This Act does all of the following: (1) Establishes a regulatory framework for substance use harm reduction programs that provides immunities for program providers and staff. (2) Modifies the definition of drug paraphernalia. (3) Decriminalizes possession of paraphernalia for individuals who use drugs, while retaining prohibitions for paraphernalia used in the manufacturing or distribution of drugs and the selling of certain drug paraphernalia. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
The Department of Health and Social Services (DHSS), through the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD), operates the Delaware Hospital for the Chronically Ill (DHCI), a Long-Term Care (LTC) facility in Smyrna, Delaware. DHCI is a facility of last resort for Delawareans that require a skilled nursing facility level of care and have no viable options for private nursing facility care. The Delaware Hospital for the Chronically Ill’s name no longer reflects the dignity of all residents who live there. The existing statute uses outdated and offensive language, often referring to residents as “inmates.” It does not align with current policies and procedures around operation and maintenance of DHCI or the skilled care, screening, and admission of its residents, nor does it recognize DHCI’s role as a skilled nursing facility that maintains a five-star rating from the Centers for Medicare and Medicaid Services (CMS). This bill provides a technical update to reflect DHCI’s current practices, policies and procedures as a LTC facility of last resort. It strikes outdated language and aligns the statute with current DHCI, state, CMS practices and requirements. Finally, this bill renames the Delaware Hospital for the Chronically Ill to the Eleanor Cain Center. It will be named in honor of Eleanor Lee Cain, who served as the DSAAPD director from 1973 to 2001 and was a champion for older adults.
Approximately one in five adults report experiencing a mental health condition. At the same time, many individuals continue to face delays or barriers when trying to access care, even when they have insurance coverage. Delays, denials, or truncation of treatment leave families and their doctors battling for coverage instead of focusing on treatment and recovery. Families must pay out of pocket for care, on top of premiums for coverage they are not receiving. Further, Delawareans are five times more likely to go out-of-network for mental health care than for primary care, resulting in higher costs. This Act, known as the Fair Standards in Mental Health Care Act, builds on previous work to advance mental health parity and aims to ensure patients with private insurance can access timely, evidence-based mental health and substance use disorder care in Delaware. This Act supports improved access to mental health disorder and substance use disorder treatment by: 1. Adding and refining key terms, including definitions of mental health disorders and substance use disorders, level of care criteria, medically necessary treatment, utilization review and utilization review criteria to ensure consistency with widely accepted clinical standards of treatment and service intensity determination. This bill forges gold-standard clinical guidelines through requiring insurers to use transparent, evidence-based standards from independent experts, including the American Academy of Child and Adolescent Psychiatry. 2. Requiring coverage for all medically necessary treatment, including emergency services and all clinically appropriate levels of care. This bill ends prior authorization delays for mental health and guarantees emergency mental health coverage, just as Delaware already does for addiction treatment. 3. Requiring at least one formulation of certain FDA-approved medications to treat substance use disorders to be placed on the lowest-cost tier of drug formularies. 4. Prohibiting discrimination against individuals with current or predicted mental health disorders or substance use disorders. 5. Requiring carriers to arrange coverage of medically necessary out-of-network services without additional cost to the enrollee if in-network options are unavailable within applicable network access standards, thus ensuring real network access. 6. Removing language currently in the code barring a private right of action for violations of 18 Del. Code § 3343. In addition, the Act clarifies that carriers must provide nonquantitative treatment limitation parity analysis (NQTL parity analysis) that they are required to have completed under federal law to health care providers and current and prospective covered persons, free of charge, upon request. This Act applies to individual health insurance policies under Chapter 33 of Title 18 and group and blanket health insurance policies under Chapter 35 of Title 18. This Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2027. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
Excess skin and subcutaneous tissue can create a risk of rashes or infections, make walking and movement difficult, and make everyday chores difficult. An example of treatment that removes excess skin and subcutaneous tissue is a panniculectomy. A panniculectomy is an operative procedure that contours, or changes the shape and form, of the abdomen by removing significant excess skin and subcutaneous tissue. Removal of excess skin and subcutaneous tissue can improve a patient’s health and quality of life. This Act requires individual health insurance plans delivered under Chapter 33 of Title 18 and group and blanket health insurance plans delivered under Chapter 35 of Title 18 to cover medically necessary removal of excess skin and subcutaneous tissue, including panniculectomies. This Act also requires the State employee health insurance plan and State Medicaid plans to cover medically necessary removal of excess skin and subcutaneous tissue, including panniculectomies. Medically necessary means as defined in § 3371(8) for individual health insurance plans and as defined in § 3581(8) for group and blanket health insurance plans, State employee health insurance plans, and State Medicaid plans. This Act applies to all policies, contracts, or certicates issued, renewed, modified, alterered, amended, or resissued after December 31, 2026.
