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.

Residents Should Remain Vigilant and Use Successful, Proven Tools

The Delaware Division of Public Health (DPH) saw a decrease in case rates and hospitalizations from COVID-19 over the past month and urges residents to remain vigilant and use the tools proven successful in the fight against the virus to continue these trends. While rates are down from the peak of the pandemic, individuals are still being hospitalized at a concerning rate from COVID-19. From October 8, 2022 through the end of February 2023, 3,570 people were newly admitted to Delaware hospitals with confirmed or suspected COVID-19. The daily total of new admissions was highest on January 6, 2023, when 62 people were newly admitted to the hospital that day. Treatment is available via oral medication or IV infusion, depending on what is best for the individual and their condition. Treatment is most effective if started within five days of symptoms beginning, so getting it early is key. For more information on treatment options and test-to-treat locations throughout Delaware, visit de.gov/covidtreatments. Full data on the impact of the pandemic in Delaware since its onset and current analysis continues to be available on the MyHealthyCommunity portal at https://myhealthycommunity.dhss.delaware.gov/home. 

Federal Program Provides Funding for High-Speed Home Internet Access

On Monday, Governor John Carney and municipal leaders launched a statewide initiative to raise awareness of the Affordable Connectivity Program (ACP), a federal initiative funded by the Bipartisan Infrastructure Law passed in November 2021 aimed at helping lower-income families pay for high-speed internet. The program, which provides eligible households with a monthly discount of up to $30 on their home internet bill and a one-time $100 discount on a laptop, desktop computer, or tablet, is estimated to be accessible to over 140,000 qualified household in Delaware. ACP-eligible households includes families with incomes at or below 200% of the federal poverty level and those who qualify for SNAP, free and reduced-price school lunch, WIC, and other government-funded program. The new initiative aims to increase awareness and enrollment by leveraging state and city channels, community-based organizations, and trusted institutions to reach unconnected households, particularly those in under-resourced communities. EducationSuperHighway will support statewide awareness efforts and recently launched GetACP.org, a virtual mobile assistant available in four languages that simplifies the ACP enrollment process by determining the easiest way for eligible households to qualify. The program is part of Delaware's efforts to connect unserved homes to high-speed fiber broadband and work towards digital equity. Learn more at https://broadband.delaware.gov/.

HRSA Announces Modernization Initiative for Accountability, Transparency

On Wednesday, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced a Modernization Initiative that includes several actions to strengthen accountability and transparency in the Organ Procurement and Transplantation Network (OPTN). HRSA is posting on its website a new data dashboard to share de-identified information on organ donors, organ procurement, transplant waitlists, and transplant recipients. Patients, families, clinicians, researchers, and others can use this data to inform decision-making as well as process improvements. This announcement also includes a plan to strengthen accountability, equity, and performance in the organ donation and transplantation system. This iterative plan will specifically focus on five key areas: technology; data transparency; governance; operations; and quality improvement and innovation. In implementing this plan, HRSA intends to issue contract solicitations for multiple awards to manage and improve the OPTN. HRSA also intends to further the OPTN Board of Directors’ independence through the contracting process and the use of multiple contracts. Finally, the President’s Budget for Fiscal Year 2024 would more than double HRSA’s budget for organ-related work, including OPTN contracting and the implementation of the Modernization Initiative, to total $67 million. In addition, the Budget requests statutory changes to the National Organ Transplant Act to remove the decades-old ceiling on the amount of appropriated funding that can be awarded to the statutorily required vendor(s) for the OPTN. It also requests that Congress expand the pool of eligible contract entities to enhance performance and innovation through increased competition, particularly with respect to information technology vendors. As a part of this commitment, HRSA has created an OPTN Modernization Website to keep stakeholders informed about the Modernization Initiative and provide regular progress updates.

