Alaska
Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium (ANTHC)
ANTHC has met the WHO elimination goals among Alaska Natives (AN) for hepatitis A and B. For hepatitis C, plans include expansion of screening and treatment in the homeless clinic, behavioral health, opioid substitution, and detox programs; work with prisons to treat Alaska Natives who are incarcerated; expand screening to include pregnant women and emergency departments; and work with community health practitioners to screen baby boomers and people who inject drugs living in isolated communities in Alaska so they can be treated in their community.
https://anthc.org/what-we-do/clinical-and-research-services/hep/
Arizona
Southwest Recovery Alliance
The Southwest Recovery Alliance is a regional grassroots organization dedicated to the implementation of harm reduction interventions, public health strategies, drug policy transformation, and justice reform in Arizona and throughout the Southwest.
The Southwest Recovery Alliance focuses on building alliances that amplify the voices of people living with Hepatitis C, impacting statewide awareness on HCV prevention and elimination, navigating people to HCV treatment, decreasing barriers to HCV treatment, and maintaining and expanding our harm reduction education campaigns and direct services throughout the region.
http://southwestrecoveryalliance.org/
California
SACRAMENTO
END B
END B is a collaborative comprised of the UC Davis Comprehensive Cancer Center (UCDCCC), the Health and Life Organization (HALO), the Sacramento (California) County Public Health, and the California Primary Care Association (CPCA). HALO is the largest healthcare provider in Sacramento County serving at-risk Asian Americans and South East Asians, particularly those born in CDC-identified hepatitis B virus (HBV) endemic areas. END B seeks to end the perinatal transmission of HBV, achieve increased vaccination of HALO’s patients (of all races/ethnicities), and link HALO patients with HBV to treatment, saving lives and sparing the next generation from HBV infection. We developed END B to serve as a national, replicable model Hepatitis B demonstration program based on the synergistic collaboration of the academic, community, and governmental sectors.
SAN DIEGO
Liver Coalition of San Diego
The Eliminate Hepatitis C San Diego County Initiative is a public-private partnership to eliminate hepatitis C by 2030. The process started in November 2018 when it was approved by the San Diego County Board of Supervisors, with the Board asking the County Health and Human Services Agency to return in twelve months with recommendations. Over the 12-month period of November 2018 to November 2019, community partners and stakeholders met, developing the Recommendation Report dated December 20, 2019. This report was approved by the Board of Supervisors on March 10, 2020. The Implementation Plan for these recommendations was approved by the Board of Supervisors on July 13, 2021. Both of these can be download by linking here:
https://livercoalition.org/advocacy/hepatitis-c-initiative/
Scott Suckow email: scott@livercoalition.org
SAN FRANCISCO
SF Hep B Free
Founded in 2007, SF Hep B Free – Bay Area is an organization dedicated to raising awareness of hepatitis B and liver cancer in the San Francisco Bay Area. It does so by creating public and healthcare provider awareness about the importance of testing and vaccinating those at risk for hepatitis B, promoting routine hepatitis B testing and vaccination for those at risk, and advocating and providing accessible, affordable, and culturally and linguistically appropriate linkages to care and treatment for individuals chronically infected with hepatitis B. SF Hep B Free -Bay Area’s goal is to make the San Francisco Bay Area free of the harmful health effects and tragic disease caused by hepatitis B. By bringing together local stakeholders including government, healthcare, business, media and advocacy groups, SF Hep B Free – Bay Area has created a model for effective grassroots education, increased community screening and compelling health advocacy.
End Hep C San Francisco
Established in 2016, End Hep C SF is a multi-sector independent consortium operating under the principles of collective impact. End Hep C SF consists of approximately 150 members representing 34 local partner public and private agencies, all working together to realize the vision of eliminating hepatitis C as a public health threat in San Francisco. End Hep C SF emphasizes collective decision-making, community leadership, data sharing, and ongoing evaluation and as key components of the initiative’s process.
