an effort known as the Hepatitis C Continuity Program, which has been in place since 2006, involves collaboration among the state Department of Correctional Services, the state Department of Health, the state Division of Parole, the New York City Health and Hospitals Corporation, medical centers throughout the state, and manufacturers of medications for hepatitis C (Klein et al., 2007). Such collaborative programs should serve as a model nationally.

Recommendation 5-8. The Centers for Disease Control and Prevention and the Department of Justice should create an initiative to foster partnerships between health departments and corrections systems to ensure the availability of comprehensive viral hepatitis services for incarcerated people.

The initiative should include at least the following:

  • All incarcerated people should be offered screening and testing for hepatitis B and hepatitis C.

  • All susceptible incarcerated people should be offered hepatitis B vaccine.

  • Educational programs, including peer education, should include emphasis on hepatitis B and hepatitis C.

  • Systems should be developed to ensure the continuity of medical management for hepatitis B and hepatitis C once infected persons are released from incarceration.

Community Health Facilities

There is a great deal of variation in the types of viral hepatitis services available within the United States. Several states—including Florida, California, Massachusetts, and Texas—have attempted to introduce some hepatitis services into publicly funded settings because of a lack of adequate federal funding for hepatitis B and hepatitis C services. Florida has been offering laboratory testing and vaccination through county health departments since 1999 by using a Hepatitis Prevention Program established and funded by the state legislature (Baldy et al., 2007). The program has expanded services and coordination between the county health departments, the Bureau of HIV/AIDS, the Bureau of Epidemiology, the Bureau of Immunization, and the Bureau of Tuberculosis and Refugee Health. Texas funded a program from 2000 to 2005 to support statewide HCV counseling and testing among high-risk adults (Heseltine and McFarlane, 2007). The program also included a Web-based data-tracking system for monitoring hepatitis C testing and counseling across the state. Of the al-



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