Hepatitis C virus (HCV) infection is the most common bloodborne infection in the United States. To determine the capacity of local health departments to respond to concerns about HCV, local health officers were surveyed regarding HCV programs and needs. Of 612 respondents, fewer reported offering HCV services (education, counseling, testing) compared with those for HIV. Most respondents reported that technical assistance would be needed for HCV services and that such services should be integrated into existing HIV programs. Many local health departments may be unprepared for a growing need for public HCV services; integrated HCV-HIV programs should be considered.