• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (737) 255-4300

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POPS Chapter 10 - First-Line Supervisors Performance Standards

These performance standards provide expectations for First-Line Supervisors (FLS) on the direction, monitoring, evaluation, and development of Disease Intervention Specialist (DIS) performance to enable the program to meet short/long term objectives and increase program effectiveness. The FLS will ensure the performance application of the disease intervention process is in accordance with CDC, DSHS, and local guidelines. Standards can help identify those workers who are especially proficient in specific areas. These workers can then become candidates for assignments involving greater responsibility or technical skill that can enhance career development. Where performance does not meet expectations, standards assist supervisors in identifying skill development needs. If a FLS is unable to perform at an acceptable level after a reasonable amount of remedial training or supervisory coaching, these standards can provide a framework for corrective action.

The success of the FLS effort is evaluated both by disease outcomes, as measured against program objectives, and by the quality of individual effort. It is the responsibility of the FLS to be familiar with  Chapter 9, Disease Intervention Specialists Performance Standards and to incorporate the DIS performance standards into the implementation of program activities.

Programmatically, detailed and specific methodologies and technical direction may vary. These standards were designed to provide a general overview of the FLS duties and responsibilities. The FLS should seek guidance and clarification from his/her supervisor on any doubts or questions about these performance standards. Signature below indicates the First-Line Supervisors Performance Standards has been received, read, and understood.

Signature block
Employee Signature     Date  
Supervisor Signature     Date  


10.1 Supervision

The quality of DIS performance must be among the highest priority concerns for all management and supervisory personnel. Each position within the STD program requires professional judgment and individual initiative. This involves a certain amount of flexibility, but it must be exercised within management’s expectations. Expectations must be widely communicated and clearly understood - but this is only a beginning. People must also believe that management will monitor process performance, correctly read what is happening, and assertively enforce compliance.

  • Each FLS will ensure that the DIS has adequate training to provide positive interaction with clients and co-workers, and will follow-up on evidence or reports to the contrary

  • The FLS will consistently plan assignments to maximize coverage for the program’s functions

  • The FLS will maintain control files of all assigned work and run open paper reports weekly from STD* MIS, and will check on any work past deadline

  • The FLS will review DIS workloads to ensure fair distribution of work among DIS

  • The FLS will maintain files on each DIS containing documentation of significant events, such as, but not limited to: audits, employee counseling sessions, time and attendance, and personnel actions (both positive and negative). This file will also contain a recent photo of the DIS and the make, model, year and license plate number of the vehicle used in the field

  • Each FLS will be responsible for conducting well-prepared monthly (at a minimum) team meetings. These team meetings should include a review of interesting or difficult cases to be used as a training tool (chalk talks)

  • The FLS will maintain a signed job description and performance standards in the personnel file. The FLS will ensure that the DIS understands and has been given a copy of the DIS guidelines. A signed statement that the DIS has read and understands the guidelines should be maintained in the personnel file

  • The FLS will conduct performance evaluations on DIS (federal, state, and local) in accordance with the appropriate agency’s guidelines

  • Performance evaluations for each DIS will be prepared using specific performance standards

  • The FLS will prepare a Performance Improvement Plan (PIP) for DIS with performance problems indicated through regular audits or failure to meet program objectives and goals for more than two consecutive months. These improvement plans will be designed to improve the DIS performance with supervisory involvement/modeling within set time frames


10.2 Orientation/Training of New DIS

Orientation is the foundation for all future DIS performance development and is a critical responsibility of the FLS. Orientation should define the DIS role, performance expectations, and identify where the person fits in the organization. Disease Intervention skills acquired through Introduction to Sexually Transmitted Disease Intervention (ISTDI) must be refined and reinforced on the job. Success of this phase depends on supervisory involvement, beginning with the evaluation and documentation of initial DIS work performance.

The FLS has a pivotal role in STD control. The supervisor’s main responsibility is to develop the performance potential of each DIS. This is the only way the job will get done and program objectives will be achieved.

