Why Should Delaware Care?
Delaware recently applied for $1 billion in federal funds to expand rural health care access. In its pitch, it budgeted more than $100 million to build a new medical school in Delaware. As part of that, the state said it would open a competitive procurement process to find a partner institution. But a signed agreement dated before the state’s recently announced plans indicates Delaware will likely partner with a Philadelphia medical school.
When Gov. Matt Meyer outlined a $1 billion proposal earlier this week to expand rural health care access, building a medical school in the First State was a pillar of his plan.
He said the state would seek out competitive bids from universities to ultimately operate Delaware’s first medical school. But a weeks-old signed agreement indicates Delaware is already in talks with Thomas Jefferson University, home to one of Philadelphia’s premier medical schools.
University and Delaware leaders, including Meyer, signed the agreement two weeks prior to the governor’s announcement that the state hopes to build a medical school with a portion of a potential $1 billion federal payout.
Delaware applied for that potential funding through the “Rural Health Transformation Program,” a provision of the Trump administration’s One Big Beautiful Bill Act that earmarks $50 billion for states to improve their rural health care infrastructure.
The non-binding agreement between Delaware and Jefferson, also known as a “Memorandum of Understanding,” was not publicly available prior to the state’s announcement. After a Spotlight Delaware inquiry on Thursday about the agreement, officials added the document to the state’s public-facing funding application.
In the application, the state said it would open a competitive procurement process to find a “partner institution,” hire staff and develop curriculum for the program. Additionally, the state said it hopes to issue that government contract by the end of September 2026.
While the agreement was not initially part of the public application, there was a small mention of it in a letter of support submitted to the federal government by Jefferson.
Jefferson, in the agreement, said it hopes the partnership will improve access and quality of health care in Kent and Sussex counties. The agreement also says the university hopes to build a branch campus of its Sidney Kimmel Medical College somewhere in the state.
“The goal of this Collaboration is to establish a phased approach leading to the creation of a four-year medical school in Delaware,” the agreement said.
The agreement, dated Oct. 29, says Delaware will “provide all necessary and appropriate financial resources for the development, implementation, and sustainability of the branch campus.”
Delaware’s application for federal dollars through the Rural Health Transformation Program estimated the state would spend more than $100.4 million through 2031 to fund the medical school.
Additionally, the agreement says Delaware will lead development and planning of the school in tandem with other universities and hospital systems.
Jefferson already has a sizable footprint in Delaware’s medical education landscape with clinical and educational relationships with ChristianaCare, Beebe Healthcare and Nemours Children’s Hospital in Wilmington.
The agreement also says the state and university would work toward the “enhancement” of Jefferson’s current branch campus in Delaware, in which third and fourth-year residents work at ChristianaCare.
Thomas Jefferson University did not respond to a request for comment.
In a statement from Mila Myles, a spokesperson for Meyer, she said the state “needs a medical school sooner rather than later.” She also said the agreement would not impact the procurement process.
“Thomas Jefferson University has a strong track record of providing quality medical education to physicians across the Philadelphia area, and while we’re glad they’ve raised their hand to collaborate with the State of Delaware, the MOU is not exclusive, and we will run an open and transparent procurement process,” Myles said in an emailed statement.
When asked by Spotlight Delaware at a press conference on Wednesday if he would commit to partnering with in-state universities to run the medical school, Meyer said he hopes to build a new campus of an “existing medical school.”
Since there are none in Delaware, that means officials would likely partner with an out-of-state institution, the governor said. Meyer added that the state is not going to build the medical school with just “one partner,” and in-state universities would be involved.
According to the state’s federal funding application, after Delaware awards a contract to an institution, it hopes to have classes begin by the end of June 2028. At Wednesday’s press conference, Meyer said the state should know its award by the end of 2025.
Neil Hockstein, chair of the Delaware Health Care Commission, a public-private partnership that can conduct pilot projects to improve health care in the state, added that it is “unlikely” Delaware will receive its full $1 billion ask because of the small size of the state.
According to the Centers for Medicare and Medicaid Services (CMS), half of the $50 billion is set to be divided evenly among all the approved states, meaning Delaware would receive at least $500 million, if selected.
The other half of the funding will be awarded based on a “variety of factors” set by CMS, meaning the additional $500 million the state requested is not guaranteed.
Leading the project proposals is $321 million in investments for rural medical providers and federally qualified health centers to expand their services and move toward providing more preventative care. It is followed by $192 million to help train non-physician, clinical support positions that are in demand.
Ranking third is $107 million to further telemedicine options to those in more remote areas, while the Hope Center homeless service centers in Kent and Sussex counties are proposed to receive $104 million while a Delaware medical school would receive $100 million.
No other appropriation breaks the nine-figure threshold.