Delaware

VIEWPOINT: This is a critical moment: Delaware must not go backward in health equity

Published

2 years ago

April 23, 2024

VIEWPOINT: This is a critical moment: Delaware must not go backward in health equity

Dr. LeRoi Hicks | PHOTO COURTESY OF CHRISTIANACARE

The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way.

As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals.

While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time.

A tale of two cities

To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter.

Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive.

The key to lowering health care costs is to improve quality, access and equity

Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments.

The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care.

Let’s do more—not less—of what we already know works

Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone.

One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition.

The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas.

These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy.

The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department.

When we work together, we succeed

We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state.

Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems.

By narrowly focusing on cost, we risk losing the progress we have made

Delaware House Bill 350, as it’s proposed, would cause harm in two ways:

First, it would compromise our ability to invest in these kinds of interventions that work.
Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware.

In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable.

These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish.

At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them.

LeRoi Hicks, M.D., MPH, FACP is the campus executive director for ChristianaCare, Wilmington Campus.

Note: This commentary was originally published on news.christianacare.org.

About ChristianaCare

Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,430 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.

ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

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Related Topics:christianacare delaware Featured HB 350 healthcare hospital New Castle County

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Delaware

50 boys outdoor track and field athletes to watch in Delaware in 2026

Published

9 hours ago

March 27, 2026

Press Room

50 boys outdoor track and field athletes to watch in Delaware in 2026

Since the start of 2025, Delaware boys track and field athletes have set 11 state records between the indoor and outdoor seasons.

After a winter season in which 17 performances reached the top five on the state all-time list, Delaware appears poised for another strong spring.

Our list of track and field athletes to watch (presented alphabetically) features athletes from 24 schools who compete in sprints, distance races, throws and jumps. They are the athletes we expect to be among the state’s leaders at the DIAA Championships at Dover High on May 15-16 although many new names could emerge by then.

After defending its indoor track and field state title, Middletown is in search of its second straight Division I championship. Saint Mark’s enters the season as the Division II winner in three of the past four seasons.

2026 Delaware boys track and field athletes to watch

Elijah Annan, sr., Dover

Jason Baker, sr., Cape Henlopen

Derick Belle, sr., Odessa

Suhayl Benson, jr., Howard

Shaun Bosman, sr., Christiana

Elijah Burke, sr., Saint Mark’s

Khalid Burton, sr., Laurel

Isaiah Charles, jr., Caravel

Chukwuma Chukwuocha, jr., Wilmington Friends

Timothy Claessens, jr., Newark Charter

Rodney Coker, so., Odessa

Jaheim Cole, sr., Dover

Josh Cox, sr., Archmere

Calvin Davis, fr., A.I. du Pont

James Dempsey, jr., Salesianum

Will DiPaolo, sr., Cape Henlopen

Logan Elmore, jr., Middletown

Dahani Everett, sr., Caesar Rodney

Jayden Feaster, sr., Middletown

Gabe Harris, sr., Caesar Rodney

Phoenix Henriquez, sr., Smyrna

Christian Jenerette, sr., Odessa

Brandon Jervey, jr., Middletown

Mekhi Jimperson, sr., Caesar Rodney

Benjamin Johnson, jr., Dickinson

Michka Johnson, sr., Hodgson

Trey Johnson, sr., Cape Henlopen

Amir Jones-Branch, sr., Middletown

Alec Jurgaitis, sr., Saint Mark’s

Gavin Leffler, sr., Tatnall

Elijah MacFarlane, sr., Caesar Rodney

Max Martire, sr., Tatnall

Dylan McCarthy, sr., Tatnall

Chase Mellen, so., Salesianum

Zamir Miller, sr., Middletown

Ryan Moody, sr., Sussex Academy

Wayne Roberts, jr., Appoquinimink

Elijah Tackett, sr., Dover

Kai Thornton, sr., Sussex Central

Marc Patterson, sr., Dover

Charles Prosser, so., Salesianum

Riley Robinson, fr., Middletown

Roan Samuels, sr., Salesianum

Douglas Simpson, jr., Cape Henlopen

Jessie Standard, jr., Middletown

Riley Stazzone, sr., Cape Henlopen

Jamar Taylor, jr., Salesianum

Jordan Welch, sr., Sussex Tech

Brandon Williams, sr., Charter of Wilmington

Xzavier Yarborough, jr., Dover

Brandon Holveck reports on high school sports for The News Journal. Contact him at bholveck@delawareonline.com.

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Delaware

DNREC’s decision to prohibit data center upheld by state board

Published

21 hours ago

March 26, 2026

Press Room

DNREC’s decision to prohibit data center upheld by state board

A Delaware board upheld the state environmental agency’s decision to prohibit the “Project Washington” data center.
The Delaware Department of Natural Resources and Environmental Control (DNREC) ruled the project violated the 1971 Coastal Zone Act.
The developer, Starwood Digital Ventures, argued the project’s infrastructure did not fall under the act’s regulations.

Project Washington’s prospects in Delaware appear murkier after a board stood on the state environmental agency’s decision to prohibit the data center proposal.

