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What is already known on this topic? Hepatitis C virus (HCV) is prevalent among and transmitted by people who inject drugs (PWID). The current rates of HCV screening and treatment are insufficient to affect population-wide HCV outcomes, particularly among PWID.What is added by this report?Our study analyzed a multifaceted intervention in a federally qualified health center that resulted in a modest increase in the proportion of PWID screened for HCV. We also found possible barriers to optimizing HCV care.What are the implications for public health practice? Risk-based HCV screening presents challenges. While new universal screening guidelines may overcome some barriers, additional efforts are needed to diagnose and ultimately treat HCV among PWID to reduce population-wide prevalence and transmission.