(1) Approximately 100,000 Delawareans have no health insurance and equal numbers of Delawareans have inadequate health care coverage.

(2) Most Delawareans without health insurance are workers and their families, and the number of working uninsured is expected to increase significantly over the next decade.

(3) The present health care insurance system is increasingly unresponsive to health needs and has taken important medical decisions away from health care professionals and patients and placed them into the hands of insurance company administrators.

(4) The present health care insurance system is increasingly bureaucratic and wastefully expensive, with a significant proportion of our health care dollars going to insurance company profits and to corporate overhead and administrative costs, including high salaries, lobbying expenses, marketing, and multiple and needlessly complex claims processing procedures.

(5) With the projection of double-digit percent annual cost increases in health care premiums, managed care has become managed costs, and has not proven to be the cure for escalating health care costs, and this Act will eliminate these large annual increases;

(6) Narrowly targeted reform activities such as a Patient's Bill of Rights will not fundamentally change a structurally flawed system; and

(7) Delawareans strongly support significant, comprehensive reform of our state's costly and inadequate health care system.

(1) Continued access to comprehensive, quality health care without regard to income, employment (except for out-of-state citizens who lose Delaware employment) or health status;

(2) Freedom to choose their health care professionals and all health providers and services;

(3) A comprehensive benefits package covering all health needs without any supplemental insurance, co-payments or deductibles;

(4) Health care providers who will practice according to professional standards, without interference from third-party decision-makers;

(5) Significant overall cost savings by streamlining health care financing, improving efficiency; and expanding preventive care and eliminating costly, unnecessary insurance industry profits and practices.

(1) "Advisory Council" means the three advisory councils that represent each of our state's three counties established pursuant to §1607of this Chapter.

(2) "Board" means the appointed members of the Delaware Health Security Authority, which will administer the Delaware Health Security Act.

(3) "Executive Director" means the executive director of the Delaware Health Security Authority.

(4) "Health Care" means care provided to an individual by a licensed health care professional to promote physical and mental health, to prevent illness and injury and to treat illness and injury.

(5) "Health Care Authority" means the Delaware Health Security Authority established in §1603 of this Chapter.

(6) "Health Care Facility" means any facility or institution, whether private or public, nonprofit or proprietary, which offer diagnosis, treatment, inpatient or ambulatory care to two or more unrelated persons.

(7) "Health Care Provider" means a person, partnership, corporation or other business organization, other than a facility or institution, licensed, certified or authorized by law to provide professional health care services in the state to an individual.

(8) "Professional Advisory Committee" means a committee of advisors appointed by a director of a division of the Delaware Health Security Authority.

(9) "Resident" means a person who lives in Delaware as evidenced by an intent to continue to live in Delaware and to return to Delaware if temporarily absent, coupled with an act or acts consistent with that intent. The Authority shall adopt standards and procedures for determining whether a person is a resident and for determining out-of-state citizens' eligibility based on receiving health care coverage through their Delaware employers. Such rules and standards shall include:

(10) "Secretary" shall mean the Secretary of the Department of Health and Social Services.

(1) To make, amend and repeal by-laws, rules and regulations for the management of its affairs;

(2) To adopt an official seal;

(3) To sue and be sued in its own name;

(4) To make contracts and execute all instruments necessary or convenient for carrying out the purposes of this Act;

(5) To acquire, own, hold, dispose of and encumber personal, real or intellectual property of any nature of any interest therein;

(6) To enter into agreements or transactions with any federal, state or municipal agency or other public institution or with any private individual, partnership, firm, corporation, association, or other entity;

(7) To appear on its own behalf before boards, commissions, departments or other agencies of federal, state or municipal government;

(8) To appoint officers and to engage and employ employees, including legal counsel, consultants, agents and advisors and prescribe their duties and fix their compensation;

(9) To establish advisory boards and councils;

(10) To procure insurance against any losses in connection with its property in such amounts, and from such insurers, as may be necessary or desirable;

(11) To invest any funds held in reserves or sinking funds, or any funds not required for immediate disbursement, in such investments as may be lawful for fiduciaries in the state;

