How States are Bolstering a Contact Tracing Workforce

May 27, 2020|12:55 p.m.| ASTHO Staff

As summer gets underway, some states are beginning to ease their community mitigation efforts for COVID-19 and allowing the cautious and partial reopening of social spots such as restaurant dining rooms, beaches, amusement parks, and summer camps. But more social interaction provides the coronavirus with the conditions it needs to continue its person-to-person spread. To help break the chain of infections, state and local health departments are conducting disease investigations and contact tracing, core tools of public health practice used to combat the spread of communicable diseases, such as tuberculosis, and sexually transmitted infections. These techniques are used to identify individuals who were exposed to the COVID-19 and gives them a chance to self-isolate or self-quarantine before passing it on to others.

With daily new COVID-19 cases across the U.S. in the tens of thousands, the public health workforce capacity for disease investigation and contact tracing is stretched thin and states are expanding and scaling up the needed workforce. The federal government is also looking to assist with the expanded capacity. Earlier this month, ASTHO reviewed several pieces of federal legislation to increase the state contact tracing workforce. Funding for contact tracing is also included in the Heroes Act the U.S. House of Representatives passed in mid-May—though it’s unlikely to get signed into law. A few states are also considering legislation addressing contact tracing and case investigation. Below is a brief review of state legislation that would impact these public health tools.

In New York, a set of proposed bills address privacy protections and confidentiality requirements for contact tracing data. The first, A 10500, requires all information collected by COVID-19 contact tracers to remain confidential. The bill would make the information inaccessible from law enforcement without a court order and would allow disclosure of the information, when appropriate and necessary, for certain court proceedings, to healthcare providers in order to gain access to healthcare services or for documentation needed for sick leave related to an isolation or quarantine order, and to third-party reimbursement for healthcare services. The other bill, A 10462, would establish enhanced privacy protections for information collected by contact tracers and provide individuals with continued control over the information after it is collected. Another set of bills in New York (A 10447 and S 8362) would require contact tracers hired within New York City to be representative of the cultural and linguistical diversity of the community in which they will work. A final bill (S 8327) would make it a crime to knowingly disseminate contact tracing information to an unauthorized person.

A few proposed bills in Minnesota would also address aspects of contact tracing. One bill (HF 4579) would establish and fund a program for contact tracing, case investigation, and follow-up services. Besides hiring and training contact tracers, the state department of health would be authorized to provide essential services such as alternate housing, food delivery, and medication delivery to those who are isolated and quarantined. The bill would also prohibit employers from firing or retaliating against furloughed employees who conduct contact tracing. Another bill (SF 4500) establishes a COVID-19 testing and contact tracing bill of rights that classifies the information collected by contract tracing as data subject to state privacy laws. An additional bill in Minnesota would limit the state health department’s ability to require participation in contact tracing (HF 4665).

State agencies are also including contact tracing measures in rulemaking. In Rhode Island, new rules require businesses and other establishments that wish to reopen or remain open to cooperate with the state health department on testing, contact tracing, and disease investigation. The businesses and establishments must also develop a written safe operation plan that designates a point of contact to work with the state health department on testing, contact tracing, and disease investigation.

As the COVID-19 pandemic continues into the summer and states ease their community mitigation efforts, disease investigation and contract tracing will be essential in preventing and stopping community spread of the virus. State health agencies will play a key role in expanding the workforce needed to carry out these activities—as well as implementing any new policies related to contact tracing and disease investigations. Additional resources for contact tracing and disease intervention are available from ASTHO and we will continue to track this important public health issue.