,996 --> 00:59:58,642
But for the launch, we decided not

1131
00:59:58,642 --> 01:00:02,336
to put some of those materials in there.

1132
01:00:02,336 --> 01:00:06,536
>> On the timeline, it was from 2023 to 2026?

1133
01:00:08,936 --> 01:00:13,696
>> I would say, once you get the money, a year and a half.

1134
01:00:13,696 --> 01:00:17,856
In terms of building community support, getting the machines.

1135
01:00:17,856 --> 01:00:20,349
I mean, that was the precursor of us

1136
01:00:20,349 --> 01:00:23,969
testing out concepts and raising awareness around harm reduction.

1137
01:00:23,969 --> 01:00:28,169
But yes, we got the funding in 2025.

1138
01:00:29,528 --> 01:00:31,636
And that's when we were doing the needs assessment

1139
01:00:31,636 --> 01:00:32,726
and building the support.

1140
01:00:32,726 --> 01:00:36,776
And we actually didn't get them plugged in until June of 2026.

1141
01:00:36,776 --> 01:00:42,776
So a lot of -- we have somebody who's interested.

1142
01:00:43,712 --> 01:00:47,400
But then, no, we can't move forward for whatever reason.

1143
01:00:47,400 --> 01:00:50,480
So we were very excited, even on our own property

1144
01:00:50,480 --> 01:00:53,387
when we couldn't put it in, because it's

1145
01:00:53,387 --> 01:00:57,903
owned by a hospital system that couldn't get the approval.

1146
01:00:57,903 --> 01:01:00,496
So that's why we went with partner organizations.

1147
01:01:00,496 --> 01:01:04,960
There were a lot of challenges.

1148
01:01:04,536 --> 01:01:10,536
>> Since June , Any of the concerns that people have had

1149
01:01:11,696 --> 01:01:13,596
come I have they come to fruition?

1150
01:01:13,596 --> 01:01:15,160
>> Not at all.

1151
01:01:15,160 --> 01:01:16,810
Not at all.

1152
01:01:16,810 --> 01:01:18,810
No.

1153
01:01:50,477 --> 01:01:52,745
>> Thank you for sharing this information with us.

1154
01:01:52,745 --> 01:01:56,345
What were the library's main concern?

1155
01:02:01,368 --> 01:02:02,243
>> I have to go back.

1156
01:02:02,243 --> 01:02:04,313
We were partnering with the libraries for a while

1157
01:02:04,313 --> 01:02:05,573
and it was central.

1158
01:02:05,573 --> 01:02:10,503
So I library manager might be in support of doing --

1159
01:02:10,503 --> 01:02:12,861
partnering with us on some of our projects.

1160
01:02:12,861 --> 01:02:17,336
But the central office, there was a barrier.

1161
01:02:17,336 --> 01:02:23,336
I don't know if it was liability serving young families,

1162
01:02:25,523 --> 01:02:27,573
they were worried about safety and security.

1163
01:02:27,573 --> 01:02:28,986
I have to go back.

1164
01:02:28,986 --> 01:02:31,413
But they were just not interested.

1165
01:02:31,413 --> 01:02:33,413
>> (Indiscernible) about libraries.

1166
01:02:34,223 --> 01:02:37,823
This library right there (Indiscernible) overdoses.

1167
01:02:38,753 --> 01:02:41,698
>> A lot of overdoses happen in library bathrooms.

1168
01:02:41,698 --> 01:02:43,249
Go ahead.

1169
01:02:43,249 --> 01:02:45,791
>> We have a great relationship with some of these libraries.

1170
01:02:45,791 --> 01:02:49,330
And I think they would be on board.

1171
01:02:49,330 --> 01:02:53,305
I don't know if they have to get approval from the city.

1172
01:02:53,305 --> 01:02:57,543
But that area right there, there's overdoses that happen.

1173
01:02:57,543 --> 01:03:00,706
That's an area where there are overdoses.

