DOVER – Revenue from a new opioid impact fee created by the Delaware General Assembly in 2019 will be used to prevent overdose deaths and provide new services to those seeking treatment for their substance use disorder, the Delaware Department of Health and Social Services (DHSS) and Sen. Stephanie Hansen announced Wednesday.

DHSS Secretary Molly Magarik this week detailed the department’s plan to spend the first $700,000 raised by the fee as of the third quarter of 2020, as required by Senate Bill 34.

Those funds will be used to bolster Delaware’s supply of naloxone, a medication that can reverse an opioid overdose; support the expansion of Bridge Clinic services to 24 hours a day in all three counties; and provide grants to people in treatment or recovery for such needs as transportation, housing, or education.

“As we work to reduce the spread of COVID-19, our state continues to respond to an opioid epidemic that is costing the lives of far too many Delawareans,” DHSS Secretary Molly Magarik said. “The opioid impact fee created by Sen. Stephanie Hansen last year is proving to be a powerful tool in that fight. These funds are helping us to expand our services and reach the people most in need of that support.”

Signed into law by Governor John Carney in June 2019, Delaware’s first-in-the-nation opioid impact fee requires some of the nation’s largest drug makers to address the costs of the opioid crisis they helped to create.

Manufacturers are now charged one penny for every morphine milligram equivalent (MME) of any brand-name opioid dispensed in Delaware and one-quarter of a cent for every MME of their generic opioids sold here. Companies that refuse to pay the fee can be charged a penalty of up to $100 a day or 10 percent of the total impact fee, whichever is greater.

Proceeds from the fee are then held in a special Prescription Opioid Impact Fund that can be used only for the prevention and treatment of opioid use disorder. According to the law, the fund is administered by DHSS with input from the Behavioral Health Consortium, the Addiction Action Committee, and the Overdose System of Care Committee.

“When we started down this road, we heard from countless naysayers who falsely claimed either that this legislation would hurt pharmacies, negatively impact consumers or fail to make a difference,” said Sen. Stephanie Hansen, the lead architect and driving force behind Senate Bill 34, along with House prime sponsor Rep. David Bentz. “Fears such as these prevent progress and have allowed this crisis to go on so long. This announcement today proves we can hold drug makers accountable. We can bring innovative, new tools to bear to confront addiction in our communities. And we can do more to break the cycle of abuse, addiction and death that has touched so many families in our state.”

Delaware is one of the top 20 states in opioid prescriptions per capita and currently leads the nation when it comes to the prescription rate for high-dose opioids. Delaware also ranks in the top five for most overdose deaths per capita. Every year since 2009, more Delawareans have died from drug overdoses than motor vehicle crashes, including 431 in 2019 alone – a record likely to be broken this year.

“The status quo simply will not suffice if we are going to get Delaware’s opioid crisis under control,” said Alexis Teitelbaum, acting director for the Delaware Division of Substance Abuse and Mental Health. “Revenue from the opioid impact fee will support our efforts to build out Delaware’s treatment infrastructure and continue our efforts to reach more people in new ways.”

Funds from the Opioid Impact Fee will be targeted for four main purposes in the coming year:

• $300,000 will be combined with federal grant funding to help fill a critical gap in the existing system of care for people struggling with addiction issues. Interventions immediately following an overdose or other hospitalization present an effective opportunity to enroll patients in treatment programs. Currently, people discharged from the hospital are brought to a Bridge Clinic, located in each county, for screening and referrals to these programs. However, Bridge Clinics do not operate 24/7. DSAMH is currently working to address this issue through the addition of Stabilization Centers that can house and counsel clients during off-hours and weekends. Funding from the Opioid Impact Fee will help cover capital start-up costs, while the State Opioid Response federal grant will be used to fund programmatic and treatment expenses.
• $250,000 will be used to help people struggling with addiction issues fill gaps in the social determinants that often present roadblocks in their efforts to enter, continue and complete the treatment and recovery process. These funds will provide DSAMH with the ability to assist clients with transportation costs and transitional housing while they seek treatment, as well as additional supports for people in recovery.   
• $100,000 will be reserved to cover the Department of State’s administrative expenses associated with the collection of the fee.
• $50,000 will be used to purchase 925 additional naloxone kits that DSAMH will make available to various community groups. Organizations can acquire these life-saving kits by contacting DSAMH. During the first three quarters of 2020, the Delaware Division of Public Health’s Office of Health Crisis Response distributed nearly 6,300 naloxone kits statewide through its community partners.