Additional Injuries and Deaths Reported

Additional deaths and cases of vision loss linked to eyedrops with Pseudomonas aeruginosa, a drug-resistant bacteria, have been reported since eyedrops from EzriCare and Delsam Pharma were recalled. The investigation to date has identified artificial tears as a common exposure for many patients. At this time, CDC and FDA recommend clinicians and patients stop using EzriCare or Delsam Pharma’s Artificial Tears products pending additional guidance from CDC and FDA. This particular drug-resistant strain of bacteria had never been seen in the US prior to this outbreak. Some cases showed those having respiratory or urinary tract infections and not eye infections. Deaths can occur when the bacteria enter the bloodstream.

CDC Issues Warning to Health Care Facilities About the Rising Threat

Candida auris (C. auris), an emerging fungus considered an urgent antimicrobial resistance (AR) threat, spread at an alarming rate in U.S. health care facilities in 2020-2021, according to data from the Centers for Disease Control and Prevention (CDC) published in the Annals of Internal Medicine. Equally concerning was a tripling in 2021 of the number of cases that were resistant to echinocandins, the antifungal medicine most recommended for treatment of C. auris infections. In general, C. auris is not a threat to healthy people. People who are very sick, have invasive medical devices, or have long or frequent stays in health care facilities are at increased risk for acquiring C. auris. CDC has deemed C. auris as an urgent AR threat, because it is often resistant to multiple antifungal drugs, spreads easily in health care facilities, and can cause severe infections with high death rates. C. auris has spread in the United States since it was first reported in 2016, with a total of 3,270 clinical cases (in which infection is present) and 7,413 screening cases (in which the fungus is detected but not causing infection) reported through December 31, 2021. Clinical cases have increased each year since 2016, with the most rapid rise occurring during 2020-2021. CDC has continued to see an increase in case counts for 2022. During 2019-2021, 17 states identified their first C. auris case ever. Nationwide, clinical cases rose from 476 in 2019 to 1,471 in 2021. Screening cases tripled from 2020 to 2021, for a total of 4,041. Screening is important to prevent spread by identifying patients carrying the fungus so that infection prevention controls can be used.

C. auris case counts have increased for many reasons, including poor general infection prevention and control (IPC) practices in health care facilities. Case counts may also have increased because of enhanced efforts to detect cases, including increased colonization screening, a test to see if someone has the fungus somewhere on their body but does not have an infection or symptoms of infection. The timing of this increase and findings from public health investigations suggest C. auris spread may have worsened due to strain on health care and public health systems during the COVID-19 pandemic.

DEA Proposed Rule to Amend Regulations to Expand Circumstances for Prescribing

The Drug Enforcement Administration (DEA) is amending its regulations, in concert with the Department of Health and Human Services (HHS), to expand the circumstances under which individual practitioners are authorized to prescribe schedule III-V narcotic drugs or combinations of such drugs that have been approved for use in continuous medical treatment (also referred to as maintenance) or withdrawal management treatment (also referred to as detoxification)—via a telemedicine encounter, including an audio-only telemedicine encounter. Electronic comments must be submitted, and written comments must be postmarked, on or before March 31, 2023. Commenters should be aware that the electronic Federal Docket Management System will not accept comments after 11:59 p.m. Eastern Time on the last day of the comment period. Read more.

40 Million+ are Enrolled in Marketplace or Medicaid Expansion Coverage

Today marks the 13^th anniversary of the Affordable Care Act (ACA) by highlighting record-breaking enrollment numbers during the 2023 Marketplace Open Enrollment Period and lower health care costs due to the American Rescue Plan (ARP) and Inflation Reduction Act (IRA). The Department of Health and Human Services (HHS) also released a report from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) that shows more than 40 million people are currently enrolled in Marketplace or Medicaid expansion coverage related to provisions of the ACA -- the highest total on record. Survey results indicate that all 50 states and the District of Columbia have experienced substantial reductions in the uninsured rate since 2013, the last year before implementation of the ACA. To view the full report, visit: https://aspe.hhs.gov/reports/current-health-coverage-under-affordable-care-act.

