Rep. Bill Bush

This Act is the product of the work of stakeholders who, with the encouragement of Senate Concurrent Resolution No. 50 (152nd General Assembly), met to examine how to integrate mobile-integrated healthcare and community paramedicine into existing regulatory structures in this State. Mobile-integrated healthcare and community paramedicine are innovative patient-centered models for the delivery of health care services that utilize mobile resources to deliver care and services to patients in an out-of-hospital environment in coordination with healthcare facilities or other healthcare providers. As part of mobile-integrated healthcare and community paramedicine programs, emergency medical services provider agencies across the country of all sizes and types are partnering with hospitals, primary care physicians, nurses, and mental health and social services providers on innovative programs that both navigate patients to the right level of care as well as achieve goals of improved care and lower costs. Clinical research studies comparing patients in traditional hospitals with patients who received hospital-level care at home through mobile-integrated healthcare and community paramedicine programs have found that those who received in-home care experienced fewer readmissions, lower mortality rates, reduced falls, and higher patient satisfaction rates. Based on temporary federal law enacted to relieve strain on healthcare systems caused by the COVID-19 pandemic, hospitals in this State developed relationships with emergency medical services provider agencies to implement mobile-integrated healthcare and community paramedicine programs. However, this temporary federal authorization will end on December 31, 2024. Many states have acted ahead of the expiration of this federal authorization to incorporate mobile-integrated healthcare and community paramedicine programs into existing regulatory structures. This Act integrates mobile-integrated healthcare and community paramedicine programs into existing regulatory structures in this State by authorizing the establishment of mobile-integrated healthcare and community paramedicine programs in this State through the Office of Emergency Medical Services (“Office”) in the Department of Health and Social Service’s Division of Public Health (“Division”). Specifically, this Act does the following: (1) Authorizes an organization licensed as or actively seeking licensure as an emergency medical services provider agency to apply to the Office to establish a mobile-integrated healthcare or community paramedicine program. (2) Requires the Office to review applications to establish mobile-integrated healthcare or community paramedicine programs and make recommendations to the Director of the Division, who is required to approve applications that meet the requirements established by this Act and regulations adopted by the Office. (3) The Office is required to establish standards, approved by the Board of Medical Licensure and Discipline, for the establishment and operation of mobile-integrated healthcare or community paramedicine programs This Act takes effect immediately for purposes of the Office of Emergency Medical Services preparing to implement this Act, but is not implemented until the date of publication in the Register of Regulations of a notice by the Director of the Office of Emergency Medical Services that the Office is prepared to implement this Act. The changes to the definition section, § 9802 of Title 16 of the Delaware Code, in Sections 2 and 3 of this Act are identical. These changes had to be made twice as § 9802 of Title 16 currently has 2 versions, one effective until July 17, 2028, and one effect as of July 17, 2028. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual and, in Section 5 of this Act, to correct an internal reference in § 6701B of Title 18 of the Delaware Code affected by changes in Sections 2 and 3 of this Act.

This Act modernizes and expands the concept of maternal mental health by replacing the definition of maternal depression with the more encompassing definition of perinatal mood and anxiety disorder. This Act contemplates treatment for any caregiver who may be affected by perinatal mood and anxiety disorder. This Act avoids use of gender-based pronouns as recommended by the Legislative Drafting Manual.

In 2023, the General Assembly passed House Bill 80, which required the coverage of doula services under the State’s Medicaid plan beginning in 2024. This Act would require similar coverage under private health insurance plans.

This Act is a result of the Joint Legislative Oversight and Sunset Committee’s (“JLOSC”) review of Adult Protective Services. This Act creates the Vulnerable Adult Populations Commission (“Commission”), whose purpose is to improve the response to and reduce the incidents of vulnerable adult abuse, neglect, or exploitation in this State. The Commission will be comprised of several members from key state agencies, legislators, and the private sector. The Commission’s duties include: (1) Studying Delaware court services and procedures, law enforcement procedures and protocols, and criminal justice data collection and analysis, as they relate to vulnerable adult abuse, neglect, or exploitation. (2) Effectuate coordination among Delaware agencies, departments, and courts to benefit victims of vulnerable adult abuse, neglect, or exploitation. (3) Promote effective prevention, intervention, and service provision based on research and data. (4) Recommend standards to state agencies and departments regarding programs and services that serve perpetrators or victims of vulnerable adult abuse, neglect, or exploitation. (5) Review and provide feedback on legislation relating to vulnerable adult abuse, neglect, or exploitation. (6) Submit an annual, written report to the Governor, General Assembly, Delaware Supreme Court, and the Director and Librarian of the Division of Research.

This Act updates provisions of the code covering the Delaware Institute of Medical Education Research (DIMER), which creates partnerships with out-of-state medical schools as an alternative to creating a state sponsored medical school. Specifically, this Act does the following: (1) Updates the name of the Jefferson Medical College of Thomas Jefferson University to “Sidney Kimmel Medical College of Thomas Jefferson University”; (2) Adds the Philadelphia College of Osteopathic Medicine as a DIMER medical school; (3) Alters and updates the composition of the DIMER Board and provides that all members will be appointed by the Governor; (4) Clarifies that a vacant Board position is not counted for quorum purposes; (5) Requires the Board Chair to be elected from the members of the Board, rather than appointed by the Chair of the Delaware Health Care Commission; (6) Requires the Board to select candidates for the Chair and Vice Chair from a nominating committee determined by the Board; and (7) Provides that the Board Chair and Vice Chair shall serve no more than 3 consecutive terms.

