TABLE 2.

Summary of Key Characteristics and Changes in the Massachusetts Department of Public Health’s STD Program, Before and After the Sudden Closure of STD Clinics

	Preclinic Closures (2007–8)	Immediate Postclosure (2009–10)	Four yrs Postclosure (2013)
DIS staff and roles	More centralized, with core partnerships with STD clinics in place Focus on partner services Focus on STDs	Uncertainty about where to send patients Increased time spent identifying providers to see STD patients and contacts Increased need to transport patients and treatment Increased need to educate providers on basic DIS role and STD control	“Out-posted” to clinical partners Broader health navigator role STD/HIV focused More cross-training in epidemiology and data analysis More mobile work place
Organizational context in the health department	Separate STD and HIV programs, lacking a strong partnership	Collaboration between STD and HIV programs began to develop MDPH restructuring began	STD & HIV programs not formally integrated but stronger partnership in place Restructuring complete
Service delivery and state funding for STD clinical services	Eight dedicated sites focused on STD service delivery funded largely by state funds	Diffused, unmapped provider network More providers who were unfamiliar with clinical and public health STD program function No explicit funding for STD clinical services in the state budget	STD services integrated into HIV expanded testing contracts and regulatory authority Continued need to educate providers on STD program functions and DIS roles and functions