Delaware health reform effort moves forward

DOVER, Del. (AP) — Delaware officials are moving ahead in implementing a state health care exchange under the national health care reform law.

The state's reform efforts are being led by the Delaware Health Care Commission, which received a status update Thursday on implementing provisions of the Affordable Care Act.

One of first steps in the state's plan is identifying and training "marketplace assisters," who will help residents and businesses navigate a health insurance exchange being set up in partnership with the federal government.

Under the proposed rules, applicants wanting to be marketplace assisters must submit to criminal background checks, but a criminal conviction would not bar a person from serving as a marketplace assister handling sensitive personal consumer information.

In response to a question about draft rules released last month, officials clarified Thursday that the state will be responsible for evaluating applicants on a case-by-case basis to determine whether a criminal conviction should prevent the person from being a marketplace assister.

Department of Health and Social Services officials have said the state will follow a targeted screening process that considers the nature of the crime, the time elapsed, and the job the individual is expected to perform.

"Marketplace assisters must be trusted members of the communities they serve," DHSS officials said in a statement last month in response to questions from The Associated Press. "The state will not discriminate against individuals who are well suited for this important position by automatically rejecting applicants if a past arrest is discovered through the criminal background check process."

According to DHSS, the decision not to automatically exclude convicted criminals from ACA-related employment is in keeping with enforcement guidance issued in April by the U.S. Equal Employment Opportunity Commission. The department also is proposing revisions to existing laws regarding long-term care facilities and home health agencies in Delaware to sharply limit automatic exclusions from employment because of prior criminal convictions.

In implementing Delaware's health care reform plan, officials expect to contract with community organizations throughout the state to hire 60 marketplace assisters, who would assist and provide information to the estimated 35,000 people expected to enroll in Delaware's exchange.

A request for proposals from interested community organizations is expected to be published sometime in the first quarter of this year. Enrollment in the exchange is scheduled to begin Oct. 1

While tackling the new health care reforms, the commission also faces challenges in ensuring the sufficiency of Delaware's health care workforce.

Commission members were reminded Thursday that Delaware has been designated by the U.S. Health Resources and Services Administration as a Health Professional Shortage Area.

Jill Rogers, executive director of the commission said the state would need to add a minimum of seven primary care providers, four psychiatrists and 31 dentists to remove the HPSA designation.

Recommendations for ensuring an adequate health care workforce in Delaware, include improving data collection, expanding the state's health information technology infrastructure, supporting education and training programs and creating recruitment strategy

"Undertaking this task for building the workforce we need going forward is pretty monumental," said commission chairwoman Bettina Riveros.

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