Delaware Health Fund Advisory
Committee
www.state.de.us/dhss/healthfund
State Fiscal Year 2002 Recommendations
to the Governor and General Assembly
May 2001?Table of Contents
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Available Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Continuing Initiatives
Delaware Prescription Assistance Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Tobacco Control & Prevention
Delaware Health & Social Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Department of Public Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Department of Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Department of Services for Children, Youth & Their Families . . . . . . . . . . . . . 15
Minor Capital Improvements to State-run Long Term Care Facilities . . . . . . . 16
Preserving Medical Coverage for Former SSI Recipients . . . . . . . . . . . . . . . . . . . . . . . .17
Uninsured Action Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Public Access Defibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Chronic Diseases: Diabetes Pilot Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Increased Medicaid Eligibility for Pregnant Women & Infants . . . . . . . . . . . . . . . . . . .23
Survey of Disabled in Delaware. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Substance Abuse Transitional Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Lesser-known Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
New Initiatives—One time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Support for People with Cancer
Resource Mothers
Gift of Life Organ Donation Awareness
New Initiatives—Ongoing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Heroin Residential Treatment Program
Hard-wired Smoke Detectors
Attendant Care Services/House Bill 30
Breast & Cervical Cancer Treatment?-1-
Health Fund Advisory Committee Recommendations
State Fiscal Year 2002 (in thousands)
Initiative FY01
Appropriation
FY02
Recommendation
Strategic Reserve $14,934.8 $5,870.6
Continuing Initiatives $18,330.4
DE Prescription Assistance $7,472.8 $5,150.4
Tobacco Prevention/Control $2,833.0 $5,004.2
DPS $315.5 $499.0
DOE $217.0 $217.0
DOJ $110.0 $131.2
DSCYF $110.0 $110.0
DHSS/DPH $2,080.5 $4,047.0
MCI for state institutions $1,900.0 $4,000.0
Medical Coverage for SSI Transition $1,485.0 $1,485.0
Uninsured Action Plan $1,000.0 $1,000.0
Chronic Disease Pilot $500.0 $500.0
Medicaid Increase for Pregnant Women $408.7 $408.7
Public Access Defibrillation $752.9 $375.0
Substance Abuse Transitional Housing $200.0 $200.0
Lesser-Known Illnesses $150.0 $150.0
DHCC Staff Assistance $56.5 $57.1
New initiatives-one time $505.0
Support for People with Cancer $200.0
Resource Mothers $200.0
Gift of Life $105.0
New initiatives-ongoing $1,490.0
Heroin Residential Program $500.0
Smoke Detectors $500.0
Attendant Care/HB 30 $340.0
Breast & Cervical Cancer Treatment $150.0
Total Initiatives $17,008.9 $ 20,325.4
Total + Strategic Reserve $31,943.7 $ 26,196.0?-2-
Delaware Tobacco Settlement Funds—FY 2002 Funds Available
Total Funds
Available
$26,196,017
Master Settlement Payments
Date Projected Actual
12/29/00 $10,069,286.22 $7,658,260.14
4/16/01 $17,311,677.36 $15,864,457.36
TOTAL $23,522,717.50
Payments were adjusted based on Master Settlement Agreement provisions relating to sales
volume and inflation. Also, $900,000 is in dispute regarding enforcement of the non-participating
manufacturer provisions. This amount is being held in escrow pending litigation.
One time Reversions (in thousands)
Initiative FY 2001
Approp
Projected
Unexpend
DE Prescription Assistance Program $7,472.8 $1,574.0
Tobacco Control & Prevention $2,833.0 $165.4
MCI to State Long Term Care Facilities $1,900.0 0
Medical Coverage: Persons who Lose SSI $1,485.0 $495.0
Uninsured Action Plan $1,000.0 0
Public Access Defibrillation $752.9 0
Chronic Diseases: Diabetes Pilot Project $500.0 0
Heroin Residential Program N/A
Increased Medicaid Eligibility for Pregnant
Women & Infants
$408.7 $308.7
Survey of Disabled in Delaware $250.0 $27.6
Substance Abuse: Transitional Housing $200.0 $17.2
Lesser-Known Illnesses: Testing Regimens $150.0 0
Staff Assistance on Health Issues: Delaware Health
Care Commission
$56.5 0
TOTAL $17,008.9 $2,673.3?-3-
Continuing Initiatives
Delaware Prescription Assistance Program
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$7,472.8 $5,150.4
The FY01 appropriation funded 18 months of program expenses. The FY02 recommendation
fully funds 12 months of operation. Enrollment is growing steadily, and the program is expected
to reach most eligible Delawareans by July, 2003.
Status as of April, 2001
What were the goals of the initiative?
The goal of the program is to provide prescription assistance for elderly and disabled citizens
currently without prescription coverage who have incomes below 200% of the poverty level or
have prescription costs exceeding 40% of their income.
What are the accomplishments to date?
