Rep. Valerie Giltner

This Act amends the continuing education requirements for nursing professionals, mandating that all nursing professionals receive at least one hour of continuing education in each reporting period on the recognition of sexual or physical abuse, exploitation, or domestic violence of vulnerable populations, or on the reporting obligations under the rules and regulations of the Board of Nursing. The Act removes the requirement for nursing professionals who work in adult gerontology to complete continuing education on the topic of diagnosis, treatment, and care of patients with Alzheimer's disease or other dementias.

Senate Bill No. 288 of the 151st General Assembly (Chapter 371 of Volume 83 of the Laws of Delaware) created a pilot program whereby motorcyclists are permitted to use pulsating headlights as a way to alert other drivers of their presence, without allowing the use of flashing lights that would otherwise be used on emergency vehicles. SB 288 contained a sunset clause providing that the pilot program would expire on January 1, 2025, unless the General Assembly took action to extend or remove the sunset clause. This Act extends the sunset clause until June 30, 2030. The main reason for the extension is that many motorcycle owners have and are continuing to replace their lights with LED technology... up until 2024 the technology of a modulating device was not available for the LED lights only standard lighting had that option. To be able to better see if the pulsating lighting is effective the pilot program should be extended to adequately gauge what the new LED systems effectiveness is.

Healthcare facility assessments are currently the second largest source of funding for states’ shares of Medicaid costs, behind general funds. Today, 49 states have at least one facility assessment in place, including Delaware, while 34 states and Washington D.C. have 3 or more provider taxes. Delaware is one of only 6 states without a facility assessment on hospitals, causing the state to miss out on critical Medicaid funding that most states are already able to access. This Act is a substitute for Senate Bill No. 13. Like Senate Bill No. 13, this Act creates the Hospital Quality Assessment, which places a 3.58% assessment on Delaware hospitals’ net patient revenues. Funds generated by the Hospital Quality Assessment must be utilized in one of two ways: (1) To increase the inpatient and outpatient payments to hospitals. (2) To develop or enhance funding for Medicaid initiatives, unlocking federal matching dollars. Funds may not be used to supplant or replace appropriations for programs in existence on the effective date of this Act, except for 25% of these funds, which may be used to support the general operations of the Medicaid program. Like Senate Bill No. 13, this Act also creates the Hospital Quality and Health Equity Assessment Commission (“Commission”), which includes state agency and hospital representation. The Commission is required to meet at least annually to monitor the implementation of the assessment. If the Centers for Medicare & Medicaid Services (CMS) determines that either the assessment or the expenditure of money does not satisfy eligibility requirements for federal financial participation or that modifications are necessary to assure continued eligibility for federal financial participation, the Commission shall develop and approve modifications to Subchapters II and III of Chapter 10 of Tile 16 of the Delaware Code and submit the modifications to the General Assembly. This Act differs from Senate Bill No. 13 as follows: (1) By directing the Department of Health and Social Services (“Department”) to administer the Hospital Quality Assessment. (2) By establishing a different method of calculating the assessment for a hospital that begins or ceases hospital operations or does not conduct hospital operations through a calendar year or fiscal year. (3) By prohibiting a hospital subject to the Hospital Quality Assessment from passing on the cost of the assessment to any patient, insurer, self-insured program, or other responsible party. (4) By requiring a hospital subject to the Hospital Quality Assessment to attest in writing to the Department that an oral or written, formal or informal agreement or arrangement does not exist to share, redirect, or redistribute Medicaid payments which would result in violation of federal or state law. (5) By updating the split in percentages of the funds collected from the Hospital Quality Assessment to reflect the wide range of federal match levels for services. The expected amount to be collected by the Assessment does not change as the result of the update. (6) By requiring the Registrar of Regulations to publish in the Register of Regulations a certification by the Commission under § 1034(d) and (e) of Title 16 of the Delaware Code, as contained in this Act. (7) By providing that appointments of members of the Minority Caucus of the House of Representatives and Senate are to be made by the Speaker of the House of Representatives and President Pro Tempore of the Senate, respectively. (8) By making modifications to the requirements for meetings of the Commission. (9) By providing that modifications to Subchapters II and III of Chapter 10 of Tile 16 of the Delaware Code recommended by the Commission take effect as of July 1 of the ensuing fiscal year unless rejected in full by an act of the General Assembly before that ensuing fiscal year. 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. This Act may be cited as the “Protect Medicaid Act of 2024”.

