Board presents recommendations across focus areas to improve efficiency and accountability in state government

WILMINGTON, Del. – Governor John Carney on Thursday released the second annual report of the Government Efficiency and Accountability Review (GEAR) Board. Governor Carney established GEAR by Executive Order in February 2017 to identify ways for state government to operate more efficiently, improve the delivery of state services, and save costs over the long term.

By December 1 of each year, the Board must submit a report to the Governor that provides recommendations for possible inclusion in the upcoming recommended state budget. Governor Carney will present his Fiscal Year 2020 budget proposal on January 24, 2019 at the Delaware Public Archives in Dover.

“Since taking office I have talked to Delawareans about our commitment to operating state government more efficiently, and identifying cost savings so we can direct resources where they are most needed,” said Governor Carney. “We remain committed to improving the way we deliver state services, and spending taxpayer dollars responsibly. That’s what Delawareans expect. Thank you to members of GEAR for their important work on this report.”

Members of the GEAR Board presented Governor Carney with a series of recommendations for efficiency initiatives to be implemented across a number of focus areas – including criminal justice, education, financial services, health and social services, human resources, information technology, and public private partnerships. Among these recommended efficiency initiatives are activities that state government agencies can undertake to improve the quality of services, lower the cost of agency operations, and create new methods for improving the recruitment, development, and retention of State employees.

Read the 2018 annual report for full details.

“GEAR seeks to make specific recommendations that will increase the efficiency of state government, improve the state’s strategic planning process, further institute the use of metrics in resource allocation decisions, and develop sustainable continuous improvement practices,” said James Myran, Executive Director of GEAR, and Bryan Sullivan, Director of Management Efficiency at the Delaware Office of Management and Budget. “We’re working to create the process effectiveness and transparency that Delaware citizens expect from their government.”

Visit GEAR’s website for more information, and to submit an idea for improving the way state government operates.

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Related news:
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Governor Carney Releases Annual Report of Government Efficiency and Accountability Review (GEAR) Board
Governor Carney Creates Government Efficiency and Accountability Review Board

Executive Order creates commission focused on reentry reform, and new office at DOC to oversee implementation

WILMINGTON, Del. – Governor John Carney on Tuesday signed Executive Order #27, which focuses on improving reentry procedures for incarcerated individuals in Delaware. The Executive Order creates a commission focused on reentry reform, policies, and procedures, with a goal of helping former inmates more successfully reenter their communities. The Order will more effectively coordinate service delivery, strengthen data sharing among agencies, create a comprehensive reentry protocol, improve the availability of academic and vocational programming prior to an inmate’s release, and strive to reduce recidivism in Delaware.

“It’s our responsibility to look out for every Delawarean. We need to make sure offenders who serve out their sentences are able to reenter society ready to positively contribute to their communities, and have the support they need to succeed,” said Governor Carney. “This Executive Order will improve our existing reentry procedures, and in turn, reduce recidivism. That will help strengthen communities across our state.”

Executive Order #27 is the result of Delaware’s participation in the National Criminal Justice Reform Project, an initiative led by the National Governors Association and the National Criminal Justice Association Center for Justice Planning to assist states in implementing evidence-based criminal justice reforms.

“This Executive Order enhances the ability for the Department of Correction to meet its goals of ensuring public safety and providing opportunities for rehabilitation to justice-involved individuals preparing to return to the community,” said Perry Phelps, Commissioner of the Delaware Department of Correction. “I look forward to working with Governor Carney and our sister agencies to reduce barriers and collateral consequences for the men and women exiting the correctional system.”

Approximately 23,000 incarcerated adults are released from the State of Delaware Department of Correction (DOC) facilities annually. Seventy-six percent of those who are released from DOC facilities are rearrested within three years. Sixty-eight percent of those released had a reconviction and sixty-five percent had a recommitment. Delaware’s percentage of probationers is approximately forty-six percent higher than the national average, and its percentage of incarcerated adults is approximately twelve percent higher than the national average. Reentry reforms in Executive Order #27 are intended to directly confront Delaware’s high rate of recidivism.