1174
01:03:00,706 --> 01:03:02,706
>> Why so many?

1175
01:03:03,173 --> 01:03:06,373
>> When people use drugs, when they get them,

1176
01:03:06,373 --> 01:03:08,630
use them as quickly as possible.

1177
01:03:08,630 --> 01:03:09,749
If they're by a library, they're going

1178
01:03:09,749 --> 01:03:12,159
to go to the restroom they're. (Indiscernible)

1179
01:03:12,159 --> 01:03:13,916
many of these libraries.

1180
01:03:13,916 --> 01:03:15,379
They are staying there.

1181
01:03:15,379 --> 01:03:17,861
So there's a lot of substance use.

1182
01:03:17,861 --> 01:03:21,860
Not only that, there was an arrest

1183
01:03:21,860 --> 01:03:23,349
that was made a few years back in one

1184
01:03:23,349 --> 01:03:24,613
of these libraries for heroin.

1185
01:03:24,613 --> 01:03:27,613
Selling heroin out of it.

1186
01:03:28,733 --> 01:03:30,733
>> Gas stations.

1187
01:03:30,785 --> 01:03:35,585
People use very close to where they buy.

1188
01:03:37,321 --> 01:03:38,613
>> So we've done a lot of work.

1189
01:03:38,613 --> 01:03:40,373
And I'm sure that West Chester has

1190
01:03:40,373 --> 01:03:44,153
to, just working with restaurant owners and training them

1191
01:03:44,153 --> 01:03:47,533
and everybody having a naloxone kit behind the bar.

1192
01:03:47,533 --> 01:03:50,613
Coupled that now with our CPR training

1193
01:03:50,613 --> 01:03:53,519
so that people who are CPR trained

1194
01:03:53,519 --> 01:03:56,519
are also training in naloxone.

1195
01:03:56,757 --> 01:03:59,490
But yes, anywhere where you can get

1196
01:03:59,490 --> 01:04:03,249
into a bathroom, a private space, yep.

1197
01:04:06,546 --> 01:04:07,879
>> Did you want to say anything?

1198
01:04:07,879 --> 01:04:10,254
>> I was just thinking about something that was mentioned

1199
01:04:10,254 --> 01:04:13,854
previously that's an alternative to that.

1200
01:04:14,773 --> 01:04:20,717
But the idea of the lock boxes that we have put in the shelters

1201
01:04:20,717 --> 01:04:23,604
that we may be able to incorporate

1202
01:04:23,604 --> 01:04:27,204
in expansion of those as well.

1203
01:04:27,773 --> 01:04:32,713
>> That's a good point because matters, if they still do them,

1204
01:04:32,713 --> 01:04:35,613
they were distributing free naloxone.

1205
01:04:35,613 --> 01:04:39,860
But we purchased them in the past (Indiscernible)

1206
01:04:39,860 --> 01:04:42,260
into the shelters (Indiscernible)

1207
01:04:42,813 --> 01:04:44,813
schools. (Indiscernible) research.

1208
01:04:49,733 --> 01:04:52,773
>> In the back of my mind, I'm thinking about how the library

1209
01:04:52,773 --> 01:04:55,853
doesn't want this but they may be willing to accept that

1210
01:04:55,853 --> 01:05:00,530
because (Indiscernible) isn't going to go away.

1211
01:05:02,287 --> 01:05:06,487
This is more of a reality check.

1212
01:05:06,933 --> 01:05:08,293
>> Kind of ease them into it.

1213
01:05:08,293 --> 01:05:09,426
Exactly.

1214
01:05:09,426 --> 01:05:11,786
>> We should have a meeting at the library.

1215
01:05:11,786 --> 01:05:13,226
>> Sure.

1216
01:05:13,226 --> 01:05:15,373
>> So I'm thinking that and first,

1217
01:05:15,373 --> 01:05:17,245
I really want to thank Adrian.

1218
01:05:17,245 --> 01:05:21,341
He was a nice distraction which we really appreciate.