· The number of clients enrolled in the program has steadily increased since the program
started in January 2000. As of March 31, 2001, 3,741 are enrolled in the program. Over
5,000 have applied for DPAP.
· During the Program’s first 13 months, DPAP provided 52,635 prescriptions at a total cost of
$1,669,816. Funds are used to fill an average of three prescriptions per member, per month
at an average cost of just over $30 each.
· The percentage of members using their benefit has increased steadily over the life of the
program to an average 67% of members during the last six months. Data on monthly
prescription use, cost, and expenditure have been increasing, indicating a steadily growing
program.
· Presentations and interactive sessions were held at over 100 sites throughout the state
beginning in March 2000. Program information was mailed to 1,932 potential DHSS clients
who are part of the Medicare Buy-In program and approximately 1,600 clients who had their
Social Security Insurance discontinued during the previous year. Outreach materials were
provided to all of the statewide Senior Citizen Centers, the Community Mental Health
Centers, and all of the 150 pharmacies participating with the program. The Medical Society?-4-
of Delaware discussed DPAP in the Society Newsletter and mailed over 3,200
brochures/applications to its statewide membership to share with patients.
· A Drug Utilization Review process, which ensures safe, appropriate pharmaceutical
coverage, was applied to all DPAP prescriptions. The process has been successful in
monitoring the inappropriate dispensing of prescriptions, while offering better coordination
and case management information for physicians making the prescriptions.
· Research has been conducted that confirms the original estimates of the number of eligible
Delawareans.
What are the next steps?
· Continued broad outreach to the target population as well as the families and agencies that
support potential program members.
· Distribution of additional outreach materials to medical service providers.?-5-
Tobacco Prevention & Control
Recommendation
(in thousands)
FY01 Appropriation FY02
Recommendation
Total $2,833.0 $5,004.2
DHSS/DPH $2,080.5 $4,047.0
DPS $315.5 $499.0
DOE $217.0 $217.0
DSCYF $110.0 $110.0
DOJ $110.0 $131.2
The increase in the Department of Health and Social Services will enhance media, community
programs, cessation, and coordination for tobacco use prevention. Funding will also support
chronic disease efforts for tobacco-related illnesses.
The increase in the Department of Public Safety will fully fund three agents working on tobacco
compliance and their equipment, and will support DARE program supplies.
The increase in the Department of Justice fully funds one staff member to enforce tobacco-related
laws.
Status as of April 2001-Department of Health & Social Services
What were the goals of the initiative?
· Prevent tobacco use among young people.
· Increase the proportion of cigarette smokers who attempt to stop smoking.
· Reduce routine exposure to environmental tobacco smoke.
· Increase the number of Delawareans who strongly disapprove of cigarette use.
· Implement chronic disease programs to reduce tobacco-related diseases.
What are the accomplishments to date?
The Division of Public Health organized the tobacco prevention initiatives into five major areas,
solicited requests for proposals, and selected contractors using standard criteria and involving
reviewers from the community. The following contracts were negotiated and the listed activities
are now underway.
Media (Aloysius, Butler & Clark):
¨ Promoting the Quitline (Adult population reach % = 90% statewide):
- Used preproduced television, radio, and outdoor transit spots?-6-
- Produced 50,000 English-language cessation brochures and 5,000 Spanish-language
brochures
- Produced “Point of Purchase” displays
- Media Campaign
§ Reached an estimated 172,000 adults through newspaper advertisements
· News Journal (150,000)
· Delaware State News (22,000)
§ Reached an estimated 285,000 adults through radio spots
· New Castle County (270,000)
· Kent/Sussex Counties (15,000)
§ Reached an estimated 204,000 adults through cable TV advertisements
· New Castle County (164,000)
· Kent/Sussex Counties (40,000)
§ Reached an estimated 501,000 adults through 11 billboard ads
· New Castle County (7 billboards/328,000 adults)
· Kent County (3 billboards/80,000 adults)
· Sussex County (1 billboard/93,000 adults)
¨ Promoting Clean Indoor Air Laws/Environmental Tobacco Smoke (ETS) Dangers (Adult
population reach % = 91%_statewide)
- Produced two versions of billboard, transit board, and newspaper inserts
- Developed one English-language and one Spanish-language radio spot
- Media Campaign
§ Reached an estimated 170,000 adults through newspaper inserts in News Journal and
Delaware State News
§ Reached an estimated 98,000 adults through radio spots
· New Castle County (72,000)
· Kent/Sussex Counties (26,000)
§ Reached an estimated 105,000 adults by cable TV advertisements
· New Castle County (71,000)
· Kent/Sussex Counties (34,000)
§ Reached an estimated 493,000 adults by Billboard
· New Castle County (328,000)
· Kent County (80,000)
· Sussex County (85,000)
¨ Tobacco Sales to Minors Campaign Promotion (“Kids Can’t Buy ‘Em Here”)
§ Outdoor Billboards: New Castle County (7), Kent County (1),
Sussex County (2)
§ Transit boards: no numbers available
In-progress:
¨ Placing more ads in weekly papers, with concentration in southern Delaware (Sussex
County)
¨ Increasing ad placement to two times per month in Delaware News Journal
¨ Self-help Quit Kits?-7-
- The cessation campaign originally had three parts (Quit Kit, Quit Line, and
Underwriting). The campaigns have been combined into one integrated campaign:
§ Decal for cover of Quit Kit is being designed
§ Underwriting of cessation aides added to print ad
¨ Promoting Youth-Designed Messages
- Brainstorming session held with kids in early March
¨ Conducted Two Focus Groups to Provide Input on the Media Campaign
- A, B & C produced concepts developed by members of Kick Butts Generation Youth
Coalitions
Cessation (Optum, Inc.)