This Substitute for House Bill No. 389, like House Bill No. 389, provides for an annual raffle license that will allow a licensee to hold up to 20 raffle events each year, requires the licensee to notify the Board at least 7 days prior to a raffle event, and requires a report to the Board after a raffle is conducted. This Substitute differs from House Bill No. 389 as follows: -It corrects the vote requirement. This Act requires a greater than majority vote for passage because § 11 of Article VIII of the Delaware Constitution requires the affirmative vote of three-fifths of the members elected to each house of the General Assembly to impose or levy a tax or license fee. -It changes the annual raffle license fee from $100 to $300. -It adds a requirement that the report to the Board following the conclusion of a raffle must include all of the information required in a report after a game under section 1521 of Title 28. -It clarifies that the number of days in which a report after a game must be filed with the Board is increased from 30 to 60 if the game in question is a raffle event conducted by the holder of an annual raffle license. -It makes technical changes to conform with the standards of the Delaware Legislative Drafting Manual. -It specifies that the Act takes effect 6 months after its enactment into law.

This Act requires that public school students receive a vision screening, including a test for color blindness, in kindergarten. Students must also receive vision screenings at appropriate intervals in grades 1 through 12, to be determined by the DOE.

For claims for line of duty death benefits for covered persons, which include police officers, firefighters, auxiliary and volunteer ambulance and rescue company members, paramedics, and others, submitted on July 1, 2023, and thereafter, this Act increases the benefits for the beneficiary or beneficiaries from $200,000 to $375,000, payable in annual installments, with the maximum amount paid in any 1 calendar year being $50,000.

This substitute for House Bill 383 does the following: Like House Bill 383, Section 1 of this Act prohibits discrimination against 340B drug distribution by manufacturers, third-party logistics providers, and wholesale distributors. Violations are deemed an unlawful practice enforceable by the Consumer Protection Unit of the Department of Justice. The Department of Justice has authority to promulgate regulations to implement the provisions of this Act. This Section differs from House Bill 383 by removing repackagers from the list of entities prohibited from engaging in 340B drug discrimination, authorizing the Board of Pharmacy to promulgate regulations and take disciplinary action against both licensees and holders of permits issued by the Board, and requiring covered entities, manufacturers, third-party-logistics providers, and wholesale distributors to publish annual reports on their websites and provide copies of the reports to the Board of Pharmacy, Speaker of the House, Senate President Pro Tempore, Office of the Governor, and members of the House and Senate Health Committees and Joint Finance Committee. Section 2 of this Act prohibits discrimination by pharmacy benefits managers against 340B covered entities. Violations are deemed unfair practices in the insurance business. Contracts purporting to include provisions in violation of this Act are deemed void and unenforceable. This Section differs from House Bill 383 by making technical changes to correct internal references and changing references to “health carriers” to reference “purchasers” instead. Section 3 of this Act contains severability language in the event that any provision or the application of the Act to a person or circumstance is deemed to be invalid. Section 4 of this Act contains non-preemption language to ensure that the Act can be read and interpreted to not conflict with other State or federal law.

Section 1 amends Title 31 to require all health benefit plans delivered or issued for Medicaid to cover services related to the termination of pregnancy. Coverage provided under this section is not subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and must cover the full scope of services permissible under the law. It also moves the definition of “carrier” out of individual provisions and into the general definition section for the chapter. Section 2 adds a definition of “religious employer” to Title 18. Sections 3 and 4 amend Title 18 to require both individual and group health carriers to cover services related to the termination of pregnancy with identical cost-sharing prohibitions. Certain types of limited coverage plans are exempt from the requirement, and HDHP and catastrophic plans are exempt from the cost-sharing prohibitions if such requirements would cause them to lose their status and treatment under federal law. A religious employer may obtain an exclusion from the carrier if the requirements conflict with the organization’s bona fide religious beliefs and practices. Section 5 amends Title 29 to require coverage for services related to the termination of pregnancy under the state employee health plan. Coverage shall not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and shall apply to the full scope of services permissible under the law. The changes to Medicaid and the state employee health plan are effective January 1 of the year following enactment. The changes to insurance requirements for private group, blanket, and individual coverage are effective for policies issued, renewed, or altered after December 31, 2025. This substitute differs from the original bill as follows: (1) It makes several technical corrections; (2) It limits the permissible applications of referral, prior authorization, and in-network requirements to ensure full and timely access to covered services; (3) It requires federal funds to be used for Medicaid services wherever the use of federal funds is allowed and specifies State funds will otherwise be used for covered services; (4) It adds a definition of religious employer and requires a religious employer to cover services when the life or health of the covered individual is at risk; (5) It changes the effective and application dates of the coverage requirements; (6) It caps the benefit at $750 per year per covered individual for Medicaid; and for private insurance it allows the benefit to be limited to $750 per covered individual per year. The bill also makes a technical change by moving the definition of “carrier” out of individual sections of Chapter 5 of Title 29 and into the general definitions section for that chapter.