Clinton County, a rural community in New York State, facilitated the implementation of an Overdose Fatality Review (OFR) to strengthen its overdose prevention efforts. OFRs are invaluable tools to identify systemic gaps, foster collaboration among partners and develop actionable strategies to prevent future overdoses. However, in a close-knit community with a relatively low number of overdose fatalities, privacy concerns and the absence of state-specific OFR legislation present implementation challenges.

To address these issues and support Clinton County’s efforts, the New York Overdose Response Strategy (ORS) team partnered with the Institute for Intergovernmental Research (IIR) to identify peer communities in rural areas that have successfully implemented OFRs without state legislation. The session was carefully designed to address Clinton County’s unique context. In August 2024, the New York ORS team hosted the OFR Q&A Session, featuring presentations from peer mentors and contributions from the ORS OFR Technical Advisor and IIR Senior Research Associate. The session was attended by more than 15 Clinton County partners, who actively participated in the discussions.
High Intensity Drug Trafficking Area (HIDTA) staff supporting the NY ORS team at the North Country Crime Analysis Center have also played a key role in Clinton County’s OFR planning efforts, engaging local law enforcement and leveraging data to inform planned case reviews. These efforts reflect the county’s commitment to building a collaborative OFR process tailored to their community’s needs.

Following the session, Clinton County determined that a county-specific approach to OFR implementation would be the most effective strategy. A small working group has since met multiple times to discuss logistics and plan a follow-up meeting with a broad group of community partners. These meetings are effective in sharing lessons learned, gathering input and laying the groundwork for establishing the county’s OFR team. Clinton County also expressed interest in participating in IIR’s peer mentoring program and applied for an opportunity to attend an in-person session at one of the OFR Peer Mentor Sites featured during the Q&A session. Their application was successful, and they will collaborate with two communities in Wisconsin, with a site visit planned for fall 2025. Through strategic partnerships, customized technical assistance and ongoing support, the NY ORS team has helped guide Clinton County from exploration to action, laying the foundation for a community-driven OFR process.