Joint Sunset Committee
2005 Final Report


A Report to the Governor
and the
General Assembly of the State of Delaware

Joint Sunset Committee

Final Report
of the
Criminal Justice Council

Crime in Delaware

The 2002 Crime in Delaware Report, published in January 2004 by the Statistical Analysis Center and the State Bureau of Identification, provides one snapshot of some of the crime related issues confronting criminal justice agencies and policymakers alike. Therefore, some statistics from the Crime Report that might be of interest are discussed below.

Overall
· Violent crimes reported statewide totaled 5,797 in 2002.
· Property crimes reported statewide totaled 29,270 in 2002.
· Reports for crimes such as simple assault, forgery, fraud, disorderly conduct, prostitution, vandalism, and other crimes known as Part II crimes, totaled 150,261.

Violent Crime (homicide, rape, robbery, and aggravated assault)

· Total statewide reported violent crime increased 3.1% from 2001 to 2002 (5,620 in 2001 vs. 5,797 in 2002).
· In 2002, New Castle County reported the most violent crimes. Kent County reported the least; however, violent crimes within Kent county increased 8.3% from 2001.
· Reported violent crime in Sussex County has steadily decreased since 1997.
· The most reported violent crime for each year 1996-2002 is aggravated assault (64% of the total violent crimes). Most reported assaults occurred in New Castle County during that time period.
· Robbery, rape, and homicides followed aggravated assaults as the most reported crime. In 2002, robberies increased by about 150 to 1,610 statewide. Statewide rape decreased to 472 from 538 in 2001. Homicides increased by 1 to 31 in 2002. Homicides between 2001 and 2002 have decreased in New Castle and Kent Counties, but have increased in Sussex County.
· Arrests for violent crime statewide were about 3.8 per 1,000, which is the same as in 2001.

Property Crime (burglary, larceny, motor vehicle theft, and arson)

· Statewide, reported property crimes increased for the first year since 1997. Property crime reports increased from 28,895 in 2001 to 29,270 in 2002.
· Total property crime reported in New Castle County has decreased fairly consistently from 1997 through 2002. Property crime in Kent County increased 6% between 2001 and 2002. For Sussex County, property crime increased slightly following six years of steady decline.
· Larceny is the most reported property crime statewide and within each county during the years 1997 through 2002. Although most larceny crimes occurred in New Castle County, the number of larceny crimes in that county has decreased for five consecutive years. Kent County’s reported larceny reports increased more than in any other county (6%).
· Following larceny, burglary, motor vehicle theft and arson followed larceny as the most reported property crimes. Statewide burglary and motor vehicle theft increased in 2002 while statewide arson decreased. Sussex County in particular saw a 19% increase in burglaries from 2001 to 2002. New Castle County saw the greatest increase in motor vehicle theft at 15%.
· Arrests for property crimes decreased by about 7% in 2002.

Juvenile Crime

· Statewide juvenile arrests totaled 8,419 in 2002. This is a 7.6% decrease from the 2001 total of 9,107. Most of the juvenile arrests were for misdemeanor offenses such as, non-aggravated assaults, disorderly conduct, liquor law violations, and vandalism (Part II offenses).
· Statewide juvenile arrests for violent crimes decreased close to 10% from 621 in 2001 to 559 in 2002. Most of the violent crime arrests were for aggravated assault and most occurred in New Castle County (66%).
· Statewide juvenile arrests for property crimes decreased by 20% from 2,226 in 2001 to 1,775 in 2002. Larceny arrests comprised most of the juvenile property crime arrests followed by burglary and motor vehicle theft.

Illicit Drug Crime

· From 1996-2002, statewide reported drug crimes have increased 71% from 7,000 to 12,000. On average, drug crimes have increased about 1% each year since 1996.
· Drug offenses in New Castle County during 2002 totaled 7,027 which is only a slight increase from 2001. Drug offenses in Kent County increased about 3% from 2001-2002. Drug offenses in Sussex County increased the most (12%) from 2001 to 2002.
· Drug arrests during 2002 increased about 1% statewide to 4,579. Drug arrests increased steadily for New Castle and Sussex Counties, but decreased in Kent County.
· More adults were arrested for drug crimes than juveniles (3,816 vs. 763).

Wilmington Shootings

A point not directly addressed in the 2002 Crime Report, but important nonetheless, is neighborhood safety in the City of Wilmington. This has been, and continues to be, an issue frequently reported in the news. In 1996, the City of Wilmington had a record number of shootings at 107 (about 10 resulted in fatalities). Shootings declined from 107 to 56 between the years 1997 and 1999, partially resulting from the Project Safe Neighborhoods and the Weed & Seed programs (both of these are funded by federal grants administered by the Criminal Justice Council). Although both of these programs are in continuance today, the number of shootings in Wilmington is rising again. Data shows 87 shootings in the City of Wilmington during 2002, which is a 43% increase from shootings in 2001. Wilmington Shootings, 2002, July 2004, Arthur Garrison, CJC. In 2004, the City of Wilmington saw 96 shootings; 18 homicides.

The Criminal Justice System in Delaware

Delaware’s criminal justice system is a complex, integrated system that includes numerous state agencies, the Courts, law enforcement agencies, and the public. The Criminal Justice Council serves the criminal justice community primarily through the distribution of federal grant dollars.

The Role of the Federal Government

Since 1984, the Office of Justice Planning (OJP), U.S. Department of Justice (US DOJ), has provided federal leadership in the identification of emerging criminal justice issues, the development and testing of pilot programs, evaluating program results, and disseminating findings and other information to state and local governments. Additionally, OJP’s five bureaus are responsible for assisting states with administering grant funding, training, and technical assistance. http://www.ojp.usdoj.gov/resguide.

In Fiscal Year 2003, Delaware received a total of $36.2 million in direct funding from the OJP to support the DOJ goals of fighting terrorism, assisting victims of crime, targeting juvenile crime and drug abuse, assisting communities, and improving the criminal justice system. http://www.ojp.usdoj.gov/pressreleases

Delaware received an additional $10 million in federal block or categorical grants. These federal block grants are “formula” grants primarily based on the state’s population and state crime data. Unlike direct federal funding, block grants typically require that the state designates one of its agencies to act as the grant administrator. With the exception of one grant administered by the Delaware Department of Corrections, the Criminal Justice Council is the state designated agency for overseeing OJP block grants.

History of the Criminal Justice Council

The Criminal Justice Council (CJC) originated from the Council on the Administration of Justice and the Delaware Criminal Justice Planning Commission. The Council on the Administration of Justice, created in 1955, consisted of 15 members representing the courts, the legislature, and the University of Delaware. The Council's primary purpose was to study the administration and operation of the Delaware court system. In 1978, Senate Bill 632 created the Delaware Criminal Justice Planning Commission in response to revisions to the federal Omnibus Crime Control and Safe Streets Act of 1968, which stipulated that, to be eligible for federal funds, states must legislatively establish (rather than establishment through executive order) a state criminal justice planning agency. The Criminal Justice Planning Commission consisted of 29 members representing the criminal justice community, the legislature, and the public.

In addition to addressing federal requirements, Senate Bill 632 specifically declared that the establishment of appropriate goals, objectives and standards for crime reduction and delinquency and for the administration of justice be a priority, and that the functions of the criminal justice system must be coordinated efficiently and effectively. As such, it empowered the Criminal Justice Planning Commission to prepare a state comprehensive plan, establish priorities and standards for the reduction of crime, recommend legislation, monitor and evaluate programs, provide technical assistance, apply for federal grants, and perform other pertinent functions.

Senate Bill 632 also included a sunset provision that would temporarily suspend the Criminal Justice Planning Commission’s operations pending a legislative review of the Commission’s performance. This “suspend and review” was to begin in 1980 and continue once every four years thereafter.

In 1984, House Bill 237 merged the Council on the Administration of Justice with the Delaware Criminal Justice Planning Commission to create the Criminal Justice Council (CJC). The CJC was initially comprised of 19 members. Fifteen members represented the criminal justice community and four represented the public. Membership was gradually expanded to 26 through a series of enactments, the last of which was House Bill 408 effective April 2000.