¨ Cessation Specialist Certification Program:
- Smoking cessation training was provided to 43 pharmacists statewide
¨ Quitline, Toll-Free Cessation Number for DE residents 18 & Older:
- Launched QuitPower telephone cessation line with press conference on February 1
- Began receiving calls on Feb. 1
- Through February, 138 individuals have received cessation services, as follows:
§ 84 information/referral cases, resulting in distribution of Quit Kit and/or referrals
to community resources and pharmacists
§ 54 assessment cases, resulting in 41 clients entering full QuitPower program
- Due to the high volume of out-of state calls, a greeting message was added to divert out-of-
state callers.
¨ QuitPower Program—Enrolled 41 clients in the telephone cessation program:
- Kent County (24)
- New Castle County (14)
- Sussex County (3)
¨ Pharmacist Counseling Service—Enrolled 54 clients in counseling sessions:
- Kent County (7)
- New Castle County (39)
- Sussex County (8)
¨ Quit Kits—Distributed 169 Quit kits:
- Kent County (54)
- New Castle County (77)
- Sussex County (38)
¨ Vouchers for Cessation Services
The program to underwrite the cost of pharmaceutical cessation aids for low-income smokers
received four calls, which resulted in one voucher being processed (Kent County).?-8-
¨ Promotion of QuitPower telephone line and voucher program
- Worked with A, B & C on media campaign
- Provided comments on text of Cessation brochure
- Lutheran Community Services coordinated with DPS to develop voucher program
Community (American Lung Association):
¨ Held SLAM 2001 event on January 26 with 160 youth, representing 14 high schools.
Participants attended workshops and began producing a variety of tobacco prevention
education products. They include:
- Youth tobacco prevention magazine
- Youth tobacco prevention Web site
- Youth-designed advertisement/poster
- Coalition recruitment brochure
¨ Counter-marketing items, including a counter-advertising message for racecar
¨ Implemented Teens Against Tobacco Use at Tatnall School for 10 students
¨ Hired youth tobacco control interns—one each in Kent, New Castle, and Sussex Counties
¨ Hired a youth tobacco control website manager
¨ Interns and Youth Coalition chair met with media contractor
¨ Held planning meeting for Kick Butts Karavan on March 14, with 15 in attendance
¨ Purchased traveling display boards for youth county councils
¨ Held meeting to discuss formation of an adult/youth Faith Community Coalition for Sussex
County
¨ Formed a planning committee to develop a smoke-free restaurant guide and incentive
program. A questionnaire has been sent to approximately 1200 restaurants to determine if
they are smoke-free.
¨ Held meeting with staff of DuPont Hospital for Children regarding developing a program
focusing on pregnant women and their smoking behaviors. Currently translating materials
into Spanish. Programs will be held in Nemours Children’s Clinics and Obstetric and
Gynecology Clinics.
¨ Met with DuPont Company officials to discuss speakers’ bureau. Wrote scripts on tobacco
cessation, second hand smoke, and youth.
¨ Ordered interactive materials and video for distribution to approximately 45 community and
health-related organizations throughout the state.
¨ Completed the youth-created design for the [1998 Pontiac Firebird] Kick Butts Mobile.
DuPont Automotive Paints has donated funds for the re-painting of the car by youth at
Polytech High School
¨ Held three meetings with the University of Delaware and the City of Newark Parks and
Recreation to develop a smoke-free fair. Two fairs will be held on May 19, one in the City
of Newark and the other on the University’s campus.
¨ In collaboration with the University of Delaware, began an environmental assessment of
tobacco issues in the City of Newark.?-9-
¨ Established three county councils with at least 15 members per county.
¨ Kick Butts Day Event on April 4 at Dover’s Legislative Mall, estimating 500 attending as of
3/21/01
¨ Take Down Tobacco Conference on April 7. Dr. Jeffrey Wigand, former Phillip Morris
researcher, will be the guest speaker
¨ Statewide youth coalition (DeKBG) April 8
¨ Little League Night at Blue Rocks game April 8
¨ Teen and adult coordinators’ meeting on April 7
In-progress:
¨ Planning for multicultural conferences in each county in May
¨ Working on establishing three county councils with at least 10 members per county
¨ Working on hiring a youth tobacco control Web site manager
¨ Planning afterhours lock-in event for teens at Dover Mall on April 13
¨ Planning teen institute, April 2001. Working with the Delaware Prevention Network.
