Detroit HCV Elimination Project - The Detroit HCV Elimination Project, led by Henry Ford Health (HFH), integrates hospital-based and street-based services to rapidly diagnose, treat, and support individuals affected by hepatitis C virus (HCV), substance use disorder (SUD), serious mental illness (SMI), and housing instability. The overarching goals of the project are to eliminate HCV as a public health threat among high-risk populations in Detroit; reduce acute care utilization and improve long-term outcomes for individuals with HCV and co-occurring conditions; and build a sustainable infrastructure that bridges emergency care, mobile outreach, and community-based primary care to address the intersecting epidemics of HCV, SUD, SMI, and homelessness. Over the grant project period, the initiative will cure at least 110 individuals of HCV in Year 1, 110 in Year 2, and 110 in Year 3, achieving a minimum of 330 HCV cures. The initiative aims to improve health for metro Detroit residents by expanding low-threshold access to care across Henry Ford Hospital’s Emergency Department (ED) in Detroit, Infectious Disease (ID) Department, mobile outreach, and community clinics such as CHASS. This project targets populations in metro Detroit with a high incidence of HCV and a high prevalence of co-occurring conditions such as opioid use disorder (OUD), SMI, HIV and housing instability. Many individuals within this population cycle through emergency and acute care settings or remain disengaged from traditional health systems. Key strategies and interventions for the Detroit HCV Elimination Project center on a coordinated, multi-setting response to HCV, substance use, and related health challenges. At HFH, all ED patients are screened using a standardized SBIRT model. Those presenting with OUD or overdose receive harm reduction education, naloxone, case management, and facilitated referral to care. Point-of-care (POC) HCV RNA testing using the Cepheid Xpert Fingerstick assay enables real-time diagnosis and same-day initiation of treatment, directly within the ED setting. Patients will be referred to CHASS or ID for follow-up care. This integrated care coordination will be provided by nurse navigators and peer recovery coaches (PRCs), who deliver behavioral health screening, education on HCV, and warm handoffs to specialty or ongoing care. The collaboration with the providers of the existing Ryan White funded HIV care infrastructure within the ID department will enhance HCV testing, treatment initiation, and longitudinal care, including those co-infected with HIV. This initiative will build upon the ID team’s Ryan White clinical expertise of over 30 years, robust infrastructure and care model to rapidly screen, initiate treatment, and cure patients with HCV, including those co-infected with HIV. Community-based outreach will be led by Community Health and Social Services Center (CHASS) and its partner, the Neighborhood Service Organization, through mobile Street Medicine units staffed by physicians, nurses, social workers, and peer workers. These teams conduct POC HCV testing, determine eligibility for simplified treatment pathways, and support adherence through modified directly observed therapy (DOT). Co-located services available through mobile units include medications for opioid use disorder (MOUD), psychiatric care, housing navigation, and assistance with ID and insurance reactivation. To strengthen linkage and retention, community health workers (CHWs) and PRCs engage individuals and their social networks, providing consistent, culturally responsive outreach that builds trust and facilitates sustained connection to care. Project teams will also make referrals to the United Way of Southeastern Michigan Community Information Exchange (CIE) for housing support and will aid with recovery housing for a limited number of vulnerable patients
