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