¨ Planning for Delaware Parent Teacher Association conference on March 31
¨ Began work with DuPont Global Company –Visual Communications on an interactive CD
ROM for tobacco prevention presentations
¨ Working with Wilmington Metropolitan Urban League on speakers’ bureau
¨ Working with Latin American Community Center on a theatre production about tobacco
prevention
¨ Working with God’s Discipleship on TV talk show programming
¨ Held discussions with subcontractor to develop school lesson plans on tobacco that can be
incorporated into a CD ROM
¨ Working on Adopt a Retailer program in each county with the Delaware Prevention Network
and the Department of Public Safety
¨ Planning tobacco-free after-prom parties for Dover High School, John Dickinson High
School, Brandywine High School, and Caesar Rodney High School
¨ Working with the Delaware Ecumenical Council on Children and Families to develop a
newsletter for the faith community
¨ Developing a tobacco control resource guide for faith communities
Coordination (Prospect Associates)
¨ Information and Resources
- Distributed list of on-line resources to contractors and subcontractors
- Distributed list of tobacco control Web sites
- Reserached national trends & resources
- Developed/distributed resource notebooks
- Developed Intranet page design; began programming links
¨ Training
- Developed and delivered 2-day training (March 1–2) on evaluation methods for
contractors and coalition members?-10-
- Designed in-depth training needs assessment and conducted one-on-one phone interviews
with identified tobacco stakeholders in preparation for April 27 training
- Conducted key stakeholders needs assessment
¨ Coordination/Technical Assistance
- Coordinated meeting for contractors and subcontractors on January 17
- Developed and disseminated minutes of January 17 meeting
- Held two technical assistance conference calls
- Developed database of contractors and other partners
- Conducted site visits with contractors
- Designed tracking tool for monthly contractor reports
Evaluation (Gallup Organization)
There was a two month delay in the approval of the evaluation contract's purchase order. The
contract was not officially authorized until late February. The Gallup/UD team has developed a
list of “stakeholders” who will be interviewed about their expectations for the Delaware Tobacco
Control Program. These in-person interviews will be scheduled as soon as possible, with an
expected completion date of April 30.
¨ Gallup/UD have drafted questions to be used in a Random Digit Dial telephone interview of
Delaware adults to measure adults’ beliefs and opinions with regard to tobacco use, related
attitudes and behavior, and knowledge of Delaware-specific programming and media
campaigns. Survey will be administered in late April. Questions cover the following areas:
¨ Perception of Tobacco as a Health/Community Issue
¨ Cigarette Use History
¨ Quit Smoking History, with a Focus on New Delaware Programs
¨ Other Tobacco Use History
¨ Environmental Tobacco Smoke (ETS) Exposure
¨ Policy Issues and Tobacco
¨ Mass Media and Tobacco Programs, with a Focus on Delaware Programs
¨ Demographics
¨ UD and Gallup are collecting data on youth and adult tobacco use for a summary report
containing Delaware-specific tobacco-related indicators. This will include data from the
Delaware School Surveys, the Youth Tobacco Survey, the Youth Risk Behavior Survey, the
Behavioral Risk Factor Survey, and the National Household Survey of Drug Abuse.
¨ Gallup/UD are planning a one-day intensive training on tobacco control program evaluation
to be held on May 2, 2001.?-11-
Chronic Disease
Cardiovascular Disease Prevention Program
Conduct CVD screening at the community level, targeting high risk and minority populations.
· Contract signed.
· Community planning and needs assessment process underway.
· Screening calendar being developed; initial screenings to begin in April.
Comprehensive Nutrition and Physical Activity Promotion
· Contract signed by both parties in January 2001. Contract approved by State Treasurer’s
Office in mid-March.
· Initial focus groups held by University of Delaware staff; survey instrument completed.
· University in process of negotiating subcontract for marketing campaign.
· Funding of vacant unfunded position – the Health Fund provided salary dollars for a chronic
disease director in the Division. This position has been filled.
· Awareness campaign on how to access cancer services in Delaware - The Division met with
providers of information and referral services in Delaware and then held focus groups
involving cancer patients and health care providers. Based on these activities the Division is
developing a tool kit for patients and providers to learn where to go for cancer information.
· Analysis and publication of cancer resources in Delaware – After meeting with key
organizations, the Division contracted with Management Concepts, Inc. to combine work
previously completed by other groups and to fill in missing information. Work should be
completed this spring.
· Enhance analysis of cancer data and its dissemination – the Division contracted with
Christiana Care Health System to develop a comprehensive statistical summary of cancer in
Delaware. The information should be released this spring.