Florida
The FL HCV elimination group convened national and local experts in August 2019 in Orlando, FL for its inaugural meeting to address screening, treatment-level barriers and liver cancer prevention. The meeting goal was to support a statewide HCV elimination program and it was attended by stakeholders including representatives from the FL DOH, patients, medical and social service providers, researchers, policymakers and others from private organizations. This followed an earlier HCV elimination meeting in February 2019, held in Miami, FL by the major liver disease societies (AASLD/EASL). Planned activities will strengthen and be synergistic with the current efforts from the FL DOH viral hepatitis program and include involvement of four major academic centers in FL. Stakeholders will continue to meet in 2020 with the goal of producing a guidance document with support from both the American Liver Foundation and ASTHO by participating in monthly peer-to-peer learning opportunities for hepatitis elimination.
Thomas Bendle email: Thomas.Bendle@flhealth.gov
Emmanuel Thomas email: ethomas1@med.miami.edu
Illinois
HEPP and Better-HEALTH
The Asian Health Coalition is a nonprofit organization located in Chicago, IL. Our aim is to eliminate health disparities among Asian, Pacific Islander, African, and other communities of color by utilizing a collaborative partnership approach to support the development and implementation of culturally and linguistically appropriate health programs and initiatives. One of our main health programs is the Hepatitis Education and Prevention Program (HEPP), and its expansion Better-HEALTH (Helping Educate All and Link Those with Hepatitis). Raising awareness for hepatitis B and liver cancer with both the community and healthcare providers, these programs work together to prevent new cases of hepatitis B, increase the identification of individuals with hepatitis B, and navigate them to high-quality, ongoing medical care. This is done through outreach, education, identification, patient navigation, screening, vaccination, management, and treatment of those already affected, and those at risk of being affected by hepatitis B in our communities.
https://www.asianhealth.org/current-work-hepatitis-b
Hawaii
Hep Free Hawaii
Hep Free Hawai’i partnered with the Hawai’i Department of Health and the Hawaii Health and Harm Reduction Center to develop Hep Free 2030: the Hawai’i Hepatitis Elimination Strategy 2020-2030, which was released on World Hepatitis Day 2020. Over the course of one year, more than 120 people representing more than 50 agencies participated in over 25 virtual and in-person convenings to help create this collaborative, nimble, and community-oriented strategy. Through this iterative process, five priorities were identified: Awareness and Education; Access to Services; Advocacy at all Levels; Equity in Everything; and Data-Driven Decision-Making. As micro-elimination opportunities are developed, HFH welcomes all stakeholders to join in the effort to make #HepFree2030 a reality in Hawai’i.
https://www.hepfreehawaii.org/hep-free-2030
Louisiana
Hepatitis C Elimination Program
The Louisiana Department of Health is pursuing hepatitis C elimination through the combination of a first-in-nation Subscription Model for hepatitis C treatment and a public health-based community-to-clinic care support model. Through these strategies, LDH plans to treat over 10,000 Medicaid and incarcerated individuals by the end of 2020, with the goal of eliminating hepatitis C as a public health threat statewide. The Subscription Model provides unrestricted access to treatment through a multi-strategy Elimination Program aimed at identifying Louisianans with hepatitis C infection and linking them to providers able to guide them successfully through treatment.
The Hepatitis C Elimination Program will:
- Expand provider capacity to treat hepatitis C
- Educate public on availability of cure and mobilize priority populations for screenings
- Expand HCV screening and expedited linkage to HCV cure
- Strengthen HCV surveillance to link persons previously diagnosed to treatment
- Implement harm reduction and complementary treatment strategies
- Extend elimination efforts to all populations within the state
Michigan
Michigan’s State Plan on Eliminating Hepatitis C
In early 2021, the Michigan Department of Health + Human Services (DHHS) released a statewide plan for eliminating hepatitis C. The plan was the result of a year-long, state-wide strategic planning process. The resulting mission statement is: Creating a collaborative approach to eliminate HCV in Michigan by improving quality of life through equitable and affordable access to testing, curative treatment, and services and supports that are stigma- and barrier-free. As part of the plan, Michigan DHHS launched the We Treat Hep C Initiative in April 2021, which aims to make treatment more accessible by removing barriers to prescribing. The initiative is a collaborative effort among the Michigan DHHS, Michigan Medicaid, and Michigan Department of Corrections in partnership with AbbVie, and it makes the antiviral MAVYRET® available for HCV treatment without prior authorization.
