The Virginia Department of Health (VDH) will utilize the funding from PS21-2103 in a variety of targeted activities with the goals of improving viral hepatitis surveillance, increasing stakeholder engagement in viral hepatitis elimination planning, and improving access to viral hepatitis prevention, diagnosis, and treatment among populations most at risk.
Component 1 will address outbreak identification and response, data collection, case follow up, and case reporting. Existing documentation serves as guidance for local jurisdictions and central office staff during outbreak situations. This documentation includes the Disease Control Manual, the State Epidemiology Response Plan, and the Rapid Response Plan for HIV/HCV Outbreaks. The Division of Surveillance and Investigation also maintains a Lab Aberration Detection System (LADS) that identifies unusual patterns in disease reporting compared to five year trends. Component 1 will create an overarching framework that ties these documents and LADS together to create a more complete and standard response for viral hepatitis outbreaks. In addition to improved outbreak response, VDH will hire contractual staff and one full-time staff to increase the capacity for viral hepatitis data collection, analysis, and reporting.
Component 2 will address viral hepatitis elimination planning; improved access to hepatitis testing and referral in two high-impact settings, including one correctional facility and one comprehensive harm reduction (CHR) site; and access to prevention services for people who inject drugs (PWID) inclusive of a needs assessment, CHR law education, and assessment of Virginia Vaccine for Adults (VVFA) eligibility. Elimination planning was underway prior to Coronavirus Disease pandemic (COVID-19). VDH plans to resume elimination planning and create a technical advisory committee that includes key stakeholders. To improve testing and referral for viral hepatitis at high-impact settings, VDH will build from existing partnerships such as the Comprehensive HIV/AIDS Resources and Linkages for Inmates (CHARLI) program, and a newly approved CHR site. Each site, one located in the southwest and one in the northern region, presents unique challenges for testing and prevention services. Lastly, VDH will conduct a two-phase needs assessment, disseminate information to local jurisdictions regarding the changes in the law that allows for CHR (including protection for CHR participants), and address VVFA eligibility among CHR sites and investigate other means to access hepatitis A and B vaccines, if necessary.
Component 3 will model a service bundle for PWID using funds from the Department of Medical Assistance Services (DMAS), and 21-2103. DMAS is the agency that administers Virginia Medicaid. Component 3 will utilize a “one-stop-shop” strategy in order to access myriad services important to the health of PWID. These services include preventive, diagnostic, and treatment services and will utilize telemedicine technology co-located with CHR sites to reduce barriers to access high-quality care. Three sites will be targeted for this model in year one, representing varied geographic locations, one metropolitan, one suburban, and one rural. Third-party billing will be a key component that improves the sustainability of the project, and allows for replication in other sites.