Why Should Delaware Care?
Delaware’s certificate of public review program is aimed at managing the amount of health services in the state and preventing oversaturation. New legislation passed on Tuesday would repeal some of those regulations to allow providers to purchase some medical equipment without the need for state approval.
Delaware senators unanimously approved legislation on Tuesday that would ease regulations on how hospitals and medical providers acquire medical equipment in the state. The bill, HB 17, will now go to the governor’s desk for a signature.
The legislation updates the state’s certificate of public review program, in which an oversight board governs additions to Delaware’s health care ecosystem by requiring approval for equipment purchases and campus expansions.
One of the bill’s sponsors, Senator Marie Pinkney (D-Bear), said the bill would allow health care providers to move quickly to purchase and replace equipment “without unnecessary regulatory delay.”
“This is a common sense reform that reduces bureaucracy where it no longer serves patients, while keeping meaningful guardrails in place for major health care expansion decisions,” Pinkney said on the Senate floor.
The state’s current certificate of need process, run through the Delaware Health Resources Board, fields applications from the state’s health care providers and determines whether they can introduce new services or facilities into the state.
Under the new legislation, providers would still need to receive approvals from the Delaware Health Resources Board for equipment purchases and large capital projects that cost more than $5.8 million.
The new law also would keep regulations that require state approval when a hospital requests an increase in bed capacity greater than 10%.
House Majority Leader Kerri Evelyn Harris (D-Dover) said in a statement to Spotlight Delaware that HB 17 would help to relieve delays for lab testing and results, allowing people to be more informed about their health in a timely fashion. Additionally, she said there is currently a “crisis” surrounding access to care in Delaware, and that she hopes the law will help alleviate some of that pressure.
“While no single bill can solve this crisis, HB 17 represents a meaningful step toward real, tangible relief for those who need it most,” Harris said.
The board is meant to act as a watchdog to ensure the state does not become oversaturated with one type of service, and to vet both programs and providers wishing to offer care in Delaware.
It has long been targeted by Republicans as an example of over-regulation that spurns free market investments in the health care sector. A dozen states, including Pennsylvania, have removed their certificate of need laws in recent decades.
A letter signed by the entirety of Delaware’s legislature, lawmakers said they would “reform” the certificate of need process “in areas where current rules may limit access or innovation, particularly in rural and underserved regions.”
The letter came as the state began to pursue federal funds through the “Rural Health Transformation Program,” a new $50 billion nationwide program meant to bolster rural health care.
During the Senate vote on Tuesday, multiple lawmakers expressed their support for the bill, requesting to be added as co-sponsors.
One of those lawmakers, Senate Minority Whip Brian Pettyjohn (R-Georgetown), said the bill would allow providers to improve their services in the wake of a growing population without delay from the state.
“I think this is a good step to making sure that as our health care facilities need to expand as we need new testing type facilities that we can get those in here to our state,” Pettyjohn said.
In recent weeks, a separate bill introduced by Rep. Bryan Shupe (R-Milford) seeks to get rid of the board entirely. House Bill 318, which was introduced last month, is awaiting a hearing in the House Health and Human Development Committee.
If passed, it would strike all the language surrounding the Health Resources Board from Delaware law. Additionally, the bill would transfer the board’s responsibility to enforce charity care requirements to the Secretary of the Department of Health and Social Services.
Nonprofit hospitals are required by the IRS to provide a “community benefit” to earn their tax-exempt status. Historically, that benefit came in the form of providing free or discounted services, sometimes called “charity care.”
But changes in recent decades to federal and state guidelines have allowed nonprofit hospitals to set charity care policies at their own discretion, removing any requirement of providing it to patients in order to receive a tax break.
In Delaware, nonprofit hospitals must provide charity care to patients living at or below 350% of the Federal Poverty Line.
For ChristianaCare, Delaware’s largest hospital system, this has translated to a steep decline in the amount of free and discounted services provided to patients in the last decade. Charity care has made up less than 1% of the health care giant’s annual expenses since 2021.
Before unanimously passing the Senate yesterday, HB 17 also unanimously passed in the House late last month.
It is unclear when Gov. Matt Meyer will sign the bill, but his office has signaled its support for the legislation. During his State of the State address in January, Meyer said the leaders needed to reform the program to increase “access and competition” in Delaware.