  • FLS will complete the Orientation Plan of ISTDI Preparation for each newly hired DIS

  • The FLS will conduct or facilitate successful completion of STD Employee Development Guide modules by planning activities to coincide with the applicable module (e.g., case management, field investigations)

  • The FLS will assure the DIS successfully completes each module by scoring 80% or above

  • The FLS will ensure the DIS maintains a calendar to document daily training activities during the pre- and post-ISTDI assessment period. The post-ISTDI assessment period is six months or longer if satisfactory performance is not achieved

  • The FLS will keep a formal log of DIS Training Demonstrations and Audits including performance. The log will be shared with the local program manager at the end of each month

  • The FLS will supplement the Employee Development Guide with demonstration/modeling of record searching, field investigation, interviewing, case management and other activities for the DIS before ISTDI. On occasion, the FLS may delegate portions of early development of the DIS to an experienced DIS peer. The FLS will still maintain the ultimate responsibility of training

  • During the post ISTDI follow-up assessment period (six months), the FLS will, at a minimum, complete the schedule below before the DIS is allowed to operate independently


Post - ISTDI Assessment Period (Six Months)

First Month Second Month through Sixth Month 
FLS demonstrates/models a minimum of two original interviews and five field investigations FLS completes the Interviewing Skills Observation/Feedback Record Monthly
FLS & DIS conducts a minimum of two dual interviews FLS completes the Pouch Audit Twice a Month
FLS observes DIS conducting a minimum of two original interviews and five field investigations FLS completes the Case Management Audit Twice a Month
FLS observes or models a minimum of two re-interviews with DIS FLS completes the Interview Observation Audit - original, cluster, re-interview Monthly
FLS observes or models a minimum of two cluster interviews with DIS FLS completes the Field Audit Monthly


  • The FLS will complete a written skills inventory assessment summary of the DIS after six months post ISTDI. The summary must include interview skills, field skills, and case management skills. The summary will document the DIS progress and potential. The summary will be presented and discussed with the DIS by the FLS, with the Program Manager present, within 30 days of the end of the assessment period

  • The Skills Inventories assessment summary is submitted to the local program manager. Within two weeks of the presentation, the program manager submits the summary to the Training Manager.


10.3 DIS Quality Assurance

Once the DIS has successfully completed the post ISTDI assessment period, the FLS will audit the DIS in accordance with the following schedules below. The FLS observes each experienced DIS to determine their current level of skills and abilities. When the accumulated assessments of any DIS confirm a consistently high quality of process performance, the FLS provides positive reinforcement and works through management channels to provide appropriate official recognition.


Quality Assurance Schedule

Type of Audit 7-12 Months Employment > 1 Year Employment
Pouch Audit Twice a Month Monthly
Case Management Audit Monthly Monthly
Interview Observation Monthly Quarterly
Field Audit Monthly Quarterly


  • The FLS will submit a monthly cumulative report of the number of reviews conducted to the next level of supervision

  • The FLS must perform audits that are evaluative, informative, and detailed. Audits are crucial to documentation of a worker’s continued performance and development. They are also critical documentation in recording work quality deficiencies and the shaping of Performance Improvement Plans (PIPs).

  • The FLS will ensure that DIS with identified performance weaknesses are placed on a written PIP with a coaching plan that includes more frequent assessments performed as if the DIS were a new hire (see above chart), or more frequently as needed

  • All audit forms will be documented, presented, and signed by the FLS and the DIS. The original form will be provided to the DIS, one copy will be given to the next level of supervision and one copy kept by the FLS, for supporting documentation for evaluations. If a DIS refuses to sign an audit form, the FLS must document the refusal of the DIS to sign it in lieu of his/her signature on the audit.