Some important statutory provisions were lost in the 1984 merger. First, the CJC does not have a defined statutory purpose or declaration. Second, a few important responsibilities formerly performed by the Criminal Justice Planning Commission were deleted from law. These included the preparation of a state comprehensive criminal justice plan, establishing goals, priorities and standards for reducing crime and improving the administration of justice, encouraging local and regional comprehensive planning, and monitoring and evaluating programs and projects. Thirdly, legislative representation is no longer included in membership requirements. Lastly, House Bill 237 deleted the sunset provision.

CJC Powers and Duties

Section 8704 of Title 11 defines the CJC’s responsibilities. These are provided below with a brief explanation from the CJC explaining how each of its responsibilities have been implemented. Sunset Questionnaire, pgs. 1-4.

1. Continuously study the administration of justice and develop and implement policies and programs for improving the effectiveness of the criminal justice system.

The CJC noted that it conducts research in the areas of prevention, juvenile justice, law enforcement, case processing, victims, corrections, technology, and terrorism. These reports are submitted to a variety of groups, including the Criminal Justice Council, its various subcommittees, the Legislature, the Governor's Office, the Congressional delegation, and various units within the United States Department of Justice.

2. Receive, consider, and at its discretion, investigate criticisms and suggestions pertaining to the administration of justice in the State.

The CJC indicated that, through public hearings and through the work of the subcommittees, it evaluates and addresses problems, gaps in services, and complaints about the criminal justice system. Through the use of federal crime dollars and through changes in policy, the CJC seeks to improve the criminal justice system in order to meet the needs of the public.

3. Submit to the General Assembly each January a program of recommended legislation to improve the criminal justice system.

Through a Legislative subcommittee and the Juvenile Justice Advisory Group, the Criminal Justice Council reviews all legislation that affects the criminal justice community. It comments on criminal justice related legislation that is before the General Assembly by sending a letter to all legislators explaining which bills the CJC opposes, supports, or takes no position. Letters were submitted twice in June 2004, once in March 2004, and once in June 2003. The March 2004 letter was the only one offering brief comments explaining the CJC’s opposition or deference to specific legislation.

The Juvenile Justice Advisory Group and the Domestic Violence Coordinating Council also reviews legislation and sends their own recommendations to the appropriate legislators.

4. Recommend to the Governor and criminal justice agencies and courts or political subdivisions, either upon request or upon the Council’s own motion, such changes in rules, organization or methods of operation.

The CJC responded that staff routinely studies and issues reports to CJC subcommittees regarding demographics and prevention that affect the criminal justice system. Programs are funded or changes are made based on the needs assessment and problem statement analysis conducted by staff. Over the years, the CJC and its staff have provided a myriad of changes to the criminal justice system and Delaware as a whole. An example of studies and changes include: (a) the removal of status offenses from the criminal code; (b) the reduction of overcrowded conditions in the juvenile correctional system by providing alternative placements for non-violent and non-criminal youth; (c) the creation of a network of Boys/Girls Clubs in the State for prevention programs; (d) the study of demographics leading to youth violence and the creation of value-based education programs for youth; (d) the reinvention of community policing and mobile community policing vans throughout the State; (e) the implementation of Sting operations where necessary; (f) the creation and operation of multi-jurisdictional drug task forces; (g) the addition of crime specific Attorney General and Public Defender units; (h) creation of DNA evidence gathering; (i) intake procedure in all the courts; (j) creation of over 100 different types of victim programs for victims of crime; (k) the creation of correctional academies; (l) the creation of prison industry, drug counseling, re-entry, and aftercare services for corrections; and (m) innovation of new technology for the criminal justice system to better protect the public, and to speed case processing.

With respect to changing rules and procedures, the CJC has been involved with the creation of: the Sentencing Accountability Commission; the Children’s Department; the creation of the Children’s Trust Fund; the creation of TASC; securing funding for videophones; and the implementation of court blitz programs.

5. Review any application for federal funds by a criminal justice agency or court or political subdivision prior to submission of application or request to the Delaware State Clearinghouse Committee, and provide the Clearinghouse Committee with any comments.

The CJC approves all the sub-grants it administers prior to submission to the State Clearinghouse. It attempts to review all grant requests from other criminal justice agencies to the federal government for the State Clearinghouse.

The CJC noted that it is extremely difficult to know of all the grants applied for by individual criminal justice agencies. Examples of grants that are generally not reviewed by the CJC are the direct applications from local police departments to the US DOJ. Some examples of direct grants that the CJC has reviewed are drug treatment grants operated by the Department of Health and Social Services; correctional re-entry programs; and some discretionary grants for victims of crime.

6. Allocate among the criminal justice agencies, courts, or political subdivisions all federal funds for the improvement of the state criminal justice system, if such funds are provided by the federal government in the form of a block or categorical grant.

Most of the CJC’s staff time is devoted to this function of awarding federal block grants. It is discussed in detail on the pages that follow.

7. Have the authority to collect from any state or local governmental entity information, reports, statistics, or other such material that is necessary to carry out the Council’s function.

The CJC responded that any data, facts, figures, etc., that it requires to define a problem, write a grant, or conduct an impact evaluation, are readily available. The CJC staff has access to crime data through the crime data system. Additionally, sub-grantees sign an acceptance award that indicates the CJC has access to all of their data relating to the CJC sub-grants.

8. Provide training and technical assistance to criminal justice agencies.

The CJC provides a wide range of training and technical assistance to criminal justice agencies. Examples of trainings have included: terrorism, gang education, juvenile case processing training, planning/grant writing trainings, and a variety of victim training. All staff members are assigned to functional areas and must attend national workshops related to their functional area of expertise. The information garnered at the workshops is passed on to the sub-grantees and committees, in order to make better informed decisions regarding criminal justice.

Organization

The CJC is an Executive Department agency. It serves state agencies and non-profit organizations as well as victims of crime, correctional clients, the General Assembly, and the U.S. Department of Justice.

Staff

The organizational chart on the next page shows the CJC’s reporting structure. All staff report to the Executive Director, Mr. James Kane. Although not shown, the Executive Director does report directly to the CJC and to the Governor.

Some other points regarding the CJC staff:

· A total of twenty-three (23) full-time employees assist the CJC and the Domestic Violence Coordinating Council. Permanent staff has been supplemented by 12 temporary or contractual workers during the 2004 fiscal year. Sunset Questionnaire, pg. 31.
· As denoted on the chart, 10.8 of the full time positions are General Fund positions. Another 12.2 positions are funded through the federal grants the CJC administers. Ibid.
· With the exception of the Executive Director of the CJC, who is appointed, all staff are merit employees.
· Most staff carry the titles of coordinator, senior planners, and management analysts with Pay Grades between 10 and 19.
· The CJC staff must attend professional association conferences and grant training events around the country. Federal grants pay for necessary travel and training expenses.

An organizational point important to clarify is that the CJC does not have oversight or staffing responsibilities for the Delaware Justice Information System (DELJIS) or for the Statistical Analysis Center (SAC), although the CJC frequently interacts with both. DELJIS is the central state agency responsible for providing efficient and reliable development and operation of the software, hardware, network, and database which comprise the Criminal Justice Information System. DELJIS is an independent agency governed by a 16 member Board of Managers.

The SAC was an arm of the CJC until the Joint Finance Committee, for efficiency purposes, transferred the SAC to the Budget Office several years ago. SAC provides the Governor, Legislature, and Criminal Justice Agencies with objective research analysis, and projections relating to criminal justice issues.