(12) To accept, hold, use, apply and dispose of any and all donations, grants, bequests and devises, conditional or otherwise, of money, property, services or other things of value, which may be received from the United States or other agency thereof, any governmental agency, any institution, person, firm or corporation, private or public. Such donations, grants, bequests and devises may be held, used, applied or disposed for any and all of the purposes specified in this Act and shall be used in accordance with the terms and conditions of any such grant. Receipt of each such donation or grant shall be detailed in the annual report of the Authority, which shall include the identity of the donor, lender, the nature of each transaction and any conditions attached thereto; and

(13) To do any and all other things necessary and convenient to carry out the purposes of the Delaware Health Security Act.

(1) Guarantee every Delaware citizen, and out-of-state citizens who receive health care coverage from Delaware employers, all necessary health care services offered by the provider of each citizen's choice;

(2) Replace the current mixture of private and public health care plans with a uniform and comprehensive single-payer health care system available to every Delaware citizen;

(3) Replace the redundant private and public bureaucracies required to support the current system with a single administrative and payment mechanism for covered health care services;

(4) Use administrative and other savings to:

(5) Approve and coordinate capital improvements in excess of $500,000 to qualified Health Care Facilities to:

(6) Supplement, when needed, private and other public financing for approved capital improvements of qualified Health Care Facilities in excess of $500,000;

(7) Assure the continuing excellence of professional training and research at Delaware Health Care Facilities; and

(8) To fund training and re-training programs for professional and non-professional workers in the health care sector displaced as a direct result of implementation of this Act.

(i) Two members of the State Senate, each of whom shall be a member of the Senate Committee concerned with health care to be appointed by the President Pro Tem;

(ii) two members of the State House of Representatives, each of whom shall be a member of the House Committee concerned with health care to be appointed by the Speaker of the House;

(iii) the Secretary of the Department of Health and Social Services;

(iv) five representatives from different health care professional organizations to be appointed by the Governor and confirmed by the Senate; and

(v) five members from consumer groups that have endorsed a single-payer health care system at least five years prior to the enactment of this Chapter, to be appointed by the Governor and confirmed by the Senate.

(i) Two members of the State Senate, each of whom shall reside within the county of the Advisory Council on which he or she serves, to be appointed by the President Pro Tem;

(ii) Two members of the State House of Representatives, each of whom shall reside within the county of the Advisory Council on which he or she serves, to be appointed by the Speaker of the House;

(iii) One member to be appointed by the Governor, who shall reside in the county of the Advisory Council on which he or she serves;

(iv) Five representatives of different health care organizations to be appointed by the Governor and confirmed by the Senate, each of whom shall be a resident of the county of the Advisory Council on which he or she serves; and

(v) Five members from consumer groups that have endorsed a single payer health care system at least five years prior to the enactment of this Chapter, to be appointed by the Governor and confirmed by the Senate, each of whom shall be a resident within the county of the Advisory Council on which he or she serves.

(1) Adopt, amend, alter, repeal and enforce, all such reasonable rules, regulations and orders as may be necessary; and

(2) Appoint and remove employees and consultants; provided, however, that, subject to the availability of funds in the Authority, at least one employee shall be hired to serve as Director of each of the Divisions created in §§1609 through 1612 of this Chapter.

(1) Negotiate or establish terms and conditions for the provision of health care services and rates of reimbursement for such services on behalf of the citizens of the state;

(2) negotiate or establish manufacturer discounts and rebates for covered prescription drugs and other health care products;

(3) Develop prospective and retrospective reimbursement systems for covered services to provide prompt and fair payment to eligible providers;

(4) Oversee preparation of annual operating and capital budgets for the statewide delivery of health care services;

(5) Oversee preparation of annual benefits reviews to determine the adequacy of covered services; and

(6) Prepare an annual report to be submitted to the Governor, the Senate Pro Tempore and Speaker of the House of Representatives and to be easily accessible to every participating member and citizen in our state.

(1) making prompt payments to providers for covered services;

(2) collecting reimbursement from non-eligible patients;

(3) developing information management systems needed for provider payment, rebate collection and utilization review;

(4) investing Authority Fund assets consistent with state laws and §1619 of this Act;

(5) developing operational budgets for the Authority; and

(6) assisting the Planning Division develop capital budgets for the Authority.