10.4 Case Reviews

  • The FLS will have a system to track case submission to ensure case write-ups are submitted by the DIS within one day

  • The FLS will maintain a system to ensure all appropriate case management forms are complete, legible, accurate and in accordance with Chapter 9, Disease Intervention Specialists Performance Standards

  • The FLS will review and analyze high priority cases (all HIV and syphilis) within two days of submission. The FLS will document the technical assessment, supervisor suggestions and instructions that will direct the DIS to conduct specific activities to enhance case management. This review will be dated and returned to the DIS

  • The FLS will ensure that morbidity is reported per program guidelines

  • The FLS will review and document the status of open case management activities at least once a week to monitor the progress of DIS follow-up in regards to re-interviews, cluster interviews, and field investigation dispositions. The FLS will recommend a change of interviewer on all unproductive high priority cases. The FLS will also be available for re-interviews and as a back-up interviewer

  • The FLS will review source and spread determination made by the DIS and ensure that all efforts have been expended to identify/notify all source and spread candidates prior to closing the case

  • FLS will review, date, initial and approve completed cases for closure after ensuring that all reasonable activities have been pursued to their full completion. A FLS may not approve a case closure if the case has any open contacts or clusters and/or a case has information that has not been followed up

  • FLS will ensure cases are closed on an ongoing basis, and will inform the next level of supervision of cases delinquent for closure (open beyond 45 days from the date interviewed)

  • The FLS will ensure that closed cases are re-opened when the potential for additional intervention is identified.


10.5 Field Record Audits

  • The FLS will conduct pouch audits to ensure that field investigations are managed in accordance with Chapter 9, Disease Intervention Specialists Performance Standards

  • The FLS will date and document supervisory instructions on the Field Record (FR) to reinvigorate stalled investigations. FLS must ensure DIS understand that stalled investigations must be brought promptly to their attention and foster a culture of teamwork to bring these investigations to a successful closure

  • The FLS will review the Open Field Record Report (generated from STD*MIS) weekly and make recommendations to the DIS to expedite these investigations. FLS will inform the next level of supervision of FRs open over 14 days from the date assigned, and take the necessary actions to bring the FR to closure

  • The FLS will initial all adverse-outcome FRs reviewed before closure. The FLS must document specific instructions to be carried out by the DIS prior to closing all D, J, G, H, L, 4 and 7 dispositions

  • Also prior to closure, on FRs disposition J or D, the FLS will conduct a field visit to ensure the DIS has explained the health consequences of refusing care to the client

  • The FLS will inform the next level of supervision of all closed D, H and J syphilis reactors, and all HIV positives that have not been located for posttest counseling or who refused a referral to Early Intervention

  • The FLS will track adverse dispositions to be aware of workers who have disproportionately high numbers or rates of adverse dispositions on the field records. The FLS will coach workers who have consistently high numbers/rates of adverse dispositions to discern and address the deficiencies in those outcomes

  • The FLS will ensure a copy of the FR will be submitted to surveillance for data entry according to the surveillance guidelines, if applicable

  • The FLS will ensure that correspondence and forms used by the DIS to refer clients are in accordance with current guidelines. In the case of mailed referrals, FLS must ensure that field visits have occurred and that mailed referrals are used as a supplement to the field visits


10.6 Records/Reports

  • The FLS will review DIS travel vouchers, time sheets, and leave slips for accuracy and sign off for approval, and ensure these forms are routed through the proper channels

  • The FLS will prepare individual and team monthly, quarterly, semi-annual and annual statistics on the DIS performance relating to the state and local objectives. FLS will use these reports, both individual and team, to provide ongoing feedback to the DIS and demonstrate how each individual contributes to the program’s success

  • The FLS will provide individual feedback to DIS on outcome and process performance indicators on monthly basis

  • The FLS will submit individual and team statistics to the next level of supervision within established deadlines on a monthly basis. The FLS will assist in analyzing the statistics to determine areas of strength and missed opportunities. The FLS will then use this information to enhance and improve program execution

  • The FLS will inform the next level of supervision of DIS performance deficiencies, as well as corrective actions


10.7 Clinic-Based Activities (if applicable)

  • The FLS will prepare DIS clinic and field schedules, and react appropriately to staffing shortages or changes that require scheduling adjustments, to ensure disease intervention activities and program operations are not affected

  • The FLS will be assigned to clinic coverage and are responsible for working with the DIS and the clinical staff to facilitate clinic flow

