Collaborations/Coordination STD Programs Immunization (Hepatitis B Coordinator) Laboratory Medical Services Surveillance Hepatitis C Coordinator Advocacy Groups; CBOs Corrections HIV/AIDS Prevention Drug Treatment State Plan

Hepatitis C Coordinator Forum: Barriers and Issues Richard D Moyer, MPA Division of Viral Hepatitis Centers for Disease Control and Prevention Hepatitis Coordinator’s Conference 2003 San Antonio, TX

FY 2000-16 FY 2001-18 FY 2002-14 Richmond Conference- 2001 9 coordinators San Antonio Conference-2003 38 coordinators- ELC 2- IHS, PHPS 10 coord- presenting

Hepatitis C Coordinator Funding- FY 2002 12 New States = $912,000 High Award = $97,000   Low Award = $53,000 Average = $76,000 Approx. 70 % of award = salary & fringe

Hepatitis C Coordinator’s Location Program No HIV/AIDS/STD 15 ID/Epidemiology 15 Comm. Disease 10 Other/unk 8 Total 48

National Hepatitis C Prevention Strategy: Goals Reduce the number of new HCV infections by reducing virus transmission. Reduce risk of chronic liver disease in HCV-infected persons through appropriate medical management and counseling.

Hepatitis C Coordinators A major goal of National Hepatitis C Prevention Strategy. Fund every state and large metropolitan health dept. Provide management, networking, and technical expertise for integration of HCV prevention and control activities into existing public health programs.  

Hepatitis C Coordinator Activities Identify opportunities to incorporate HCV counseling and testing   Ensure that health care professionals receive appropriate training  Develop capacity to provide HCV testing  Identify sources for medical referral of HCV positive persons  Ensure appropriate surveillance for HCV infection  Evaluate effectiveness of HCV prevention activities

What’s Working? Partnering Enthusiasm Coordination/Collaboration/Advocacy Good working relationships Dedicated Staff Getting the message out

What’s Working? Getting on peoples’ agenda Administrative buy-in Integrating hepatitis messages/practices into HIV/STD Piggy-backing HCV Screening into existing programs

What’s Not Working? Integrating activities that fall upon staff resources Getting into the school system Giving hepatitis C education /HCV tests in STD clinics Not having money for testing Not having resources identified for patients who need care Lack of DIS participation

What are the Barriers? FUNDING Testing Treatment Staffing Case Management Vaccine

Administrative Issues Funding Staffing

Technical Assistance Needs Internet access for rural areas Train the Trainer Workshops Assistance with program development and implementation in corrections Guidance on evaluating hepatitis prevention services and treatment T.A. on how to deliver hepatitis education messages for differing audiences

Newsletter/Information Sharing Newsletter would be helpful List-serv

Other Issues/Recommendations/Suggestions More collaboration for consolidating regional testing Continued funding for adult vaccine is a must Coordinators are struggling with limitations of not being a program Integration of HCV counseling and testing into the perinatal program BRFSS should clearly target HCV and associate risk factors for infection Standardized (national) follow-up letter sent to clinicians/patients re risk behaviors, viral load, LFT’s

Conclusions Programs are taking shape Making progress with implementing the hepatitis C prevention strategy Coordinators are qualified and motivated Leveraging support (e.g., vaccines for high-risk populations Networking is increasing