Hep C Free - Project Abstract: Hep C Free Delaware Brandywine Counseling and Community Services (BCCS) will implement Hep C Free Delaware. This pilot will deliver statewide, low-threshold care integrating rapid HCV testing, same-day treatment, and behavioral health services for individuals with SUD and/or SMI, including those experiencing homelessness. The program will serve 200 individuals annually (600 total) and cure HCV in 51-100 people each year. The population of focus includes adults (18+) statewide who are disproportionately impacted by hepatitis C (HCV) due to current or past injection drug use, co-occurring substance use and/or mental health disorders (SUD/SMI), and homelessness. Delaware reports over 5,600 individuals living with chronic HCV, with prevalence sharply higher among people who inject drugs (Kahal & Rutan, 2020; University of Washington, 2025). Based on the demographics of HCV prevalence, the population served will be predominantly male, with racial and ethnic characteristics reflecting Delaware's demographics – 60.4% White, 10.5% Hispanic (U.S. Census Bureau, 2025). Homelessness, behavioral health needs, and high rates of uninsurance compound care access barriers. Hep C Free Delaware will address these challenges with trauma-informed, mobile, and low-threshold care strategies targeting individuals who are unsheltered or disconnected from traditional healthcare. Key interventions include HCV RNA point-of-care testing, DAA-based treatment, HIV/STI screening and prevention, FDA-approved MAT, mental health counseling, and care coordination. The program will use BCCS’s NextStep electronic health record and submit data via SPARS, employing a Cascade of Care evaluation model. Services will be provided at four fixed clinic sites and through a mobile treatment unit. Goals are to: (1) increase the number of individuals cured of HCV; (2) reduce the incidence of HCV and HIV in Delaware through outreach and prevention; (3) address the intersection of SUD, SMI, infectious diseases, and homelessness; (4) reduce infectious diseases and conditions, including HIV/AIDS, STI’s, viral hepatitis, and tuberculosis, as appropriate; and (5) increase access to peer support and care coordination. Measurable objectives include serving at least 200 individuals annually, providing same-day HCV screening, testing, and treatment with a goal of curing HCV in 51–100 participants each year. All clients will be assessed for co-occurring mental health and substance use disorders, and 100% who are eligible for and consent to participate will receive integrated, evidence-based treatment with care coordination and peer support. The program will offer screening for HCV, HIV, STIs, hepatitis A/B/C, and tuberculosis to all participants, ensuring immediate linkage to care for those who test positive and prevention education for those who test negative. At least 75% of clients will demonstrate reduced symptoms or harmful behaviors by six months post-treatment. Mobile outreach will engage unsheltered individuals across the state, while prevention and education campaigns will be implemented in each of Delaware’s three counties.