Wilmington Weed and Seed Committee Hon. Colm Connolly *+ Col. Edward Smith Brother Ronald Giannone + Patrick Callahan Matt Ebling Mercedes Fields Michael Brown Linda Richardson Chris Dolley Richard Harris Adrienne Bey Kim Reeves Timothy Crawl-Bey Darlene Sokola Hon. M. Jane Brady * Timothy Bucher James Kane Bryan Glynn Joseph Paesani Doug Denney Diane Lello Jack McDonough Jeffrey Starkey Mayor James Baker Chief Michael Szczerba * James Mosley Dover Weed and Seed Committee Hon. Colm Connolly *+ Col. Edward Smith Matt Ebling Richard Harris Kate Lugg Kim Reeves Suchita Hiresave Rick Culver Sherwanda Rachal Timothy Bucher Hon. M. Jane Brady * Bryan Glynn James Kane Doug Denney Joseph Paesani Nancy Klingler Chief Jeffrey Horvath Mayor Stephen R. Speed

CJC Legislative Committee Bill Bush + Col. L. Aaron Chaffinch * Arthur Garrison Steve Wood, Esq. Mike McLaughlin Hon. Stan Taylor * Hon. Chandlee Johnson Kuhn * Hon. Patricia W. Griffin * Sheldon Hudson Beth A. Dawson Hon. M. Jane Brady * Michael Arrington, Esq. * Col. David McAllister * Debra L. Rees RSAT (Residential Substance Abuse Treatment) Hon. Stan Taylor *+ Paul Howard * Valarie Tickle Nancy Pearsall Safe Neighborhoods Colm Connally *+ Chief Michael Szcerba * Chuck Pugh Col. David McAllister * Stephanie Smith Chief Michael Capriglione * Hon. Jan Brady * Chief Gary Morris Col. Aaron Chaffinch * Chief Jeffrey Horvath Brian Glynn

*Members of the CJC +Chair , co-chair of the Committee; ++Vice Chair

Joint Sunset Committee

Final Report
of the
Delaware Health Resources Board

The Delaware Health Resources Board (“Board”) and the Certificate of Public Review (“CPR”) program that it administers will sunset on June 30, 2005, unless legislation re-establishes it. CPRs (formerly known as Certificates of Need) are the state’s stamp of approval for specific construction and expansion projects of certain health care facilities, and for the acquisition of major medical equipment. The CPR program, in existence in some form since 1972, is supposed to control health care costs, at least in theory, by squeezing out excess supply of health care services. Its history has roots in federal and state legislation.

Federal History

Federal legislation created the Comprehensive Health Planning Program in 1966 to control unnecessary or duplicative hospital investments in plant and equipment Sunset Questionnaire, pg. 4.. Six years later, the Certificate of Need concept was developed to control Medicare and Medicaid costs. Both the 1966 and 1972 federal legislation proved ineffective. Consequently, in 1974, the U.S. Congress developed a consolidated planning program requiring each state to establish a mandatory Certificate of Need (CON) process and concurrently establish a national system of local and state planning agencies. Federal funding of the CON program slowly dissolved through a series of Congressional resolutions until the mid-1980s when the Reagan administration, favoring competition versus government regulation, repealed the CON program in its entirety Ibid..

State History and Joint Sunset Committee Review

States responded to the federal repeal of the CON program by establishing their own health planning framework. In Delaware, Governor Castle established the Health Care Cost Containment Commission in 1985. This Commission later recommended establishing the Health Resources Management Council (HRMC) to oversee the state’s health planning. The Commission’s recommendation became effective with the passage of Senate Bill 132 in 1987.

Seven years later, the Joint Sunset Committee commenced a review of the HRMC. The JSC concluded, in its 1993 Final Report, that there was a need to develop a comprehensive health planning process, and that the various commissions, councils, and boards responsible for health planning should be brought under one umbrella agency for the purpose of centralizing health planning decisions. The JSC further agreed that the CON program and a regionally based health care planning process should be part of the state’s comprehensive health plan. It therefore sunset the HRMC and, with passage of House Bill 331, initiated an overhaul of the CON program.

Specifically, HB 331 established the Delaware Health Resources Board to assume the functions of the HRMC as the state’s overseer of the CON process. It also brought the Board under the Administrative Procedures Act and the State Ethics Code. Moreover, House Bill 331 made significant changes to the CON policies. It vested the final CON decision making power solely with the Board rather than the previous policy in which the Bureau of Health Planning and Resources made final decisions based on the HRMC recommendation. Additionally, the bill abolished the CON Appeals Board.

Other JSC recommendations made minor management modifications. These were implemented upon commencement of the Board’s activities.

House Bill 331 included a June 30, 1996, sunset provision for the Board, and directed the Delaware Health Care Commission (DHCC) to conduct a study examining the necessity of the CON program.
In response, the DHCC’s Health Care Cost Containment Committee, with assistance from Dr. Frank Sloan, a nationally recognized scholar on Certificates of Need, from the Center for Health Policy Research and Education at Duke University, produced one of the most comprehensive evaluations of a state administered CON program at that time. The study concluded that, “the most prudent course of action is to allow the market to work and resort to regulation only if this approach is found to have serious limitations.” Evaluation of Certificate of Need and Other Health Planning Mechanisms, Vol. I, pg. XV. The DHCC’s Cost Containment Committee therefore recommended a three-year phase-out of the CON program beginning in 1996 and ending in 1999. This phase-out included raising the capital expenditures threshold from $750,000 to $3 million and discontinuing the review of health services and bed decreases. Ibid, pg. vii. The gradual program phase-out was enacted through House Bill 640 in 1996.

In 1999, Senate Bill 74 delayed the sunset of the CON program until June 30, 2002 and replaced “Certificate of Need” with “Certificate of Public Review.” It also continued to phase out and reduce the scope of activities subject to Board review by raising the capital expenditure threshold from $3 million to $5 million. The CON sunset date was delayed again -- until June 30, 2005 -- with enactment of Senate Bill 305 in May 2002.

Organization

The Board is an independent public entity. The organizational chart shows that the Board is located within the Health Systems Management Section of the Division of Public Health, Department of Health and Social Services. The Board is assigned to this agency for administrative and budgetary purposes only. 16 Del. C. §9303(c).

Staff

The Board is supported by 2.25 full-time merit positions from the Bureau of Health Planning and Resources Management Sunset Questionnaire, pg. 14.. One position is a Management Analyst III, one position is an administrative support specialist, and .25 of the Bureau of Health Planning Director position is allocated to serving as the Board’s Secretary and Chief Administrative Officer, as required by 16 Del. C. §9303(c). The Director supervises the staff assigned to the Board and the Director is supervised by the Chief of Health Systems management.

Staff size was recently reduced by 1 full time employee when the Division of Public Health realigned. The sunset questionnaire noted that the Board depends heavily on the Bureau staff to review applications and write reports in addition to performing other Board duties. The questionnaire also noted that as the size of the health care industry grows, the ability of the staff to analyze and monitor projects decreases. Staffing issues have been and will continue to be discussed with the Division of Public Health Sunset Questionnaire, pg. 15..

Staff participates in data management, health planning, and communications training opportunities.

