Annual Performance Report—Component 2--Form Instructions Year 3 Reporting Period (10/1/22-9/30/23)

OMB Control Number 0920-1353

Annual Performance Report—Component 2--Form Instructions

Year 3 Reporting Period (10/1/22-9/30/23)

Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

Core Viral Hepatitis Prevention Activities

The Annual Performance Report (APR) for CDC-RFA-PS21-2103 is required for all award recipients. The instructions in this document are to be used when submitting your APR data through the online form provided by CDC. Data submitted through the online form will be reviewed by CDC and analyzed for future reports (e.g., rapid feedback report).

Recipients must also submit a copy of their APR data via www.Grantsolutions.gov no later than 120 days prior to the end of the budget period (as part of the year 4 continuation application). Please see the Notice of Funding Opportunity (NOFO) document for this cooperative agreement starting on page 68 for additional information.

Evaluation and Performance Measures are listed starting on page 29 of the NOFO. Please review that information, along with Strategies and Activities starting on page 11, before submitting your APR through the online form.

Note: Timelines are provided in the NOFO for each measure, however, in general:

• Short-term outcomes should be reached by the end of year 3 (4/30/24). Measures associated with these outcomes should be reported annually. Recipients can define year 1 and year 2 goals that are related to the short-term outcomes, based on interim activities.

• Intermediate outcomes should be reached by the end of year 5 (4/30/26). Measures associated with these outcomes should be reported annually. Recipients may define interim goals (for year 1-year 5) that are related to the intermediate outcomes to track progress.

• Outcomes for measures that are “contingent on funding” are not required to be reached unless they are funded during the course of the award. Reporting of these measures is recommended but not required.

2.1—Support viral hepatitis elimination planning and surveillance, and maximize access to testing, treatment, and prevention

Measure 2.1.1.a-2.1.1.b

Have you established a viral hepatitis elimination technical advisory committee (or coalition) to support viral hepatitis elimination planning?

Identify the groups that are (or will be) represented on this committee/coalition. (select all that apply)

How many times did the committee (or coalition) meet during this reporting period?

If the committee (or coalition) met during this reporting period, please submit copies of all meeting agenda(s) with the APR.

• The purpose of this section is to collect information about the elimination planning committee (or coalition). This is a short-term outcome (years 1–3). Jurisdictions will vary when they are able to establish a viral hepatitis elimination technical advisory committee (or coalition) within years 1–3. After the committee (or coalition) is established, jurisdictions should continue to report on progress of the committee (or coalition) proceedings throughout the five-year funded reporting period. Committee meetings should begin once the committee (or coalition) is established. Each recipient should conduct at least two meetings per year.

• Committee (or coalition) status — Report the committee (or coalition) status as of the close of the reporting period.

• Groups represented (select all that apply) — Once the committee (or coalition) is established, report the stakeholder groups represented on the committee (or coalition) as of the close of the reporting period.

• Committee (or coalition) meetings — Report the number of times the committee (or coalition) met during this reporting period.

• Meeting agenda(s) — For informational purposes, submit meeting agendas for the committee (or coalition) meetings that occurred during this reporting period.

• See NOFO page 14 for more information.

Measure 2.1.1.c, 2.1.2.c, and 2.1.4.a

Have you developed a viral hepatitis elimination plan?

Does it contain plans for elimination of hepatitis C and/or hepatitis B? (select all that apply)

Does your viral hepatitis elimination plan address any of the following: recommendations for increasing HCV RNA reflex testing, provider training in prescribing hepatitis C treatment, and/or provider training in prescribing hepatitis B treatment?

If the viral hepatitis elimination plan is completed, please submit a copy with the APR.

• The purpose of this section is to collect information about the viral hepatitis elimination plan which should be developed with support from the technical advisory committee (or coalition). The plan should reflect coordination and collaboration with key partners to improve viral hepatitis testing and provider capacity and training. Jurisdictions may choose to prioritize hepatitis C elimination initially, depending upon available resources.

