It is estimated that over 300,000 Florida residents are infected with hepatitis C virus and most are not aware of their infection. The state legislature recognized the importance of chronic viral hepatitis prevention and control in the 1999 session by appropriating $2.5 million towards development of the beginning of a comprehensive hepatitis prevention program. The legislature has continued their support of the comprehensive program by appropriating $3.5 million in subsequent fiscal year.

The purpose of this program is the prevention of viral hepatitis in people at increased risk for infection or the serious consequences of infection. The objectives of the Florida Hepatitis Prevention Program include:

1. Providing leadership, policy development, and technical assistance that supports hepatitis prevention and control
2. Supporting the development of a comprehensive prevention plan for hepatitis and liver failure
3. Overseeing counseling and testing services for hepatitis
4. Providing hepatitis vaccination for adults at high risk
5. Promoting treatment and community-based patient care services to persons infected with hepatitis virus
6. Promoting activities to support prevention initiatives at the local and state levels
7. Allocating state hepatitis resources for prevention, education, vaccination, testing, surveillance, patient care, and other hepatitis services

Comprehensive hepatitis prevention programs are needed in state health departments. The Florida Hepatitis Prevention Program demonstrates an early, integrated approach to developing this important public health program.

HIGHLIGHTS AND ACCOMPLISHMENTS
The Hepatitis Prevention Program has active integration projects with public and private partners, including:

Hepatitis Prevention Programs

1. Continued funding for six counties (Broward, Collier, Miami-Dade, Monroe, Pinellas, and Polk) for the provision of comprehensive hepatitis services (since July 1, 1999)
2. Initiated limited funding for three additional counties' hepatitis programs (Seminole, Lee and Escambia); providing support for a nurse and clerk (since October 2002)
3. Initiated limited funding for four additional counties' hepatitis programs in July 2005 ( Palm Beach, Okeechobee, Bay and Alachua)
4. Initiated funding to two counties in January 2007 (Orange and Duval)
5. Continued availability in county health departments of hepatitis A and hepatitis B vaccines for adults at increased risk for infection or serious consequences of infection (since January 2001)
6. Continued availability in county health departments of chronic hepatitis B and hepatitis C testing for adults at increased risk for infection or serious consequences of infection (since January 2001)
7. Outreach, individual level interventions, group level interventions, counseling and testing are provided in community based organizations.

Community-Based Planning

1. Convened Statewide Hepatitis Action-Planning Meeting (April 2003)
2. Convened statewide hepatitis A meeting in Tampa with private and public partners to list and prioritize hepatitis A issues for the State of Florida (February 2001)
3. Established the Florida Viral Hepatitis Council in 2004. The council meets twice a year and has 20 members with representation from the community, clinical/medical services, public health, other governmental agencies, associations/community based organizations and academic/research/university facilities.
4. Had Florida's first statewide hepatitis educational conference in Orlando in June 2007; Planning the next statewide hepatitis educational conference for September 2008
5. Work with the Florida Community Planning Group (HIV/AIDS Program) to provide Hepatitis Prevention Program technical assistance for Comprehensive HIV Prevention Plan (since July 2001)
6. Wrote and sponsored position paper on adult hepatitis vaccine availability for the Council of State and Territorial Epidemiologists (May 2002).

Corrections Programs

1. Several county jails, along with their county health departments, provide counseling, testing, education, and vaccination for hepatitis, as part of integrated HIV, hepatitis, tuberculosis and STD projects. (Since 2002)
2. Continue to work with Florida Department of Corrections on issues related to immunizations for inmates, including seroprevalence (since September 2000).

Professional and Public Education and Training

1. Educational packets sent as requested
2. Addition of hepatitis to the HIV/AIDS 501 manual (since January 2002)
3. Web-based hepatitis clearinghouse which includes information and referral resources for hepatitis A, B and C (since September 2000)
4. Provide Hepatitis 101 teleconferences quarterly (continuing education 1 contact hour for nurses & laboratorians)
5. Provide educational presentations, trainings, technical assistance and materials to county health departments, CBO's, public and private providers, consumers and state government agencies.

Research and Evaluation

1. Continued and enhanced quality improvement process since July 2001
2. Tracking the Burden of the Disease – Surveillance
3. Collaborated with Bureau of Epidemiology for enhanced surveillance and notification of Merlin ability to accept chronic hepatitis reports (since September 2000)
4. Work closely with the Surveillance Unit of the Bureau of HIV/AIDS and contribute hepatitis data to the Monthly Surveillance Report
5. Statewide chronic hepatitis B and C reporting through Merlin web-based surveillance system (July 16, 2002).

Medical Management and Treatment

Currently, there is no funding to provide medical evaluation and referral for Floridians infected with chronic viral hepatitis, specifically hepatitis B and hepatitis C. The Florida Hepatitis Collaboration, Assessment, Resources and Education (Hep-CARE) is a unique partnership between the Department of Health, Florida academic institutions and private industry. This project helps provide hepatitis care and treatment to clients who are medically qualified. It is currently available in four Florida counties.