“One Stop Shop: A Program Evaluation of Streamlining Services for Hepatitis C Screening & Treatment”

Background: Hepatitis C virus (HCV) remains a global public health concern due to the physical and economic burden of progressive liver disease. The World Health Organization has prioritized HCV elimination through the care cascade: screening, linkage to care, antiviral treatment, and sustained virologic response (SVR). Despite the availability of effective direct-acting antivirals, barriers such as stigma, cost, and limited provider accessibility continue to hinder treatment. These barriers disproportionately affect underserved populations, including individuals experiencing homelessness, people who inject drugs, and those with opioid use disorder. Growing research supports streamlining the care cascade to reduce disparities and improve treatment access.Purpose: This program evaluation assessed newly implemented services at the Chatham County Public Health Department aimed at increasing HCV screening among high-risk individuals, initiating antiviral therapy, and monitoring patients throughout the treatment process with the goal of achieving SVR. Methods: Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework, a program evaluation was conducted on the nurse-led model developed to facilitate HCV screening, follow-up laboratory testing, financial assistance for medications, and treatment initiation with sofosbuvir-velpatasvir (Epclusa). Execution of these services was evaluated over the course of eight weeks by following patients through the care cascade to assess for efficacy and sustainability of the program. Stakeholders provided qualitative feedback to augment evaluation findings. Results: Numerous opportunities for improvement were highlighted pertaining to eligibility screening, delays in lab results, and questions regarding medical coverage. Stakeholder feedback was primarily positive, with recommendations for increased staff training, greater promotion for community awareness, and methods to address patient barriers that interfere with care.Conclusion: Nurse-led programs in local health departments may expand access to HCV screening and treatment, reduce disparities, and support national elimination goals. Increasing awareness and partnerships with community organizations such as MOUD clinics and county jails may improve program utilization and sustainability. Collaboration with stakeholders in incorporating evaluation findings, staff feedback, and evidence-based literature is essential in advancing the program.