CHAPTER 334

FORMERLY

HOUSE BILL NO. 745

AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO THE ESTABLISHMENT OF THE DELAWARE HEALTH CARE COMMISSION.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Title 16 of the Delaware Code by adding thereto Part XI to read as follows:

"PART XI. DELAWARE HEALTH CARE COMMISSION CHAPTER 98. DELAWARE HEALTH CARE COMMISSION

§9801. Findings.

The General Assembly finds and declares that substantial numbers of Delawareans have no health care coverage and that most of these residents are wage earners and their dependents. One-third of these individuals are children.

The General Assembly further finds and declares that when these individuals enter the health care system they have often foregone preventative care and are in need of more expensive treatment that often exceeds their financial resources. Much of the cost for these uncompensated services to the uninsured are already included in health care systems costs in the form of increased insurance and provider rates.

The General Assembly further finds and declares that spreading these costs among the already insured represents an extremely inefficient method for providing basic preventive and acute care for the uninsured and represents an added cost to employers now providing health insurance to their employees.

The General Assembly further finds and declares that it is necessary to ensure basic and affordable health care to all Delawareans while addressing the economic pressures on the health care system as a whole in Delaware.

§9802. Delaware Health Care Commission.

(a) There is hereby established the Delaware Health Care Commission, hereinafter in this Chapter referred to as the Commission. Said Commission shall consist of 9 members, 4 of whom shall be appointed by the Governor, 1 of whom shall be appointed by the President Pro Tempore of the Senate and 1 of whom shall be appointed by the Speaker of the House of Representatives. Of the 6 appointed members, at least 1 shall be a resident of each county. The Insurance Commissioner, the Secretary of Health and Social Services and the Secretary of Finance shall serve as ex-officio members of the Commission.

The Governor shall designate 1 member of the Commission to be chairman who shall serve at the pleasure of the Governor. The terms of the remaining 5 appointed members shall be for 4 years except that the initial term of each may be for a lesser period. Any vacancy shall be filled by the Governor for the balance of the unexpired term. A member of the Commission shall be eligible for reappointment. No more than 5 of the Commission members shall be of the same political party.

(b) The Commission is constituted an independent public instrumentality and may call upon the Department of Health and Social Services, the Insurance Department and/or the Department of Finance for any assistance, information or data that may be necessary to carry out the purposes for which it has been established. For administrative and budgetary purposes only, the Commission shall be located within the Department of Health and Social Services.

§9803. Duties and Authority of the Commission.

(a) The Commission shall have the authority to hire staff, contract for consulting services, conduct any technical and/or actuarial studies which it deems to be necessary to support its work, and to publish reports as required in order to accomplish its purposes in accordance with the provisions of this Chapter.

(b) The Commission shall be responsible for overseeing the implementation of the Governor's Indigent Health Care Task Force Report issued May 31, 1990. The Task Force Report specifically identifies programs and initiatives which address the access and affordability problems recognized as the primary barriers to provision of appropriate health care to the uninsured. The Task Force further recognized that the initial report would address only a portion of the problems of indigent/uncompensated health care.

(c) As relates to the pilot health access projects, the Commission is expressly authorized to develop such programs in consultation with the appropriate public and private entities; to assign implementation to the appropriate State agency; to monitor and oversee program progress and to ensure that each pilot program is evaluated by an outside, independent evaluator after no more than 2 years of operations.

(d) Other functions which the Commission should undertake include:

1. Determining, in conjunction with the State's Health Statistics Center, the additional data needed to carry out its mission and evaluating the effectiveness of pilot programs; preparing appropriate legislation to obtain such data and ensuring that data to support the goals of health access is available and accessible;

2. Recommending methods to reduce and control health care costs, in conjunction with the private sector;

3. Coordinating efforts with the Health Resources Management Council, which is responsible for overall health planning and the State's Certificate of Need Program, to ensure that Delaware has a balanced approach to access, quality and costs of health care;

4. Reviewing and recommending changes to State medical insurance regulations (in conjunction with the insurance commissioner) to promote efficiency, equity and affordability in health care insurance premiums;

5. Exploring all potential insurance options including size and makeup of risk groups;

6. Studying and making recommendations as to incentives to ensure that employers continue to provide health insurance coverage;

7. Studying and making recommendations regarding benefits to be covered by health plans that would be available through the health care access programs, including prevention, well-child care, and prenatal care;

8. Identifying cost savings to public programs that would result from implementation of health care access programs;

9. Studying alternative financing plans for the State share of premium costs for those who cannot afford health insurance or who are unemployed;

10. Examining and making recommendations as to gatekeeping mechanisms for access to health care services and various benefit and service packages for a minimum care coverage plan;

11. Examining and studying actuarial analyses, sliding fee scale analyses, co-payment levels and limits on provider reimbursements and covered services In developing proposals for core benefit packages;

12. Developing a methodology to coordinate the health care access program with other government-subsidized programs, and;

13. Conducting other activities it considers necessary to carry out the intent of the General Assembly as expressed in this Chapter.

§9804. Reporting Requirements.

(a) On or before January 15, 1991, the Commission shall report to the Governor and the General Assembly on the status of the recommendations contained in the May 31, 1990 Task Force Report. On or before March 15, 1991, the Commission shall submit to the Governor and the General Assembly its recommendations for legislative action on insurance reform. On or before May 15, 1991, the Commission shall report to the Governor and the General Assembly on the status of specific initiatives in Medicaid, Education, Outreach and Case Management, and the Pilot Model Projects.

(b) On or before January 15, 1991, and on or before every January 15 thereafter, the Commission shall report to the Governor and the General Assembly on the status of all of the Task Force recommendations. The comprehensive report shall identify any segments of the population which remain without access to health care and any further recommendations deemed necessary to meet the Commission's charge."

Section 2. This Act shall take effect immediately upon its adoption.

Approved July 11, 1990.