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Delaware State Profile and Policy Report

Delaware State Profile and Policy Report

Table of Contents

Heart Disease and Stroke Burden

Delaware - State Deaths for Heart Disease and Stroke

  • More than 1 out of 4 deaths in the Delaware are due to heart disease.

  • 1,866 Delaware residents died from heart disease in 2006 (25.9 percent of total deaths in the Delaware).

  • 384 Delaware residents died from stroke in 2006 (5.3 percent of total deaths in the Delaware).
    Source: National Vital Statistics Report, 2009.

Delaware - 2007 State Risk Factors for Heart Disease and Stroke

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Delaware - 2003 State Costs for Cardiovascular Disease

In October 2007, the Milken Institute, an independent research group, released a study, An Unhealthy America: The Economic Impact of Chronic Disease. The study details the economic effects of treatment costs resulting from chronic disease in the United States. Below is a breakdown of Delaware’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.    

Delaware-Annual Cost of Hypertension, Heart Disease and Stroke 

Treatment Expenditures (Direct Costs) - Total annual medical cost.

Hypertension 

$.12 billion

Heart Disease          

$.22 billion

Stroke                     

$.04 billion

Source: Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007. 

 

Delaware - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases

Based on the Delaware's Medicaid population, economic estimates for 2007 were projected using Medical Expenditure Panel Survey data.  Medicaid spending has grown rapidly in recent years, placing a significant burden on state budgets.  To help states estimate the financial impact of cardiovascular diseases among their Medicaid beneficiaries, the Centers for Disease Control and Prevention (CDC) and RTI International developed the Chronic Disease Cost Calculator, which was used to estimate the Medicaid costs below. 

 Heart Disease

 $16 million

 Hypertension

 $39.7  million

 Stroke

 $23 million

 Congestive Heart Failure

 $5.5 million

 

Delaware Heart Disease and Stroke Prevention Initiative

Delaware State Highlight

  • As part of the DelaWELL program, Get HEART Smart encourages people to visit their doctor and find out their healthy heart numbers.  

State Laws and Policies

Public Awareness of Heart Disease and Stroke

DE SCR 34 (2010, adopted) - Recognizes the week of June 1-7, 2010 as National Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) week in Delaware. Encourages citizens to seek training in CPR and learn how to operate AED devices.

DE SCR 18 (2009) - Recognizes the week of June 1-7, 2009 As National Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) Awareness Week in Delaware.

HCR59 (2008) - We hereby proclaim June 1-7, 2008, CPR-AED Awareness Week in the State of Delaware and encourage all Delawareans to become properly trained in CPR and AED usage. We commend the good work of the American Heart Association, American Red Cross, Delaware Department of Education, Matthew Krug Foundation, Parent Heart Watch, and Youth Heart Watch at The Children’s Hospital of Philadelphia an affiliate of Project ADAM.

HCR39 (2008) - In recognition of the importance of the ongoing fight against heart disease and stroke, we hereby proclaim Friday, February 1, 2008, to be “Go Red For Women and Wear Red Day” in the State of Delaware and urge all citizens to show their support for women and the fight against heart disease by commemorating this day by the wearing of the color red. By increasing awareness and empowering women to reduce their risk for cardiovascular disease, we can save thousands of lives each year.

HCR45 (2006) - We hereby proclaim February 3, 2006, to be Wear Red Day in Delaware; and that all citizens are urged to show their support for women and the fight against heart disease by the wearing of the color red to commemorate this day; and that by increasing awareness and empowering women to reduce their risk for cardiovascular disease, thousands of lives can be saved each year. We call upon all women to recognize the importance of the ongoing fight against heart disease and urge all women to be educated, to speak with their health care providers, to be aware of the risk factors for this devastating disease, and to take steps to reduce their personal risk factors. We hereby proclaim the month of February to be American Heart Month in Delaware, and that we call upon everyone in Delaware to be aware of cardiovascular disease and its risk factors and to take action to reduce their personal risk factors.

HCR36 (2005) - The Department of Health and Social Services is hereby requested to take all necessary steps to apply for available Federal funding for awareness and prevention of cardiovascular disease in women, and undertake an awareness campaign in this State.

SRC15 (2005) - The Senate of the 143rd General Assembly of the State of Delaware, the House of Representatives concurring therein, that the members do hereby recognize the month of May 2005 as American Stroke Month in the State of Delaware. The members remind all Delawareans that only one month each year is dedicated to stroke awareness, but strokes happen year round. The members hereby call on all Delaware citizens to familiarize themselves with the warning signs, symptoms, and risk factors associated with stroke so that our State might begin to reduce the devastating effects of stroke.