• These measures are short-term outcomes (years 1–3). Jurisdictions will vary when they are able to complete a viral hepatitis elimination plan within years 1–3. After the elimination plan is completed, jurisdictions should continue to report on elimination plan updates throughout the five-year funded reporting period.

• Plan status — Report the status of plan development as of the close of the reporting period.

• Content (select all that apply) — Does it contain plans for elimination of hepatitis C and/or hepatitis B? Jurisdictions may choose to prioritize hepatitis C elimination initially, depending upon available resources.

• HCV RNA reflex testing, prescribing hepatitis C and hepatitis B treatment — Report if the viral hepatitis elimination plan addresses HCV RNA reflex testing, provider training in prescribing hepatitis C treatment, and/or provider training in prescribing hepatitis B treatment.

• Elimination plans — For informational purposes, please submit a copy of your elimination plan, if completed.

• See NOFO pages 14-18 for more information.

Trainings/Resources for Primary Care Providers and the General Public

Expanding provider capacity to treat hepatitis C and/or hepatitis B, and disseminating materials regarding evidence-based practices for access to hepatitis C treatment and viral hepatitis prevention, are required activities (see NOFO pages 16-18 for more information).

• Trainings and resources shared with primary care providers — Specify the types of trainings and resources that were shared with primary care providers related to increasing their capacity to prescribe treatment for hepatitis B or hepatitis C.

  • Specify whether these training programs/curricula were newly developed as part of PS21-2103 funding, developed outside of PS21-2103 (e.g., Project ECHO), or represent a combination of both types of trainings.

  • If trainings were conducted with providers during the reporting period, specify the number of trainings and the number of primary care providers who attended these trainings (separately for trainings about prescribing hepatitis C treatment and trainings about prescribing hepatitis B treatment).

  • If number is unknown enter, "-999". If number is 0, enter “0”.

• Dissemination of evidence-based practices to the general public (or any audience) — Specify the type of information and materials disseminated during the reporting period related to evidence-based practices for access to hepatitis C treatment and viral hepatitis prevention. This information represents materials not specifically targeted to primary care providers.

Measures 2.1.2.a and 2.1.2.b

Have you worked with your surveillance and/or epidemiology teams to identify the total number of CLIA-certified laboratories in your jurisdiction that report hepatitis C antibody testing results?

Of the CLIA-certified laboratories you have identified that report hepatitis C antibody testing results, have you selected the subset that reports at least 80% of the hepatitis C antibody testing results in your jurisdiction?

Of this subset, have you performed a needs assessment to identify key barriers and challenges to increasing HCV RNA reflex testing?

What is the proportion of the subset that is conducting HCV RNA reflex testing?

Have you provided recommendations to increase HCV RNA reflex testing? Were the results used for anything else?

• The purpose of this section is to collect information about CLIA-certified laboratories in the jurisdiction that perform hepatitis C antibody testing, conducting a needs assessment regarding the performance of HCV RNA reflex testing, and providing feedback to these laboratories with recommendations. These are short-term outcomes (years 1–3).

• In years 3–5, each jurisdiction should, in consultation with the technical advisory committee (or coalition), work with the laboratories to improve HCV RNA reflex testing.

• Clinical Laboratory Improvement Amendments (CLIA) of 1988 — Regulations that include federal standards applicable to all U.S. facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. For more information, please refer to CLIA at 42 CFR 493.3. Demographic information about CLIA-certified laboratories is available here: https://www.cdc.gov/clia/LabSearch.html.

• Laboratory identification — Each jurisdiction should work with their surveillance and/or epidemiology teams to identify the total number of CLIA-certified laboratories in their jurisdiction that report hepatitis C antibody testing results. Labs included could be CLIA-certified labs conducting hepatitis tests or labs conducting hepatitis tests under CLIA. Among these, they should select the subset of laboratories that report 80% or more of the hepatitis C antibody testing results.

• Needs assessment — Each jurisdiction should, in consultation with the technical advisory committee (or coalition), conduct a needs assessment that describes the current hepatitis C antibody and HCV RNA reflex testing practices among this subset of laboratories and identifies key barriers and challenges to HCV RNA reflex testing. Laboratories that routinely perform RNA reflex testing on all HCV antibody positive tests (e.g., QUEST Diagnostics, etc.) should be included in the numerator, but jurisdictions do not need to conduct a detailed needs assessment.

