1. Mission Statement The Delaware Health Care Commission is an independent public body reporting to the Governor and the General Assembly, working to promote accessible, affordable, quality health care for all Delawareans.

2. Key Goals Access - Improve access to health care for all Delawareans. Cost - Promote a regulatory and financial framework to manage the affordability of health care. Quality - Promote a comprehensive health care system assuring quality care for all Delawareans.

3. Strategic Initiatives Uninsured Action Plan Health Professional Workforce Development Information and Technology Research and Policy Development Specific Health Care Issues Cost Containment

4. Uninsured Action Plan Uninsured Persons Number/Percent Of Uninsured PeopleStrategies  Eligible for existing programs – Medicaid, CHIP, etc. 27,066 30% Outreach and Enrollment through CHAP Supporting Medical Society of Delaware RWJ grant  Income between 100% - 200% FPL 17,360 20% CHAP  Income above 200% FPL 44,900 50% Developing strategies to expand coverage – target small businesses

5. Uninsured Action Plan CHAP State Planning Program CHAP Issues and Questions: Health Status improvement Non-citizen enrollment Effectiveness – CHAP model vs. alternatives Future beyond August, 2003 Hospitals – not enrolling as many people as Community Health Care Centers Action: Workgroup to examine issues

6. Uninsured Action Plan CHAP State Planning Program Issues and Questions: Prepare options for when implementation is feasible Public Interest in pooling vs. Del. small size Old association plans (i.e. DSCC) Affordability of insurance – small business Action: Address small employer issues through HR 82 Task Force Continue briefings and interviews Prepare final report for HRSA Determine feasibility for health policy conference

7. Health Professional Workforce Development Downstate Residency Rotation Pilot Project Issues and Questions: What is best value of program? Recruitment or education? Level of interest in program Action: Continue program for one additional year and evaluate next steps, including continuation, or “spin-off” Dr. J. Lieberman to discuss with key program participants

8. Health Professional Workforce Development Loan Repayment Program Good results Action: Continue program and monitor and fine-tune as needed

9. Health Professional Workforce Development DIMER Issues and Questions: Delawareans returning after medical education Low number of applicants from Downstate Low number of minority applicants Action: Workgroup to: Explore outreach opportunities for minorities and Kent and Sussex Countians Identify opportunities to promote DIMER

10. Health Professional Workforce Development DIDER Issues and Questions: Ability of DIDER to implement Dental Task Force Recommendations Working relationship with DHCC – DIDER newest member of the “family” Action: Establish closer working relationship, and invite DIDER chair to participate when appropriate

11. Health Professional Workforce Development Nursing Report and recommendations released Action: Proceed with committee to oversee implementation of recommendations

12. Information and Technology Delaware Health Information Network Community Clinical Information Sharing (CCIS) CCIS is departure from original intent of DHIN, but does enjoy support from provider community Evidence that access to better information results in improved patient care How did DHIN arrive at this concept as best course of action? Comprehensiveness of utility – Implications of not including all medical records Most appropriate role of DHCC Action: DHIN completes business plan Seriously examine opportunity to increase quality and decrease cost of health care Info on whether doctors make better decisions with more information

13. Information and Technology Delaware Health Information Network Website Issues and Questions: How much is it used? (Has not been publicized) Opportunities to promote? Can it be used to achieve other commission initiatives? Should it be merged with commission’s website? Action: Form workgroup to evaluate and report

14. Information and Technology Delaware Health Information Network HIPAA Education Issues and Questions: Previous DHIN pilot explored using organization as focal point for HIPAA compliance, but very little interest both in public and private sector Now that HIPAA deadlines are approaching, new need identified Action: Explore whether DHIN should re-examine role in HIPAA compliance activities.

15. Research and Technology Delaware Health Fund Advisory Committee Issues and Questions: Increased spending on DPAP Decreased funding for strategic reserve DHCC continue its role in funding priorities Action: Continue to provide research and support for committee Encourage cost-efficient management of DPAP Continued $1million funding for uninsured Continued funding for diabetes

16. Research and Policy Development Survey Research Issues and Questions: Is commission making best and fullest use of research reports? Should they be conducted on an annual basis? Action: Data workgroup to review and report - Particular focus - CAHPS report

17. Specific Health Care Issues Diabetes Issues and Questions: Should DHCC continue to oversee? Should diabetes continue to be the chronic disease funded through Health Fund? Action: Complete SFY 02 activities Identify projects for SFY 03 with Diabetes control plan as guide Determine SFY 04 priorities

18. Specific Health Care Issues Infant Mortality DHCC representation on Perinatal Board works well Action: Continue Health Disparities What is role of commission in addressing issue? Action: Participate in informal discussions and determine appropriate role

19. Cost Containment Rising costs becoming over-arching theme in health care. Where can DHCC make a difference? Action: Form workgroup to identify opportunities to address cost issues.

20. Uninsured Action Plan Action Items: CHAP Workgroup to examine questions and issues Make recommendations to Commission State Planning Participate in HR 82 Task Force Examine next steps in preparing options Prepare final report for HRSA Continued briefings and interviews

21. Health Professional Workforce Development Action Items: Downstate Residency Rotation Continue monitoring – determine future in one year. Loan Repayment Program Continue as is – fine tune as needed

22. Health Professional Workforce Development Action Items: DIMER Workgroup to examine opportunities to promote program and recruit downstaters and minorities DIDER Develop closer working relationship and include DIDER chair Nursing Implementation committee

23. Information and Technology Action Items: DHIN Receive business plan and recommendations from DHIN Board on CCIS Workgroup to examine DHIN website vs. DHCC website Re-examine feasibility of HIPAA compliance activities

24. Research and Technology Action Items: Health Fund Advisory Committee Continue supportive and research guidance role Recommend funding for: $1 million uninsured $500,000 for diabetes

25. Research and Policy Development Action Items: Survey Research Workgroup to evaluate research reports and determine more effective use

26. Specific Health Care Issues Action Items: Infant Mortality Continued DHCC representation – Dr. Gorum Health Disparities Participation in informal discussions; determine appropriate role

27. Cost Containment Action Items: Workgroup to determine how DHCC should address

28. New Workgroups CHAP Evaluation DHIN Website Survey Research Evaluation Cost Containment DIMER Mental Health