Lt. Governor Releases Statement

The Delaware Senate on Tuesday passed House Bill 1 (HB 1) and House Bill 2 (HB 2) that, together, legalize and regulate recreational marijuana use in the state. Both bills passed the House earlier this month.

HB 1 removes penalties for use or possession of a personal use quantity of marijuana and marijuana accessories, as well as specifying it is legal for those 21 years of age or older. Personal use quantity is defined as not only 1 ounce or less of leaf marijuana, but also equivalent amounts of marijuana product in other forms.

HB 2 creates the Delaware Marijuana Control Act that regulates and taxes marijuana for recreational use similar to alcohol. This bill includes the following:

• Creation of an Oversite Committee to coordinate implementation of the Act with the Medical Marijuana Program, the Division of Public Health, the Division of Substance Abuse and Mental Health, and the public.
• A Marijuana Commissioner and an Appeals Commission will also be created with the Commissioner having authority to grant licenses for marijuana establishments, establish regulations for cultivation, regulate distribution, and hear complaints regarding establishments licensed under the Act.
• Require that products containing marijuana use a symbol and a standard measurement on all marijuana products for identification; regulate packaging; and contain a warning label explaining evidence-based harms from consumption.
• Creation of a Marijuana Regulation Fund and the Justice Reinvestment Fund to collect fees, taxes, and penalties imposed.

Both bills are ready for Governor Carney's action.

Lt. Governor Bethany Hall-Long released a statement on the Senate Passage HB 1 and HB 2 by saying, “I have been a longtime advocate for legalizing marijuana in Delaware and as a member of the General Assembly, I voted for both medical and de-criminalization legislation. Moving forward, we need to avoid mistakes made in other states and regulate marijuana properly to keep it out of the hands of our children, to ensure product and workplace safety and to also ensure fairness for businesses and for the medical use of marijuana. There is work to be done to establish the necessary regulations to achieve these goals and a timeline that achieves the goal of safely legalizing marijuana for recreational use.”

2023 Meeting Will Be Held In-Person at the Smyrna Opera House

The MSD 2023 Interim Council Meeting will be held on Thursday, April 20, 2023 at the Smyrna Opera House, located at 7 W. South St., Smyrna, DE. This is the first in-person Council Meeting since the start of the pandemic. The evening will begin at 6:00 p.m. with sign-in and a half-hour cocktail social, followed by the Interim Council Meeting beginning promptly at 6:30 p.m. All MSD members are invited to attend and Council members are highly encouraged to register early to ensure receipt of meeting materials to review prior to the meeting. Resolution submission deadline is Monday, April 3rd. Click to register your attendance.

Renew Today and Avoid Losing Membership Benefits

Beginning April 1st, those who have not renewed their 2023 MSD membership will no longer receive any further communications from MSD, including the eNews and Views weekly newsletter, announcements of important events, legislative and advocacy updates, and Practice Matters that is sent to your office staff. MSD has made the membership renewal process simple through our secure website link. Please renew now if you have not already done so. If you have questions about your membership status or payment, please contact Michelle Seymour at Michelle.Seymour@medsocdel.org or by calling (302) 224-4905.

What Does This Mean?

The U.S. Senate voted to end the COVID-19 national emergency order that was implemented in 2020, and President Biden is expected to sign the resolution, despite opposing the measure. The Senate vote comes after the House in February voted to end the COVID-19 national emergency order. Ending the national emergency order — which is separate from the public health emergency order that is slated to expire in May — means certain waivers intended to help the health care system serve patients during the pandemic will end sooner than May. Those waivers from the Centers for Medicare and Medicaid Services (CMS) include:

• one that allows hospitals to screen patients for COVID-19 off-campus
• one that requires private Medicare Advantage plans to cover services provided at out-of-network facilities , and
• another that allows hospices to not provide physical or occupational therapy during the emergency.

