Hepatitis C virus (HCV) infection remains a pressing public health issue. Identification of long term infection in primary care settings and community health centers can facilitate patients’ access to appropriate care. Given the increase in HCV prevalence in the United States, improving the HCV care continuum and expanding medication access to disproportionately affected populations can help reduce disease burden, health care system costs, and transmission. Innovative treatment programs developed in the primary care setting are needed to deliver quality care to meet the demand of those engaging in treatment. This article describes an HCV treatment program developed within a primary care federally qualified health center (FQHC) using physician assistants (PAs) and nurse practitioners (NPs) to address the high number of HCV positive patients identified at the clinic. An interdisciplinary care team was established to optimize patient experience around HCV care and treatment, using on-site primary care behavioral health consultants, an HCV treatment coordinator, and a 340B contracted specialty pharmacy. From January 2015 to April 2017, the Public Health Management Corporation (PHMC) Care Clinic medical providers referred 189 patients for HCV treatment. Of those referred, 102 patients successfully obtained a sustained virologic response (SVR), representing a 53.7% success rate from referral to cure. This treatment program successfully integrated HCV treatment in a patient population heavily affected by substance use and mental illness. Support and adoption of similar programs in primary care community health centers testing for HCV can help meet the clinical/behavioral needs of these marginalized populations.

Primary care providers are increasingly relying on psychologists to assist with patient health needs. Hepatitis C is an infectious viral disease that affects 4 million Americans, with an estimated 70% to 80% unaware they have this condition. Untreated chronic hepatitis C virus (HCV) infections cause fibrosis of the liver, which can lead to cirrhosis, hepatocellular carcinoma, liver failure, and early death. Breakthroughs in the effectiveness and reduced burden of medication treatments, along with increased screening and detection, have led to HCV treatment being increasingly offered in primary care settings. It is estimated that 1 million people will be treated for HCV in the next five years. Individuals with HCV typically receive behavioral health screening and treatment readiness assessment as part of their HCV medication payer approval process, usually in integrated primary care behavioral health. A larger segment of behavioral health providers will need to be knowledgeable about HCV and complete the consultative assessments for primary care providers to meet the high treatment demand. The purpose of this article is threefold: (a) provide background on HCV and the treatment process; (b) discuss how HCV assessments are within the scope of practice of a typical behavioral health provider; and (c) provide a step-by-step framework for conducting a HCV evaluation by a behavioral health provider. With this knowledge, psychologists will be well-prepared to help with the reduction of persons affected by Hepatitis C in our communities. Public Significance StatementHepatitis C is a health condition that requires a psychological evaluation before insurance companies will approve treatment. However, there has been little guidance for behavioral health providers to conduct these evaluations. This article seeks to fill this void, providing education on Hepatitis C and its assessment.

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