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