The public hearings with the Coastal Zone Industrial Control Board kicked off in Dover on March 24 at the Delaware Department of Natural Resources and Environmental Control’s Auditorium near Legislative Hall. It finished on March 26 after days of testimony from witnesses supporting and opposing the DNREC decision on the data center, which would be the largest in the state.

Project Washington was prohibited by DNREC in February because the agency said it violated the Coastal Zone Act, which was signed in 1971. Project Washington’s developer, Starwood Digital Ventures, filed an appeal of that decision soon after.

A little more than 30 people attended the meeting on March 24. It was modeled more like a court hearing than a public government meeting. The next two days included testimony from witnesses from both Starwood Digital Ventures’ and DNREC’s attorneys.

The Coastal Zone board consists of nine members, five of which are appointed by the governor and approved by the state Senate. Four other members are the state director of the Division of Small Business and Tourism and the chairs of the planning commissions of each county.

It’s the first time this assembly of the board has been called to action. Board members said they are making decisions on a fact and law basis, and are trying to cut out the noise this project has caused on social media and in other public meetings.

Witnesses and experts explained a ton of technical definitions for generators and got into the nitty-gritty of emissions and infrastructure. It was up to the board to take those facts in stride and make their decision.

“What we have to do is come back to the purpose of the appeal,” said Willie Scott, a member of the board during a break between sessions on March 24.

They voted unanimously to uphold the DNREC decision to prohibit the project based on the Coastal Zone Act.

Courtroom-like arguments for and against the data center

The hearing on March 24 began with opening arguments. Attorneys for Starwood Digital Ventures, Project Washington’s developer, argued that Project Washington’s purpose and infrastructure fall outside of the Coastal Zone Act’s regulations, and that DNREC’s definitions of smokestacks and tank farms are flawed.

“It fails every element of the statutory definition, as interpreted by the Delaware Supreme Court and the Delaware Superior Court,” said Jeff Moyer, an attorney representing Starwood. “Its limited diesel infrastructure is not a tank farm within any reasonable meaning of that term, and each of the core three functions of Project Washington – data storage, electrical infrastructure and backup power – are all expressly not regulated.”

DNREC’s attorneys argued the data center campuses fall under heavy industry in a modern context, and it is the kind of project the act is intended to kill. They also argued it has a potential to pollute when backup generators are working if the power fails.

“The law requires that it be prohibited, not recharacterized, not broken into pieces and minimized, but prohibited,” said Michael Hoffman, attorney representing DNREC. “Over the course of the next few days, we will show that Starwood’s proposed hyperscale data center is one such project.”

Closing arguments on March 26 reiterated arguments from both sides, and the board voted to stand with DNREC.

How Project Washington and DNREC got here

The Coastal Zone Act prevents heavy industrial projects from developing along the Delaware River and Bay, Chesapeake and Delaware Canal, Atlantic Ocean, Indian River Bay and other Sussex County bays. The 14 projects that have been grandfathered include the Delaware City Refinery and the Port of Wilmington.

Project Washington’s proposed site falls within the defined coastal zone, which extends west to Dupont Highway in that specific spot. In February, DNREC said the massive data center is prohibited, stifling the project while it worked through state and county permits.

It would be 11 two-story data center buildings surrounded by electrical fields on two large land parcels north of Delaware City accessible by Hamburg Road, Governor Lea Road and River Road.

DNREC’s beef with the project is in the backup generators and their accompanying diesel tanks. The data center is proposed to run 24 hours a day, seven days a week, 365 days a year. If power goes out, it needs to use the backup generators to keep running. DNREC’s decision says the project includes some 516 double-walled diesel fuel belly tanks, each capable of storing some 5,020 gallons of fuel. That’s about five acres of tank farm.

There would be 516 backup generators with 516 smokestacks, which DNREC said in its original decision is the exact type of infrastructure the Coastal Zone Act targets by prohibiting “heavy industrial” projects.

Starwood Digital Ventures, appealed the decision, mentioning countervailing factors including avoiding wetlands, no direct surface water discharges and projected economic benefits.

Their appeal said the original DNREC decision “solely focuses on alleged environmental risk and worst-case emissions, and does not fairly weigh or explain these countervailing factors in light of regulating criteria.”

Jim Lamb, who is handling media communication for the project, said the backup generators would only run 37 to 45 minutes per month just to test if they are operational. Project Washington will also use a closed-loop cooling system, limiting its water intake.

The appeal required a hearing, which is the first time the board made a decision since 2021.

The developer of the project did not immediately respond to Delaware Online/The News Journal’s request for comment. New Castle County officials did not immediately respond to either.

Shane Brennan covers Wilmington and other Delaware issues. Reach out with ideas, tips or feedback at slbrennan@delawareonline.com.

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Delaware

GGE of Delaware Jumps on the Rally Sponsor Train!

Published

1 day ago

March 26, 2026

Press Room

GGE of Delaware Jumps on the Rally Sponsor Train!

The Rally Sponsor Train keeps rolling! We are incredibly proud to welcome GGE of Delaware as a Premium Sponsor ($2,500) for the 5th Annual Rally for Our First Responders! This level of support makes a tremendous impact and helps us continue to grow…

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