Delaware Health Fund Advisory
Committee
www.state.de.us/dhss/healthfund
State Fiscal Year 2003 Recommendations
to the Governor and General Assembly
December, 2001?Table of Contents
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Continuing Initiatives
Delaware Prescription Assistance Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Tobacco Control & Prevention
Delaware Health & Social Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Department of Public Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Department of Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Department of Justice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Department of Services for Children, Youth & Their Families . . . . . . . . . . . . . . .3
Preserving Medical Coverage for Former SSI Recipients . . . . . . . . . . . . . . . . . . . . . . . . .4
Uninsured Action Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Public Access Defibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chronic Diseases: Diabetes Pilot Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Increased Medicaid Eligibility for Pregnant Women & Infants . . . . . . . . . . . . . . . . . . . . .6
Substance Abuse Transitional Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Lesser-known Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
The Wellness Community. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Cancer Care Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Heroin Residential Treatment Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Attendant Care Services/House Bill 30. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Breast & Cervical Cancer Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Delaware Breast Cancer Coalition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Instruments for TB & Metabolic Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Southbridge Community Health Outreach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Delaware Schools Survey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11?-1-
Health Fund Advisory Committee Recommendations
State Fiscal Year 2003 (in thousands)
Initiative FY03 Recommendation
FY2003 Funds Available: $29,829.2
(Projected Settlement Payment of $29,400.0
plus anticipated FY2002 Reversions of $429.2)
Strategic Reserve $11,927.8
Continuing Initiatives
DE Prescription Assistance $7,212.7
Tobacco Prevention/Control $5,008.9
DHSS/DPH $4,047.0
DPS $499.0
DOE $217.7
DOJ $135.2
DSCYF $110.0
Medical Coverage for SSI Transition $1,485.0
Uninsured Action Plan $1,000.0
Chronic Disease Pilot $500.0
Medicaid Increase for Pregnant Women $408.7
Public Access Defibrillation $141.4
Substance Abuse Transitional Housing $200.0
Lesser-Known Illnesses $100.0
DHCC Staff Assistance $57.1
Cancer Care Connection $150.0
The Wellness Community $200.0
Heroin Residential Program $500.0
Attendant Care/HB 30 $430.0
Breast & Cervical Cancer Treatment $150.0
DE Breast Cancer Coalition $40.0
Instruments for TB & Metabolic Disorders $150.0
Southbridge Comm. Health Outreach $120.0
Univ. of DE/Drug & Alcohol Studies $47.6
Total Initiatives $17,901.4
Grand Total $29,829.2?-2-
Continuing Initiatives
Delaware Prescription Assistance Program
Department of Health & Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$5,150.4 $7,212.7
The program provides 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.
The FY03 recommendation fully funds 12 months of operation, serving approximately 7,926
recipients. Enrollment in the program continues to grow steadily. The committee will monitor
program growth, combined with increasing drug costs, to determine strategies for continued
funding.
Tobacco Prevention & Control
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
Total $5,004.9 $5,008.9
DHSS/DPH $4,047.0 $4,047.0
DPS $499.0 $499.0
DOE $217.7 $217.7
DOJ $131.2 $135.2
DSCYF $110.0 $110.0
DHSS/DPH
Through it’s Division of Public Health, the Department of Health and Social Services will
continue to provide media, community programs, cessation, and coordination for tobacco use
prevention. Funding will also support chronic disease efforts for tobacco-related illnesses.?-3-
The Division of Public Health will use FY2003 funding to continue to administer and implement
programming with the primary goals of:
· Preventing tobacco use among young people.
· Increasing the proportion of cigarette smokers who attempt to stop smoking.
· Reducing routine exposure to environmental tobacco smoke.
· Increasing the number of Delawareans who strongly disapprove of cigarette use.
· Implementing chronic disease programs to reduce tobacco-related diseases.
DPS
The department will continue to maintain and expand enforcement of Delaware’s youth tobacco
access laws. At level funding from 2002, the Department of Public Safety will continue to fully
fund three agents working on tobacco compliance and their equipment, and will support DARE
program supplies.
DOE
FY2003 funding will enable the department to continue to:
· 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 resources 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 programs.
DOJ
The increase in the Department of Justice fully funds two staff members to enforce tobacco-related
laws.
DSCYF
FY2003 will enable the department to continue to:
· Support community-based programming designed to encourage youth involvement, promote
life skills, and provide alternatives to tobacco use.
· Prevent tobacco use among youth by promoting and delivering effective youth-led tobacco
prevention strategies.
· Strengthen collaboration among communities, State government, schools, and private
nonprofit agencies to support community efforts to prevent tobacco use among youth.?-4-
Preserving Medical Coverage for Former SSI Recipients
Department of Health & Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$1,485.0 $1,485.0
Implemented on March 1, 2001, this program provides medical coverage for up to 48 months for
former SSI recipients losing Medicaid due to unearned income from government benefits. The
program will serve approximately 80 participants in FY2003.
Uninsured Action Plan
Delaware Health Care Commission
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$1,000.0 $1,000.0
The program will continue in FY2003 with the same key components:
Community Access Component
· Building infrastructure capacity to deliver health care services through support and expansion
of existing “safety net” system.
· Enrolling individuals eligible for existing insurance programs.
· Finding health homes for the remaining uninsured.