Senate Bill 89 from the first half of the 152nd General Assembly allowed for state owned-and-operated vehicles used for snow removal to operate with green revolving or flashing lights during winter weather operations. This Bill extends the same use of green lights on municipal owned-and-operated snow removal equipment and vehicles during winter weather operations. Studies have shown green lights are more visible to the traveling public during winter weather conditions. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

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 transfers the sections pertaining to assessment functions and the New Castle County Board of Assessment Review from the subchapter governing the functions of the Department of Land Use to the subchapter governing the functions of the Department of Administration and updates reference to the Department of Land Use to the Office of Finance in Chapter 83 of Title 9. It changes the New Castle County Board of Assessment Review from 8 members appointed by New Castle County Council and 1 member appointed by the County Executive, with the advice and consent of County Council, to 8 regular members and 3 alternate members appointed by New Castle County Council and 1 regular member appointed by the County Executive, with the advice and consent of County Council. It changes the Sussex County Board of Assessment Review from 5 members to 5 regular members and 3 alternate members. It permits Sussex County Council to provide for the term, residency requirement, compensation, and procedure for filling vacancies. It authorizes the appointment of a representative called a “referee” or a panel of 3 members of the Board to hear assessment appeals. It increases the time period in which the appeal process may take place from one month to three months. In all counties, it removes the requirement that a board of assessment or Department or Office of Finance to show the names of the owners, last owners, or reputed owners, the value of the property, and the amount of each owner’s assessment in their written assessments. In all counties, it clarifies that all property subject to assessment shall be assessed at its fair market value as of the date of the most recent reassessment base year in the county in which the property is located. It removes the requirement in Sussex County that the written assessment must state whether unimproved land is timberland, swamp, or marsh, and the number of acres. It provides the Board of Assessment Review for New Castle County the ability to determine the schedule and manner of hearings necessary to handle its higher volume of appeals in a timely manner and increases the time for the Board to provide appealing parties notice of the hearing from 5 to 10 days. Further, it changes the date that the Board of Assessment for Sussex County or its representatives must hear appeals and make additions, alterations, or corrections to assessments from February 15 through March 1 to March 1 through May 31 of each year or until all appeals have been heard and acted upon during a year of reassessment. It removes the requirement that the Board or representatives must sit in their offices during each secular day to hear such appeals. It provides that duplicate assessments may be in the form of a widely accepted electronic file format. It clarifies that when a board of assessment, Department or Office of Finance makes a supplemental assessment that does not alter, amend, or make a new one, it is treated like a general or annual assessment and the notice provisions required of an altered, amended, or new assessment do not apply. In all counties, it provides that any notices required to be given under Title 9, Chapter 83 may be sent by e-mail when the property owner has provided an electronic mail address for notice purposes. In all counties, it provides that each board of assessment or Department or Office of Finance shall publish notices of the place, and the website if made available electronically, where the annual and supplemental assessment roll may be inspected together with a notice of the time and place of the sittings to hear appeals. It changes the publication requirements for such notices in the case of Kent and Sussex Counties to one time in at least 2 newspapers and in the case of New Castle County to the newspaper with the highest general circulation. It clarifies the method for determining taxation value, frequency of assessments, and assessment rate for mobile homes by providing that Ad Valorem assessments for mobile homes shall be developed in the same manner as real property and be predicated on their market value and taxed at the same rate as real property throughout the county and school district in which the mobile home is located and in the name of the owner. In instances where the land is leased, the land upon which the mobile home is located shall be separately assessed and shall not include the value of the mobile home located thereon. It removes the provision that mobile homes be subject to a tax based on their value as rated in a nationally recognized appraisal guide and that a recognized guide be used to determine the assessed value on mobile homes. It removes the provision that for model homes not appearing in a guide, the board of assessors must contact a reputable mobile home dealer to determine value.

This Act addresses the growing concern over the safety of emergency responders. It increases the penalties for persons who violate this section, which requires drivers to yield the right of way to an emergency vehicle making use of audible or visual signals, or a police vehicle using an audible signal only. The fines are increased and after two penalties, a person who violates this section will be subject to a 90-day suspension of their driver’s license. This change in fines and loss of driving privileges increases the penalty to make this a serious offense. This Act also clarifies that a driver who is unable to safely yield the right of way must slow to at least 20 miles per hour less than the posted speed limit. There have been numerous accidents causing personal injury and even death by inattentive drivers. Hopefully, this will help improve awareness and safety and avoid putting our Police, Fire, Ambulance, Paramedics, Fire Police, DelDOT employees, tow truck operators , utility crews and the distressed citizen broken down on our highways in jeopardy.

This Act is a result of the Delaware Interscholastic Athletic Association ("DIAA") Task Force. Based on the findings of the task force, this Act updates the DIAA's Executive Director from an education associate level position in the Department of Education to a director level position in the Department.

This Resolution recognizes June 2024 as “Post-Traumatic Stress Injury Month” and June 27, 2024, as “Post-Traumatic Stress Injury Day”, and encourages citizens of the state to continue their work educating victims of assault or abuse, combat, serious accidents, and natural disasters about the causes, symptoms, and treatment of PTSI.

This House Concurrent Resolution urges the establishment of a medical school in the State of Delaware; calls for the formation of a formal Steering Group to guide the planning and implementation of a medical school; encourages the pursuit of partnerships with established medical schools and other medical education programs; and commits to supporting efforts to secure necessary funding needed to establish a medical school.