Healthcare

The purpose of this Act is to expand patient access to physical therapy services. Currently, a physical therapist may treat an individual without a referral up to 30 days after which time a physician must be consulted. The amendment extends that deadline to 90 days with the objective of ensuring continuity of care. Physical therapists will still be required to practice within their scope of training and expertise. This Act also clarifies the requirements for renewal and reactivation of licenses to ensure consistency with other Title 24 boards and the processes used by the Division of Professional Regulation.

This Act updates the Respiratory Care Advisory Council to the Board of Medical Licensure and Discipline’s enabling act to allow qualified licensed respiratory therapists to perform all duties associated with extracorporeal life support. Under the current law, respiratory therapists are authorized to assist with such support but may not administer medication during the process. As a result, a therapist is required to wait for another licensed professional to do so, resulting in delays to patient care. This bill eliminates this delay in patient care and allows qualified respiratory therapists to work within the full scope of their training. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

This Act authorizes physician assistants, occupational therapists, and nurse practitioners to practice dry needling. This Act sets forth requirements and limitations pertaining to the practice of dry needling. Dry needling may not be performed without a physician referral, and physician assistants, nurse practitioners, and occupational therapists may not hold themselves out as acupuncturists unless they are licensed acupuncturists.

Senate Bill 166, passed in 2022, created the Prescription Opioid Impact Fund as part of an overall structure that would both maximize the monies paid by settling Opioids defendants to Delaware and to create a structure whereby those settlement monies could be managed and distributed on a statewide basis through a stakeholder-informed process. The complete legislation is found at Title 16 of the Delaware Code, Chapter 48B, Sections 4801B through 4809B. Chapter 48B applied to settlements with entities, and did not apply to bankruptcies. This is because the bankruptcy process itself extinguishes claims and thus provides the necessary “global peace” for settling parties. At the time SB 166 was passed, it was contemplated that, in the context of the Purdue Pharma bankruptcy, the Sackler family members would obtain this type of bankruptcy-style discharge and release. However, in the summer of 2024, the United States Supreme Court ruled that such a discharge was impermissible. This decision thus required that the states negotiate a non-bankruptcy settlement with the Sacklers, which the Delaware Department has since been pursuing diligently. As announced on January 23, 2025, the Delaware Department of Justice has reached a proposed settlement-in-principle with Purdue Pharma and the Sackler family. In order to once again maximize the amount of Sackler money that Delaware will receive, it is now necessary to update the statutory bar created by the SB 166 to account for the fact that the Sackler family members are “individuals” not “entities." Consequently, the Delaware Department of Justice is recommending the amendments to Chapter 48B of Title 16 reflected in this Act.

This Act would allow for Exceptional Care for Children (ECC) to continue receiving an exemption from the nursing facility quality assessment. It is intended to be a technical clean-up bill to continue ECC's exemption once the Bridge Unit is open. The Bridge Unit will allow ECC to help a small number of individuals, who turn 21 while in ECC's care, transition from a pediatric setting to an adult setting.

Early access to language is essential to child development. Children identified as Deaf or hard of hearing, rely on hearing aids for language development. Language development leads to success in school. Medicaid coverage of hearing aids for children younger than 21 years old applies only to children who qualify. Delaware currently requires private insurers to provide minimum coverage of $1,000 for each hearing aid for individuals younger than 24 years old, covered as a dependent by the policyholder. The cost of pediatric hearing aids can vary widely but can cost from $3,000 to $5,000 out-of-pocket. This can be too expensive for families who are not qualified for Medicaid coverage, even with the current $1,000 coverage requirement. This Act increases the minimum required coverage for hearing aids by requiring insurers to cover the entire cost of medically necessary hearing aids, and the services of a hearing care professional related to prescribing, fitting, or dispensing the hearing aid or earmold, for individuals younger than 24 years old, covered as a dependent by the policyholder. Insurers are required to cover hearing aids at least every 3 years, or sooner if new hearing aids are medically necessary. For hearing aids with earmolds, insurers are required to cover earmolds at least annually, or sooner if new earmolds are medically necessary. For purposes of the coverage requirement, “hearing aid” means any non-experimental, wearable instrument or device designed for the ear and offered for the purpose of aiding or compensating for impaired human hearing and any related parts, attachments, or accessories, including earmolds. The required coverage for hearing aids applies to all of the following: 1. Individual policies under Chapter 33 of Title 18. 2. Group and blanket policies under Chapter 35 of Title 18. 3. The State employee health plan under Chapter 52 of Title 29. The Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2026. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual and reorganizes paragraphs for clarity.

