Background:
A number of state and local health departments have reached a public health infrastructure crisis. With budget reductions and staff attrition, many STD programs are struggling to conduct surveillance and provide quality case management and partner services. Current, on-the-job methods of training disease intervention specialists (DIS) can be burdensome, incomplete or inconsistent. The California STD Control Branch has worked with local health officials to refine the role of the DIS, articulating specific expertise and reinstituting a DIS training program to enhance capacity for communicable disease investigation statewide.

Objective:
Develop a standardized training program to rebuild capacity for disease intervention at the local level.

Method:
The California Department of Public Health STD Control Branch has developed a structured, two year training program to recruit and prepare new DIS. The revised the program model consists of two components: 1) an 8-week intensive training; and 2) skill-building and on-the-job assignment in high morbidity local health jurisdictions (LHJs) for the remainder of the two years. Training also includes medical record abstraction, conducting surveillance surveys, provider visitation and participation in outbreak response. The DIS trainees will be available for hire into independent assignments in LHJs or the state regional offices after the training.

Result:
In 2006-2007, eight DIS Trainees completed the initial phase of the training program. The DIS Trainees have augmented local capacity for syphilis and gonorrhea surveillance, syphilis case management, STD/HIV partner services and field investigation, and have been mobilized to assist in outbreak response for TB and other communicable diseases.

Conclusion:
The California STD Branch DIS Trainees are a public health resource in communicable disease investigation at the state and local levels.

Implications:
Standardized training in disease intervention and communicable disease investigation and recruitment of energetic individuals can assist to rebuild the eroding public health infrastructure at the local level.