  • HCV RNA reflex testing — For the subset that reports 80% or more of the hepatitis C antibody testing results, each jurisdiction should determine the proportion that is conducting HCV RNA reflex testing. If number is unknown enter, "-999". If number is 0, enter “0”.

  • Providing recommendations — Each jurisdiction should, in consultation with the technical advisory committee (or coalition), summarize this needs assessment, develop recommendations to improve HCV RNA reflex testing, and share these recommendations with this subset of laboratories. Specify in the APR the status of providing these recommendations to these laboratories.

• Using results from needs assessment in other ways — If the results from the needs assessment were used for something other than providing recommendations to increase HCV RNA reflex testing, describe how the results were used.

• See NOFO page 15 for more information.

Measures 2.1.3.a and 2.1.3.b

Have you identified the top 5 highest volume health systems in your jurisdiction? Please list these health systems.

Have you assessed how many of these health systems are promoting routine HCV testing? If so, what proportion is promoting routine HCV testing?

Have you assessed how many of these health systems are promoting routine HBV testing? If so, what proportion is promoting routine HBV testing?

Have you provided feedback to the top 5 highest volume health systems with recommendations on promoting routine HCV and/or HBV testing? Were the results used for anything else?

• The purpose of this section is to collect information about high volume health systems in your jurisdiction and the extent to which they are promoting routine HCV and/or HBV testing. Health systems are defined as organizations of people, institutions, and resources that deliver health care services to meet the health needs of the target population. Examples of health systems could include a group of Federally Qualified Health Systems that share the same Electronic Medical Records system or a group of affiliated hospitals and clinics. These are short-term outcome (years 1–3).

• In years 3–5, each jurisdiction should, in consultation with the technical advisory committee (or coalition), work with these high-volume health systems to improve routine HCV and/or HBV testing.

• Top 5 highest volume health systems — Each jurisdiction should work with their surveillance and/or epidemiology teams to identify the top five highest volume health systems, either by volume of patients or by volume of HCV and/or HBV testing.

• Needs assessment — Each jurisdiction should, in consultation with the technical advisory committee (or coalition), conduct a needs assessment for these high-volume health systems to describe their current HCV and/or HBV testing practices, disease prevalence, and key barriers and challenges to routine HCV and/or HBV testing.

  • Routine HCV testing — Specify the proportion of these health systems that is promoting HCVA testing. If number is unknown enter, "-999". If number is 0, enter “0”.

  • Providing feedback — Each jurisdiction should, in consultation with the technical advisory committee (or coalition), summarize this needs assessment, develop recommendations to improve routine HCV and/or HBV testing, and share these recommendations with these high-volume health systems. Specify in the APR the status of providing these recommendations to these health systems.

• Using results from needs assessment in other ways — If the results from the needs assessment were used for something other than promoting routine HCV and/or HBV testing, describe how the results were used.

• See NOFO page 15 for more information.

Additional information (challenges and successes)

Recipients must describe challenges and successes experienced when implementing Strategy 2.1 activities.

• This information should be reported in the APR form. Please do not develop a separate document to submit with your jurisdiction’s non-competing continuation application.

• If you need technical assistance from CDC, please indicate this in the Challenges field. Describe how CDC could provide support to your jurisdiction to complete activities in the work plan and achieve the short and intermediate outcomes.

• Include additional contextual information that would help us interpret your annual performance data, including challenges experienced for any activities in progress or not started. See NOFO page 68 for more information.

2.2—Increase access to hepatitis C and/or hepatitis B testing and referral to care in high-impact settings (not funded)

Hepatitis C and/or hepatitis B testing and referral to care

• If you used PS21-2103 funds (non-supplemental) to conduct Strategy 2.2 activities (i.e., hepatitis C and/or hepatitis B testing and referral to care in high-impact settings), please describe how the funds were used.

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