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2. City of Framingham Opioid Task Force - Citizen Feedback Form 

4. At this time, the Task Force is inviting those who live and/or work in the City of Framingham to contribute their voice to a community dialogue around the Opioid epidemic in our City. Please note that while suggestions will be used to guide decision-making, feedback may not have a direct or immediate impact on policy. Please take the time to complete this Community Feedback Form.

   Below are some questions to consider when providing input:

   1) What gaps/barriers do you see locally, regionally, or statewide that need to be addressed?

   2) What programs or activities do you think Framingham should prioritize with this funding?

   3) What outcomes do you hope to see? 

6. 1. Name:
7. 2. Email:
9. 3. City Council District (if applicable):
11. 4. How do you identify your race and ethnicity? (Select all that apply)

    1. Black or African American
    2. Asian
    3. Hispanic/Latinx
    4. White
    5. Multi-racial
    6. Not sure
    7. I prefer not to answer
12. 4a. Another race or ethnicity:
14. 5. What is your gender?

    1. Female
    2. Male
    3. Non-binary
    4. I prefer not to answer
15. 5a. Another gender:
17. 6. What is your age?
    -- Select One --Under 1818-2425-3435-4950-6465-7475 or olderI prefer not to answer
18. 7. What is your connection with the City of Framingham? Select all that apply.

    1. I live in the City of Framingham
    2. I work in the City of Framingham
    3. I do not live or work in the City of Framingham
20. 8. How, if at all, are you impacted by the opioid epidemic? Select all that apply.

    1. I have lost a family member(s) to opioid addiction/overdose
    2. I have a family member(s) who currently has an opioid use disorder
    3. I myself am in recovery from opioid use disorder
    4. I currently use opioids
    5. I work with individuals/families impacted by opioid addiction
    6. I have not personally been impacted by opioid addiction
    7. I have a loved one in recovery from substance-use disorder.
22. 9. What needs do you observe in the City of Framingham related to the opioid crisis?
24. 10. What input do you have on how the opioid settlement funds should be spent by the City of Framingham?
26. 11. The opioid settlement funds are allowed to be used towards the following seven areas. Please select two areas that you would like to be prioritized:

    1. Opioid Use Disorder Treatment: Includes medication and therapeutic counseling for people with opioid use disorders
    2. Support People in Treatment and Recovery: Includes recovery, housing, transportation, employment, and community services for people in treatment or recovery from an opioid use disorder
    3. Connections to Care: Includes early identification and intervention for individuals at risk of or who have recently developed an opioid use disorder
    4. Harm Reduction: Includes efforts to prevent opioid-related death and illnesses
    5. Address The Needs Of Criminal-Justice-Involved Persons: Includes providing treatment and recovery services during incarceration, supports upon reentry, and creating programs to divert individuals from entering the criminal justice system
    6. Support Pregnant Or Parenting Women And Their Families, Including Babies With Neonatal Abstinence Syndrome: Includes services for pregnant people with opioid use disorder, childcare, and family supports
    7. Prevent Misuse Of Opioids And Implement Prevention Education: Includes youth prevention, anti-stigma campaigns, and community education about opioid use
28. 12. What would you like to see as the outcome of the use of the opioid settlement funds?
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

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