  • The FLS will ensure the method for referring client(s) from clinician to DIS for interviewing/counseling is efficient and confidential

  • The FLS will ensure a system is in place for clinicians and DIS to communicate with each other about client’s relevant concerns and/or problems

  • The FLS will work with the clinic management to ensure DIS referrals receive priority in the clinic

  • The FLS will ensure the expected-in box is located at the registration area and inaccessible to clients. If this box is not accessible to DIS, then an “Open Investigation” box containing pending investigations is maintained in the DIS area

  • The FLS will work with the clinic management to ensure that the expected-in box is checked upon each client intake to determine if the client is a DIS referral and ensure the referral is attached to the client’s medical record for clinician review

  • The FLS ensures expected-in box is reviewed and purged weekly of all closed field records

  • FLS will review medical records to ensure DIS interviewing and counseling activities are documented per program standards

  • For new DIS ( < 1 year) or DIS on PIPs, the FLS will discuss pre-interview analysis and plan prior to original interviewing/counseling sessions and related re-interviews, cluster interviews

  • For new DIS with unproductive cases, the FLS will discuss original


10.8 Educational Presentation/Screenings

  • The FLS will coordinate and oversee STD presentations and community outreach screenings

  • The FLS will maintain records on educational presentations/screenings conducted

  • The FLS will establish and maintain collaborative relationships with community-based organizations to identify target groups and to assist with outreach activities

  • The FLS will establish and maintain collaborations with external and internal programs/agencies (as appropriate) to enhance disease intervention activities

  • The FLS will initiate innovative screening and disease intervention methods including evaluating the performance and impact of these new activities


10.9 Orientation Plan for ISTDI Preparation

Refer to the Orientation Plan for ISTDI Preparation.


10.10 Worker Professional Development

The FLS will support DIS in diversifying their skill sets within program needs and work to increase their own skill sets on an ongoing basis


10.10.1 Worker Career Development (New DIS)

  • The FLS will assist DIS in preparing for career development during the first 24 months of the new DIS’ career

  • The FLS will assist DIS in selecting and applying for professional development training during the first 24 months of the new DIS’ career

  • The FLS will assist DIS in developing 6, 12, and 24 month plans for professional development beyond ISTDI

  • The FLS will guide new DIS in carrying out their 12 and 24 month plans for career development


10.10.2 Worker Career Development (Experienced DIS)

  • The FLS will provide professional development feedback on a quarterly basis to DIS

  • The FLS will encourage DIS to select and apply for professional development training

  • The FLS will assist more experienced DIS in preparing to assume greater levels of responsibility within program needs (surveillance, Lead DIS, health presentations, etc.) through modeling, coaching, and mentoring

  • These activities will be thoroughly documented


10.10.3 FLS Career Self-Development

  • The FLS will help develop 12 and 24 month plans for his/her own career development in conjunction with the Program Manager

  • The plans will include specific dates for FLS assuming greater levels of responsibility within program needs (surveillance, program evaluation, rapid response team membership, etc.)

  • The FLS will seek training opportunities for his/her own professional development

  • The FLS will seek support from their Operations Manager and Program manager in diversifying his/her skill sets within program needs

  • These activities will be thoroughly documented

10.11 Program Strategies and Goals

  • The FLS will seek active participation in developing, implementing, and evaluating local area program strategies

  • The FLS will provide periodic reports regarding progress toward achieving program objectives and goals. The reports will be submitted according to program requirements

  • The FLS will analyze current strategies and adjust them as results from activities become known

  • The FLS will seek innovations and solve problems when clients are prevented from receiving program services

  • The FLS will provide leadership both in quality of work and as a role model for achieving program objectives and goals



10.1 Supervision

10.2 Orientation/Training of New DIS

10.3 DIS Quality Assurance

10.4 Case Reviews

10.5 Field Record Audits

10.6 Records/Reports

10.7 Clinic-Based Activities (if applicable)

10.8 Educational Presentation/Screenings

10.9 Orientation Plan for ISTDI Preparation

10.10 Worker Professional Development

10.11 Program Strategies and Goals

Last updated May 7, 2020