“The Delaware Criminal Justice Council is excited to work with Governor Carney and the newly-established commission to build on the continuing work of improving reentry services to all justice involved individuals,” said Christian Kervick, Executive Director of the Delaware Criminal Justice Council. “This Executive Order includes best practices and reforms to improve our Criminal Justice System and increase public safety throughout the State.”

The Delaware Correctional Reentry Commission will consist of members of the Governor’s Cabinet, the Chief Judge of the Court of Common Pleas, the Attorney General and others who work closely on this issue, including the Executive Director of the Criminal Justice Council. This Commission will oversee implementation and further develop the State’s comprehensive strategic reentry initiatives, ensuring that federal, state, and local resources are used most efficiently to reduce duplicative reentry services and align with the application of evidence-based approaches.

“Ninety-eight percent of the people who enter Delaware prisons will return to the community. They are our neighbors. We live, shop, and work in the same community,” said Adam Balick, Chair of the newly-created Delaware Correctional Reentry Commission. “It is in all of our interests to give them the tools they need to succeed when they return to our community. We know the factors that lead to recidivism. Homelessness, unemployment, drug addiction, among other things. We can lower recidivism rates in Delaware by helping these men and women reintegrate successfully.”

This Executive Order also restructures the DOC Office of Research and Planning to the Office of Planning, Research and Reentry. This office will oversee the implementation and maintenance of the Commission’s initiatives from prison to community corrections centers to probation and parole to the community.

“The National Criminal Justice Association is extremely pleased to have worked with Governor Carney and his leadership team to advance prisoner reentry reform efforts in the State of Delaware,” said Chris Asplen, Executive Director of the National Criminal Justice Association. “This Executive Order represents over a year and a half of work by many committed, hard-working leaders from a myriad of disciplines and agencies who make up the steering committee and many working groups and community groups who are dedicated to increasing public safety by improving the state’s prisoner reentry process. This EO includes the many priorities identified in Delaware’s Prisoner Reentry Strategic Plan. We are grateful to our partners at the National Governor’s Association, our consultants and to the John and Laura Arnold Foundation for the support that made this work possible.”

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NEW CASTLE (Dec. 4, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission has awarded eight additional value-based payment reform mini-grants to Delaware health care providers in order to facilitate data integration, improve the coordination of patient care or increase readiness to integrate into an Accountable Care Organization (ACO) or operate through an Alternative Payment Method (APM)

The awards, through the Value-Based Payment Reform Fund, range from $25,000 to $250,000 for work that must be completed by Jan. 31, 2019. The commission received a total of 45 applications from primary care providers, behavioral health providers, hospitals, Accountable Care Organizations (ACOs), Federally Qualified Health Centers (FQHCs) and clinically integrated networks, all of which must be licensed in the State of Delaware. The commission expects to award a few more additional grants for small projects (up to $50,000) and large projects (up to $250,000), based on the scope of the project.

This round of awards went to:

• Nanticoke Hospital ($250,000): To conduct a study on global budgeting and how it could be implemented by Nanticoke and the State of Delaware.

• MedNet ($200,230): To speed up development of a population health management platform through expedited integration of clinical data from the Electronic Medical Records (EMR) platforms represented across the MedNet network.

• Nemours/A.I. duPont Hospital for Children ($200,000): To increase readiness to integrate into an Accountable Care Organization (ACO) or Clinically Integrated Network (CIN) or operate through an Alternative Payment Method (APM), as well as to ensure data integration/infrastructure analytics and improve coordination of patient care.

• Westside Family Healthcare ($179,190): To improve the Federally Qualified Health Center’s ability to thrive into Alternative Payment Methods (APM) by focusing on utilization of Health Information Technology (HIT) to identify and coordinate care of high-risk/cost patients, identify barriers limiting patients from utilizing the appropriate level of care and develop improved data integration with one of its Medicaid Managed Care (MMC) payers to allow use of clinical data for pay-for-value program performance. Part of the work will involve integration of Westside’s Allscripts Electronic Health Records (EHR) system with the Delaware Health Information Network (DHIN).