· Develop and maintain a cancer network – The Division met with cancer services providers
and based on their recommendation developed a concept for an interactive web site. The
web site is designed to help providers learn how they can better serve patients by knowing
more about the services available statewide. The Division has contracted with Panoptics,
Inc. to develop the web site, which is in prototype stage.?-12-
Status as of April 2001-Department of Public Safety
What were the goals of the initiative?
To maintain and expand enforcement of Delaware’s youth tobacco access laws.
What are the accomplishments to date?
· The Division for the first time has been able to develop and maintain a list of retail locations
licensed and actively selling tobacco products, which is 95% accurate.
· Each and every tobacco retailer has been personally visited by an agent and has been
provided with copies of Delaware’s youth access to tobacco laws.
· “Kid’s Can’t Buy ‘Em Here” buttons were delivered to each and every tobacco retailer.
· The tobacco database software has been obtained and is being modified to accommodate all
users.
· During the month of April, agents are traveling to Florida, Washington DC, Virginia and
Maryland to observe the enforcement activities of these states and to bring back to Delaware
the best of each state’s enforcement activities and programs.
· The number of Cooperating Underage Witnesses participating in the program has reached an
all time high.
· Planning is underway for the Cooperating Underage Witness recognition luncheon, which
will be held in June of this year.
· Two public service announcements, one targeting underage smokers and one targeting
tobacco retailers, have been developed and are currently being aired on local television
stations.
· The design of the new point-of-sale educational material is nearly complete and a
manufacturer for these items is being solicited.
· This year for the first time we will conduct a compliance check at every licensed location
throughout the state.
· Year-to-date, retailer compliance is running at 90%.
What are the next steps?
· Develop a Web page where the public can access tobacco enforcement activities and
statistics.
· Develop a Web-based retailer-training program. (We expect to return from Florida with this
program.)
· Deliver the new point of sale educational information.?-13-
Status as of April 2001-Department of Education
What were the goals of the initiative?
· Strengthen coordination of tobacco prevention education that focuses on risk behaviors and
youth development by developing and institutionalizing a training structure that supports
effective tobacco prevention programming.
· Provide Delaware students in grades K-12 age appropriate, skills-based Tobacco Prevention
Education taught by trained teachers.
· Increase the number of places students receive health and asset development education to
prevent priority risk behaviors that result in tobacco use.
· Build capacity of agencies serving youth in high-risk situations to provide tobacco education
programs.
· Strengthen policies and resource for Comprehensive Health Education to prevent priority risk
behaviors that result in tobacco use.
· Monitor the health risk behaviors of students and evaluate health education program.
What are the accomplishments to date?
· 50% of district coordinators and charter schools have had awareness sessions designed to
make staff knowledgeable about the new health education regulation and curriculum
frameworks and the state and local resources available to comply with these mandates.
· Providing technical assistance to local school districts through state sponsored in-depth
training on health education instruction and assessment as it relates to reducing youth risk
behaviors associated with tobacco use.
· Contracted with the YMCA Resource Center to provide staff development and training for
the implementation of the Life Skills curriculum in middle school.
· Assisting school districts by providing tobacco prevention activities utilizing a coordinated
school health approach.
· Partnered with other state agencies on the 1st State Alcohol, Tobacco, and Other Drugs
Coalition to carry out goals, objectives and activities relevant to tobacco prevention
education.
· Shared data from a CDC survey on tobacco policies and programs in our districts with the
Safe and Drug Free School Coordinators and Advisory board to aid in their planning and
evaluation efforts
· Awarded 4 Request For Proposals (RFP) from 4 districts and/or charter schools that did not
receive the 30% discretionary funds. These districts are going to extend tobacco use policies
to meet CDC guidelines, use survey data to plan tobacco related programs, train staff to
implement Lifeskills curriculum, involve parents and community partners in district/school
initiatives, and offer cessation programs to students as an alternative to strictly punitive
damages?-14-
What are the next steps?
· Continue above activities.
· 70% of the Delaware Health Education cadre members will successfully implement their
action plans to support local district coordinators in developing and implementing a skills-based
health education curricula including tobacco-use prevention.
· Develop a catalog of health education and skills-based professional development courses that
comply with the new school health regulations.
· Identify children and youth at high risk for initiating tobacco use and develop a plan to
address their needs.
· Work collaborative with districts/charter schools that were awarded RFP’s to help them
successfully accomplish stated goals and objectives of proposal.?-15-
Status as of April 2001-Department of Services for Children, Youth, and their Families
What were the goals of the initiative?
· To support community-based programming designed to encourage youth involvement,
promote life skills, and provide alternatives to tobacco use.
· To prevent tobacco use among youth by promoting and delivering effective youth-led
tobacco prevention strategies.
· To strengthen collaboration among communities, State government, schools, and private
nonprofit agencies to support community efforts to prevent tobacco use among youth.