HEALTH SYSTEMS MANAGEMENT SECTION ORGANIZATIONAL CHART



DIVISION OF PUBLIC HEALTH

Board Member Name	Appointed by & Other Stipulations for Appointment	Address, City, State	Appointment Date
Jaime H. Rivera, M.D.	Governor appointment Stipulation: designated by the Secretary, DHSS	Div. of Public Health Jesse Cooper Bldg. Federal & Water Sts. Dover, DE 19903	Initial Appt.: Oct. 13, 2004 Term Expires: April 22, 2005
John A.J. Forest, Jr.	Governor appointment Stipulation: designated by the Medical Society of Delaware	195 Lynnhaven Dr. Dover, DE 19901	Initial Appt.: Jan. 10, 1995 Appt.: Jan. 10, 1998 Exp: Jan. 10, 2001 Appt.: April 22, 2002 Exp.: April 22, 2005 (3 terms)
Richard D. Pack	Governor appointment Stipulation: designated by the Delaware State Chamber of Commerce	PO Box 320 Milford, DE 19963	Appt.: March 12, 1998 Exp.: March 12, 2001 Appt.: April 22, 2002 Exp.: April 22, 2005 (2 terms)
Suzanne Raab-Long	Governor appointment Stipulation: designated by the Delaware Healthcare Association	Delaware Health Care Assoc. 1280 S. Governors Ave. Dover, DE 19904	Initial Appt.: April 19, 2004 Exp.: April 19, 2007
Yrene E. Waldron	Governor appointment Stipulation: designated by the Delaware Health Care Facilities Assoc.	Delaware Health Care Facilities Assoc. Two Mill Rd., Suite 200 Wilmington, DE 19806	Appt.: May 13, 1999 Exp.: May 13, 2002 Appt.: June 7, 2002 Exp.: June 7, 2005 (2 terms)
Vacant	Governor to appoint Stipulation: designated by the Delaware Health Care Coalition
Vacant	Governor to appoint Stipulation: designated by the Delaware Health Care Commission
Katherine R. Deitcher	Governor appointment Stipulation: rep. involved in purchasing health care coverage for employers w/over 200 employees	4406 Lowell Rd. Wilmington, DE 19802	Initial appt.: Oct. 13, 2004 Exp.: April 22, 2005
Dana J. Jefferson, Ph.D.	Governor appointment Stipulation: rep. involved in purchasing health care coverage on behalf of state employees	709 W. 26th St. Wilmington, DE 19802	Appt.: April 22, 2002 Exp.: April 22, 2005 (1st term)
Timothy J. Constantine	Governor appointment Stipulation: rep. of the Health Insurance Industry	Blue Cross Blue Shield of Delaware One Brandywine Gateway Wilmington, DE 19801	Appt.: Oct. 25, 1999 Exp.: Oct. 25, 2002 Appt.: May 12, 2003 Exp.: May 12, 2006 (3 terms)
Thomas E. Mulhern	Governor appointment Stipulation: rep. of a provider group other than hospitals, nursing homes, physicians	PO Box 3706 Wilmington, DE 19807	Initial Appt.: July 23, 2004 Exp.: July 20, 2007
Frank Smith	Governor appointment Stipulation: rep. of organized labor	1324 Walnut Shade Rd. Dover, DE 19901	Appt.: June 7, 2002 Exp.: June 7, 2005 (1st term)
Phyllis A. Sheppard (Chair)	Governor appointment Stipulation: public at large	103 New Churchmans Rd. New Castle, DE 19720	Initial appt.: Dec. 9, 1994 Appt.: Dec. 30, 1997 Exp.: Dec. 30, 2000 Appt.: April 22, 2002 Exp.: April 22, 2005 (4 terms)
Robert F. Miller (Vice Chair: Appointed Oct. 13, 2004)	Governor appointment Stipulation: public at large	714 Westcliff Rd. Wilmington, DE 19803	Initial appt.: Jan. 10, 1995 Appt.: Oct. 24, 2000 Exp.: Oct. 24, 2003 Appt.: Oct. 25, 2003 Exp.: April 19, 2007 (5 terms – 1 in current slot)
Donald Derrickson	Governor appointment Stipulation: public at large	154 Fairground Rd. Harrington, DE 19952	Appt.: June 7, 2002 Exp.: June 7, 2005 (1st term)
Joann O. Hasse	Governor appointment Stipulation: public at large	712 Kilburn Rd. Wilmington, DE 19803	Initial Appt.: Dec. 9, 1994 Appt.: March 30, 1999 Exp.: March 30, 2002 Appt.: April 22, 2002 Exp.: April 22, 2005 (4 terms)
S. Bernard Ableman	Governor appointment Stipulation: public at large	Park Plaza 906 1100 Lovering Ave. Wilmington, DE 19806	Initial Appt.: Jan. 5, 1995 Appt.: Jan. 5, 1998 Exp.: Jan. 5, 2001 Appt.: April 22, 2002 Exp.: April 22, 2005
Lloyd Mills, III	Governor appointment Stipulation: public at large	2 De Vries Circle Lewis, DE 19958	Initial appt.: Feb. 16, 1995 Appt.: March 30, 1999 Exp.: March 30, 2002 Appt.: April 22, 2002 Exp.: April 22, 2005 (4 terms)s
J. Kenneth Saunders	Governor appointment Stipulation: public at large	2 Spectrum Drive Newark, DE 19713	Appt.: April 22, 2002 Exp.: April 22, 2005 (1st term)
Linda Heller	Governor appointment Stipulation: public at large	3204 Powhatan Drive Wilmington, DE 19808	Appt.: May 12, 2003 Exp.: May 12, 2006 (1st term)
Richard J. Cherrin	Governor appointment Stipulation: public at large	205 N. Pembrey Drive Wilmington, DE 19803	Initial Appt.: Aug. 15, 1997 Appt.: Oct. 24, 2000 Exp.: Oct. 24, 2003 Appt.: April 19, 2004 Exp.: April 19, 2004 (3 terms – 1 in current slot)

Freedom of Information Act (FOIA)

A review of Board meeting minutes shows that the Board complies with FOIA requirements.

CPR Revisited

CPRs are required for the following activities: 16 Del. C. §9304.

1. Construction, development or other establishment of a health care facility or the acquisition of a non-profit health care facility. “Health facility” is defined to include hospitals, nursing homes, freestanding birthing centers, freestanding surgical centers and freestanding emergency centers.

Health facility does not include home health agencies, assisted living facilities, or in-patient hospice facilities. Home health agencies and assisted living facilities are some of the fastest growing portions of the nursing home industry. In-patient hospice facilities are a new type of facility that houses residents who are dying in a hospital type facility designed to emulate a home setting rather than providing care in the patient’s home until death, as is the case with hospice services. The Board, if retained, would like to add in-patient hospice facilities to the definition of “health facility”.

2. Any capital expenditure by or on behalf of a health care facility in excess of $5 million.

3. A change in bed capacity which increases the total number of beds by more than 10 beds or more than 10% of total licensed bed capacity over a two year period, whichever is greater.

4. The acquisition of major medical equipment, defined as medical equipment used for the diagnosis and treatment of patients and which: exceeds $5 million, or represents medical technology not available in Delaware or has been designated by the Board as being subject to review regardless of cost, such as MRIs, PETs, megavoltage radiation therapy and extracorporeal shock wave lithotripsy.

Undertaking any of the above activities without obtaining a CPR means that the organization or individual operating license will be revoked or restricted. The Board may initiate civil action and the applicant may be fined not less than $500 but no more than $2,500. 16 Del. C. §9308.

Criteria for Review

Health Resources Management Plan

One key criterion that the Board must consider in its review of a CPR application is the relationship of the project’s proposal to the Health Resources Management Plan. The Plan, first adopted in 1995 and last updated in 2003, “shall address the supply of health care resources, particularly facilities and medical technologies, and the need for such resources” and “shall include a statement of principles to guide the allocation of resources and specific criteria and other guidance for use in reviewing CPR applications.” 16 Del. C. §9303(d)(1).

The most recent version of the Plan does include 7 general principles for considering a review proposal. These principles touch on: balancing cost, quality, and access; medical indigency; coordination of health care services; geographic considerations; and over-utilization. Medical technology applications in particular are supposed to be evaluated on access, cost, and quality dimensions.

Beyond these principles, much of the Plan explains projection formulas for nursing home, medical-surgical, and obstetric beds. For example, based on 2004 bed need projections and the approved supply of beds, there is a net surplus of medical surgical beds for all hospitals in the state, and New Castle County, in particular. Health Resources Management Plan, pg. 11. There is a net shortage of obstetric beds at Christiana Care, Beebe Medical Center, and Nanticoke. Health Resources Management Plan, pg. 15. For nursing home beds, the Plan shows a surplus of them in New Castle and Kent Counties and a 26-bed shortage in Sussex County. Health Resources Management Plan, pg. 20. Additionally, the Plan has put a moratorium on the construction of additional hospitals offering medical/surgical beds or obstetric beds for the next five years.

On a related procedural matter, the Board offers an opportunity for public comments on the Plan’s content. It is then submitted to the Delaware Health Care Commission for review and comment. The Plan becomes effective upon the signature of the Secretary of the Department of Health and Social Services. Sunset Questionnaire, pg. 5.

Other Criteria

In addition to the Health Plan, the Board, in its review of a CPR application, must also consider: 1) the need of the population; 2) the availability of less costly and/or more effective alternatives to the proposal (including the use of resources located outside of the State); 3) the relationship of the proposal to the existing health care delivery system; 4) the immediate and long-term viability of the proposal in terms of the applicant’s access to financial/management and other resources; 5) the anticipated effect of the proposal on the costs of and charges for health care; and 6) the anticipated effect of the proposal on the quality of health care.

CPR Process

The CPR process consists of several phases and procedural steps. Timelines for task completion are established by law. 16 Del. C. §9305.:

1. Notice of Intent. An applicant must file a Notice of Intent at least 30 days prior to filing the application. Bargaining and negotiations take place during this pre-application phase. The notice does not expire, meaning that some projects have notices on file for years with no action, thus preventing others from engaging in a similar project. The Board would like the Notice to expire after 180 days.

2. Applicant Files Application. Upon receipt of the application, the Bureau of Health Resources Management has 15 days to notify the applicant as to whether the application is complete.

a. As a side note, the CPR Application was adopted in 1995 and last updated in May 2002. It focuses mostly on the proposal’s financial feasibility. There are a few questions regarding the population served by the project and additional questions regarding programmatic changes and bed use data.