Helping to Spread the Message About COVID-19 Treatments

The Delaware Division of Public Health (DPH) has resources to assist you in informing your patients that COVID-19 treatment is available. As you are aware, treatment remains one of the most effective tools for preventing severe outcomes from COVID-19. If an individual tests positive, FDA authorized treatments reduce the risk of severe illness from the disease, especially for those more likely to get very sick from the virus due to a health condition. Please follow this link (https://covidmaterialsde.com/resources/treatment) for downloadable and printable materials, including posters, flyers, and fact sheets. Additionally, there is social media content ready to be shared. Posters and flyers can also be printed and delivered for free by emailing requests to order@covidmaterialsde.com

Satisfying the New One-Time, Eight-Hour Training Requirement

The US Drug Enforcement Administration (DEA) issued a letter this week to DEA-registered practitioners outlining the training that will meet the requirements of the Medication Access and Training Expansion (MATE) Act that was passed as part of the Consolidated Appropriations Act of 2023. The Act requires new or renewing DEA registrants, as of June 27, 2023, to have completed a total of at least eight hours of accredited continuing education on the treatment and management of patients with opioid or other substance use disorders before renewing their licenses. The letter also states that physicians will be able to simply check a box on their DEA registration application or renewal form indicating that they have satisfied this training requirement.

The new DEA letter appears to be largely consistent with the recommendations that the American Medical Association (AMA) made to the DEA in a letter earlier this month. The AMA Ed Hub has multiple offerings on the treatment and management of patients with opioid or other substance use disorders, which are included in their Opioid Therapy and Pain Management CME course. Using the new DEA guidance, the AMA is thoroughly reviewing these materials to determine which ones to include in a dedicated web page that will soon be created to help physicians and other practitioners satisfy the one-time, eight-hour training requirement.

The State's Ban on Assault Weapons, Large Capacity Mags Remain in Effect

A federal judge hearing a challenge against two gun safety measures in Delaware has ruled against the gun lobby on a critical question in Delaware State Sportsmen’s Association, Inc. et al. v. Delaware Department of Safety and Homeland Security et al. In an opinion issued this week, Judge Richard G. Andrews of the U.S. District Court for the District of Delaware denied a preliminary injunction sought by the Delaware State Sportsmen’s Association, the NRA’s Delaware affiliate, against the State’s bans on assault weapons and large-capacity magazines. Assault weapons have become the leading weapon of choice in major mass shootings — including this week’s attack in Nashville — and large capacity magazines have been used in a majority of mass shootings where magazine types could be identified. Under the Court’s opinion, Delaware’s assault weapons ban and large capacity magazine ban will remain in effect during the pendency of the case-in-chief.  

Monitoring on Spill that Happened Late Friday Night, March 24

Philadelphia water officials have been monitoring water quality closely following a chemical spill last Friday. A leak late Friday evening at the Trinseo Altuglas chemical facility in Bristol Township spilled between 8,100 and 12,000 gallons of a water-based latex finishing solution. Officials said it is non-toxic to humans, and no known adverse health effects have been reported in the county. The Division of Public Health (DPH) on Sunday shared that Delaware drinking water has not been impacted by the chemical spill in a tributary of the Delaware River in Bristol, PA. “Delaware’s drinking water has not been impacted by the spill in Pennsylvania,” said DPH Interim Director Dr. Rick Hong. “Unlike neighboring states, water treatment facilities that service Delaware do not take in water directly from the Delaware River. There is no impact to Delawareans at this time. We continue to monitor the situation with our water treatment facilities and the Department of Natural Resources and Environmental Control.” 

Continues to Take Critical Steps to Reduce Drug Overdose Deaths

On Wednesday the U.S. Food and Drug Administration (FDA) approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription. Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for opioid overdose. Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online. The timeline for availability and price of this OTC product is determined by the manufacturer. The FDA will work with all stakeholders to help facilitate the continued availability of naloxone nasal spray products during the time needed to implement the Narcan switch from prescription to OTC status, which may take months. Other formulations and dosages of naloxone will remain available by prescription only. Narcan nasal spray was first approved by the FDA in 2015 as a prescription drug.

To Reduce Sodium in Standardized Foods

The U.S. Food and Drug Administration (FDA) will soon propose to amend the standards of identity (SOIs) to permit the use of salt substitutes in foods for which salt is a required or optional ingredient. The proposed rule would provide manufacturers with flexibility and facilitate industry innovation to reduce sodium in standardized foods. The FDA is making available the pre-publication text of the Federal Register notice. Read the full update.

To Support Accelerated Approval Applications

The U.S. Food and Drug Administration (FDA) issued draft guidance, Clinical Trial Considerations to Support Accelerated Approval of Oncology Therapeutics, regarding clinical trial design considerations to support accelerated approval applications. The accelerated approval pathway is commonly used for approval of oncology drugs in part due to the serious and life-threatening nature of cancer and because of available intermediate clinical endpoints likely to predict clinical benefit. The draft guidance discusses the design of clinical trials, and ways to improve the data available at the time of accelerated approval and reduce clinical uncertainty for patients by initiating postmarketing confirmatory studies in a timely manner. Specifically, the draft guidance addresses the design, conduct and analysis of data through two randomized clinical trial approaches – conducting two separate randomized controlled clinical trials or using one trial for both accelerated approval and to verify clinical benefit. The draft guidance also provides considerations for sponsors to determine the adequacy of single-arm studies to support an application.