What are the accomplishments to date?
· Currently the Office of Prevention and Early Intervention has negotiated contracts with the
four approved bidders. The contracts are awaiting approval.
What are the next steps?
· Implement contracts.?-16-
Minor Capital Improvements to State-run Long Term Care Facilities
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$1,900.0 $4,000.0
The committee recommends that this funding be the last capital funding appropriation from the
Delaware Health Fund. A first draft of likely projects is listed below.
LOCATION PROJECT AMOUNT
DHCI 1 Dietary Equipment Renovations $350,000
DHCI Resident Equipment Replacement $160,000
EPBH 2 Main Building HVAC $31,000
EPBH Resident Medical Equipment $20,000
STOCKLEY Residential Building Renovations $500,000
STOCKLEY Misc Equipment $250,000
GBHC 3 P-1 4 Projects (Tilton, M/C 5 , maint.) $277,800
STOCKLEY Telecommunications $100,000
DHCI Prickett Building Renovations $567,930
GBHC Medical Center --
Mechanical//Plumbing
$62,900
DHCI Candee Building Renovations $567,930
STOCKLEY Roof Replacement $150,000
DHCI Residential Environment- Renovations $450,000
DHCI Laundry Equipment Replacement $423,000
EPBH Bldg. "A" P-1 Compliance $250,000
GBHC Patient Care Equipment $25,000
TOTAL: $4,185,560
LEGEND 1 DHCI: Delaware Home for the Chronically ill
2 EPBH: Emily P. Bissell Hospital
3 GBHC: Governor Bacon Health Center
4 P-1: Priority One
5 M/C: Medical Center?-17-
Preserving Medical Coverage for Former SSI Recipients
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$1,485.0 $1,485.0
This appropriation was originally for six months, but DHSS was directed to seek federal
Medicaid matching funds. DHSS was successful in obtaining federal match, so the same funds
will cover the state portion of twelve months of operation.
Status as of April, 2001
What were the goals of the initiative?
· To provide medical coverage for up to 48 months for former SSI recipients losing Medicaid
due to unearned income from government benefits.
What are the accomplishments to date?
· Applied for federal funding to offset the cost to the state for this service.
· Program was implemented on March 1, 2001.
What are the next steps?
· Automate administration of the benefit.
· Track expenditures?-18-
Uninsured Action Plan
Delaware Health Care Commission
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$1,000.0 $1,000.0
Status as of April 2001
What were the goals of the initiative?
Community Access Component
· Build infrastructure capacity to deliver health care services through support and expansion of
existing “safety net” system.
· Enroll individuals eligible for existing insurance programs.
· Find health homes for the remaining uninsured.
State Planning Component
· Design and test new strategies to expand access to appropriate health care for all
Delawareans.
What are the accomplishments to date?
· Leveraged funds to secure additional resources and technical assistance to implement both
components.
· Retained project director.
· Created Health Care Access Improvement Coalition to implement Community Access
component.
· Pilot project support for research and operational activities of community health centers.
· Contracts for survey research complete.
· Health Policy Planning Conference held February 22, 2001.
· Individual planning meetings with key stakeholders underway.
· Contract negotiations for Marketplace, Actuarial and Qualitative analysis nearly complete
(will be complete by the time this report is published).
· Financial Analysis of financial viability of community safety net providers underway.
· Small Employer focus group complete.
· Employer survey in progress.
· Initial demographic report of uninsured complete.
· In-depth analysis of uninsured in progress.
· Updated cost-shift analysis in progress.
· Two public summits scheduled: June 7 and September 13.
· Presentations to various stakeholder groups complete – additional presentations to be held.?-19-
What are the next steps?
· Continue implementation of health care infrastructure development via Community Access
Program. Projected enrollment of first uninsured in statewide, integrated safety net system -May
2001.
· Evaluate both components and identify next steps.?-20-
Public Access Defibrillation/Chain of Survival Improvement Program
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$752.9 $375.0
Funds for FY01 purchased 366 units. FY02 funding would purchase 200 additional units and
fund ongoing training and evaluation.
Status as of April 2001
What were the goals of the initiative?
Improve the Chain of Survival in Delaware by:
· Supporting heart health promotion and early recognition of heart attack activities.
· Distributing Automatic External Defibrillators (AEDs) to high-risk locations.
· Enhancing CPR and AED training efforts.
· Tracking outcome to guide future efforts.
What are the accomplishments to date?
· Established Chain of Survival Improvement Coalition consisting of Office of Emergency
Medical Services, American Heart Association (AHA), American Red Cross (ARC), and
Christiana Care Health System (CCHS).
· Used state purchasing process to purchased 366 automatic external defibrillators.
· Established contract with two AHA training centers to provide CPR/AED training.
· Established contract with ARC to provide CPR/AED training.
· Established contract with CCHS to provide program coordination.
· Established placement criteria.