Nationwide, 4.6 million more consumers are receiving financial assistance in 2023, compared to 2021, representing 90% of all 2023 plan selections – meaning, 90% of people selecting plans are receiving help to pay for premiums. And thanks to these laws passed, 1.4 million middle income consumers (those with household incomes over 400% of the Federal Poverty Level (FPL), or about $54,000 for an individual), who were previously ineligible for assistance, were able to access financial help during the 2023 open enrollment. CMS partnered with cultural marketing experts to connect more people to resources including African Americans, Spanish and English-speaking Latinos, and Asian American and Pacific Islander communities in multiple languages. Among consumers who reported their race or ethnicity, 21% identified as Hispanic/Latino in the 2023 Open Enrollment Period, compared to 19% in the 2022 Open Enrollment Period, and 9% identified as Black in the 2023 Open Enrollment Period.

For Calendar Years 2025 Through 2023

The Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model will be extended for calendar years 2025 through 2030 and will introduce changes intended to more fully address the health-related social needs of patients, advance health equity, and improve care coordination for patients with serious illness. The CMS Innovation Center plans to share more information on model updates when available. For more information on the current model design, see the overview CY24 RFA fact sheet. You can also contact the model team at VBID@cms.hhs.gov.

Delaware Law Allows Single-Use Misoprostol

Delaware Attorney General Kathy Jennings has voiced her support for medication abortion, following a federal case to ban the medication mifepristone, which is one of two drugs used in medication abortion and miscarriage care. The case could have nationwide impacts on reproductive health care access, and if the judge orders the FDA to withdraw approval, the medication could potentially be taken off the shelves in every hospital and clinic across the country. The ACLU of Delaware, Planned Parenthood of Delaware, and All* Above All hosted a live-streamed event earlier this month to educate audiences on the case, as well as the significance of medication abortion to reproductive health care. Banning the use of mifepristone for medication abortion is expected to compound the public health crisis created after Roe v. Wade was overturned, and many clinics across the country are experiencing an overwhelming influx of patients from states that have banned abortion, an issue that Delaware faces as one of the few eastern states with relatively unrestricted access to abortion care for both in and out-of-state patients. Reproductive health care advocates in Delaware have been voicing concern over the potential outcomes of the case, including the disproportionate impact on young people, low-income communities, and people of color. However, Delaware law allows single-use misoprostol, another commonly used abortion medication, even if mifepristone ceases to be available. Those seeking assistance for reproductive health care services can access the Abortion Legal Helpline by calling (302) 992-8096 or visiting the State of Delaware website.

Hospice Care Contributed to $3.5 Billion in Medicare Savings in One Year

New research shows that patients’ use of hospice care contributed to $3.5 billion in savings for Medicare in 2019, while providing multiple benefits to patients, families, and caregivers. The study, conducted by NORC at the University of Chicago, is one of the most comprehensive analyses of enrollment and administrative claims data for Medicare patients covered by Medicare Advantage and Traditional Medicare. The study was funded by the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO). To access the full report and related materials, visit nhpco.org/hospiceworks.

Medical Licensure Renewal Deadline is March 31st

Medical licensure renewal takes place every two years on odd years, with 2023 being the biennial medical licensure renewal year. The deadline to renew medical licenses is March 31, 2023. Physicians must have a minimum of 40 continuing medical education credits to renew their license. Prior to your licensure renewal, you must take the Mandatory Reporting for Medical Professionals education. Failure to complete the training will delay the renewal of your medical license. There is a specific course approved for meeting this requirement. To complete the education, go to https://stateofdelaware.csod.com/default.aspx?c=courts-oca to create an account or if you have an account, to login. Once you have completed the course, you can reapply for licensure through the Division of Professional Regulation website at https://delpros.delaware.gov/OH_HomePage. Note that MSD does not have access to DELPROS. If you have questions or need technical assistance on the DELPROS website, please contact the State of Delaware.

Barrier Removal Fund Provides Funding for Accessibility Improvements

Delaware First Health is partnering with the National Council on Independent Living (NCIL) to assist physicians with removing barriers to accessibility at their practice by creating the Barrier Removal Fund program. The goal of this program is to increase the percentage of participating physicians that meet the minimum federal and state disability access standards by providing grant funds. The Barrier Removal Fund is in its sixth year and is expanding to Delaware. Below are links to the Request for Proposal (RFP), which will allow you to apply for grant funds for accessibility improvements at your practice, as well as a Frequently Asked Question (FAQ) document to address any questions.

