The following survey is being distributed to you and other rural public health stakeholders in your county and other counties participating in the Northern Nevada Cross Jurisdiction Services (CJS) Project. The project team will develop a cross jurisdictional sharing model and toolkit for implementation of the model to be shared with participating and neighboring jurisdictions. The goal of this project is to improve public health service efficiency and effectiveness.
The purpose of this survey is to inventory public health services that do or do not exist in your county. The survey should take no more than 15 minutes to complete. If you have any questions about this survey or the uses of the data collected, please contact District Health Officer, Washoe County Health District at (775) 328-2400 or
- Please complete the following contact information.
Name:
Title:
Agency or Organization:
City:
County:
E-mail:
Phone:
- Are preventive immunization services provided in your county (other than immunizations provided by hospitals in the region)?
Adult Immunization Yes No Not Sure
Child Immunization Yes No Not Sure
- Are screenings for diseases andconditions provided in your county?
AnemiaYes No Not Sure
Blood LeadYes No Not Sure
CancerYes No Not Sure
Cardiovascular DiseaseYes No Not Sure
DiabetesYes No Not Sure
High Blood PressureYes No Not Sure
HIV/AIDSYes No Not Sure
Other Sexually Transmitted DiseasesYes No Not Sure
TuberculosisYes No Not Sure
- Are treatments for communicable diseases provided in your county?
HIV/ADISYes No Not Sure
Other Sexually Transmitted DiseasesYes No Not Sure
TuberculosisYes No Not Sure
- Are maternal and child health services provided in your county?
Early Periodic Screening, Detection and TreatmentYes No Not Sure
Family PlanningYes No Not Sure
MCH Home VisitsYes No Not Sure
Obstetrical CartYes No Not Sure
Prenatal CareYes No Not Sure
Well Child ClinicYes No Not Sure
WICYes No Not Sure
- Are epidemiology and surveillance activities provided in your county?
Behavioral Risk FactorsYes No Not Sure
Chronic Disease SurveillanceYes No Not Sure
Communicable/Infectious Disease SurveillanceYes No Not Sure
Food Safety SurveillanceYes No Not Sure
Injury SurveillanceYes No Not Sure
Maternal and Child Health (Data Collection)Yes No Not Sure
Syndromic Surveillance (Respiratory or Yes No Not Sure
Gastrointestinal Surveillance)
- Are primary prevention services provided in your county?
Chronic Disease ProgramsYes No Not Sure
Depression and Suicide PreventionYes No Not Sure
InjuryYes No Not Sure
NutritionYes No Not Sure
Physical ActivityYes No Not Sure
Substance AbuseYes No Not Sure
TobaccoYes No Not Sure
Unintended PregnancyYes No Not Sure
ViolenceYes No Not Sure
- Are environmental health activities provided in your county?
Air Pollution MonitoringYes No Not Sure
Collection of unused PharmaceuticalsYes No Not Sure
Food Safety EducationYes No Not Sure
Groundwater ProtectionYes No Not Sure
Hazardous Waste DisposalYes No Not Sure
Hazmat ResponseYes No Not Sure
Indoor Air QualityYes No Not Sure
Land Use PlanningYes No Not Sure
Noise PollutionYes No Not Sure
Pollution PreventionYes No Not Sure
Radiation ControlYes No Not Sure
Surface Water ProtectionYes No Not Sure
Vector Control (e.g., Mosquito Control)Yes No Not Sure
- Are select regulation, inspection, and/or licensing activities provided in
your county?
Body Art and TattooingYes No Not Sure
Campgrounds and RVsYes No Not Sure
Cosmetology BusinessesYes No Not Sure
Children’s CampsYes No Not Sure
Food ProcessingYes No Not Sure
Food Service Establishments – PermanentYes No Not Sure
Food Service Establishments – TemporaryYes No Not Sure
Health-Related FacilitiesYes No Not Sure
Hotel/MotelsYes No Not Sure
Housing InspectionsYes No Not Sure
Lead InspectionsYes No Not Sure
Milk processingYes No Not Sure
Mobile HomesYes No Not Sure
Private Drinking Water (Wells)Yes No Not Sure
Public Drinking WaterYes No Not Sure
Public Swimming PoolsYes No Not Sure
Schools/DaycaresYes No Not Sure
Septic Systems RegulationsYes No Not Sure
Smoke-Free OrdinancesYes No Not Sure
Solid Waste Disposal SitesYes No Not Sure
Solid Waste HaulersYes No Not Sure
Tobacco RetailersYes No Not Sure
- Are other public health activities provided in your county?
Animal ControlYes No Not Sure
Asthma ControlYes No Not Sure
Emergency Medical ServicesYes No Not Sure
Emergency Preparedness – Public HealthYes No Not Sure
Laboratory ServicesYes No Not Sure
Medical Examiner’s OfficeYes No Not Sure
Occupational Health and SafetyYes No Not Sure
Outreach and Enrollment for Medical InsuranceYes No Not Sure
School-Based Clinics (Primary Care)Yes No Not Sure
School Health (School Nurse)Yes No Not Sure
Veterinarian Public HealthYes No Not Sure
Vital RecordsYes No Not Sure
- Are other health services provided in your county?
Behavioral/Mental Health ServicesYes No Not Sure
Comprehensive Primary CareYes No Not Sure
Correctional Health Yes No Not Sure
Home HealthcareYes No Not Sure
Home Visitation – Elder CareYes No Not Sure
Oral HealthYes No Not Sure
Substance Abuse ServicesYes No Not Sure
- Is there any additional information you can provide on the availability of public health services in your community?
If you have any questions about this survey or the Northern Nevada Cross Jurisdiction Services Project, please contact the District Health Officer, Washoe County Health District at (775) 328-2400 or .
Thank you for completing this survey.