This community health survey has been developed by the Los Alamos Community Health Council to gather information from a diverse group of people. The survey is focused on community health, broadly defined. Your answers remain confidential. 

Community Members: Please complete Part I. 
Agency Staff, Board Members and Volunteers: Please complete both Part I and Part II of the survey, as Part II is focused on agency issues.

Please complete this survey as soon as possible. Surveys entered after February 18th may not be included in the survey results.  Thank you for your participation. Your involvement is helping us to build community health.  Questions? Please contact Deni Fell, LACHC Coordinator, at deni.fell@lacnm.us or 505-663-1875.

The Los Alamos Community Health Council (LACHC) aims to take the lead in community health improvement through representative membership empowered to identify and address health issues in our community.  LACHC’s vision is for consumers, service providers, business interests, local government, and youth to work together to ensure that the Los Alamos community is a healthy place for all who live, work, and visit. This survey has been developed by the LACHC, working with New Ventures Consulting.

* 1. Please rate the following community health issues, indicating your level of concern about each issue.

  Not at all concerned Somewhat concerned Neutral Concerned Very concerned No opinion
Children, youth and family issues, including availability of affordable services (i.e. child care, after school programs, summer and day programs).
Family stresses, and youth and families at risk, including youth suicidal ideation and suicides.
Financial problems and basic needs services for the poor, families with limited incomes and those in financial crisis.
Health care, including access to care, affordability of medical resources, and access to specialists.
Health conditions such as heart attacks, strokes, cancer, and upper respiratory diseases.
Housing, including affordable housing and rental units.
Information about services and resources, including access to information about community resources and social service programs.
Mental health and substance abuse (access to services, concerns about Q clearance issues, local availability of services, confidentiality, and prevention).
Older adults, including resources for Alzheimer's, fall prevention, more help in the home, support for independent and assisted living, and other resources.
Social service delivery infrastructure, including funding and support for community services and resources.

* 2. How well do you feel the community has been able to respond to its health and social needs? (Please indicate your level of agreement with each item.)

  Strongly disagree Disagree Neutral Agree Strongly agree No opinion
The community has always been responsive to local issues and local concerns.
There are a number of issues that have been concerns, which are being addressed by community leaders and local organizations.
Community leaders and local government have invested in local services.
Community needs have been growing and, even though they are being addressed, the growing needs are more than agencies can handle. 
Trends indicate there are serious community needs that will become more significant in future years, which must be planned for and addressed now.
Additional funds are required in order to address community needs effectively.
Local community organizations need to provide additional information to the community about their services, outcomes achieved, their impact, and the community’s return on investment.
Los Alamos is a resilient community, has been able to handle issues that face us, and will continue to do so because of the resources that we have and the depth of skills that exist.

* 4. For the past 5-6 years, the LACHC has focused on work in a number of key areas listed below. What do you consider to be the most important challenges facing the community in each of these areas?

* 5. Where has the community made progress in LACHC’s areas of focus?

* 6. What are the things that make Los Alamos a healthy community, or what are the community’s greatest assets?

* 7. What are the most important things that the community needs to do to address health concerns and create greater individual, family and community health?

* 8. Please indicate which of the following represent your affinity with the community (check all that apply).

* 9. Please indicate your family household configuration, and who lives together in your household.

* 10. What is your housing status?

* 11. What is your age? (Please check age range)

* 12. What is your family's average annual income? (This information helps with analysis.)

* 13. My gender is

* 14. I have lived in the community for:

* 15. Community members, thank you!. This is the end of Part I. Please feel free to provide additional comments and suggestions to the LACHC, using the box below.

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PART II - Service providers, please continue to answer the remaining questions below. Thanks very much taking the time to complete this survey.

* 16. What type of provider is your organization?

* 17. What kinds of services do you provide? (Please describe briefly.)

* 18. Which age groups does your organization serve? (Check all that apply.)

* 19. Which population groups does your agency serve (check all that apply).

* 20. Does your agency have a waiting list, or a time delay (more than one week) in being able to schedule clients for appointments?  (If the answer is "no," please skip the next question.)

* 21. Which of the following provide funding to your agency? (Please check all that apply, answers remain confidential.)

* 23. What are the top priorities for your agency?

* 24. What do you see as some of the most important unmet needs in the community?

* 25. Other comments. Thanks for taking the time to respond.

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