At-A-Glance Summary of March News from Around the Agency

“First, Do No Harm”: CMS Shares How it is Pursuing its Zero-Harm Goal to Keep Patients Safe

CMS is pursuing a zero-harm goal to keep patients safe when receiving care, using the many tools and authorities at its disposal, and in partnership with providers, payer and patient advocates. The agency shared all the details in a blog published in observance of National Patient Safety Week.

Joint Statement on Implementation of Transformational Home- and Community-Based Services Settings Regulation

CMS released a joint statement with the Administration for Community Living to mark an important milestone that further enables people with disabilities and older adults to live and fully participate in their communities. Effective March 18, 2023, all states must be fully compliant with the Home- and Community-Based Services (HCBS) Settings regulation, which was created to make sure every person receiving Medicaid-funded HCBS has access to quality, person-centered services and is treated with privacy, dignity, and respect. The rule also ensures individuals covered under the program are able to maintain control of decisions that impact their lives regarding visitors, nutrition, personal resources, and more.

Inflation Reduction Act News: CMS’ Drug Pricing Negotiation Timeline Is on Track for 2026

CMS is moving full steam ahead implementing the Medicare Drug Price Negotiation Program under the Inflation Reduction Act (IRA). CMS published an Information Collection Request for Medicare Drug Price Negotiation Program negotiation data elements. The Inflation Reduction Act specifies nine factors CMS must consider when negotiating the maximum fair price of a selected drug. The new request seeks public input on the particular data to be included in these factors. It also outlines the process for drug companies and the public to submit relevant data. The request is open for a 60-day public comment period. More information can be found here.

CMS Updates Guidance to States for Reviewing Delivery of Home Dialysis in Nursing Homes

CMS continues to act to improve the safety and quality of care in the nation’s nursing homes. CMS has updated its guidance to state survey agencies (SAs) for reviewing home dialysis services delivered within a Long-Term Care (LTC) Facility to ensure patients get the reliable, high-quality care they deserve. The revised memorandum aligns CMS guidance to SAs with its Care at Home requirements (42 CFR §494.100); addresses questions and concerns raised during engagements with the provider community and SAs, and ensures the information provided in the guidance reflects existing practices and models of care for delivering home dialysis in the nursing home setting. The guidance can be found here.

CMS Extends Medicare Advantage Value-Based Insurance Design (VBID) Model

The Center for Medicare and Medicaid Innovation’s Medicare Advantage Value-Based Insurance Design (VBID) Model is being extended through 2025-2030. The extension will introduce changes intended to more fully address the health-related social needs of patients, such as food, transportation and housing insecurity and/or living environment, and enhance the seamless delivery of serious illness care across settings. The model was previously scheduled to end at the end of 2024. Additional information about the model can be found here.

New Cybersecurity Guide Offers Steps to Manage Cyber Risks to Health Care IT Systems  

CMS is encouraging its health care partners to review and consider using the new cybersecurity implementation guide recently released by the HHS Administration for Strategic Preparedness and Response (ASPR), and developed in partnership with the Health Sector Coordinating Council (HSCC) Cybersecurity Working Group. The guide is intended to help the public and private health care sectors prevent cybersecurity incidents by providing specific steps that health care organizations can take immediately to manage cyber risks to their information technology systems. Additional information about the guide and its purpose can be found here.

To Improve Maternal Health Outcomes

The Maternal and Child Health Bureau is announcing three open funding opportunities focused on improving maternal health outcomes. Two funding opportunities close May 9 and the other closes May 24. Any domestic public or private entity is eligible to apply to these opportunities, as well as domestic faith based and community-based organizations, tribes, and tribal organizations. Find more details at grants.gov and on their webpage, as well as summary information below.

Alliance for Innovation on Maternal Health (AIM) Capacity - The purpose is to support state and regional capacity to implement AIM patient safety bundles and expand the reach, depth, and quality of AIM implementation throughout the United States. Up to $200,000 per award per year. Closing date is May 9, 2023.

