What is Hep ElimiNATION?
Many states have or are developing comprehensive, systemic strategies to improve their capacity to prevent, diagnose, and provide linkage to care for viral hepatitis, yet the U.S. still is not on track to achieve the World Health Organization’s (WHO) viral hepatitis elimination goals by the 2030 target. Hep ElimiNATION is a grading system that assesses the policy and programmatic strategies impacting viral hepatitis in the 50 states, Washington, DC, and Puerto Rico. Each jurisdiction will receive a letter grade assessing its current capacity to eliminate viral hepatitis using a rubric developed in consultation with key stakeholders. In addition to the scores, Hep ElimiNATION has a forthcoming Viral Hepatitis Elimination Toolkit that will define the components of a comprehensive viral hepatitis elimination program, and establish key benchmarks for assessing progress. It will provide guidance and resources to enable jurisdictions to develop actionable viral hepatitis elimination strategies.
The goal of Hep ElimiNATION is to promote the development of comprehensive viral hepatitis elimination strategies in all states that reflect evidence-based best practices, and set the U.S. on a course to meet the WHO elimination goals.
How are grades assigned to states? How were the metrics used to grade states selected?
The Hep ElimiNATION team developed a scoring rubric that assesses states’ readiness to eliminate viral hepatitis by outlining key policy, programmatic and surveillance considerations for an effective elimination strategy. The metrics for the rubric and the weights given to questions and categories were developed to align with the priorities outlined in HHS’s Viral Hepatitis National Strategic Plan. Metrics were ultimately included based on whether they were meaningful in the context of current elimination efforts, ascertainable using public information, easily quantifiable, and objective.
The data for the metrics were compiled from publicly available information from sources such as state agency and community organization websites, and public health law and policy databases. States receive a letter-grade calculated from a maximum of 55 points. Details on the points per question and total scoring scale can be found here.
How often will the rubric be evaluated? How often will grades be updated?
The scoring rubric will be evaluated annually to ensure that it is responsive to the evolving elimination landscape and reflects the most current strategic needs.
State scores will be updated annually.
Hep ElimiNATION will continually monitor nationwide elimination efforts, and may alter this schedule as needed.
Who developed the rubric?
The rubric was developed by members of the partner organizations that comprise the Hep ElimiNATION team in consultation with key stakeholders. In April 2020, we convened three meetings of more than 40 advocates, clinicians, government partners, and people who have lived experience with viral hepatitis to hear their input on what metrics should be included in the rubric and accompanying resources.
Are amendments allowed?
Yes. Following the initial grade release, there will be a one-time 90-day public comment period to submit requests for amendment. The comment period will end on April 15, 2022. Any score modifications resulting from this comment period will be reflected in an update scheduled for June 2022.
How should questions or comments be submitted?
Comments and amendment requests related to the initial grade release can be submitted on this form by April 15, 2022. Any other questions can be directed to Sonia Canzater, O’Neill Institute for National and Global Health Law, at firstname.lastname@example.org.
How is Hep ElimiNATION different from the Hepatitis C: State of Medicaid Access?
Hep ElimiNATION is a holistic evaluation of each state’s capacity to eliminate viral hepatitis. While Hepatitis C: State of Medicaid Access focuses specifically on hepatitis C treatment policy in state Medicaid programs, Hep ElimiNATION evaluates states more broadly, considering not only treatment access but also prevention and planning activities. Additionally, Hep ElimiNATION considers efforts to address hepatitis A, hepatitis B, and hepatitis C. Notably, each state’s Hepatitis C: State of Medicaid Access grade is part of their Hep ElimiNATION grade, recognizing the importance of treatment access in any comprehensive hepatitis elimination strategy.
How can advocates use Hep ElimiNATION to draw attention to eliminating viral hepatitis in their state?
Whether you’re a person who has lived/living experience with viral hepatitis, you’re a medical provider caring for people impacted by viral hepatitis, or you simply care about the people in your community – Hep ElimiNATION is an advocacy tool to bring awareness to policymakers, public health agencies, and communities about a broad range of key considerations for elimination. Here are some ways to raise awareness in your state:
- Share your state’s grade on social media using our social media toolkit
- Write a letter to the editor of your local newspaper to educate the community about this public health crisis
- Use this form to inform state officials about gaps and areas of improvement and to call on them to fund a comprehensive strategy to eliminate viral hepatitis in your state
- Reach out to your state’s viral hepatitis coordinator to get involved with the development of a state elimination plan
- Use your state’s grade to identify community organizing opportunities and join (or start) a coalition in your state
How else can advocates get involved in elimination planning in their state?
All states who receive funding from the Centers for Disease Control and Prevention will be required to develop an elimination plan. Most states have a viral hepatitis coordinator within the State Department of Health. Use this template to email your coordinator and inquire about opportunities to get involved. If you’d like additional support for engaging in elimination planning, please reach out to NVHR at email@example.com.