Prevention of Risk Factors (Nutrition, Physical Activity, Tobacco)

Tobacco Control

Delaware's state employee tobacco cessation program meets one of three CDC guidelines that include:

1) Coverage for at least four counseling sessions of at least 30 minutes; YES 
2) Access to smoking cessation agents, including prescriptions and nicotine replacement; NO
3) Counseling and medication coverage for at least two quit attempts annually; NO 

  • Delaware has a statewide tobacco-free policy and cigarette excise tax.  The cigarette excise tax in Delaware is $1.15.

  • Delaware's state Medicaid tobacco cessation program covers over-the-counter and prescription products.

Increase Detection and Treatment of Risk Factors

DE S 66 (2009, enacted) - Establishes Heart Disease and Stroke Prevention Program within the Division of Public Health of the Department of Health and Social Services. The program is established to address heart and cardiovascular disease and stroke-related health issues for the following purposes: (1) to conduct health education, public awareness, and community outreach activities that relate to primary and secondary prevention of cardiovascular disease and stroke; (2) to assist the division director in identifying, coordinating and establishing priorities for programs, services and resources the State should provide for cardiovascular disease and stroke prevention; (3) to serve as a resource for information regarding cardiovascular disease and stroke data, prevention strategies, treatment services and programs that address cardiovascular disease and stroke-related health issues; (4) to provide health care providers, employers, schools, community health centers, and other groups with innovative and effective programs that achieve the objectives of improved treatment, prevention, and public awareness; (5) to provide guidance regarding the roles and responsibilities of government agencies, health care providers, employers, third-party payers, patients, and families of patients of best practices in the treatment, primary and secondary prevention, and public awareness of cardiovascular disease and stroke; (6) to improve access to treatment for primary and secondary prevention of heart and cardiovascular disease and stroke through public awareness programs, including access for uninsured individuals and individuals living in rural or underserved areas; (7) to assist communities in developing comprehensive local cardiovascular disease and stroke prevention programs; (8) to establish appropriate forums, programs, or initiatives designed to educate the public regarding the impact of heart disease and stroke on women's health, with an emphasis on preventive health and healthy lifestyles; (9) to coordinate the activities and programs of the department with other entities that focus on cardiovascular health or cardiovascular disease prevention or control, including but not limited to other state agencies; (10) to evaluate and enhance the implementation and effectiveness of the department and to seek funding from private or governmental entities to carry out the purposes of this section.

 

State Employee Health and Wellness

  • In the 2009 calendar year, Delaware paid the entire individual plan and family plan premium for its employees.

  • Delaware officially launched DelaWELL on April 1, 2007, as a new comprehensive wellness program for state employees. This statewide initiative is available free to all full-time state employees, school district, charter school and higher education employees and pre-65 retirees currently enrolled in group health insurance programs. The program will assess employee health risks and provide confidential, personalized feedback and coaching for interventional strategies that target lifestyle topics such as back care, blood pressure management, exercise, nutrition and stress management through various modes of communication and health-related events.

  • Delaware: The State Employee Benefits Committee (SEBC) has awarded Blue Cross Blue Shield of Delaware and Aetna the contracts to administer the state group health insurance program, while dropping Coventry Health, effective July 1, 2007. 

Improve Quality of Care and Access to Care

HR29 (2007) - Be it resolved by the House of Representatives of the 144th General Assembly of the State of Delaware that a Women’s Healthy Heart Task Force be created to study the issues of women’s heart risk in Delaware to develop a comprehensive strategy to encourage healthy heart activities for women. Be it further resolved, that the Women’s Healthy Heart Task Force be composed of the following members: (1) Secretary of the Department of Health and Social Services or his designee; (2) A representative of the Delaware Heart Association; (3) A representative of the Delaware Medical Society; (4) Chair to be a member of the House of Representatives selected by the Speaker of the House; (5) Two (2) public members selected by the Chair; (6) Two (2) members of the House of Representatives selected by the Speaker of the House; (7) Two (2) members of the House of Representatives selected by the Minority Leader of the House; (8) A practicing cardiologist; and (9) Chair of the Delaware Health Care Committee or designee. Be it further resolved, that the Task Force report its findings and recommendations to the 144th General Assembly by March 2008.

HJR10 (2003) - The Task Force is to be created within the Delaware Health Care Commission to examine issues surrounding disease management strategies, including their potential to improve individual health, promote quality health care and contain health care costs. Such examination can include review of existing programs in the public and private sectors in Delaware and other states, and identification of methods to promote and coordinate disease management activities. The Task Force shall study the best approaches for coordinating chronic disease management between the private and public sector with specific suggestions for implementing said coordination and submit its findings to the Speaker of the House, the President Pro Tempore of the Senate and the Governor by March 31, 2004.