Alliance for Innovation on Maternal Health (AIM) Technical Assistance (TA) Center - The purpose of this program is to expand implementation and reach of AIM program activities by funding the AIM TA Center to support all 50 states, D.C., jurisdictions, U.S. territories, tribal communities, and birthing facilities that are participating in the AIM program. Up to $3 million per year. Closing date is May 9, 2023.

Integrated Maternal Health Services (IMHS) - The purpose of the IMHS initiative is to improve maternal health outcomes in the U.S. by increasing access to quality, equitable, comprehensive care for pregnant and postpartum people. Up to $1.8 million per award per year. Closing date is May 24, 2023.

News from The Joint Commission: Quick Safety Issue 68

Suicide risk screening is intended to identify individuals who may be at risk of suicide. Brief validated screening tools are an effective way to identify individuals at risk for suicide who may require both further assessment and steps to protect them from attempting suicide.  While there are numerous types of suicide screening tools available, any tool not used appropriately may hinder the intended results. Read more.

Due to Detection of N-Nitrosodimethylamine (NDMA) Impurity

Ascend Laboratories LLC. is voluntarily recalling Dabigatran Etexilate Capsules, USP 75 mg and 150 mg to the consumer/user level due to the presence of a nitrosamine, N-nitroso-dabigatran, above the established Acceptable Daily Intake (ADI) level. To date, Ascend Laboratories LLC., has not received any reports of adverse events related to this recall. Nitrosamines are common in water and foods, including cured and grilled meats, dairy products and vegetables. Everyone is exposed to some level of nitrosamines. These impurities may increase the risk of cancer if people are exposed to them above acceptable levels over long periods of time. The product is used as an oral anticoagulant to lower the risk of stroke and blood clots. The NDC, Lot Number, Expiration Date, and Packaging Configuration details for Dabigatran Etexilate Capsules that are subjected to this recall are indicated in the announcement. The product lots were distributed nationwide to wholesalers, Distributors, and Retailers (dispensers) in the United States from June 2022 to October 2022.

Six Pieces of Legislation Aim to Improve Safety on Delaware's Roadways

Governor Carney on Wednesday joined the Delaware Department of Transportation (DelDOT), the Delaware Department of Safety and Homeland Security (DSHS), members of the General Assembly, and advocates to announce a package of new initiatives and legislation designed to improve safety on Delaware’s roadways.

The legislative package includes bills to: 

• Curb reckless driving
• Prohibit open containers of alcohol in most vehicles
• Expand “Move Over” protections
• Require helmets in the first two years of a motorcycle license
• Strengthen child safety seat requirements
• Enable green lights on snow plows to increase visibility

Wellness Leadership Award Entries Now Open

Lt. Governor Bethany Hall-Long announced today that entries are open for the 2023 Lt. Governor’s Challenge Wellness Leadership Award. This award is given annually to honor individuals and organizations throughout Delaware that contribute to the advancement of health and wellness. The Lt. Governor’s Challenge recognizes Delawareans who have worked tirelessly to make the First State a healthier place. Past winners have gone the extra mile to provide accessible, healthy choices for their communities. The Lt. Governor’s Office is accepting nominations for this year’s challenge until May 12, 2023. Organizations, community groups, individuals, and institutions are invited to nominate themselves or members of their community who are advancing the goals of a healthier Delaware in one of four areas of focus: Emotional well-being; Healthy Living; Chronic Disease Management and Prevention; and Mother and Child Health. Visit ltgovernorschallenge.org for more information and full entry rules and requirements.

The CPT 2023 Code Set At-A-Glance

The CPT® Quarterly is dedicated to exploring the many ways to answer the question: What makes Current Procedural Terminology (CPT®) the language of medicine today? Published by the American Medical Association (AMA) and delivered every few months to your inbox, this is your resource for staying current with the CPT code set and keeping pace with the speed of health care.

Crime Victims' Rights Week - April 23-29, 2023

The Victims’ Rights Task Force is excited to offer these free seminars focusing on fraud and scams targeting older Delawareans, during Crime Victims’ Rights Week. Events will be held in Millsboro on April 25; Wilmington on April 26; and Dover on April 27. Please feel free to post these flyers in your office for your patients' information.

Also during Crime Victims' Rights Week, the Victims' Rights Task Force has partnered with Jennifer Boileau to offer three free events across the state. Ms. Boileau will help participants explore the use of meditation and breathing exercises to move through trauma. Refer to the flyer for additional information.

