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Program Details


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Practice Type: Promising
Program Name: FL Hep-CARE Project (Florida Hepatitis Collaboration, Assessment, Resources, and Education)
Organization: Alachua County Health Department
Web site: http://www.doh.state.fl.us/chdalachua/epi/hepatitis.htm
Overview: The goal of the program was to provide Hepatitis C treatment to low income patients. The target population of the FL Hep-CARE Project consists of low income adults with chronic Hepatitis C. Out of 328 patients who were screened positive, 40 were eligible for the Hep-CARE clinic. Others did not meet financial or medical criteria. The objectives are to: 1) enroll as many eligible candidates as possible in the FL Hep-CARE project; 2) achieve sustained viral response in a percentage of the enrolled patients which is comparable to the success rate in traditional practices; and 3) be a model for other local hepatitis treatment programs.

As of February 16, 2006 40 patients have been scheduled for the liver care clinic at the Alachua County Health Department. Twenty four have kept their appointment in the clinic. Thirteen have started treatment. One has completed treatment (which takes 6 to 12 months to complete depending on the genotype). At this time seven are still on treatment.

Year Submitted: 2006
Responsiveness and Innovation: Public Health Issue- Lack of access to hepatitis C treatment for the low income population. Through the hepatitis testing program and epidemiological reporting it was determined there was no place for low income hepatitis C adults to receive treatment. This practice model provides the needed treatment. The local health department already has an established hepatitis testing and vaccination program. From this program those with hepatitis C positive results can be referred to the treatment clinic.

Very few programs provide actual treatment for hepatitis C within a local county health department. No other LHD in Florida provides this at this time. This practice provides tertiary care for low income patients who would not otherwise have access to this specialty treatment. The only other options for the low income in the past have been to enroll in clinical trials as they become available.

Agency and Community Roles: The LHD was instrumental in developing this program by bringing together health care professionals, pharmaceutical companies, and people living with hepatitis C. The state Hepatitis Program provided leadership in this collaboration of private and public partnerships.

Costs and Expenditures:
Implementation: Public Health Issue- Lack of access to hepatitis C treatment for the low income population. Through the hepatitis testing program and epidemiological reporting it was determined there was no place for low income hepatitis C adults to receive treatment. This practice model provides the needed treatment. The local health department already has an established hepatitis testing and vaccination program. From this program those with hepatitis C positive results can be referred to the treatment clinic.

Very few programs provide actual treatment for hepatitis C within a local county health department. No other LHD in Florida provides this at this time. This practice provides tertiary care for low income patients who would not otherwise have access to this specialty treatment. The only other options for the low income in the past have been to enroll in clinical trials as they become available.

Sustainability: By showing success in treatment, the commitment to continuing this program will be reinforced. It is hoped that by obtaining desired results with the initial funding of $50,000 for one year, additional funding will be forthcoming in the future. Also, the possibility of more effective treatments becoming available in the future justifies maintaining the infrastructure and client base for future treatment. Presenting this model program at seminars, meetings and to the legislature are considerations for sustaining funding for this and similar projects in other LHD’s. Treating Hepatitis C now at a cost of less than $40,000 a year saves the later cost of a liver transplant at $240,000 to $350,000, not to mention hospitalizations and quality of life. The latter is a cost of 6-9 times the cost to treat now. Although HIV/AIDS treatment is ongoing, hepatitis treatment only lasts 6-12 months and the percentage of a sustained viral response (cure) is increasing each year.

Lessons Learned:

 

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