State Policies Relevant to Disease Intervention Specialists in the United States

Abstract

Background The functions of disease intervention specialists (DIS) represent core infectious disease control practices and have legal foundations in the United States. Although important for state and local health departments to understand this authority, these policies have not been systematically collected and analyzed. We analyzed the authority for investigation of sexually transmitted infections (STIs) across all 50 US states and the District of Columbia. Methods In January 2022, we collected state policies addressing the investigation of STIs using a legal research database. We coded these policies into a database on variables of interest: (1) whether the policy authorized/required investigation, (2) what type of infection triggers an investigation, (3) and the entity who is authorized/required to perform the investigation. Results All 50 US states and District of Columbia explicitly authorize/require investigation of cases of STI. Of these jurisdictions, 62.7% require investigations, 41% authorize investigations, and 3.9% both authorize and require investigations. Sixty-seven percent authorize/require investigations for cases of communicable disease (inclusive of an STI), 45.1% authorize/require investigations for cases of STIs generally, and 3.9% authorize/require investigations for cases of a specific STI. Eighty-two percent of jurisdictions authorize/require the state to investigate, 62.7% authorize/require local governments to investigate, and 39.2% authorize/require investigations by both state and local governments. Conclusions State laws that establish authority or duties regarding the investigation of STIs differ across states. It may be useful for state and local health departments to examine these policies relative to the morbidity of their jurisdiction and their STI prevention priorities.

Creating a Sexually Transmitted Infection Disease Intervention Workforce for the 21st Century

“…A recent analysis of state law found that states authorize or require disease investigation for communicable disease or sexually STIs to varying degrees. 37 In addition, funding accountability is important because public programs use taxpayer dollars and must prioritize public trust and confidence and is central to improving equitable access to public services. 38 Another factor that can impact disease intervention activities is workforce retention.…”

“…As previously noted, various contextual factors that are often interconnected can impact disease intervention activities, and this relationship is often bidirectional. A recent analysis of state law found that states authorize or require disease investigation for communicable disease or sexually STIs to varying degrees 37 . In addition, funding accountability is important because public programs use taxpayer dollars and must prioritize public trust and confidence and is central to improving equitable access to public services 38 .…”