“There are no easy solutions when it comes to treating people struggling with substance use disorder,” said Lt. Gov. Bethany Hall-Long, who chairs the Delaware Behavioral Health Consortium. “To be successful, we must take a truly holistic approach. This means supporting both the individual and their family as we attempt to remove the social determinant barriers that hinder an individual on a path to recovery,” she said. “The Opioid Impact Fee is helping Delaware to build that behavioral health system infrastructure. This legislation is doing more than just generating revenue. It will help us to save lives, rebuild families, and restore communities torn apart by addiction. Sen. Hansen, Rep. Bentz, the community advocates, and DHSS deserve a lot of credit for the plan being put forward today.”

New regulations increase oversight of Pharmacy Benefit Managers

Excessive pharmaceutical costs are a concerning trend occurring across the nation, and today the Delaware Department of Insurance has finalized new regulations for Pharmacy Benefit Managers (PBMs) to proactively combat the issue. The regulations go into effect on August 11 as part of implementing HB 194, and come after extensive stakeholder discussions.

PBMs administer prescription drug plans for health insurers, large employers, Medicare Part D plans, and other groups, determining the list of medications that a plan will cover and the consumer costs of those drugs. These companies hold massive negotiating power and receive billions of dollars in rebates from manufacturers, but to date have widely not used their power to reduce the costs of medications and insurance. The new regulations from the Department of Insurance will begin an increasing level of oversight and transparency, allowing the department to investigate companies, require corrective actions, and to suspend, deny, or revoke a PBM’s registration if they are acting in violation of the Code.

“Increasing the affordability of prescriptions and healthcare increases their accessibility, creating a healthier Delaware. These steps towards regulating this multi-billion-dollar industry will save residents money, and could save residents lives,” said Insurance Commissioner Trinidad Navarro. “I want to commend Pharmacy Reimbursement Task Force co-chairs Sen. Sokola and Rep. Bennett, as well as Chair of the former Interagency Pharmaceuticals Purchasing Study Group Rep. Seigfried, for their passion and hard work towards these regulations and their inclusion of a diverse array of stakeholders throughout the process. Our work on this issue is just beginning, and we are grateful for your partnership.”

The Pharmacy Reimbursement Task Force and the former Interagency Pharmaceuticals Purchasing Study Group each demonstrated the General Assembly’s focus on lowering the cost of care, working on a range of issues surrounding protecting Delawareans from excessive medication costs, negotiating and lowering drug prices, and creating price transparency and corporate accountability.

“One of the most important things we can do as elected officials is work to keep prescription drugs affordable and accessible, particularly for our most vulnerable residents,” said Sen. David Sokola, D-Newark. “I’m proud of our work on the Pharmacy Reimbursement Task Force and proud to have helped develop regulations that will increase transparency around a little-known sector of our health care industry. These regulations from Commissioner Navarro and his team at the Department of Insurance represent a solid beginning to the work I look forward to continuing in 2021.”

The department and the General Assembly plan to work together to advance legislation regarding PBMs in the future. A related bill was proposed during this year’s session, but it did not advance due to the compressed legislative timeline during COVID-19.

“High prescription drug costs can debilitate a person’s finances, hindering how they save and plan for daily and long-term expenses. We owe it to consumers to fight for their best interests, increasing access and affordability to needed medications,” said Rep. Andria Bennett, who sponsored HB 194 to regulate PBMs. “Pharmacy benefit managers should put the consumer first, not profit. That’s why we fought to increase transparency and oversight: so Delawareans are not taken advantage of in such a vulnerable way. Commissioner Navarro’s regulation will provide even more transparency and comfort to our residents, and I thank him for his commitment to them.”

“Pharmacy Benefit Managers are companies that have, through the years, gained significant control over the supply, demand, and cost of pharmaceuticals – around 80% of the market – with little to no regulation at all. They are, in essence, governing both the cost and flow of medicines between people in need of medication and the manufacturer, health insurance company, community pharmacies, and the company providing medication benefits. This has led to higher costs for residents who don’t really have a choice in whether to pay for lifesaving medication,” said Rep. Ray Seigfried, a former Christiana Care senior vice president.

“My colleagues and I pushed HB 194 to require registration of all PBMs doing business in Delaware as a first step to reining in these managers. Commissioner Navarro’s regulations create standards such as having access to books and records of their operation, contract templates, and staffing. It provides the right to denial, suspension, or revocation. This order will provide the first step to begin opening the door to greater transparency. I thank Commissioner Navarro and his team for taking these important steps forward.”

