Implementing the Nation’s First State Hepatitis C Testing Law

As the first state hepatitis C testing law in the nation progresses into its second year of implementation, the New York State Department of Health (NYSDOH) is taking steps to educate both healthcare providers and consumers about the importance of HCV screening for individuals born between 1945 and 1965 (often referred to as the “Baby Boomers”) and New York’s related law requiring that healthcare providers offer a one-time HCV screening to patients in this birth cohort as part of routine primary care. Here is an overview of the activities that the NYSDOH has been engaged in to implement and evaluate the new law.

The Law

The NYS Hepatitis C Testing Law was signed into law by the governor on October 23, 2013 and implemented effective January 1, 2014. This new law mirrors the Centers for Disease Control and Prevention's (CDC). The law was enacted to increase HCV testing and ensure timely diagnosis and linkage to care.

The two key provisions of the NYS Hepatitis C Testing Law are:

• A hepatitis C screening test must be offered to every individual born between 1945 and 1965 receiving services as an inpatient of a hospital or receiving primary care services in the outpatient department of a hospital or in a freestanding diagnostic and treatment center or from a physician, physician assistant, or nurse practitioner providing primary care.
• If an individual accepts the test and the screening test is reactive, the health care provider must offer or refer for follow-up health care, including a HCV diagnostic test (i.e., HCV RNA).

Educating Providers and Consumers

All activities related to the testing law implementation and evaluation are being coordinated by the NYS Department of Health’s AIDS Institute.

To inform healthcare providers of the new law, the AIDS Institute:

• Issued a “Dear Colleague” letter ;
• Developed a “Frequently Asked Questions” document;
• Conducted stakeholder conference calls and in-person meetings; and
• Released a web castExit Disclaimer.

In April 2015, the AIDS Institute launched a statewide media campaign to raise awareness of the law among providers and consumers. A post card was mailed to providers (i.e., MDs as well as Doctors of Osteopathic Medicine, Physician Assistants, and Nurse Practitioners) across the state making them aware of the recent law. The post cards included a link to the NYSDOH hepatitis web site where new provider and consumer educational materials are posted and available for download or ordering. The materials include:

• Fact Sheets (Provider , Consumer )
• Consumer Post Card
• Waiting Room Posters

Additionally, advertisements were placed in the AARP regional newsletter, and a short videoExit Disclaimer was created for physician office waiting rooms.

Finally, the law requires the NYSDOH to conduct an evaluation on its impact with respect to the number of persons who are screened for hepatitis C and the number of persons who have accessed care following a positive test. The final report is due to the Governor by January 2016. The evaluation activities will include:

• To determine number of tests conducted
  • Survey of all commercial laboratories in NYS
  • Analysis of Medicaid and HCV surveillance data
• To determine the number of persons who have accessed care following a positive test
  • Analysis of HCV surveillance data
• To learn more about how providers have implemented the law, a survey will be mailed to a sample of providers statewide (i.e., MD, DO, PA, and NP).

The NYS HCV Testing Law has a sunset date of 2020. At that time, it will be repealed and will have to be re-introduced if it is still needed.

Contributing to National Viral Hepatitis Goals

This law is the first of its kind and potentially a model for other states seeking to avoid thousands of illnesses and deaths that would otherwise result from undiagnosed HCV infection. The NYS HCV Testing Law is also the first law that directly supports a key goal of the national Viral Hepatitis Action Plan: the plan calls for increasing the proportion of persons who are aware of their hepatitis C virus infection, from 45% to 66% by 2020. “The support for implementation of the HCV Testing Law from the NYSDOH and its AIDS Institute are substantial contributions toward identifying people who are chronically infected with HCV in New York,” said Dr. Ronald Valdiserri, the U.S. Deputy Assistant Secretary for Health, Infectious Diseases. “We’ll be watching their progress and urging other stakeholders to learn from New York.”Ms. Flanigan also serves as the CDC-funded Viral Hepatitis Prevention Coordinator in New York.