· Distributed 23 AEDs. 108 units are slated to be delivered as each site completes training
(Please see addendum with list of placements).
· Over 150 persons trained to date.
· Initiated direct telephone contact at targeted facilities to invite participation.
What are the next steps?
· Continue to promote and market AED availability
· Continue focused contacts with targeted facilities
· Target to distribute a minimum of 10 AEDs weekly until complete, relying on enhanced
staffing.
· Expand participation in public education activities about the Chain of Survival.
· Develop and produce a quarterly report on cardiac arrests.?-21-
Chronic Disease: Diabetes Pilot Project
Delaware Health Care Commission
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$500.0 $500.0
Status as of April 2001
What were the goals of the initiative?
Implement the following recommendations of the Diabetes Task Force of the Delaware Health
Care Commission, established by House Concurrent Resolution 86:
Implement a multifaceted diabetes education campaign. General and targeted audiences for the
campaign include high-risk populations, people who have diabetes and their families, health
professionals, employers, and the general public. The plan includes:
· Education plan targeting employers with the major themes: “It’s good business” to purchase
insurance plans that cover basic supplies necessary to managed diabetes; and making the
workplace “diabetes friendly” allows employees with diabetes to manage their disease and
remain healthy and more productive.
· Diabetes “Do you know?” campaign focusing on care, treatment and risk of complications,
targeting the general public and people with diabetes.
Adopt the American Diabetes Association Standards of Care for the clinical treatment and
management of diabetes.
Standardize coverage benefits among health plans. Continue discussions among Delaware health
plan medical directors and the director of the Delaware Division Public Health.
What are the accomplishments to date?
· Contract negotiations for the multifaceted education campaign are complete. Campaign
slated to begin as soon as state paperwork complete.
· Contract issued with the Medical Society of Delaware to, through its Uniform Treatment
Guidelines Project:
· Collaborate with major health plans to agree upon uniform clinical treatment
protocols.
· Encourage all major health plans to adopt these treatment protocols within their
health plans, and design benefit packages accordingly.
· Disseminate the information and encourage physicians in Delaware to adopt and use
the uniform treatment protocols.?-22-
The Medical Society of Delaware collaborated with all major insurance companies in
Delaware, Quality Insights of Delaware (the state’s Peer Review Organization), and other
organizations.
What are the next steps?
· Monitor progress of both pilots, evaluate impact and determine next steps
· Monitor progress of standards of care and health benefits, evaluate impact, and determine
next steps.?-23-
Expansion of Medicaid Coverage to Pregnant Women Between 185% to 200% of Poverty
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$408.7 $408.7
What were the goals of the initiative?
· To expand Medicaid coverage to pregnant women and infants in families with incomes
between 185% and 200% of the federal poverty level.
What are the accomplishments to date?
· The program is fully implemented and services are available.
What are the next steps?
· Track expenditures for the expansion.?-24-
Survey of the Disabled in Delaware
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$250.0 $0
This was a one-time appropriation.
Status as of April 2001
What were the goals of the initiative?
· To conduct a statewide, comprehensive market survey of people with disabilities in
Delaware.
What are the accomplishments to date?
· A contractor has been finalized to conduct the survey.
What are the next steps?
· Implement the survey.
· Analyze the survey data and develop a report of findings.?-25-
Substance Abuse Transitional Housing
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$200.0 $200.0
This is year two of a three-year appropriation.
Status as of April 2001
What were the goals of the initiative?
· Provide 15 additional slots for transitional housing in Delaware for persons with drug and
alcohol addictions.
· Create a system for better monitoring client activity and compliance with treatment orders.
· Bridge the gap in the current array of services.
What are the accomplishments to date?
· Scope of work for contractor defined, and bids for the contract have been received.
What are the next steps?
· Contract awarded to Brandywine Counseling. Contractor is making preparations to the
facility, and plans to start services in June.?-26-
Lesser-known Illnesses
Department of Health & Social Services
Recommendation
(in thousands)
FY01
Appropriation
FY02
Recommendation
$150.0 $150.0
Status as of April 2001
What were the goals of the initiative?
· Obtain definitions of ‘lessor known” and “devastating and costly” through existing medical
and public health literature.
· Obtain data on the prevalence of these disorders through state and national data, state
employee and Medicaid claims experiences.
· Identify clinical and supporting evidence concerning each disorder identified by the Division
as well as additional disorders that may be identified through consultation with the medical
community.
· Identify available testing regimens for each disorder and cost of each regimen.
· Describe support system currently in place in Delaware for each disorder.
What are the accomplishments to date?
· Contract was awarded to Christiana Care and went into effect on January 15 th .
· The following “lesser known” diseases have been chosen to include in the study:
Hemochromatosis, Sarcoidosis, Reflex Sympathetic Dystrophy syndrome, Lupus, Chronic
Fatigue syndrome, Lyme disease, Fibromyalgia, Celic sprue, and Cystic fibrosis. These were
selected by literature review and by interviewing medical experts.
