Client Chelmsford Health Department (CHD)
Practice Area Substance Use Abatement
How a trauma-informed Community Health Assessment empowered Chelmsford, MA to strategically allocate settlement funds and close systemic gaps.
Like many communities, the suburban town of Chelmsford, Massachusetts (population ~36,220), has been deeply impacted by the opioid epidemic. While the town had successfully navigated the complexities of public health programming for years, the influx of opioid abatement settlement funds created a new challenge for municipalities. The Chelmsford Health Department (CHD) was tasked with managing approximately $1.2 million in abatement funding through 2038, all while adhering to strict Massachusetts State-Subdivision Agreement mandates. Under these statutory requirements, all work done with abatement funds must reflect the input of Massachusetts communities, of People with Lived and Living Experience (PWLLE) with the opioid crisis, of experts in treatment and prevention, and of staff and organizations that are carrying out the abatement work.
Already managing a broad portfolio of municipal duties, the CHD faced a critical capacity gap: how to execute a rigorous, community-driven assessment that satisfied state requirements without overburdening their existing staff. They needed a partner capable of translating community input into actionable recommendations and meaningful investments.
Serving more than 400,000 residents across both urban and rural areas, HCHC focuses on enhancing regional readiness and strengthening cooperation. Many member towns operate with limited public health staff—often fewer than one full-time equivalent—making independent emergency planning difficult. Consequently, these communities rely on HCHC for shared regional resources, mutual aid coordination, and planning support to ensure consistent preparedness and effective disaster response.
We initiated this engagement with a clear objective: to prepare Chelmsford with the tools and information needed to engage in proactive, data-driven planning. Our approach was anchored in the belief that the most effective public health solutions are not designed for a community, but with them.
We deployed a mixed-methods engagement strategy, beginning with landscape analysis of Massachusetts Bureau of Substance Addiction Services dashboards and demographic data to identify service gaps. To elucidate those most affected by the crisis, where stigma and fear often prevent residents from interacting with government systems, we moved beyond traditional outreach, utilizing the CHD’s relationships with recovery centers to directly connect with PWLLE in spaces where they already lived their lives.
In collaboration with the CHD, we co-designed a community engagement process that prioritized qualitative narratives. Partnering with REAL Recovery Centers allowed us to design community-led focus groups in a comfortable, non-clinical way. This trusted recovery environment yielded authentic, actionable insights from PWLLE, capturing critical nuances that numbers alone could never surface.