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November 5, 2015

MNHC’s Clínica Esperanza Pilots Hepatitis C Virus Care Model

In 1989, Mission Neighborhood Health Center created Clínica Esperanza to extend a medical home for people living with HIV/AIDS. Clínica Esperanza is known for its close-knit support and warm welcome for patients managing several chronic illnesses, including HIV.

In April 2014, Clínica Esperanza launched the 12 week Hepatitis C Virus (HCV) pilot program. With the clinic’s multidisciplinary HIV approach in mind(see figure 1), the program was shaped to provide MNHC patients HCV treatment in their medial home setting, which aims to increase treatment access while looking at cost effectiveness, sustainability, quality outcomes and patient experience.

“In the US, current Hepatitis C Virus (HCV) treatments have cure rates upwards of 90%, however only 56% of chronic HCV positive individuals have been successfully treated to cure” [i] . Treatment for vulnerable populations including patients who are homeless, addicted to substances or who face other psychosocial barriers can be difficult. The pilot’s multidisciplinary approach supports comprehensive treatment that can include substance abuse counseling and closer monitoring for patients who may need this intervention.

Kristina Gunhouse, former Clínica Esperanza’s recruitment and retention coordinator, worked closely with many of the patients in the pilot. “HCV treatment has had a bad reputation, many patients feared physical and psychological side effects, but once the treatment and the process was explained, many patients welcomed the treatment,” said Kristina.

The program engages staff from multiple disciplines and each patient receives an individualized plan based on his or her needs. It is not only the medication that is imperative, but also the relationship with their medical provider, the health educator and the counselor.

Ric West, a MNHC patient for 16 years, is one of the selected patients who went through the HCV treatment process. When Mr. West heard about the program he was very excited. He and many of his friends affected by HCV had been waiting for almost two decades for an HCV cure.

Because of Mr. West’s previous experience with HCV drugs, he knew he had to commit completely to the treatment program. The programs support provided him with enough time to prepare himself physically and mentally to begin treatment.

The HCV pilot team at Clínica Esperanza worked unwaveringly to outreach to as many patients as possible for the program and assist each patient in receiving coverage for their HCV medication. Because of the dedication of the care team and patients, 19 of the patients in the pilot have completed treatment and have been cured of HCV.

The goal of the health center is to integrate the lessons learned from the pilot and expand HCV care so that patients can receive treatment directly from their medical provider at MNHC. Given the opportunity to collaborate with other community organizations, expand outreach and integrate HCV into primary care, the pilot program could become an integral part of MNHC’s Adult Medicine clinic.

As for Mr. West he is now free of HCV and is grateful for the dedication and care he received from his care team at Clínica Esperanza. “For someone like me who has chronic illnesses, being able to say I’m cured of at least one of my illnesses is amazing”.

If you would like to donate to help expand this pilot please follow this link: https://www.mnhc.org/donate/

[i]http://hivforumannals.org/index.php/annals/article/view/115/154

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