• Delaware Barrier Removal Fund RFP
• Delaware Barrier Removal Fund FAQ



Delaware First Health is committed to providing equal access to quality health care and services that are physically and programmatically accessible for their members with disabilities and their companions. “Physical access,” also referred to as “architectural access,” refers to a person with a disability’s ability to access buildings, structures, and the environment. “Programmatic access” refers to a person with a disability’s ability to access goods, services, activities and equipment. Completed RFPs must be submitted by March 31, 2023, for consideration. The determination for grant awards will take approximately 3 months. Please note there are instructions included in the RFP regarding requirements and submission details. If you have any questions about the Barrier Removal Fund or RFP, please contact Jenny Sichel at jenny@ncil.org.

Improving the Diagnostic Process, A Free 18-Month Program

Is your practice interested in improving the cancer diagnostic process for your patients who 

receive some or all of their care via telemedicine? The Agency for Healthcare Research and Quality (AHRQ) is recruiting practices for a free 18-month program to improve diagnostic verification, timeliness, and communication with patients. Practices will receive training and one-on-one expert coaching to implement sustainable improvements to effectively close the loop at critical points in the cancer diagnostic process. Learn more and sign up for an informational webinar on the program website: safetyprogram4telemedicine.org. Access the flyer for more detailed information.

Attention: Sussex County Primary Care Community

The Delaware Division of Substance Abuse and Mental Health is reaching out to the Sussex Country primary care community to share information about the Rural Communities Opioid Response Program (RCORP) Behavioral Health Care Support grant and to partner with several practices. 

The Grant seeks to:

1. Strengthen care coordination and linkages to services, including mental health and related services for people engaged in behavioral health care. 
2. Facilitate access to services for populations who are underserved and/or less likely to engage in services, and therefore more likely to suffer from poorer health outcomes, health disparities, and other inequities. 
3. Strengthen the capacity and quality of the existing and emerging workforce of physicians and health care professionals to care for patients utilizing evidence-based mental health and substance use treatment approaches. 
4. Address community-level risk factors and increase support for people facing addiction and co-occurring mental health conditions by increasing community empathy, decreasing stigma, and increasing family and caregiver skills to provide support. 

The primary care community in Sussex County is invited to attend a virtual information session on Wednesday, March 29th at 1 p.m. Click the link below to register to attend. 

https://us06web.zoom.us/meeting/register/tZEkc-yuqDgrGNF1wPMs7TygukASSnWdscs6

Application Period Now Open

The 2023 Million Hearts® Hypertension Control Challenge is now accepting applications. The challenge identifies and spotlights health care professionals, practices, and systems that have achieved nationally laudable hypertension control rates. Applicants must have a hypertension control rate of at least 80 percent during the 12-month reporting period preceding the Challenge, among the practice’s hypertensive patient population. Control is defined as having a blood pressure that is <140 mmHg systolic and <90 mmHg diastolic.

The deadline to apply is April 14, 2023. Quality Insights can assist you in applying for the Millions Hearts® Hypertension Control Challenge. If your practice is interested, please reach out to your Quality Insights Practice Transformation Specialist or contact Ashley Biscardi via email or phone at 1.800.642.8686, ext. 137.  Access the application online.

Bayhealth

The trauma center at Bayhealth Hospital Kent Campus has been reverified as a Level III Trauma Center by the Verification Review Committee (VRC), an ad hoc committee of the Committee on Trauma (COT) of the American College of Surgeons (ACS). This achievement recognizes the trauma center's dedication to providing optimal care for injured patients. 

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.

Ronald M. Lieberman, DO - Tristate Physical Medicine Associates, LLC

Please join MSD in welcoming the newest members of the Medical Society of Delaware. As the third oldest medical society in the country, MSD has an amazing history. Thank you for taking part in our continued success!

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.