Dr. Robert Abel Invited to Rwanda International Institute of Ophthalmology

Rwanda is a geographically small country located in central Africa with one of the highest population densities in sub-Saharan Africa. Its dominant feature is a chain of mountains that runs on a north-south axis and forms part of the Congo-Nile divide. The interior highlands consist of rolling hills and valleys. Only a small percentage of the country is covered in natural forest vegetation. Reforestation programs have added eucalyptus trees to previously denuded hillsides and roadsides. Among the volcanoes in the bamboo forests of the Virunga Mountains to the north lives Rwanda's main tourist attraction: the mountain gorilla.

MSD Member Robert Abel, MD, award winning ophthalmologist, author, and educator, had the opportunity to go to Rwanda on a medical outreach trip. Below he shares a brief on his experience being in Rwanda this past February.

I recently returned from being invited to teach and work at the Rwanda International Institute of Ophthalmology (RIIO). What makes this program truly unique and international is the commitment to train residents from three other African countries as well. We brought 16 corneas for transplantation and their doctors performed 14 of the surgeries. The permanent faculty consists of two leading East African ophthalmologists, one Nepalese and an American who is a former Wills Eye Hospital resident. Even more amazing is how Rwanda has recovered from a genocide 29 years ago to become the safest country in the world. The prisons are guarded but not fenced and previous poachers have been transformed to become trackers and guides. This democracy can teach many lessons to the world and not just that the mountain gorilla are prospering.

ChrisitianaCare

ChristianaCare provided new details about its plans to restore needed health care services to the southern Chester County community at its West Grove Campus, formerly Jennersville Hospital. ChristianaCare finalized the purchase of its West Grove campus from Tower Health in June 2022. The hospital has been closed since Dec. 31, 2021. ChristianaCare will open a neighborhood hospital that includes 10 emergency department beds and 10 inpatient beds. The neighborhood hospital will offer emergency care, behavioral health emergency care and provide diagnostic capabilities including ultrasound, computed tomography (CT), X-ray and laboratory services. The emergency department will treat common emergency care needs such as falls, injuries, heart attacks and strokes. Additionally, the hospital will benefit from access to ChristianaCare’s large network of specialists and support services — such as neurology and cardiology — through virtual consults. ChristianaCare’s plans for a neighborhood hospital meet the Pennsylvania Department of Health’s requirements for a micro-hospital, which must have a minimum of 10 inpatient beds and 10 emergency department treatment rooms and offer imaging services onsite. ChristianaCare anticipates an opening date in late 2024, although the date is subject to change due to the significant work that will be required to renovate the facility to bring it up to current standards, including the build-out of an entirely new information technology infrastructure.

ChristianaCare has been recognized as one of the Top 100 Companies with Inclusive Benefits by Mogul, a diversity recruitment platform that partners with the world’s fastest-growing companies to attract and advance top diverse talent. ChristianaCare was recognized for both its “diverse hiring practices” and “progressive workplace resources.”

Delaware Diagnostic Labs 

MSD is pleased to highlight a 2023 Premier Educational Program Partner. Delaware Diagnostic Labs is part of the growing effort to keep our medical professionals educated through its partnership with MSD as a Premier Educational Program (PEP) Partner.

Delaware Diagnostic Labs is a CLIA-certified and COLA accredited full-service laboratory providing hematology, chemistry, toxicology, immunology, and virology testing. They are dedicated to providing personalized, efficient, quality-oriented laboratory services.

They are a growing force in the health care industry, and have been providing customized service to a wide array of clientele, including physicians offices, pain management clinics, urgent cares, and more. Phone: 302-407-5903; Email: info@deldxlabs.com or admin@deldxlabs.com; Website: www.deldxlabs.com.

If you would like to become a PEP Partner, please contact Lynn Robinson, Director of

Professional Education.

Reserve your seat for this important webinar! Affirmative action in med ed: Exploring the consequences of an adverse Supreme Court decision. This webinar will be held 4-5 p.m. (ET) on Monday, April 3rd. Affirmative action has been a central element in efforts to promote diversity in higher education and the workplace. In anticipation of the Supreme Court's decision in the Students for Fair Admissions' cases against Harvard University and the University of North Carolina, the American Medical Association will convene a group of thought leaders in medical education and health equity to discuss the potential consequences of an adverse decision - and to explore new perspectives that may allow us to continue the journey toward health equity and social justice. Details/registration.