The Department of Education (“Department”) currently administers the High Needs Educator Student Loan Repayment Program, the Speech-Language Pathologist Student Loan Repayment Program, and the Mental Health Services Student Loan Repayment Program. Annually, these programs help roughly 600 public school employees, including educators, speech-language pathologists, school counselors, school psychologists, and school social workers, through a single application process, by making loan payments directly to student loan lenders. But paying the lenders directly has caused 2 persistent issues: 1. Because the payments are considered taxable income, award recipients have the tax withheld from their paychecks, even though the payments go directly to the lenders. This lowers the award recipients’ take-home pay and can create confusion and hardship. 2. The process involves sending out 600 or more individual checks each year. And many checks are returned or delayed due to changes in lender information or system mismatches. To avoid these issues, the Department recommends combining the 3 different student loan repayment programs into a single program and changing the award process from a system that repays lenders directly to a system that pays stipends to public school employees through the State central payroll operation. These changes would streamline a system that already uses a single application and would do all of the following: 1. Avoid surprise tax impacts and imputed income issues. 2. Reduce administrative burden and failed payments. 3. Provide more timely and transparent support to award recipients. The suggested changes are easy to implement, budget-neutral, and could allow public school employees who previously declined awards due to the tax consequences to benefit from the financial support. This Act makes the changes recommended by the Department by doing all of the following: 1. Eliminates the separate Speech-Language Pathologist Student Loan Repayment Program, Mental Health Services Student Loan Repayment Program, and High Needs Educator Student Loan Repayment Program, and combines them into a single program under § 4163 of Title 14. 2. Shifts payment of awards from paying the lenders directly to paying the award recipients a stipend through the State central payroll operation. 3. Streamlines the process for determining financial need by allowing the Department to focus on collecting the income and loan information that is necessary to fairly allocate program funds. 4. Changes the title of § 4163 of Title 14 from the High Needs Educator Student Loan Repayment Program to the “Public School Employee Support Program for High Need Areas” because the 3 programs are now combined into a single program and the program is no longer a direct student loan repayment program. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

This Act makes the following updates to the Behavioral Health Consortium: - Expands the charge of the Consortium to include all aspects of behavioral health care, in addition to substance use disorder. - Adds term limits for appointed members. - Modifies the membership to remove nonoperational organizations and include representation from the Maternal and Child Death Review Board and Delaware’s Veteran community. - Removes the Behavioral Health Commission’s approval authority over the Prescription Opioid Settlement Distribution Commission’s granting and contracting processes. Additionally, this Act makes the following updates to the Prescription Opioid Settlement Distribution Commission: - Revises the Commission’s organization to reflect one Chairperson. The Commission may elect a vice chair from among its members. - Updates authorities related to the distribution of the Prescription Opioid Settlement Fund and the Prescription Opioid Impact Fund. - Ensures any reports produced by the Commission are distributed to the Behavioral Health Consortium. This Act also makes minor technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. This Substitute differs from the original House Bill No. 169 in that it incorporates the conforming changes in House Amendment No. 1 to House Bill No. 169 directly into the body of the bill.

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.

This Act establishes the Office of Suicide Prevention to address suicide prevention and to do the following: (1) Serve in coordination with the Department of Services for Children, Youth and their Families as a place to reach all suicide prevention resources in the State. (2) Assist the suicide prevention coalition in its mission. (3) Provide suicide prevention, intervention, and postvention vision and guidance to stakeholders throughout the State. (4) Work with community level prevention organizations to promote best practices in suicide prevention, intervention, and postvention. (5) Oversee suicide prevention, intervention, and postvention funding application processes and seek grant funds to further suicide prevention, intervention, and postvention. (6) Prepare an annual report for the General Assembly and Governor that outlines the work of the Office and progress made towards suicide prevention, intervention, and postvention, beginning on October 15, 2026. (7) Create the State’s Suicide Prevention Plan, with approval of the suicide prevention coalition, and update it no fewer than every three years. The Act provides that the Division of Substance Abuse and Mental Health will choose a Director to carry out the Office’s duties.