Minnesota
Planning for State Viral Hepatitis Elimination Programs
The Minnesota Department of Health- Hepatitis Unit is convening local public health, community leaders, healthcare providers, individuals affected by viral hepatitis and other stakeholders to review current hepatitis B and hepatitis C epidemiological trends in Minnesota to identify data gaps. The Hepatitis Unit will then work with stakeholders to develop hepatitis B and C epidemiological profiles to minimize the local hepatitis disease burden and work toward elimination.
https://www.health.state.mn.us/hepatitis
New York
New York State (NYS) Hepatitis C Elimination Task Force
In March 2018, New York State (NYS) made a commitment to eliminate hepatitis C as a public health problem by allocating $5 million to implement new programs and activities and establishing a task force. The NYS Hepatitis C Elimination Task Force will provide input to the NYS Department of Health on the hepatitis C elimination plan. Task Force members include key stakeholders representing government, private industry, consumers, and community leaders who are hepatitis C experts. The Task Force is supported by five workgroups: 1) Hepatitis C prevention; 2) Hepatitis C care and treatment access; 3) Hepatitis C testing and linkage to care; 4) Surveillance, data and metrics; and 5) Social determinants. The additional funding will support: patient navigation programs; innovative care models to address barriers people who inject drugs face when accessing hepatitis C treatment; reentry and peer programs for incarcerated individuals; surveillance infrastructure; and a multi-media campaign. https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/elimination.htm
Oklahoma
CHEROKEE NATION
Hepatitis C in Native Oklahoma: Optimizing Care and Setting a Path Towards Elimination of Disease and Disparity
The goal of the Cherokee Nation hepatitis C (HCV) initiative is to eliminate HCV from the Cherokee Nation Health Services (CNHS) and improve the health of American Indians in the CNHS by developing a community-based program to test, treat, and cure HCV, coupled with public awareness efforts to reduce new HCV infections. The program is based on universal screening, increasing the number of primary care providers who are managing individual with HCV by utilizing projectECHO, and expansion of harm reduction. The project will also include data collection and analysis to help understand how many people may have HCV, determine risk factors for acquiring HCV, and provide evidence to inform future efforts to eliminate HCV.
Pennsylvania
Viral Hepatitis Elimination Planning in Pennsylvania
The Pennsylvania Department of Health initiated viral hepatitis elimination planning through a stakeholder summit in May 2019. Following this meeting, stakeholders nominated themselves to serve on Pennsylvania’s Viral Hepatitis Elimination Planning Committee. This committee convened in October 2019 to begin drafting strategies to be included in Pennsylvania’s viral hepatitis elimination plan. In addition, workgroups have been formed to build upon the work of the Planning Committee and identify specific goals and objectives. Stakeholders participating in this statewide elimination planning recently created Hep Free PA, a statewide coalition dedicated to improving the continuum of viral hepatitis prevention, diagnosis, care, and treatment with the goal of eliminating viral hepatitis and its related stigma from Pennsylvania.
https://www.communityliveralliance.org/hep-free-pa
ALLEGHENY COUNTY
Hep C Free Allegheny
Formed in 2018, “Hep C Free Allegheny” is a campaign spearheaded by several major health and social service agencies in Allegheny County, Pennsylvania. Its vision is a county in which coordinated efforts result in the prevention of new hepatitis C infections, timely identification of those already infected with subsequent linkage to treatment, and the elimination of hepatitis C-related health inequities. Reducing the stigma that is sometimes associated with hepatitis C infection is an important component of these efforts. Hep C Free Allegheny is currently guided by a Steering Committee and four workgroups.