(1) Identifying underserved populations and geographic areas; and

(2) Approving capital expenditures in excess of $500,000.

(1) A11 Delaware citizens;

(2) All non-residents who:

(3) A11 patients requiring emergency treatment for illness or injury; provided, however, that the Authority shall recoup expenses for such patients wherever possible.

(1) Is licensed to operate or practice in the state;

(2) Furnishes a signed agreement that:

(3) Meets whatever additional requirements may be established by the Authority.

(1) Assure that payments to such providers and facilities reflect the difference between actual and projected utilization and expenditures for covered services; and

(2) Protect health care providers and facilities who serve a disproportionate share of eligible participants whose expected utilization of covered health care services and expected health care expenditures for such services are greater than the average utilization and expenditure rates for eligible participants statewide.

(1) Provide appropriate and necessary health care services;

(2) Encourage reductions in health risks and increase use of preventive and primary care services; and

(3) Attempt to integrate physical health, mental health, emotional health and substance abuse services.

(1) The prevention, diagnosis and treatment of illness and injury, including laboratory, diagnostic imaging, inpatient, ambulatory and emergency medical care, blood, dialysis, mental health services, dental care, acupuncture, optometric, chiropractic and pediatric services;

(2) The rehabilitation of sick and disabled persons (including addiction to all drugs), providing physical, psychological and other specialized therapies, and long term services in community-based and institutional settings;

(3) The provision of prescription drugs, therapeutic devices, prosthetics, eyeglasses, hearing aids and other health care supplies;

(4) The promotion and maintenance of individual good health through appropriate screening, counseling and health education;

(5) The provisions of home health, personal care, hospice and services of nurse practitioners, nurse midwives, language interpretation and such other medical & remedial services as the Authority shall determine;

(6) Emergency and other medically necessary transportation; and

(7) Prenatal, perinatal and maternity care, family planning, fertility and reproductive health care.

(1) To reimburse eligible health care providers and facilities for covered services rendered to eligible patients;

(2) To pay for preventive care, educational and outreach programs and related health care activities;

(3) To supplement other sources of financing for approved capital investments in excess of $500,000, for eligible health care providers and facilities;

(4) To supplement other sources of financing for health care education and research;

(5) To fund training and retraining programs for professional and non-professional workers in the health care sector displaced as a result of administrative streamlining gained by moving from a multi-payer to a single-payer system; provided, however, that such funding shall end June 30 of the third year following full implementation of this Act;

(6) To fund a reserve account to finance anticipated long-term cost increases due to demographic changes, inflation or other foreseeable trends that would increase Authority Fund liabilities, and, for budgetary shortfalls, epidemics and other extraordinary events;

(7) To pay the administrative costs of the Health Care Authority; and

(8) To pay the administrative costs of the three county Advisory Council offices.

(1) All monies the state currently appropriates to pay for health care services or health insurance premiums, including, but not limited to, all current state programs which provide covered benefits and appropriations to cities, towns and other government subdivisions to pay for health care services or health insurance premiums: provided, however, that the Authority shall then assume responsibility for all benefits and services previously paid for by the state with these funds. All current state health care programs which provide covered benefits shall be included in this requirement;

(2) All monies the state receives from the federal government to pay for health care services or health insurance premiums; provided, however, that the Authority shall assume the responsibility for all benefits and services previously paid by the federal government with these funds. The Authority shall seek to maximize all sources of federal financial support for health care services in Delaware. Accordingly, the Executive Director of the Authority shall obtain waivers, exemptions, or legislation if needed, so that all current federal payments for health care shall, consistent with federal law, be paid directly to the Authority Fund;

(3) Private individual and employer health insurance payments and out-of-pocket health care expenses will be replaced in this single-payer Delaware Health Security Act as follows:

(1) Any charitable donations, gifts, grants or bequests made to it from whatever source consistent with state and federal law;

(2) Any rebates negotiated or established; and

(3) Income from the investment of Authority assets, consistent with state and federal law.