Rep. David Bentz

This Act requires that feminine hygiene products be provided free of charge to individuals in custody at facilities operated by the Department of Correction and facilities operated by the Department of Services for Children, Youth and Their Families. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

This Act encourages prescribers and patients to use proven non-opioid methods of treating back pain by doing the following: 1. Prohibits numerical limits on physical therapy and chiropractic care, which might deter prescribers or patients from using those treatments rather than opioids. 2. Adds continuing education requirements for prescribers relating to risks of opioids and alternatives to opioids. 3. Creates a pilot program within the state employee health care plan that allows the use of massage therapy, acupuncture, and yoga for the treatment of back pain.

House Substitute No. 1 for House Bill 440 differs from House Bill 440 only in that it locates the Overdose System of Care and the Overdose System of Care Committee in Chapter 97 of Title 16 instead of in Chapter 10 of Title 16. House Substitute No. 1 for House Bill 440 establishes an overdose system of care to improve care, treatment, and survival of the overdose patient in State of Delaware. This Act allows the Secretary of the Department of Health and Social Services to establish stabilization centers that can receive overdose patients from Emergency Medical Services and designate acute health care facilities, freestanding emergency departments, and hospitals that meet established requirements as an overdose system of care centers. This Act also establishes a standing Overdose System of Care Committee to assist in the oversight of the overdose system of care and provide recommendations for its implementation and maintenance.

Far too many Delawareans have been personally affected by addiction and substance use disorder and have experienced the tragedy of watching loved ones suffer from this chronic disease. Nearly 2,000 individuals in Delaware suffered a non-fatal overdose in 2017, but data suggest that many of these individuals continued to be prescribed opioid pain medications or did not receive substance use disorder treatment. This Act links specific patient care data related to overdose collected by the Office of Emergency Medical Services or the Office of the State Epidemiologist with data in the Delaware Prescription Monitoring Program (“PMP”). This Act will foster best practices in the use of health information, to ensure that consistent, humane, evidence-based treatment and care is available and provided to those suffering from substance use disorder or non-fatal overdose. Linking this data may assist prescribers and pharmacists in the identification of substance use disorder and promote safer prescribing. This Act also provides prescriber and dispenser identified data to the PMP Advisory Committee and the Addiction Action Committee, which will enable these committees to do the following: 1. Appropriately identify prescribing and dispensing patterns of concern. 2. Make recommendations to the PMP administrator. 3. Provide targeted education to those individuals whose prescribing or dispensing practices are outliers from the Delaware average. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

This Act establishes the High Needs Educator Student Loan Payment Program. The Program allows qualified applicants to apply for a payment from the State to the applicant’s lending agency, to pay a portion of the applicant’s student loan debt. The purpose of the Program is to encourage Educators to work and remain working in certification areas in which Delaware has a shortage and to encourage Educators to work and remain working in Delaware’s hardest-to-staff Schools. The amount of the award shall be no less than $1000 and no more than $2000. This substitute redesignates the chapter where this language will be placed in the code.

This Act amends § 2532 of Title 29, in the Not-for-Profit Healthcare Conversion Act, to ensure that the Attorney General has sufficient time to review a proposed not-for-profit healthcare conversion and, if appropriate, take action to protect the charitable assets being held for public benefit. Due to an apparent drafting error, the Not-for-Profit Healthcare Conversion Act currently permits a not-for-profit healthcare entity to provide notice to the Attorney General of a proposed not-for-profit healthcare conversion as late as the day of the proposed transaction, which would prevent the Attorney General from performing the functions intended by the General Assembly when it enacted the Not-for-Profit Healthcare Conversion Act.

The 146th General Assembly gave the Department of Health and Social Services the authority to promulgate regulations and require accreditation for facilities that perform invasive medical procedures. The current terminology and definition of an “invasive medical procedure” has been frequently misinterpreted and caused a great deal of confusion in the medical community. This Act revises the current language to be consistent with terminology used by accreditation organizations and other states, replacing the term “invasive medical procedure” with the term “office-based surgery”. In addition, this Act clarifies the definition to ensure that all facilities that perform such procedures do so in a safe and sanitary environment. Finally, this Act adds a requirement that the approved accreditation organizations shall report, at a minimum, findings of surveys and complaint and incident investigations, and data for all office-based surgical facilities to the Department. This Act also updates Title 24 where the term "invasive medical procedure" is used and § 122(3) of Title 16 is referenced.

This bill amends Title 18 of the Delaware Code, § 3343, by setting annual reporting requirements for insurance carriers with regard to coverage for serious mental illness and drug and alcohol dependencies. This bill also amends Chapter 35, Title 18 of the Delaware Code by adding a new § 3571T to set annual reporting requirements for insurance carriers providing mental illness and drug and alcohol dependencies benefits, and the carriers' compliance with the Mental Health Parity and Addiction Equity Act of 2008. This bill also amends Title 31 of the Delaware Code, § 525, by setting annual reporting requirements for insurance carriers regarding coverage for serious mental illness and drug and alcohol dependencies for recipients of public assistance.

This Act promotes the use of primary care by doing the following: 1. Creating a Primary Care Reform Collaborative under the Delaware Health Care Commission. 2. Requiring all health insurance providers to participate in the Delaware Health Care Claims Database. 3. Requiring individual, group, and State employee insurance plans to reimburse primary care physicians, certified nurse practitioners, physician assistants, and other front-line practitioners for chronic care management and primary care at no less than the physician Medicare rate for the next 3 years. Despite the demonstrated value of primary care, access to primary care for Delawareans has become increasingly difficult because insurance reimbursement rates fail to support an adequate infrastructure. The national average for primary care spending for an insurance plan is between 6% and 8% of the insurer’s total medical expenditures. Studies recommend, and some states are actively implementing, a 12% to 15% spending rate to have an effective system. Delaware’s average insurance spending on chronic care management and primary care is between 3% and 4%. Nationally, insurance reimbursement for primary care averages between 120% and 140% of Medicare rates. In Delaware the commercial market reimburses independent primary care at rates as low as between 65% and 85% of Medicare rates. Reliable data regarding insurance spending is difficult to obtain due to a combination of contractual restrictions and an absence of mandatory health care price transparency requirements applicable to commercial plans in Delaware This Act simultaneously enacts short-term and long-term solutions to strengthen the primary care system in this State. While the Primary Care Reform Collaborative and the Delaware Health Care Commission study and development long-term recommendations, requiring insurers to reimburse for chronic care management and primary care at the Medicare rates will stabilize existing resources and provide immediate benefits. The Primary Care Reform Collaborative and the Delaware Health Care Commission have reliable data and information from the Delaware Health Care Claims Database to use in this analysis and to make recommendations that will strengthen the primary care system in Delaware.

Expedited partner therapy (EPT) is the clinical practice of treating the sex partners of patients diagnosed with a sexually transmitted disease without clinical assessment of the partners. In August 2006, the Centers for Disease Control and Prevention (CDC) recommended EPT as an evidence-based option to manage chlamydial infection and gonorrhea by treating index patient’s sex partners to prevent reinfection and curtail further transmission. As of July 2017, EPT is permissible in 41 states. This Act makes EPT clearly permissible in Delaware and requires that health care professionals provide information developed by the Department of Health & Social Services when providing EPT. This Act provides immunity to health care practitioners and pharmacists acting in compliance with the statute and also provides immunity to health care practitioners who do not provide EPT and pharmacists who do not fill a prescription written under this statute if doing so would violate any of the laws that govern pharmacies and pharmacists. This Act also makes technical corrections to the definitions section to correct a reference and to conform existing law to the standards of the Delaware Legislative Drafting Manual.