Move to a Three-Year Reappoint Cycle: To change or not to change? That is the question. The Joint Commission recently revised its medical staff standards and published an FAQ that states “Reappointment/re-privileging is due no later than three years from the same date from the previous appointment or reappointment, or for a period required by law or regulation if shorter.” While many in the industry review this change as favorable, a multitude of decisions must be made before this change should occur within an organization. This free webinar will be held on Wednesday, April 12th at 1 p.m. (ET) and discuss the pros and cons of transitioning to a reappointment period of three years as well as the industry standards and governance documents that will need to be evaluated and considered. Participants are encouraged to bring their questions for the closing Q&A session. This webinar will be recorded and available to watch on-demand within a few days of the live broadcast. Register to receive a link to the recording. Click to register.

MSD Night at the Blue Rocks. Tickets are available to watch the Wilmington Blue Rocks take on the Aberdeen Iron Birds on Tuesday April 25, 2023. Game time is 6:35 p.m. at Frawley Stadium in Wilmington. By registering for this event, you are reserving (1) entrance ticket for yourself to watch the game from a suite and stadium food will be provided. Space is limited, and this is a MSD member only event. Tickets will be provided via email prior to the event date. The tickets for this event are being offered at no charge to MSD members. All MSD members must be current & membership dues for 2023 paid. Please contact MSD to renew if needed. Register

SAVE THE DATE! For the Delaware Chapter, American Academy of Pediatrics Justice, Equity, Diversity, and Inclusion CME Webinar discussing health care literacy in the perioperative arena. This webinar will take place on Thursday, April 27th at 5:30 p.m.

The Delaware Academy of Family Physicians (DAFP) is also looking to strengthen our programs and offerings to our primary care community. To help us address the concerns of primary care access and physician shortages, the DAFP Research & Education Foundation (REF) is a 501(c)(3) corporation and the philanthropic arm of the Delaware Academy of Family Physicians. The DAFP REF offers important programs to encourage medical students and residents to come to Delaware to explore the world of primary care and consider becoming a family physician in our state to improve access to care and provide patient education for our Delaware communities. To support these programs the DAFP Research & Education Foundation invites you to join us as a golfer and/or sponsor to our 2023 DAFP Healthcare Heroes Golf Outing being held on Friday, May 12, 2023 at the White Clay Creek Country Club in Wilmington, DE. A Shotgun start will be at 10:00am. Learn more and register.

Claudette E. Anderson, MD - OB/GYN, Allgyn, Inc.

MSD members are afforded a seven-day review period from the date of this publication to comment regarding applicants for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdelorg with any comments on the current pending member(s) listed above or if you know someone interested in joining MSD. You could be eligible for a referral discount!

On January 30, 2023, the Biden-Harris Administration announced its intent to end the national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic on May 11, 2023. The Centers for Medicare & Medicaid Services (CMS) has resources available to help you prepare for the end of the PHE, some of which have been updated based on recent action by Congress. The following materials reflect recent changes and are currently available on the CMS Emergencies Page:

• Provider-specific fact sheets for information about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
• CMS 1135 Waiver / Flexibility Request and Inquiry Form: https://cmsqualitysupport.servicenowservices.com/cms_1135
• Acute Hospital At Home: https://qualitynet.cms.gov/acute-hospital-care-at-home

Updates will continue to be provided as we approach the end of the PHE. You are encouraged to regularly visit the CMS Emergencies Page for the most up to date information.

• (Delaware) General Questions: call 211 or email DPHCall@delaware.gov or Vaccine@delaware.gov for vaccine-specific questions.
• Latest information on Delaware's response (testing, treatment, vaccination): de.gov/coronavirus (Updated 2/2023)
• CDC COVID-19 Testing Locator Website (no-cost COVID-19 Testing. launched 1/2023)
• Delaware "My Healthy Community" COVID-19 Dashboard (updated weekly on Wednesdays)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• COVID-19 Community Transmission (based on cases per 100,000 people and positivity rate, both measured over the last 7 days)
• DPH Public Health Alerts: de.gov/publichealthalerts
• Federal website for information on navigating COVID: COVID.gov
• CDC COVID-19 Quarantine and Isolation Calculator
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• FDA At-Home OTC COVID-19 Diagnostic Tests provides a list of all FDA-authorized at-home over-the-counter (OTC) COVID-19 diagnostic tests
• Subscribe to the COVID-19 Update podcast - on Apple Podcasts or Simplecast.  

The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section, we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.