3. If the application is determined complete, the Bureau has 5 working days to provide notification to all health care facilities and other interested parties of the beginning of a review. The Bureau must also notify the applicant of any applicable filing fees, which are determined as follows:

Capital Expenditure Filing Fee

Less than $500,000 $100
$500,000 - $999,999 $750
$1,000,000 - $4,999,999 $3,000
$5,000,000 - $9,999,999 $7,500
$10 million and over $10,000

Filing fees are deposited into the General Fund.

4. Presentation. Once the application is considered complete, the applicant makes a brief presentation to the Board and responds to questions. Staff recommends whether the Board should proceed with a staff review or use a Review Committee, to be appointed by the Chair. (Staff conducts reviews for acquisition of an existing facility, new services, equipment replacement upgrades and capital expenditures not involving direct patient care. Review Committees generally review applications for new facilities, major renovation/bed replacement projects, increased beds and emerging technology.) Review Committee or staff reports are then sent to the Board for its final decision. Certificate of Public Review Procedures.

5. Public Hearings. Anyone may request a public hearing on a CPR application within 10 days after the notification appears in the newspaper. A public hearing may also commence if anyone requests in writing reconsideration of a Board decision within 10 days of the decision.

6. Board Decision. CPR reviews must not proceed longer than 90 days from the date of notification. If a public hearing is requested, the maximum review period may be extended to 120 days. Extensions may be granted up to 180 days if the Board determines an extension is necessary and it must make that determination within 30 days from the date of notification (60 days if a public hearing is requested).

a. For emergency situations, the Chair or Vice-Chair is authorized to issue a CPR at his or her discretion but within 72 hours after receipt of the emergency application.

b. The Bureau notifies the applicant in writing of the Board’s decision and the basis for it and any conditions specifically related to the project in question. Conditions may include charity care requirements, Medicare certification, or other accreditation requirements. The applicant may appeal the Board’s decision to Superior Court within 30 days following the decision.

7. Post Decision. Certificates are valid for one year. CPR recipients are required to submit progress reports to staff a month before the anniversary of the projects approval date. The Board then determines if the applicant has made sufficient progress toward project implementation. A six month extension may be granted for insufficient progress.

a. CPRs may also be revoked by the Board for failure to comply with conditions in a timely manner, misrepresenting the application, or loss of operating license. Applicants may also surrender the license or have it transferred.

b. Staff monitor CPR approved projects during the first year and after if conditions are tied to the certificate, however, according to the CPR Procedure Manual, monitoring is “generally a low priority item because of the limited resources and the competing demands of new applications.”

CPR Data

· Since 1988, the Board has reviewed a total of 157 applications. It approved a total of 143 (124 approved without conditions and 19 approved with conditions) and rejected a total of 14.
· Of those rejected, 5 CPR applications were for nursing homes, 3 were for cardiac catheterization services, 1 was for a foot center, 2 related to renal dialysis centers, 2 related to radiation therapy equipment, and 1 was for MRI equipment.
· The Medical Center of Delaware, Beebe Medical Center, Alfred I. DuPont Institute, St. Francis Hospital, and Christiana Care Health Services are the health care institutions that have most frequently applied for and received CPR approval since 1988.
· Christiana Care received CPR approval for a $114.5 million expansion and renovation project at Christiana Hospital. That was the single highest capital expenditure approved by the Board.
· CON data shows changing trends within the health facility system from construction of traditional health facilities, such as hospitals, nursing homes, and clinics, to freestanding single or multi-specialty surgical centers. Close to 20 freestanding facilities have applied for and received CPR approval since the trend began in the mid-1990s.

CPR/CON Impact on Cost, Quality, and Access

The 1996 Health Care Commission report referenced earlier concluded that there was little evidence that CONs result in a reduction of costs, and some evidence to suggest the opposite. This conclusion holds true today. Research has conclusively stated that CON laws do not effectively control overall per capita health spending or control hospital spending Conover, Christopher and Frank A. Sloan, “Does Removing Certificate of Need Regulations Lead to a Surge in Health Care Spending?, Journal of Health Politics, Policy, and Law, Vol. 23, No.3, June 1998; and other works cited in the State of Washington Joint Legislative Audit and Review Committee report 99-1, Jan. 1999.. Additionally, Michigan, Washington, and several other recent state CON studies reached the same conclusion as the Health Care Commission. It appears that CON programs across the nation have fallen short of reaching their goals of restraining health care costs.

Research regarding the effect of CONs, or the effect of repealing CONs, on quality and access has been inconclusive. Some studies show that CON programs control quality by serving a “gatekeeper” function, essentially screening an applicant’s quality record or ability to meet certain financial and staffing conditions. CON laws also attempt to improve quality by increasing the volume of services, which should result in better outcomes (practice makes perfect). Many other studies suggest CON is unnecessary as a quality control mechanism because other more recognized methods of quality controls exist (i.e., facility licensure requirements, Medicaid/Medicare accreditations, Joint Commission on the Accreditation of Hospital Organizations certification, and patient satisfaction reports).

With respect to access, proponents argue CON laws can provide financial stability to existing providers by shielding them from competition, and therefore allow them to extend access to the more expensive uninsured or underinsured populations. On the flip side, as concluded in the DHCC 1996 report, CONs may have a beneficial impact on access, but it is relatively modest compared to other governmental interventions.

In a nutshell, CON does not restrain health care costs. Its impact on improving quality and access are questionable when compared to other quality and access driven policies or programs.

CPR/CON Impact on Charity Care

Delaware’s Health Resources Board periodically attaches a charity condition to its grant of a CPR certificate. This condition requires that a CPR holder set aside 2.75% of its gross revenue for charity care and then submit a report to the Board after the end of each fiscal year showing total gross charges and the amount of charges foregone.

The Board acknowledges that recent reports from most applicants show that they were unable to meet the 2.75% goal. A Charity Care subcommittee is meeting to develop ways to better ensure Charity Care provisions are met each year by these facilities. Sunset Questionnaire, pg. 9.

Other State CPR/CON Programs

Thirty-six (36) states have a CON program. The regulatory structures vary considerably from state to state with some states regulating as few as one or two categories of services (Ohio, Nebraska, and Louisiana) while other states regulate 25 or more categories of services (Hawaii, New York, Vermont, Alaska). Maryland regulates 16 categories of services and New Jersey regulates 11. 2004 Relative Scope and Review Thresholds, Thomas R. Piper, Missouri CON Program. Delaware regulates 8 categories (acute care, ambulatory surgery centers, cardiac catheterization, lithotripsy, long term care, Position Emission Tomography, radiation therapy, and birthing centers.)

Capital and medical equipment thresholds triggering CON review also vary from state to state. Florida has no thresholds for review---anything falling into one of its 11 categories of services is reviewed. Oklahoma and Arkansas capital thresholds are the lowest at $500,000. Massachusetts has the highest capital threshold at $10 million. Delaware’s threshold is $5 million.

The remaining14 states have repealed their CON programs (AZ, CA, CO, ID, IN, KS, MN, NM, ND, PA, SD, TX, UT, and WY). Most of the repeals occurred in the mid to late 1980s (PA and ND occurred in the mid-1990s). Generally, programs were repealed because the CON program lacked legislative and public support once federal dollars were discontinued, and because these states generally believed the CON program was an administrative burden with no proven ability to control health care costs.

The effects of CON repeal on a state’s health care system depends on its specific characteristics and on the state’s varying market interactions; however, there is a similar scenario among the 14 states who have repealed their CON programs: after repeal, states experienced an initial rush to construct nursing homes, hospitals, and psychiatric centers but a restructured health care market, i.e., the growth of managed care and other cost cutting initiatives created a competitive environment, which generally prevented any over-building because facilities unable to compete simply closed. NCSL, Health Policy Tracking Service Issue Brief, December 2003. Nonetheless, as a precautionary measure to guard against potential increases in Medicaid costs, many of these 14 states that had repealed the CON program instituted a moratorium on the construction of nursing home beds. Ibid.

Pros and Cons of the CPR Program

Pros

· The CPR program offers an opportunity for public scrutiny of and participation in decisions regarding health care facilities and services.
· CPR criteria and guiding principles provide a method of deliberately considering the health care market and community in which a facility or service is planned.
· CPR provides a way of at least considering quality and access issues.
· Board member expertise and commitment have positively contributed to the health planning process in Delaware.
· CPR is a low-cost program for the state to administer. Its budget is less than $100,000.

