Wisconsin Regional Office Assessment Survey Questions for Local Health Departments Questions will be scored on a Likert scale

from Strongly Disagree to Strongly Agee, except for the last questions in each Essential Service set which will be open ended. Essential Service 1 Monitor Health Status to Identify Health Problems 1. The regional office provides technical assistance and support with data collection and management. 2. The regional office provides technical assistance and support in data analysis and interpretation. 3. The regional office provides technical assistance and support related to use of data systems required by the state (i.e. ROSIE and WIR) 4. The regional office provides technical assistance and support in developing methods and processes for monitoring and on-going assessment within the jurisdiction 5. Are there other types of support or services that would be helpful to your agencys success in carrying out monitoring and surveillance activities? Essential Service 2 Diagnose and Investigate Health Problems and Health Hazards 6. The regional office provides or arranges orientation and on-going training related to communicable disease follow-up and outbreak investigation. 7. The regional office assists in investigation of public health problems as needed 8. The regional office provides links to other state agencies including State Lab of Hygiene, Agriculture and DNR. 9. Are there other types of support or services that would be helpful to your agencys success in carrying out investigation activities? Essential Service 3 Inform, Educate and Empower People about Health Issues 10. The regional office provides technical assistance and support related to health communication (i.e. press release templates, sample materials for developing brochures) 11. The regional office provides training and assistance on best practices related to health promotion 12. The regional office provides support regarding risk communication during drills and exercises, and actual events. 13. Are there other types of support or services that would be helpful to your agencys success in carrying out health communication, education and promotion activities?

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Essential Service 4 Mobilize Partnerships to Identify and Solve Health Problems 14. The regional office provides technical assistance and support related to building, maintaining and strengthening coalitions and partnerships 15. The regional office fosters a partnership between local health departments and the state division of public health. 16. The regional office supports regional networking groups such as WALHDAB. 17. Are there other types of support or services that would be helpful to your agencys success in building and maintaining partnerships and coalitions? Essential Service 5 Develop Policies and Plans that Support Individual and Statewide Health Efforts 18. The regional office provides technical assistance and support on planning and implementation of the Community Health Improvement Process (CHIP). 19. The regional office provides technical assistance on developing or improving local policies related to public health issues including human health hazards, tobacco, etc 20. The regional office provides technical assistance and support related to program planning and implementation (i.e. WIC, family planning, lead, immunizations). 21. The regional office coordinates and/or provides technical assistance for preparedness planning 22. Regional office staff participate in drills and exercises 23. The regional office assists in local response to real disasters and emergencies. 24. The regional office provides technical assistance and support with strategic planning processes 25. Are there other types of support or services that would be helpful to your agencys success in carrying out policy and plan development? Essential Service 6 Enforce Laws and Regulations that Protect Health and Ensure Safety 26. The regional office provides technical assistance and support related to statute/rule interpretation 27. The regional office provides support and technical assistance regarding the enforcement of public health laws and regulations.

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28. The regional office provides support in environmental health enforcement activities 29. Are there other types of support or services that would be helpful to your agencys success in enforcing laws and regulations? Essential Service 7 Link People to Needed Personal Health Services and Assure the Provision of Health Care When Otherwise Unavailable 30. The regional office provides information that highlights the issue of disparities in my community 31. The regional office provides assistance in identifying data and other resources necessary to assess the needs of underserved and special populations 32. The regional office shares knowledge of how to work with the Medical Assistance system, and other health care systems 33. Are there other types of support or services that would be helpful to your agencys success in providing and/or linking clients to care? Essential Service 8 Assure a Competent Public and Personal Healthcare Workforce 34. The regional office provides technical assistance and support on the assessment of public health workforce to determine workforce needs 35. The regional office plans and/or coordinates trainings for the professional development of agency staff. 36. The regional office provides orientation to new health officers regarding public health statute and administrative rule responsibilities 37. The regional office provides orientation to BOH members and other governmental leaders regarding public health statute and administrative responsibility 38. The regional office provides support and technical assistance for licensed professionals (RN, RD, RS) in their professional public health practice. 39. Are there other types of support or services that would be helpful to your agencys success in assuring a competent workforce? Essential Service 9 Evaluate Effectiveness, Accessibility and Quality of Personal and Population-Based Health Services 40. The regional office provides consultation on the successful completion of the 140 Review process 41. The regional office provides technical assistance and support on program evaluation

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42. The regional office provides technical assistance and support of quality improvement initiatives. 43. Regional contract administrators assist with contract process. 44. Are there other types of support or services that would be helpful to your agencys success in carrying out evaluation activities? Essential Service 10 Research for New Insights and Innovative Solutions to Health Problems 45. The regional office provides assistance to my agency in proposing or linking to research activities. 46. The regional office communicates research findings and best practices 47. The regional office provides technical assistance and support in interpreting research findings and applying them to population based interventions 48. Are there other types of support or services that would be helpful to your agencys success in carrying out research activities? Other support activities 49. I know who to call in the regional office to get answers to my questions 50. I feel confident that regional office staff can answer my questions 51. The regional office responds to requests in a timely manner 52. The regional office provides accurate information 53. The regional office staff are pleasant, helpful and professional in manner