Panhandle Community Services (PCS) was organized as a part of the War on Poverty and is a major provider of public health and human services to children and families in the areas of health and nutrition, child development, youth and families, and housing services. PCS serves a diverse population primarily consisting of white, Hispanic, and Native American clients. Of the 7,900 clients seen in this time period, 6,982 fell below the 100% poverty federal guidelines.

In May 2002, the PCS Community Health Center (PCSHC) combined the hepatitis C and HIV counseling and testing programs, based on information gathered which indicated a need for expanded services. The PCS HIV program began offering hepatitis C testing and counseling to the public. We provide outreach at many high-risk settings, including the county jail, outpatient substance abuse treatment centers, detox centers, migrant services, and the juvenile detention center. In these sites, we give a presentation about HIV, viral hepatitis, and other STDs and offer hepatitis C testing and hepatitis B vaccination if the facility allows it.

The HCV-positive clients have a initial consult with our internal medicine physician who deals with GI conditions. The clients are then offered treatment if indicated. Due to mental health and substance abuse issues, many do not choose treatment, are not recommended for treatment, or drop out of care. The physician also provides hepatitis training to providers and staff and consults with PCSHC providers between clinics.

When the program started, clients were charged a fee to cover hepatitis B and C testing. In August 2004, we were chosen as a site for a state pilot project and given 120 kits for HCV testing. These are given free to clients. In May 2005, Nebraska Health and Humans Services donated hepatitis B vaccine for use with the at-risk populations in the detox and substance abuse treatment sites. We recently received a grant that enables us to do free hepatitis C testing as indicated.

We collaborate with the Nebraska AIDS Project, our Panhandle Advocacy Care Team, the substance abuse treatment centers, the mental health setting client advocate, and the Nebraska Department of Health and Human Services. We are also a part of a outreach project to reach our MSM and IDU clients, and we are now setting up a drop-in center. We work with pharmaceutical companies in requesting free medications for those who do not have health coverage. PCSHC operates on a sliding fee scale based on the client's income. One problem is finding payment for the standard protocol of lab tests done with hepatitis C treatment which puts a strain financially on the health center.