https://www.hepcfreeallegheny.org/
PHILADELPHIA
C Change
C Change, a partnership between the Hepatitis C Allies of Philadelphia (HepCAP) and the Philadelphia Department of Public Health (PDPH), is a project to eliminate hepatitis C virus (HCV) among people who use drugs in Philadelphia. Guided by the belief that everyone deserves a cure, C Change is working to transform HCV care delivery by building flexible, low threshold models of integrated care. C Change provides direct patient services, clinical training, and infrastructure support to build treatment capacity in settings not traditionally treating HCV. Currently, C Change works in collaboration with Prevention Point Philadelphia, the city’s syringe service program (SSP), the Stephen Klein Wellness Center, a Federally Qualified Health Center (FQHC), and Merakey Parkside, an outpatient medication assisted treatment program for substance use disorder.
Philadelphia Hepatitis B Virus Infection Prevention, Vaccination, Navigation, Testing, and Treatment Elimination Program (HBV PreVNTT)
In July 2019, the Philadelphia Department of Public Health (PDPH) received funding from the Office of Minority Health for a Hepatitis B virus (HBV) elimination demonstration project: Philadelphia Hepatitis B Virus Infection Prevention, Vaccination, Navigation, Testing, and Treatment Elimination Program (HBV PreVNTT). This project aims to address HBV among priority populations including individuals from East/Southeast Asia and Sub-Saharan Africa, pregnant persons, and people who use drugs. This program uses surveillance data to tailor interventions to communities and settings most affected by hepatitis B and partners with community-based organizations to create sustainable, longitudinal change at the city, clinic, and patient level. Citywide interventions encompass a multi-pronged approach including:
- education of communities most at risk, providers, pharmacists and medical students;
- continuous quality improvement processes prioritizing cultural competency, and HBV vaccination, screening, and linkage to care;
- an online HBV education module available to all networked providers at a large area health system;
- patient navigation to assist in linking individuals living with HBV who are out of care and/or pregnant to a specialist for monitoring and treatment; and
- screening and vaccination events in highly affected communities.
http://www.phillyhepatitis.org/
http://www.hepcap.org/
http://www.hepbunited.org/
Puerto Rico
Puerto Rico Hepatitis C Elimination Program
Puerto Rico Government Health Insurance Administration (GHIP), Plan Vital’s administrator and Medicaid Program equivalent, joins the WHO goal to eliminate hepatitis C by 2030. In 2020, Plan Vital included direct-acting antiviral treatment and provided treatment guidelines for providers. Patients with chronic hepatitis C qualify for treatment without alcohol or drug use screening or fibrosis score restrictions. The protocol specifies that any general or primary care physician with hepatitis C certification, is authorized to prescribe treatment for “non-complicated patients”. Complicated patients should be referred to specialists. This initiative allows Medicaid’s patients with hepatitis C to have access to treatment without barriers. GHIP also requires physicians to order screening tests to Vital’s population ≥18yrs, at least once in a lifetime, and pregnant women on each pregnancy.
