307. Overcoming Hepatitis C Elimination Challenges in the Coachella Valley through the Collaboration of Linkage to Care, a Managed Care Organization, and a Federally Qualified Health Center

BACKGROUND: Per the Centers for Disease Control and Prevention, 2.4 million Americans have the hepatitis C virus (HCV). New cases increased by 14% from 2014 to 2016 in California with 400,000 infections, 4,000 infections in the Coachella Valley and about 50% unaware of their diagnosis. A barrier to elimination is the lack of rapid screenings and linkage to care (LTC) of infected individuals into an integrated system. Thus, we developed a program at the Hepatitis Center of Excellence (HCE) where pharmacists in a managed care organization (MCO) provide opportunities to overcome these boundaries. The partnership of the MCO and federally qualified health center (FQHC) was established in 2017 to expand access to care to the HCV community. We anticipate that our program will eliminate HCV in the Coachella Valley by modeling past success in human immunodeficiency virus (HIV) testing and LTC at the FQHC through an interdisciplinary approach. METHODS: A single-center, retrospective analysis from January 2017 to December 2018 of HCV individuals was conducted at the pharmacist-led HCE in Palm Springs, California. The LTC team approached barriers through prompt free screenings and major advocacy. Pharmacists and specialty physicians collaborated to ensure rapid assessment, treatment initiation and completion, and sustained virologic response (SVR). The HCE has adapted the HIV testing and LTC model in hopes of achieving similar feats. From 2014 to 2018, 92,947 total HIV tests were performed with 90.2% of HIV-positive patients linked to care. HCV testing was then added to HIV screening and expanded to other testing sites. RESULTS: The first visit with a clinical pharmacist consists of education, reviewing lab tests, cost assistance, and providing treatment options. From 2017 to 2018, 169 of 172 HCV positive individuals (98.2%) achieved SVR by treatment completion. The HCV LTC program demonstrated a 3.8% increase in HCV testing from 2017 to 2018. CONCLUSION: Pharmacist-led care for a large volume of HCV patients allows time for specialty physicians to manage more complex cases. The collaboration between the FQHC, MCO, and LTC team showed HCV elimination is possible based on high SVR rates. HCE is projecting successful linkages to care and continuous campaigning for individuals to be treated for HCV in the Coachella Valley. DISCLOSURES: All authors: No reported disclosures.