· Contractor has begun to analyze several of the federal databases to measure prevalence of the
diseases of interest.
· Memorandum of understanding with Medicaid for data sharing is complete, and analysis of
data has begun. This will help determine the extent of diseases in Delaware.
· The contractor has hired staff needed to complete this project and has established
collaborative agreements with the University of Delaware and the Medical University of
South Carolina.
What are the next steps?
· An interim progress report to be provided to Public Health on April 15, 2001. This is a
progress report that outlines the work to date and provides a brief summary of results.
· Final project report is to be provided to Public Health on or before June 30, 2001. This report
shall outline the methodologies used to conduct this research and provide a comprehensive
review of all findings as outlined above in the “Description of Services” for this contract.?-27-
New Initiatives—One Time
Support for People with Cancer
Department of Health & Social Services/Division of Public Health
Recommendation (in thousands): $200.0
These one-time funds would support psychosocial support for people with cancer. This support
includes impartial information and referral services, practical information about living with
cancer, and other non-medical services.
The committee recommends that these funds be divided between two organizations—Cancer
Care Connection and the Wellness Community. The following epilogue language is
recommended:
“Section 1 of this Act provides an appropriation to the Department of Health & Social Services,
Division of Public Health, Community Health (35-05-20) to provide support services for people
with cancer. Of that amount, $100.0 shall be used to contract with Cancer Care Connection and
$100.0 shall be used to contract with The Wellness Community. This funding shall be made
available for FY2002 only.”
Resource Mothers
Department of Health & Social Services/Division of Public Health
Recommendation (in thousands): $200.0
These one-time funds would replace part of an expiring federal grant to provide services to high-risk
pregnant women, including overcoming barriers to prenatal care, accessing support services
and encouraging good health behaviors.
The committee recommends that these funds be directed to the Perinatal Association of
Delaware. The following epilogue language is recommended:
“Section 1 of this Act provides an appropriation to the Department of Health & Social Services,
Division of Public Health, Community Health (35-05-20) for the Resource Mothers program. Of
that amount, $200.0 shall be used to contract with the Perinatal Association of Delaware. This
funding shall be made available for FY2002 only.”?-28-
Gift of Life Organ Donation Program
Department of Health & Social Services/Division of Public Health
Recommendation (in thousands): $105.0
These one-time funds would support a targeted organ donor awareness program and promotional
campaign for the State of Delaware. The Gift of Life Donor Program would work with the
Delaware State Organ and Tissue Donor Awareness Board to implement this program.
The committee recommends that these funds be directed to the Gift of Life Donor Program. The
following epilogue language is recommended:
“Section 1 of this Act provides an appropriation to the Department of Health & Social Services,
Division of Public Health, Community Health (35-05-20) to promote organ and tissue donor
awareness. Of that amount, $105.0 shall be used to contract with the Gift of Life Program. This
funding shall be made available for FY2002 only.”?-29-
New Initiatives—Ongoing
Heroin Residential Program
Department of Health & Social Services/Division of Alcoholism, Drug Abuse & Mental
Health
Recommendation (in thousands): $500.0
The new Residential Substance Abuse Treatment Program for Young Adults will be designed to
meet the special needs of the 18 to 25 year old age group. The primary target population for this
program will be those young men and women who have been abusing heroin and illegal drugs
and alcohol to point where drug craving and other compulsive behaviors are controlling their
lives. The residential program will provide a safe, drug free environment and a tightly structured
treatment regimen that will empower them to begin the process of recovery. The funds would be
contracted out to a community provider.
Hard-wired Smoke Detectors
Delaware Fire Detection Fund/State Fire Marshall
Recommendation (in thousands): $500.0
These funds would be used to install hard-wired smoke detectors with battery backup in homes
throughout the state by authorized contractors. It is estimated that the cost will be under $500
per home, with over 1,000 homes served.
Attendant Care Services/House Bill #30
Delaware Health & Social Services/Division of Social Services
Recommendation (in thousands): $340.0
The recommended funding covers six months of operating expenses ($215.0) plus one-time costs
($125.0). A full year of service for 50 people with disabilities would costs an estimated $430.0
in state funds. These figures assume a 50% federal Medicaid match, which will require federal
approval. If no federal approval is obtained, the program would serve half as many people.
House Bill 30 would establish the program, allowing for broader eligibility in the future.?-30-
Breast & Cervical Cancer Treatment
Delaware Health & Social Services/Division of Social Services
Recommendation (in thousands): $150.0
These funds would allow Delaware to implement a new Medicaid option for women with cancer.
Currently, the Division of Public Health runs Screening for Life, a federal grant to provide
screening and diagnosis for older women. This option allows women who are diagnosed with
cancer through the program to obtain Medicaid coverage for the course of their treatment. The
program includes a 65% federal match for a total annual cost of approximately $430.0