1219
01:05:21,341 --> 01:05:25,541
And we wish you all the success.

1220
01:05:26,893 --> 01:05:29,893
Our hope is that (Indiscernible).

1221
01:05:32,584 --> 01:05:34,933
>> Are no longer needed, yes.

1222
01:05:34,933 --> 01:05:40,550
I will say that naloxone is not a top thing that (Indiscernible)

1223
01:05:40,550 --> 01:05:40,805
from our machines.

1224
01:05:40,805 --> 01:05:42,685
That's why I was inquiring, if you're

1225
01:05:42,685 --> 01:05:44,557
going to have other products.

1226
01:05:44,557 --> 01:05:46,909
Because I think we've done such a good job

1227
01:05:46,909 --> 01:05:48,605
of getting naloxone out there.

1228
01:05:48,605 --> 01:05:55,805
I think that maybe there would be a higher demand for it.

1229
01:05:56,293 --> 01:05:58,839
I think we're trying to do targeted promotion

1230
01:05:58,839 --> 01:06:00,653
in different communities.

1231
01:06:00,653 --> 01:06:02,756
It's I know it's very early and I

1232
01:06:02,756 --> 01:06:04,381
don't know if we should be sharing this

1233
01:06:04,381 --> 01:06:06,423
because I want to be careful about what we share.

1234
01:06:06,423 --> 01:06:10,840
But this is one of the things that we are noticing.

1235
01:06:10,840 --> 01:06:11,917
It's more of the wound care and hygiene kits

1236
01:06:11,917 --> 01:06:15,517
that the people are gravitating towards.

1237
01:06:16,533 --> 01:06:18,393
>> I'm not surprised about that.

1238
01:06:18,393 --> 01:06:21,993
>> That's a sign of the times.

1239
01:06:23,139 --> 01:06:24,306
>> Again, thank you so much.

1240
01:06:24,306 --> 01:06:25,268
>> It was my pleasure.

1241
01:06:25,268 --> 01:06:27,853
If you have any more questions, I'm

1242
01:06:27,853 --> 01:06:33,493
happy to Zoom back into a room with you all. (Laughs).

1243
01:06:33,493 --> 01:06:37,293
>> I'll give you her contact information so you have it.

1244
01:06:37,293 --> 01:06:39,693
Thank you very much.

1245
01:06:40,613 --> 01:06:46,565
I'm thinking along with having a meeting with the library system

1246
01:06:46,565 --> 01:06:52,730
that maybe we could attend -- you hold meetings with all

1247
01:06:52,730 --> 01:06:54,473
of the municipalities, right?

1248
01:06:56,199 --> 01:06:57,366
>> Not necessarily.

1249
01:06:57,366 --> 01:07:00,173
We do have regular communications with emergency

1250
01:07:00,173 --> 01:07:04,973
services personnel but not really the municipal leadership.

1251
01:07:08,750 --> 01:07:11,103
>> Maybe we can go into one of those meetings and get them

1252
01:07:11,103 --> 01:07:16,503
to start thinking about or share with us locations.

1253
01:08:04,956 --> 01:08:06,311
>> (Indiscernible).

1254
01:08:06,311 --> 01:08:08,659
Thank you so very much.

1255
01:08:08,659 --> 01:08:10,961
I really appreciate you.

1256
01:08:10,961 --> 01:08:13,961
Let's talk about next steps.

1257
01:08:16,161 --> 01:08:17,654
>> Thank you.

1258
01:08:17,654 --> 01:08:21,854
>> We are officially adjourning at 12:15 p.m..

1259
01:08:24,650 --> 01:08:27,500
>> (Indiscernible) wound kits (Indiscernible).

1260
01:08:30,236 --> 01:08:33,236
>> (Indiscernible) in the lock boxes.

1261
01:08:34,833 --> 01:08:38,433
>> (Indiscernible) all right let's get (Indiscernible).