Utah
Utah Department of Health
This year (2019), the Utah Department of Health (UDOH) is in the initial stages of hepatitis elimination planning and was recently awarded an ASTHO grant to begin work on these activities. Current UDOH elimination activities include working with the Center for Disease Analysis Foundation (CDAF) to develop a Utah-specific disease progression model for hepatitis C, participating in a regional meeting to begin hepatitis elimination planning, and participating in monthly ASTHO peer-to-peer learning opportunities for hepatitis elimination
Virginia
Hepatitis C Education and Patient Connection (HEPC)
Sentara Martha Jefferson Medical Group and Virginia Department of Health are working together in an innovative partnership to expand patient access to hepatitis C treatment across Virginia. HEPC provides telemedicine appointments to meet patients where they are, self or clinician referred. We offer clinician and support staff training to increase the capacity of treatment across the state. Training is followed up with ID physician consultations and monthly community of practice webinars to learn from peers and share knowledge. Our Referral on Release Program offers navigation to those being released from incarceration who are positive with hepatitis C ensuring they access treatment without barriers. www.virginiahepc.com
Terry Kemp Knick email: txkempkn@sentara.com
Washington
Hep C Free Elimination Plan
The Washington State Department of Health (DOH) has convened the Hep C Free Washington coordinating committee and three topic-specific work groups, Data & Strategic Information, Community-Based Responses & Interventions, and Clinical Strategies, in order to develop a plan to eliminate the public health threat of hepatitis C in Washington State by 2030. As part of that plan, the Department of Health is working with partners to bolster efforts to ensure those living with hepatitis C know their status and are connected to care and the cure, and that those at risk have access to preventive services. Complementary to the elimination plan development, Washington State’s Health Care Authority (HCA) is leading a first-in-nation comprehensive procurement of hepatitis C medications purchased by state agencies (including Medicaid, the Department of Corrections, and other state agencies) to get the best prices from manufacturers and ensure that curative treatment is more readily available to all people living with hepatitis C in Washington State.
https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Hepatitis/HepatitisC/EliminatingHepatitisC
TACOMA
Tacoma-Pierce County Health Department
Tacoma-Pierce County Health Department (TPCHD) takes a department-wide approach to hepatitis B and C (HBV & HCV). Coordinated case identification occurs within multiple programs: Refugee Health, STD/HIV, Methadone Treatment and Tuberculosis as well as the Dave Purchase Project (a community-based syringe exchange).
In 2018 the Viral Hepatitis program added to existing perinatal hepatitis B work by creating a perinatal hepatitis C program. The immediate goal of this program is to establish a routine RNA test for babies exposed in-utero to HCV, especially since current data show that most exposed babies remain untested. The long-term goal is to decrease the percent of women actively infected with HCV during pregnancy. This will be achieved by:
- Recommending universal HCV screening for pregnant women.
- Increasing awareness of perinatal transmission among providers.
- Encouraging HCV treatment for women who are not pregnant.
A variety of tools have been created for providers to use with patients.
Washington, D.C.
HBI-DC
Hepatitis B Initiative of Washington DC (HBI-DC) is a 501(c)(3) nonprofit organization that works to eliminate liver cancer caused by hepatitis B and hepatitis C among persons of Asian, Pacific Islander, and African descent, and other high-risk groups. HBI-DC provides culturally and linguistically appropriate viral hepatitis outreach, education, screening, hepatitis B vaccination, linkage to care, and patient navigation services for impacted communities in Maryland, Virginia, and Washington DC. Complete hepatitis B and hepatitis C testing and diagnosis are provided free to participants. HBI-DC links participants to care and provides navigation services in multiple languages to help access treatment and patient assistance programs for uninsured and low-income participants. HBI-DC has developed a comprehensive network of primary care providers, clinics, and hospitals that aid patients in navigating the health care system.
Appalachia
HepConnect
HepConnect, a five-year, multi-million-dollar initiative is aimed at addressing the sharp increase in chronic hepatitis C virus (HCV) infections fueled by the nation’s opioid crisis. In partnership with the Harm Reduction Coalition (HRC) and local organizations, the initiative will support evidence-based solutions to meet the needs of people most affected by the opioid crisis in Indiana, Kentucky, North Carolina, Tennessee, and West Virginia.
Midwest Regional
Veterans Integrated Service Network (VISN) 12
VISN 12 has worked with several community harm reduction centers in the Danville and Chicago areas to improve education, knowledge and linkage to care for services to veterans and their partners. The organization collaborated across different agencies including the Illinois Department of Health and the American Liver Foundation (Great Lakes Division). Providers utilize a national electronic tool (developed by VISN 12 in collaboration with several other networks) to help identify high risk patients for HCV screening as well as patients with chronic HCV. The network of infectious disease, liver providers and primary care providers communicate on a frequent basis to re-engage patients for a variety of services in order to educate, stabilize and offer curative regimens. VISN 12 includes portions of Wisconsin, Michigan, Illinois, and Indiana.