• Brandywine Counseling and Community Services ($111,716.50): To implement a data integration project that will reorganize its institutional structure to accommodate value-based payments and improve the coordination of patient care, especially for those clients with co-occurring disorders.

• Stoney Batter Family Medicine ($73,000): To upgrade its Allscripts system to facilitate better data-sharing required for participation in value-based programs, conversion to electronic billing and training sessions for employees.

• Delaware Health Net ($34,375): To develop “cost of care” analytics tool to adequately define the cost of a chronic condition population historically when cared that population has been cared for at a health center.

• Stoney Batter Family Medicine ($20,000): To design a training program for care coordinators/providers on how to prevent emergency department and hospital readmissions utilizing hospital-based admission information from DHIN, its ACO practice dashboard for Medicare patients, and its EHR stem to optimize communication.

“We are excited to announce this next round of mini-grant awards in the area of value-based payment reform,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “These grants reflect a diversity of ways that providers, hospitals, health centers and health systems are embracing payment reform.”

The first award ($62,168), to Christiana Care Health System’s CareLink Behavioral Health Medical Home Pilot, was announced in November. Applications, which were received during the summer, fell into one of three areas:

• Data integration: Project must enhance the applicant’s data integration, clinical informatics or population-based analytics capabilities. Examples include data exchange infrastructure and analytics projects or support; data warehousing and reporting capacity; and development of data-sharing agreements.
• Improve the coordination of patient care: Project must enhance the applicant’s clinical integration. Examples include conducting data analytics and developing care guidelines for a primary care-based system of complex care management for high-risk population(s); implementing improvements in care transitions such as new business processes or mutual agreements with partner providers; and implementing a practice support call center.
• Increase readiness to integrate into an Accountable Care Organization (ACO) or operate through an Alternative Payment Method (APM): Project must develop, expand or enhance the applicant’s shared governance structures and organizational integration strategies, linking the applicant with ACO leadership and across the continuum of care with providers already contracted with an ACO. An example would be support to model costs of care in preparation for participation in value-based payment arrangements with multiple payers.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

Op-ed by Tracey Quillen Carney, First Lady of Delaware
Honorary Chair, Kindergarten Registration Campaign

This month, we launched the first ever Kindergarten Registration Campaign in Delaware. And I can hear families asking exactly what I would have asked in the hectic preschool years of our kids’ lives: “You want me to think about next fall – now?”

Of course, students won’t ever be turned away from attending their feeder pattern school. But families should know that kindergarten registration is not a one-step process, and there are advantages and opportunities that come with starting early—opportunities that can help give children the best possible start to the school year. A good start to kindergarten helps set kids on a path to future success, including the all-important benchmark of grade-level reading.

So yes, speaking to my fellow parents/caregivers, now really is the best time to start planning for next fall, and our schools are eager to help. We can help each other, too, by spreading the word and encouraging all parents/caregivers of children who will be age five by August 31, 2019, to learn about and complete kindergarten registration as early as possible.

First, families need to identify your home schools, even if you plan to look into choice or charter options, and learn exactly what each school requires for registration. No one should be wary of the documents requested; schools will work with all Delaware residents in consideration of family circumstances. But recognize that you might need time to make physical exam appointments and gather materials. Each school also has a number of forms for families to complete, and it’s worth finding out early if you—or your family members, neighbors, or friends with rising K students—are going to need any help or additional information.

You also want to ask about kindergarten registration events, which are already underway at some schools and will continue into the spring. Most districts host both day and evening events—some even have “kindergarten registration weeks”—not only to offer help with forms, but also to get to know your child and your family. Early registration maximizes opportunities to build a sense of connection to the school community, with the adults who will work with your child and with other families who will be starting K along with yours.

In addition, at registration events and appointments, schools are able to share information about learning activities and opportunities that are available before the start of kindergarten—including a variety of spring/summer programs and free online materials, like those at ReadingBrightStart.org and delawarereadinessteam.com.

We have 28 districts and charters that offer kindergarten in Delaware. Each has its own schedule of registration events. Along with the Delaware Department of Education, school districts are working hard to make the registration process as easy as possible. But it just doesn’t make sense to leave registration until late spring or summer, as many families currently do. It deprives you of opportunities to help children to be ready on day one of kindergarten, and it impedes our schools’ ability to plan with precision for incoming K classes.