Address and Eliminate Disparities 

No policy listed at this time

 

Emergency Medical Services (EMS) and Automated External Defibrillators

Delaware Code Title 16, Ch. 97, §9705/Ch. 137/HB 332 (2008) - (1) The Department of Health and Social Services shall promulgate regulations specific to the use of semi-automatic external defibrillators and shall seek input and review from the Board of Medical Practice, the Delaware EMS Oversight Council and the Delaware State Fire Prevention Commission. (2) The Office shall coordinate a statewide effort to promote and implement widespread use of semi-automatic external defibrillators and cardio-pulmonary resuscitation to increase the number of publicly available SAEDs to 100 by January 1, 2002, and 200 by January 1, 2004. In addition, the Office shall coordinate a statewide effort to provide, train and maintain a minimum of 5 qualified individuals for each publicly available SAED. (3) All law enforcement vehicles on patrol shall be equipped with a semi-automatic external defibrillator by January 1, 2001, subject to appropriations.

SCR20 (2007) - The Staff and members of the Delaware Department of Education, in concert with the Department of Health and Social Services, the State Emergency Medical Services Director and/or other appropriate public or private entities, are hereby requested to conduct a study of the feasibility and effects of integrating a mandatory CPR/AED certification program within the now mandatory high school physical education courses or elsewhere within the high school curriculum required for graduation.

Delaware Code Chapter 307 (2004) - This act makes appropriations for the expense of the state government for the fiscal year ending June 30, 2005; specifying certain procedures, conditions and limitations for the expenditure of such funds; and amending certain pertinent statutory provisions. It includes a $133.50 appropriation for the Public Access Defibrillation initiative.

Delaware Code Title 16, Chapter 30C/Ch. 412 /HB430 (2000) - (a) Any entity to whom AEDs are distributed shall insure that: (1) Each prospective defibrillator user receives appropriate training by the American Red Cross, the American Heart Association, Delaware State Fire School or by another nationally recognized provider of training for cardio-pulmonary resuscitation and AED use; provided, however, that such training shall be approved by the State EMS Medical Director; (2) The defibrillator is maintained and tested according to the manufacturer's guidelines; and (3) Any person who renders emergency care or treatment on a person in cardiac arrest by using an AED shall notify the appropriate EMS units as soon as possible and report any clinical use of the AED to the appropriate licensed physician or medical authority. (b) The State EMS Medical Director shall maintain a file containing the name of each person or entity that acquires an AED with State funding. (a) Any person or entity, who in good faith and without compensation, renders emergency care or treatment by the use of an AED shall be immune from civil liability for any personal injury as a result of such care or treatment, or as a result of any act or failure to act in providing or arranging further medical treatment, if such person acts as an ordinary, reasonably prudent person would have acted under the same or similar circumstances and such act or acts do not amount to willful or wanton misconduct or gross negligence. (b) Any individual who authorizes the purchase of an AED, any person or entity who provides training in cardiopulmonary resuscitation and the use of an AED, and any person or entity responsible for the site where the AED is located shall be immune from civil liability for any personal injury that results from any act or omission that does not amount to wilful or wanton misconduct or gross negligence.

Stroke Systems of Care

DE S 66 (2009, enacted) - Stroke Continuous Quality Improvement and Data. (a) The intent is to achieve continuous quality improvement (CQI) in the quality of care to stroke patients, by improving stroke treatment and preventing future strokes and cardiovascular events. The Department of Health and Social Services shall maintain aggregate statewide stroke data using stroke guidelines and allowing access to real-time data to facilitate process changes that lead to improved patient outcomes. The Department of Health and Social Services shall utilize a nationally available quality improvement and data collection tool that is based on nationally recognized, evidence-based guidelines and align with the stroke consensus metrics developed and approved by the American Heart Association/American Stroke Association, the Centers for Disease Control and Prevention and the Joint Commission; and endorsed by the National Quality Forum. The Department of Health and Social Services shall make information and statistics available to the public on the agency's website. To every extent possible, the Department of Health and Social Services shall coordinate with national voluntary health organizations involved in stroke prevention and treatment to avoid duplication and redundancy."

Delaware Code Title 16, Ch. 10, §1019/Ch. 299/HB378 (2008) - (a) The Secretary of Health and Social Services shall designate as a primary stroke center any hospital which has received a Certificate of Distinction for Primary Stroke Centers issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (b) The Secretary shall suspend or revoke a hospital's distinction as a primary stroke center if the JCAHO suspends or revoke's a hospital's Certificate of Distinction for Primary Stoke Center.

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