State Planning Component
· Designing, testing and implementing new strategies to expand access to appropriate health
care for all Delawareans.?-5-
Public Access Defibrillation/Chain of Survival Improvement Program
Department of Health & Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$375.0 $141.4
FY03 funds complete the third of the three-year request for this program. Funds for FY01
purchased 366 units. FY02 funding purchased 200 additional units and fund ongoing training
and evaluation. FY03 funds would purchase 50 units and provide associated training, materials
and coordination activities.
The goal of the program is to 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 outcomes to guide future efforts.
Chronic Disease: Diabetes Pilot Project
Delaware Health Care Commission
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$500.0 $500.0
The program implements recommendations of the Diabetes Task Force of the Delaware Health
Care Commission, established by House Concurrent Resolution 86.
FY2003 funding will continue to 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.?-6-
Expansion of Medicaid Coverage to Pregnant Women Between 185% to 200% of Poverty
Department of Health & Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$408.7 $408.7
FY2003 funding will allow continued expansion of Medicaid coverage to pregnant women and
infants in families with incomes between 185% and 200% of the federal poverty level.
Substance Abuse Transitional Housing
Department of Health & Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$200.0 $200.0
FY2003 marks year three of a three-year appropriation. The program:
· Provides 15 additional slots each year for transitional housing in Delaware for persons with
drug and alcohol addictions.
· Creates a system for better monitoring client activity and compliance with treatment orders.
· Bridges the gap in the current array of services.?-7-
Lesser-known Illnesses
Department of Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$150.0 $100.0
Funding in FY2003 will allow the Division of Public Health to contract funds out to an entity
that will implement recommendations from the FY2002 research, including a comprehensive
program to educate the medical community on diagnosis and treatment of specified diseases.
FY2002 funding provided for the following activities:
· Obtain definitions of ‘lesser 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.
· An interim progress report was provided to the Division of Public Health in April, 2001, and
presented to the committee in November, 2001. The report outlined 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.
The Wellness Community
Department of Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$100.0 $200.0
FY2003 funds will allow for program expansion into Kent County to provide psychosocial
support for people with cancer and their caregivers. The program will also focus resources on
further expanding into Sussex County following successful implementation in Kent County.?-8-
Cancer Care Connection
Department of Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$100.0 $150.0
FY2003 funding would support recently expanded statewide care specialist services for cancer
patients. This support includes impartial information and referral services, practical information
about living with cancer, and other non-medical services.
Heroin Residential Program
Department of Health & Social Services/Division of Alcoholism, Drug Abuse & Mental
Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$500.0 $500.0
FY2003 funding of the Residential Substance Abuse Treatment Program for Young Adults will
continue to address the special needs of the 18 to 25 year old age group. The primary target
population for this program will continue to be those young men and women who have been
abusing heroin and illegal drugs and alcohol to the 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. As in previous years, FY2003 funds would be contracted out to a
community provider.?-9-
Attendant Care Services/House Bill #30
Delaware Health & Social Services/Division of Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$340.0 $430.0
First year funding at $340.0 covered six months of operating expenses ($215.0) plus one-time
costs ($125.0). A full year of service for 50 people with disabilities will cost an estimated
$430.0 in state funds. These figures assume a 50% federal Medicaid match, for which federal
approval is pending.
Breast & Cervical Cancer Treatment
Delaware Health & Social Services/Division of Social Services
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$150.0 $150.0
These funds would allow Delaware to continue a 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 that program to obtain Medicaid coverage for the course of their treatment. The
program includes a 65% federal match .?-10-
Delaware Breast Cancer Coalition
Department of Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$40.0 $40.0
The program was funded in FY2002 to raise breast cancer awareness, and to promote early
detection and prevention programs. FY2003 funding would be used to:
· Provide breast education programs to at least 300 women between the ages of 20-64 years of
age, especially low-income women in Kent and Sussex Counties.
· Provide programs and encourage participation in wellness programs focusing on lesbian and
bisexual women, a group that experiences an increased risk of breast cancer.
· Schedule the Living and Giving Exhibit at six non-profits throughout the state.
· Provide tobacco awareness and information to over 600 Delaware women at two separate
conferences.
Instruments for TB & Metabolic Disorders
Delaware Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY02
Appropriation
FY03
Recommendation
$150.0 $150.0
FY2003 funding will be used to enhance progress made in FY2002. Specifically, the Advanced
Technology Center for Medical Devices will continue expansion of a database and systems for
bacterial identification, linking hospitals within the state, and eventual interface with a national
database.?-11-
Southbridge Community Health Outreach
Delaware Health & Social Services/Division of Public Health
Recommendation
(in thousands)
FY03
Recommendation
$120.0
This program would be receiving funding for the first time in FY2003. A collaboration among
the community’s Neighborhood Planning Council, Community Development Corporation, and
Henrietta Johnson Medical Center, the funds will be used to implement a comprehensive
community outreach program to address the health profile of the targeted community.
Delaware Schools Survey
University of Delaware/Center for Drug & Alcohol Studies
Recommendation
(in thousands)
FY03
Recommendation
$47.6
First time funding for this program will allow for continued surveying and evaluation of
Delaware students to assess attitudes, incidence, prevalence, abuse and dependence related to
alcohol and drug abuse. The funding will provide information by county on 3,000 students from
5 th , 8 th and 11 th grade, for a total of 9,000 students. The information obtained from the survey
will provide ongoing trend data for analysis, as well as information for state and local planning
purposes, as desired.