Improving notifiable disease/condition surveillance through revising state regulations (Chapter 64D-3, Florida Administrative Code)

Background: Notifiable disease/condition surveillance is a core public health function codified in state law. Each state has governing notifiable disease/condition reporting regulatory language (statute, administrative code, etc.) that must be reviewed and updated to maintain effective case reporting and surveillance data necessary for public health action. In order to enhance disease reporting, Florida has re-written Chapter 64D-3 Florida Administrative Code, which governs notifiable disease/condition reporting within the state. Methods: Multiple state's notifiable disease/condition laws and mandates were reviewed in order to gather information regarding best-practice language. The re-write of the FL notifiable disease/condition reporting regulations was a collaborative process that included five official public comment periods, as well as topic specific workshops including one with laboratories regarding mandating electronic laboratory reporting. Results: Re-write updates include: (1) High priority disease (anthrax, botulism, etc.) provider reporting time frame changed to require immediate phone reporting upon initial suspicion of diagnosis. As such, laboratories are required to report the receipt of a laboratory test order, as requests for laboratory test identification are considered suspicion of disease. (2) Electronic laboratory reporting is now required. Conclusions: Effectively engaging state and county public health officials as well as public health partners in a collaborative process is essential and challenging. Establishing clear guidelines and laws for notifiable disease/condition surveillance improves compliance.