Cons

· Overall, the CPR program has had difficulty achieving its goals.
· CPR was created to restrain health care costs. Research and other states’ experiences has proven it does not control per capita health care spending or hospital spending.
· Quality assurances have not been attainable because of insufficient staff resources to provide on-going project monitoring.
· CPR impact on access has been negligible.
· The CPR program’s charity care policy is not applied to all projects. For those that it does apply to, the policy’s 2.75% goal has not been met.
· CPRs pose significant direct and indirect costs to the applicants (i.e., filing fees, application completion, consultations, and legal fees). This could make Delaware less competitive with other states, such as Pennsylvania, which does not require a Certificate of Need.
· Consider whether the program is necessary given that almost all project applications are approved (only 14 applications have been rejected over the past 16 years).

Joint Sunset Committee

Interim Report
of the

Case Initiation

Cases may be initiated by any of the following individuals or agencies:

1. Any individual enrolled in the TANF program administered through the Division of Social Services.
2. Any individual who applies for and receives medical assistance through the Medicaid Program directly for, or on behalf of, a child.
3. Any non-public assistance IV-D recipient. This is an individual who does not receive monetary or medical assistance from the state and who applies for DCSE services by paying a one-time $25.00 application fee.
4. Any individual ordered by the court to pay child support through DCSE. The DCSE monitors these cases for accounting purposes only.
5. Any case received from another state or territory that requests enforcement in Delaware.

Individuals may request services from DCSE by mail, in person, or through referrals. Most cases are initiated through referrals from the Division of Social Services after the client has applied for TANF or Medicaid benefits, and has signed the Assignment of Support Rights form. As a condition of eligibility for assistance, TANF or Medicaid recipients must cooperate in good faith in locating the NCP, establishing parentage, and establishing, modifying, and enforcing support orders, subject to good cause exemptions (i.e., harm to the child or custodial parent, rape, adoption.) Policy Manual, Chapter 6, pg. 9.

Within 20 calendar days of receipt of a referral or filing of an application, DCSE must open a case and establish a record.

For interstate child support cases, an initiating state has 20 days from the time it determines a NCP lives in another state to refer the case to the appropriate interstate registry for further action. A responding state in an interstate case, has 75 days from the receipt of request for interstate action to provide locate, establishment, enforcement, or modification services. Policy Manual, Chapter 11, pg. 13.

Locate
“Locate” refers to the obtaining of information concerning the physical whereabouts of the NCP, the NCP’s employers, and sources of income or assets in order to take the next appropriate action in a case.

Some of the resources available to the State’s Parent Locator Service, comprised of DCSE Child Support Specialists, include:

· Federal Parent Locator Service (FPLS). The FPLS is a computerized national location network operated by the Federal Office of Child Support Enforcement providing address and Social Security information to child support agencies.
· National New Hire Directory (central repository of employment, unemployment insurance, and wage data from State Directories of New Hires, State Employment Security Agencies, and federal agencies).
· Postal Service, phone records, credit reports, unemployment records, motor vehicle records, TANF and Medicaid records.
· IRS

Within no more than 75 calendar days of determining that location is necessary, the worker must access all appropriate location sources. Location attempts must be repeated either quarterly or immediately if new information is received that will aid in the attempt to locate the NCP. Sunset Questionnaire, Section 6, pg. 2.

Paternity Establishment

Paternity establishment fosters the basic emotional, social, and economic ties between the father and his child; legally entitling the child to financial support; and develops a child’s sense of identity. Paternity establishment is also an essential first step to obtaining a child support order and a medical support order.

Presumption of Paternity

Delaware law establishes a presumption of paternity. This means that a man is presumed to be the father of a child if he and the mother of the child were married to each other and the child was born during the marriage or within a certain time after the marriage ends. Uniform Parentage Act, Section 204.

Paternity Establishment for Children Born Out-of-Wedlock

For unmarried parents, DCSE establishes paternity through any one of the following:

· Voluntary Acknowledgement of Paternity. This program, in conjunction with all hospitals and birthing centers throughout the state, is for parents who were not married when the child was born and who wish to legally establish paternity of their child without going to court. A valid acknowledgment of paternity is the equivalent to the adjudication of paternity of a child. The acknowledged father assumes all the rights and duties of a parent. The program averages 1,500 voluntary acknowledgments per year since it began in 1995.

· Genetic Testing (voluntary or court ordered). Federal law requires DCSE to pay for state-ordered genetic tests subject to recoupment from the challenging party if the test result is negative. NCSL Six Steps to Child Support Enforcement, pg. 4.
A genetic test in and of itself will not establish paternity. It can be used as preponderance of evidence, but must still be adjudicated by the Court.

· Petition to Determine Parentage. DCSE files a Petition to Determine Parentage in Family Court for cases in which the parties have not responded to a Paternity Testing Letter, which is sent to the parties by DCSE during the Intake process, or if the parties refuse paternity establishment procedures, or if the parties fail to show up for related appointments. Policy Manual, Chapter 7, pg. 9.

Under federal law, DCSE must permit paternity establishment at any time before the child reaches 18, and must provide a written and oral notice to both parents of the consequences of paternity acknowledgement.

Exceptions

According to Federal Regulations, Section 303.5 of 45 CFR, DCSE need not establish paternity in any case involving incest or forcible rape, or in any case in which legal proceedings for adoption are pending.

Disestablishment of Paternity

Recent advances in the science of DNA and genetic testing have brought with it an onslaught of public policy issues concerning paternity disestablishment. Delaware’s Uniform Parentage Act establishes policies for paternity disestablishment some of which include:

For Presumed Fathers:

· Delaware law permits a rebuttal presumption of paternity if genetic test results are positive to a certain probability.
· Presumed fathers may sign a Denial of Paternity. (The Denial must meet specific criteria for it to be considered valid).

For Acknowledged Fathers:

· An Acknowledgement of Paternity may be rescinded within 60 days. After that, parties challenging an acknowledgement of paternity may do so on the basis of fraud, duress, or mistake of fact, and within two years after the acknowledgement has been filed.

Support Order Establishment

Monetary Support

Federal regulations require the DCSE to establish an order for support or complete a service of process needed to establish a support order within 90 days of locating the alleged father. Once the alleged father has been located, and paternity has been established, DCSE follows a three step process to create the child support order: Policy Manual, Chapter 8, pg. 16.

1. DCSE Child Support Specialists file a Petition for Support with Family Court.
2. The case is sent to mediation. Rule 16 of the Family Court requires that all child support cases be scheduled for mediation before they can be scheduled for a court hearing. (Mediation resolves more than 80% of DCSE’s cases).
3. If mediation fails, Family Court staff refers the case to a Family Court Commissioner for a hearing and issuance of a support order.

Appeals of the Commissioner’s order are filed directly with Family Court within 10 days of the date of the appeal. The case is then heard de novo before a judge.

Medical Support Orders

Federal law requires DCSE to take the legal steps necessary to establish an order for medical support in cases where the child is receiving Medicaid. For children who are not enrolled in Medicaid, the court’s order will require the NCP to either provide health insurance or, if the NCP does not have health insurance but the custodial parent does, the NCP will be ordered to contribute to the cost of health insurance in addition to the standard child support amount. If neither party has health insurance, then the court’s order will require the NCP to provide it when it does become available.

When the NCP or custodial parent, or both, seek health care coverage for a child from an employment-related group health plan, DCSE must issue to the employer the National Medical Support Notice required by Title IV-D of the Social Security Act. DCSE is also responsible for notifying the employer when a medical support order ends.

Child Support Formula

Federal Title IV-D child support mandates require each state to establish guidelines for setting child support obligations in every case. Delaware is one of two states that use the Melson Formula to calculate child support. The Melson calculation is based on the mother and father’s net income and the number of children the mother and father had together. The calculation also considers employment related child care costs, health insurance costs, hardship factors, and may consider special expenses for the child. A standard of living adjustment is made if income is available after the parents have met their primary support needs and those of their children.

If the net income is unknown because the parent fails to show up for their court hearing, then the judges “impute” income. This means that the judges act as though the parent earns a certain income, based on such factors as previous work history, physical and mental condition, educational background, and current employment market.