The purpose of this Act is to protect medical providers in the State from out-of-state lawsuits and investigations that threaten the practice of medicine in the State. To that end this Act does the following: 1) Clarifies that physicians, physician assistants, and nurses that provide lawful healthcare services in the State do not engage in unprofessional conduct and cannot be disciplined for such services even if such services are illegal or considered to be unprofessional conduct or the unauthorized practice of medicine or nursing in another state. 2) In a civil action or proceeding, prohibits any healthcare provider from disclosing communications and records concerning healthcare services unless the patient authorizes such disclosure, with some exceptions. 3) Provides protections from civil and criminal actions that arise in another state that are based on the provision of health care services that are legal in Delaware. 4) Creates a cause of action for persons against whom a judgment was entered in another state based upon that person allegedly providing, receiving, or helping another person to provide healthcare services that are lawful in Delaware. (This does not apply to an action where no part of the acts that formed the basis for liability occurred in Delaware.) 5) Prohibits an insurer from taking an adverse action against a healthcare provider or organization for performing or providing healthcare services that are lawful in this State. 6) Prohibits any State or local agency, commission, board, or department from assisting a federal law-enforcement agency, another state’s law-enforcement agency, a private citizen, or a quasi-law-enforcement agency in relation to an investigation or inquiry concerning the lawfulness of healthcare services, if such services would be lawful as provided if they occurred entirely in the State.
This Act permits a terminally ill individual who is an adult resident of Delaware to request and self-administer medication to end the individual's life in a humane and dignified manner if both the individual's attending physician or attending advanced practice registered nurse (APRN) and a consulting physician or consulting APRN agree on the individual's diagnosis and prognosis and believe the individual has decision-making capacity, is making an informed decision, and is acting voluntarily. This Act is the same as House Bill No. 140 (152nd) with 1 technical revision to include a definition of "physician" for consistency and to clarify that a physician must be licensed in Delaware. This Act provides the following procedural safeguards: 1. No one may request medication to end life on behalf of another individual. 2. An individual cannot qualify for medication to end life under this chapter solely because of the individual's age or disability. A mental illness or mental health condition is not a qualifying condition under this Act and a mental illness or mental health condition may be the reason that an individual does not have decision-making capacity and is thus, ineligible for medication to end their life in a humane and dignified manner. 3. Both the individual's attending physician or attending APRN and a consulting physician or consulting APRN must confirm that the individual has a terminal illness and a prognosis of 6 months or less to live, has decision-making capacity, is making an informed decision, and is acting voluntarily. 4. The individual's attending physician or attending APRN must also provide specific disclosures to the individual to ensure that the individual is making an informed decision, including the presentation of all end of life options which include comfort care, palliative care, hospice care, and pain control. 5. The individual must be evaluated by a psychiatrist or a psychologist if either the attending or consulting physicians or APRNs are concerned that the individual lacks decision-making capacity. 6. The individual must complete a witnessed form requesting medication to end life and there are limitations on who can witness the signing of the form. 7. The attending physician or attending APRN must offer the individual the opportunity to rescind the request for medication to end life before writing a prescription for the medication. 8. Two waiting periods must pass before the attending physician or attending APRN may prescribe the medication to end life. 9. The attending physician or attending APRN must provide the qualified patient with instructions about the proper safe-keeping and disposal of unused medication to end life in a humane and dignified manner under applicable state or federal guidelines. The United States Food and Drug Administration guidelines include using a medication collection site or a medication disposal pouch, that deactivates and renders drugs ineffective. 10. An insurer or health-care provider may not deny or alter health-care benefits otherwise available to an individual based upon the availability of medication to end life or otherwise coerce or require a request for medication to end life as a condition of receiving care. 11. A health-care institution may prohibit a physician or APRN from prescribing medication under this Act on the health-care institution's premises and a physician or APRN may to refuse to prescribe medication under this Act. 12. A request or prescription for or the dispensing of medication under this Act does not constitute elder abuse, suicide, assisted-suicide, homicide, or euthanasia. 13. People acting in good faith and in accordance with generally accepted health-care standards under this Act have immunity, but those acting with negligence, recklessness, or intentional misconduct do not have criminal or civil immunity. 14. The Department of Health and Social Services (DHSS) must develop rules and regulations to collect information regarding compliance with this Act and require health-care providers to file a report when medication to end life in a humane and dignified manner is prescribed or dispensed. DHSS may review samples of records maintained under this Act. The information DHSS collects must include the information necessary to assess a physician's or APRN's compliance with their responsibilities under this Act and DHSS has explicit authority to share information with the Division of Professional Regulation if DHSS suspects that a health-care provider failed to comply with the requirements under this Act. 15. DHSS must complete an annual statistical report of information collected under this Act, similar to public reports available in other states such as New Jersey where this end of life option is available. This report has the following purposes: • To assist the DHSS in its oversight responsibilities for this Act. • To assist the public in learning how well this new law is operating. 16. The Department of State may also promulgate regulations or develop forms and protocols necessary under this Act. 17. Allows the Office of Controlled Substances to provide reports of data in the prescription monitoring program to DHSS to assess compliance with this Act. This Act takes effect when final regulations required under this Act have been promulgated or January 1, 2026, whichever occurs earlier. This Act is known as "The Ron Silverio/Heather Block End of Life Options Law" in memory of Ron Silverio and Heather Block, who were passionate advocates that passed away without this option becoming available to them.