Registration of Pharmacy Benefits Managers Regulation

DOVER, Del. – Governor John Carney early Saturday morning issued the following statement on the General Assembly’s failure to reach a budget agreement:

“I’m deeply disappointed that the General Assembly has failed to reach an agreement to pass a balanced budget, and a responsible long-term financial plan. The people of Delaware expect us to responsibly do their business, and that includes working together to enact a responsible financial plan for the state. As I’ve been saying for months, we need a balanced, long-term plan that relies on spending reductions and new revenue to solve our financial challenges in a sustainable way. The fact is we met Republican leaders more than halfway. We have pledged to support real spending reductions, and fiscal reforms that would place controls on future spending. Unfortunately, Republicans have been unwilling to compromise on their ideological demands, and have not agreed to support a sustainable plan to raise new revenue. But our work will continue, and it’s time for members of the General Assembly to get serious about passing a long-term budget.”

Lawmakers early Saturday approved and Governor Carney signed Senate Bill 137, a short-term appropriation measure that will fund state government at Fiscal Year 2017 levels for 72 hours.

Governor Carney sent a memorandum to General Assembly Leadership before the vote, outlining details of the short-term appropriation measure and the importance of continuing state government operations, including paying state employees.

The Governor also signed an extraordinary session proclamation to call the General Assembly back to session at 1:00 PM on Sunday, July 2. The Governor intends to call the General Assembly into session each day until a Fiscal Year 2018 budget is enacted into law.

Legislation sponsored by Representative Matthews and Senator McDowell

WILMINGTON, Del. – Governor John Carney has signed House Bill 23, legislation aimed at reducing the dropout rate in Delaware’s public schools.

Representative Sean Matthews and Senator Harris McDowell sponsored the legislation.

“All of Delaware’s students deserve an equal opportunity to learn and succeed,” said Governor Carney. “We know that Delawareans without a high school degree are more likely to be unemployed, and more likely to earn less than those who complete their education. Students who are considering withdrawing from school, and their families, should understand those potential consequences. The changes made in this legislation would help us reach some of those students. Thank you to Representative Matthews, Senator McDowell and all members of the General Assembly for taking on this important issue.”

The new law requires that students over the age of 16 who wish to withdraw from school prior to graduation both obtain written consent from their parent or guardian, and attend an exit interview. Schools will inform those students about the potential consequences of dropping out of school, including a greater risk for unemployment and a lower earning potential. The Department of Education will provide materials for the exit interviews. Those interviews also will cover any available support services or programs that may assist the student in pursuing their education, and information about training and employment opportunities.

“Research and experience has shown that a student dropping out of high school is often a gradual process of disengagement between the student and school community. For the most part, students don’t just drop out because they reach 16 years of age and are allowed to drop out,” said Representative Matthews. “Reaching out and engaging these students and their parents before a situation becomes serious are critical to reducing and preventing students from dropping out in the first place. We must take positive steps to engage students and educate them on the significance of dropping out and the challenges it creates for them later in life.”

“Kids who graduate high school are likely to go on to lead stable, productive and in many cases extraordinary lives and we need to do all we can as a state to help them realize that potential,” said Senator McDowell. “This new law ensures that some real thought, collaboration, and analysis is a part of the life-altering decision to leave high school.”

Read Governor Carney’s full Legislative Advisory #4 to learn more about legislation recently signed into law.

DOVER – DNREC’s Division of Energy & Climate will hold a public hearing this month on newly proposed regulations for the evaluation, measurement and verification of energy efficiency programs recommended by Delaware’s Energy Efficiency Advisory Council. The public hearing is scheduled for 6 p.m., Monday, Aug. 29, in DNREC’s Auditorium, Richardson & Robbins Building, 89 Kings Highway, Dover, DE 19901.

The Energy Efficiency Advisory Council is a collaborative group of stakeholders representing utilities, industry, residents, agencies and partners that was established by the General Assembly to create and implement energy efficiency programs and wise energy-use practices across the state. As utilities make their plans for providing energy-efficiency solutions, DNREC is developing a set of regulations that will outline methods for evaluating projects and measuring their effectiveness, known as Evaluation, Measurement and Verification (EM&V) regulations.

The proposed regulations can be found on the Division of Energy & Climate website. For more information, please contact Emily St. Clair at 302-735-3366 or email Emily.StClair@delaware.gov.

About the Energy Efficiency Advisory Council
The Energy Efficiency Advisory Council is comprised of representatives from DNREC, energy providers, large and small businesses, manufacturers, low-income and residential populations, Delaware’s Sustainable Energy Utility (SEU) and other interested parties affected by energy efficiency standards, including environmentalists and agriculturalists. The Council also collaborates with the Public Service Commission and the Public Advocate. Together, the council members work to reach Delaware’s energy efficiency goals while ensuring that all energy efficiency and reduction programs are cost-effective.

Contact: Joanna Wilson, DNREC Public Affairs, 302-739-9902

Vol. 46, No. 289

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