Delaware law provides a rebuttal presumption that the support amount calculated by Delaware’s Melson Formula is appropriate and fair. Either party may contest the amount if shown to be unfair. Contests have occurred only in a small percentage of cases. Policy Manual, Chapter 8, pg. 17.

Formula Deviations

· Low-Income Families. TANF recipients may be eligible for a Child Support Supplemental Payment to ensure that families do not experience a net loss of income due to the State’s retaining child support payments to reimburse the TANF program. Fill the gap budgeting, established in 1975, calculates a payment based on specific criteria that may result in 50% to 100% of the child support payments being returned to the custodial parent’s household.
· Support Adjustments/Extended Visitation. Child Support payments may be adjusted if the parents equally share custody, residence, and expenses of the children by agreement or by prior court order. A judicial officer may make adjustments to the calculation based on the amount of time a child spends with a non-custodial parent. Delaware Child Support Guideline, Form 509.

Support Order Modification

Delaware law permits a support order modification if the TANF case is 2 ½ years old or if there is proof that a substantial change in circumstances has occurred in a TANF or non-TANF case. A request for modification may be made by the NCP, custodial parent, or another state agency. Modification criteria include:

· Changed circumstances result in a change in the support amount of at least 10%. This change is usually due to substantial increases or decreases to the NCP’s or CP’s earnings, the needs of the child have changed significantly, or work-related child care expenses are incurred.
· Health insurance becomes available when it was previously unavailable.
· The child reaches age 18.

Duration of Support

By law, the duty of support ends when a child reaches 18 years of age, unless the child is in high school, in which case the duty of support ends when the child receives a high school diploma or reaches age 19, whichever comes first.

Enforcement: How the State Collects Child Support

Income withholding, or wage garnishment, is the most effective way to ensure regular support payments, regardless of arrears (i.e., overdue child support), when the NCP has regular income. An income withholding provision is included with every support order and a wage attachment is automatically generated in any case where the address of the NCP, the NCP’s employer and address, and the employers Federal Employer Identification number are known. Sunset Questionnaire, Section 6, pg.4.

Employers must begin withholding income no later than 7 days after the first payday following receipt of the income withholding notice. Policy Manual, Chapter 9, pg. 7.

The General Assembly has designated DCSE as the State Income Withholding Agency, vesting it with certain administrative powers that include:

· Ordering income withholding without the necessity of a court order.
· Recognizing similar withholding orders from other states and jurisdictions.
· Executing an income withholding order without giving the NCP advance notice – this includes issuance by electronic means.
· Placing a payor, including the NCP, on notice to make payments pursuant to an income withholding order to DCSE.

Certain exceptions to immediate income withholding provision include:

· One party demonstrates, and the court finds, good cause not to require immediate income withholding. If the court makes a finding of good cause, it is required to include within the order a provision as to why immediate income withholding would not be in the best interest of the child. The NCP is required to provide proof of timely payments of previously ordered support.
· A written agreement between the parties that provides for an alternative payment arrangement.

Other Enforcement Tools

Federal law requires that the DCSE implement policies and procedures for handling child support payment delinquencies, defined as those cases which have not received a payment equal to one month’s support. Should a delinquency occur, DCSE may initiate one or more of the following remedies made exclusively available to it:

· License Suspension. Driver’s, recreational, professional and business licenses may be suspended if arrears total $3,600 or more. Delaware law permits license suspension if the NCP is $1,000 or more in arrears.
· State and Federal Income Tax Refund Intercept. Federal Income Tax Refund Intercepts are first allocated to cover TANF arrears.
· Lottery Intercept.
· Unemployment Compensation Intercept.
· Cooperating with the court in the issuance of a capias.
· Placing liens on real property and personal property.
· Reporting the child support debt to credit reporting agencies.
· Denying passports.
· Collecting from third parties such as banks.
· Criminal non-support prosecution.
· Filing lawsuits to recover assets that are transferred from the NCP to another individual so the NCP can avoid paying child support.
· Interstate Enforcement.

DCSE, Family Court, and the Attorney General’s staff are currently developing an Amnesty Program. This enforcement program offers a period of amnesty for the 1,300 NCPs who have active capiases and who have failed to appear at Family Court for child support-related matters, or have failed to meet a specific condition of their child support order. Basically, the NCP would agree to a good faith payment toward owed arrears. Once the good faith payment is satisfied, their capias would be dismissed. The goals of the Amnesty Program are to resolve child support capiases, increase payments by delinquent NCPs, and enable child support staff to better enforce delinquent cases. Self Assessment Report, pgs. 18-19.

Administrative Hearings (for enforcement actions)

DCSE must offer administrative hearings for enforcement actions not ordered by a court (i.e., federal and state tax offsets or intercepts, passport denials, liens, arrears adjustment, income withholding.) Policy Manual, Chp. 2, pg. 11.

Hearings follow the Administrative Procedures Act. Requests are made in writing and within the time stated in the DCSE notice of intent to take a specific enforcement action. Hearing decisions are usually issued within five working days after the hearing and may be appealed to Family Court within 30 days thereafter. Individuals may appear for an administrative hearing with or without an attorney.

Case Closings

Cases are closed if one of the following occurs: 1) Family Court revokes the support order; 2) a non-public assistance Custodial Parent requests discontinuation of services; or 3) the case meets case closing specific criteria set forth in the DCSE’s Policy Manual.

Distribution of Collections

In FY 2004, DCSE collected over $87 million in child support collections. This represents around 60% of the total current child support payments due.

The $87 million in child support collections was distributed as follows:

· $62 million was distributed directly to non-public assistance (IV-D) families. These are families who have an enforcement case filed with DCSE but who do not receive TANF benefits.
· $12 million was distributed to non-IV-D families. These are families for whom DCSE collects support but the custodial parent has not requested support enforcement.
· $7 million was forwarded to other states for child support distribution
· $3 million was returned to the federal government to offset their TANF Program costs.
· $3 million was retained by the State to offset its TANF and other program costs.
· $337,000 was distributed for foster care purposes.


Undistributed Collections

In Fiscal Year 2004, approximately $2.2 million of child support collections was undistributed (around the same amount went undistributed in Fiscal Years 2003 and 2002). The presumed reasons for undistributed payments vary. Most collections are undistributed because the collections are being held for future support ($634,288) or the payment has been disbursed but has not been cashed ($617,342).

The Delaware Automated Child Support Enforcement System needs enhancement before it can code reasons for undistributed collections. In the meantime, DCSE manually tracks the reasons for undistributed payments and calculates the total dollar amounts attributed to each reason. Since 2001, the manual project has been successful in reducing undistributed collections by over $2 million total.

Child Support Arrears (Overdue Child Support)

The chart below shows the accumulated arrearages due to the state (versus due to the custodial parent) for each of the past three Federal Fiscal Years. Cumulative arrears due to Delaware appear overwhelming, totaling in the hundreds of millions of dollars. To provide some perspective, consider cumulative arrears due nationally, which total in the billions.

Federal Fiscal Year	Amount of Cumulative Arrears Due to DE	Amount Distributed on Arrears due to DE	Amount Distributed as a % of Cumulative Arrears due DE	Amount of Cumulative Arrears Due Nationally	Amount Distributed on Arrears National	Amount Distributed as a % of Cumulative Arrears Due National
2001	$253,286,261	$17,068,707	7%	$88,132,073,076	$5,745,655,874	7%
2002	$218,181,217	$17,680,388	8%	$92,322,939,347	$6,268,704,140	7%
2003	$227,910,511	$18,211,150	8%	$95,798,858,586	$6,462,335,036	7%

A recent NCSL publication, Six Steps to Child Support Enforcement, discusses several reasons why arrearages accrue:

1. Retroactive Child Support Awards. If the Court orders retroactive child support payments (i.e., payments dating back to the birth of the child or up to 2 years maximum from filing for retroactivity), then the NCP begins his child support payments with an accumulated debt. The longer the period of retroactivity, the less likely it is that the NCP will pay any support.
2. “Deadbeat” Dads. A number of NCPs are reluctant to pay child support, or evade paying it even if they can afford to do so. Enforcement measures actively target this group.
3. “Deadbroke” Dads. Many NCPs are unable to pay child support because they are low-income or unemployed.
4. Uninformed Parents. At times, NCPs are not adequately informed of their child support obligations, nor do they understand the repercussions of failing to pay.