For families who want to explore choice/charter options, remember that you must register in your “home school” first and then complete the choice/charter process, as well. There is not an official deadline for choice requests, but keep in mind that the first lottery selections for choice spots are in early January. Again, whatever your plans, starting the registration process now just makes sense.

In a recent survey conducted by the Delaware Readiness Teams—community-based teams of early childhood specialists and early learning providers, district and school staff, teachers, parents, and neighbors—76% of parents/caregivers described the kindergarten registration process as “hard” or “extremely hard.” For those who completed the survey in Spanish, 98% said the registration process was hard or extremely hard. The sooner families learn about kindergarten registration, the more support they can get in addressing any questions.

The Delaware Readiness Teams have compiled “Get Ready for Kindergarten” packets, which have been available at special events this month and have been distributed to many libraries and pediatric/family practice offices, as well as to early childhood education providers, throughout our State. To request a packet—or to learn more in support of your family, friends, and neighbors—please email delawarereadinessteams@gmail.com.

When it comes to promoting school readiness and the future of our children—all of Delaware’s children—we are in this together. Thank you to everyone who is a part of Delaware’s Kindergarten Registration Campaign.

Order will create subcommittee focused on bettering health care spending, quality across the state

WILMINGTON, Del. – Governor Carney on Tuesday signed Executive Order #25 establishing health care spending and quality benchmarks. This Executive Order will form a subcommittee of the Delaware Economic and Financial Advisory Council to focus on reducing the cost of health care for Delaware families, taxpayers, and businesses. The subcommittee will advise DEFAC and other relevant state agencies on spending, and will work closely with the Delaware Health Care Commission (DHCC) on improving the quality of health care in Delaware.

“Delaware has consistently ranked among the highest-spending states for health care, but we have not traditionally been a leader in health care outcomes. That needs to change,” said Governor John Carney. “This Executive Order reaffirms our commitment to lowering costs for Delaware families and improving the quality of care that Delawareans receive. We’ll do that, first and foremost, by improving transparency around the cost of health care services.”

In addition to setting the State’s health care spending benchmark for 2019 and beyond, the new subcommittee will consistently review its methodology and provide the public and interested stakeholders an opportunity to provide input and consider their recommendations.

This Executive Order also lays out quality benchmarks for the State for calendar years 2019 through 2021 for the Delaware Health Care Commission to follow in the categories of:

• Emergency Department Utilization Rate,
• Opioid-Related Overdose Deaths,
• Overlapping Opioid and Benzodiazepine Prescriptions,
• Adult Obesity,
• Adult Tobacco Use,
• High School Students Who Were Physically Active,
• Statin Therapy for Patients with Cardiovascular Disease, and
• Persistence of Beta-Blocker Treatment After a Heart Attack.

These quality benchmarks will be reviewed every three years, starting after 2022, to reflect improved health care performance in the state.

“I am grateful to all of the health care stakeholders for the work they have done to change how care is delivered and paid for in our state,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “As a state, we must address the cost of health care and the outcomes we are getting for that spending. The Executive Order that Governor Carney signed adds transparency and attention to our health care system, both from a spending and a quality standpoint. Today is an important milestone in moving toward a health care system that is financial sustainable for families, employers, providers and insurers, and one that rewards providers for keeping Delawareans healthy.”

This Executive Order was based on recommendations from Secretary Walker in August of this year, after a year of outreach and feedback from health stakeholders. Secretary Walker will publish a manual that contains the methodology for the health care spending and quality benchmarks no later than January 31, 2019.

“For more than four decades, the Delaware Economic and Financial Advisory Council has played a vital, non-partisan role in tracking national and state economic trends and preparing credible and trusted state revenue and expenditure estimates,” said Rick Geisenberger, Secretary of Finance. “This Executive Order creates a DEFAC Health Care Spending Benchmark Subcommittee that will solicit public and stakeholder input toward recommending a credible and trusted annual target for per capita growth of total health care costs in Delaware.”

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