Policymakers should be concerned about child support arrears for several reasons.

1. Part of the mission of child support enforcement agencies is to collect child support from NCPs. Arrearages make the child support program appear ineffective at achieving the mission.
2. Collecting arrearages promote family self-sufficiency by supporting family income.
3. The federal government evaluates and financially rewards state performance for the number of cases in arrears with collections.
4. Collecting arrearages could help offset the decline in child support revenue, which has been caused by a child support caseload that is increasingly comprised of non-TANF families.
Arrears Management in Other States

States manage arrears in many ways. Some states have statutes of limitation determining the length of time a child support debt is collectable. Delaware joins Pennsylvania and New Jersey as one of the 13 states that do not have a statute of limitation for arrearages. In Maryland, arrearages may be collected for up to 12 years. In Vermont, child support arrearages may be collected until the child reaches 24. NCSL, Six Steps for Child Support Enforcement, page 9.

Other state strategies targeting child support arrears include:

· Compromising or forgiving child support debts through amnesty programs, provided that all parties involved, including the state, agree to it.
· Changing the calculation of retroactive child support.
· Ensuring child support orders accurately reflect earnings.
· Regularly reviewing and modifying support orders.
· Providing more job services programs to NCPs. Welfare Information Network, Issue Notes, Vol. 6, No.7, October 2002.
· Actively pursuing child support obligations through enforcement measures.

Other timely strategies affect the armed forces. Excessive, unmanageable child support arrears are a common legal problem facing reservists when they return from deployment. Case in point—a January 2003 memo released from the Head Legal Assistance, Judge Advocate Division, United States Marine Corps. to all Marines, advised them about the importance of seeking modification of support orders prior to troop deployment to avoid unmanageable child support debt. Public Works, Options for the Scott County Child Support Initiative, October 22, 2004 Some states are taking it a step further. Oregon has introduced legislation requiring the state to pay child support of Oregon National Guard members on active duty in Iraq or Afghanistan.

Technology and Automation

To be effective, a child support enforcement program must receive adequate funding for technology and service automation initiatives. This point is critical. States lose federal funds if their child support agencies do not meet federal data system requirements. Additionally, service automation improves case management efficiencies, resulting in greater customer service satisfaction, improved communication between state agencies, and more opportunities for the state to receive federal incentive payments. The latter point ultimately reduces the state’s cost of administering the child support enforcement program.

The Delaware Automated Child Support Enforcement System (DACSES) became operational in 1987 for an initial cost of $1.4 million. Additional development, operating, and maintenance costs have totaled $22.3 million, for an overall cost of $23.7 million. DACSES has since been certified as meeting federal requirements. It was first certified in February 1996 after meeting all of the Federal Family Support Act requirements, including the development of a comprehensive, fully operational, integrated statewide automated data system with effective capabilities for establishing paternity and collecting child support. Sunset Questionnaire, page 1, Section 7. DACSES was certified as meeting PRWORA requirements on May 19, 2004. PRWORA required that all states adopt new child support enforcement initiatives such as, establishing a nationwide and individual state New Hire Reporting system, improving the Child Support Network among states, and implementing License Suspension and Financial Institution Data Match programs for seriously delinquent child support obligors. Ibid.

Both the state and federal governments have financed federal automation mandates. The federal government funds 66% of the total costs and the State covers the remaining 34%. Projected operating and maintenance costs for Fiscal Year 2005 total approximately $5.3 million (approximately the same annual cost as in previous years). These costs consist of:

DB2 Conversion Project (contractor services) $3,000,000
Operating Costs Charged by DTI $1,200,000
Programming Maintenance Requests (contractor) $ 500,000
State Staff Allocated Payroll Costs $ 562,000
Advance Planning Document Update (contractor) $ 35,000
TOTAL $5,297,024

State Share of FY 05 DACSES Costs $1,800,988
Federal Share of FY 05 DACSES Costs $3,496,036

Future DACSES costs will vary depending on federal mandates and new programs. For example, as part of DCSE’s long term IT plan, DACSES will need to be totally rewritten because it has passed the normal 10-year useful life of an automated system. For this particular project, DCSE has requested funding for one-time consultant fees, necessary to obtain approval from the federal government for a total re-write of DACSES, in the amount of $750,000 ($255,000 General Fund). Replacing the DACSES may begin in Fiscal Year 2007.

Several short term projects are underway to enhance the overall processing and service delivery of the child support enforcement system.

DACSES is managed by Division staff, the state IRM, and a contractor, Northrop Grumman. Ibid.

Data Integrity

As with any automated system, data integrity is a major concern. DCSE has edits in the DACSES to validate data when entered or updated manually to insure correctness of the data. Information is also validated against other databases including vital statistics, Foster Care, and the Family Court’s data system. Error reports for batch processing are printed and distributed to management for review and corrections. DACSES eliminates data entry by capturing information automatically from other databases whenever possible. Lastly, inputting and updating case information is tracked by case events identifying the caseworker making the changes. Sunset Questionnaire, pg. 5, Section 7.

Customer Service

The DCSE Customer Service Unit is the initial point of contact for client communications. DCSE’s Self Assessment Report, dated March 2004, states that the Customer Service Unit received 16,000 calls between December 2002 and December 2003. Of that total, 14,000 calls were answered. The same report also stated that DCSE is working to reduce call wait time and hang-ups.

In 1999, DCSE implemented an Enhanced Delivery Initiative to increase customer inquiry processing. Specifically, this Initiative:

· Created an Automated Call Distribution System within the Customer Service Unit, which distributed calls to specially trained, customer service child support specialists who were able to respond and resolve issues at the lowest level possible. The benefit: customer service inquiries are addressed more expeditiously and the caseworkers devote more time to case processing.

· Implemented the Automated Assistance Line (AAL), which provides customers with general information about child support services. It also allows them to access payment information 24 hours a day/7days a week and links to the Customer Service Unit for questions not resolved by the AAL.

The AAL receives a monthly average of 137,000. Approximately 16,000 of these callers choose to speak to a live Customer Service Child Support Specialist. In 2003, the AAL received 1.5 million calls. The CSU answered 160,000 of those. Together, the AAL and the CSU resolved around 87% of the incoming calls with no further need for case worker interaction. Sunset Questionnaire, pg. 2, Section 8.

DCSE clients also interact with the main and field offices through face-to-face contact with walk-ins (on average about 50-60 clients visit DCSE offices daily), and through inquires made through the Governor, DHSS Secretary, DCSE Director, the legislative offices, and through community outreach. Sunset Questionnaire, pg. 1, Section 8.

Complaints/Inquiries

External inquiries are generally channeled through the DHSS Secretary’s office to the Customer Service Unit. Inquiries to the Director’s office come to the unit via a “tickle” system. Once received by CSU, the inquiry is entered into a database for tracking. Sunset Questionnaire, pg. 4, Section 8.

Inquiries received via e-mail, telephone, and website are forwarded to the Secretary’s office. The Secretary’s office then monitors these inquiries for completeness of resolution and timeliness of response. Written complaints and inquires are addressed in writing under the signature of the Governor, Secretary, or Division Director.

Responses to e-mail inquiries are to be completed within 72 hours, while responses to written inquiries are forwarded within 10 days. DCSE maintains a hard copy and an electronic copy of both.

DCSE does not track complaints separately from general inquiries received via letter, e-mail or phone to the Director, DHSS Secretary, or legislative offices. Instead, DCSE’s Customer Service Unit tracks and responds to incoming constituent issues by categories (i.e., accounting, enforcement, interstate issues, wage attachments, tax intercepts). DCSE recognizes the broadness of these categories and is reviewing them to create more appropriate tracking measures.

DCSE received a total of 263 inquiries in FY 02; 227 in FY 03; and 270 in FY 04. The five most common issues received by year are:

July 2001 – June 2002	July 2002 – June 2003	July 2003 – June 2004
Enforcement (83)	Enforcement (87)	Enforcement (86)
Accounting: all issues (73)	Accounting: all issues (51)	Accounting: all issues (47)
Interstate (20)	Tax intercept (21)	Interstate (32)
Tax intercept (16)	Interstate (5)	Tax intercept (10)
Wage Attachment (15)	Wage Attachment (3)	Wage Attachment (5)