Medical Practice Act

Del. Code tit. 24, ch. 17
in effect

Del. Code tit. 24, § 1701 Statement of purpose.

Recognizing that the practice of medicine and the practices of certain other healthcare professions are privileges and not natural rights, it is hereby considered a matter of policy in the interests of public health, safety, and welfare to provide laws covering the granting of those privileges and their subsequent use and control, and to provide regulations to the end that the public health, safety, and welfare are promoted and that the public is properly protected from the unprofessional, improper, unauthorized, or unqualified practice of medicine and practice of certain other healthcare professions and from unprofessional conduct by persons authorized to practice medicine or to practice certain other healthcare professions.

Del. Code tit. 24, § 1702 Definitions [For application of this section, see 85 Del. Laws, c. 253, § 23].

The following definitions apply to this chapter unless otherwise expressly stated or implied by the context: (1) “Board” means the Board of Medical Licensure and Discipline. (2) “Certificate to practice medicine” means the authorization awarded by the Board to a person who has been qualified to practice medicine in this State by meeting the requirements of this chapter. (3) “Conversion therapy” means any practice or treatment that seeks to change an individual’s sexual orientation or gender identity, as “sexual orientation” and “gender identity” are defined in § 710 of Title 19, including any effort to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender. “Conversion therapy” does not mean any of the following: a. Counseling that provides assistance to an individual who is seeking to undergo a gender transition or who is in the process of undergoing gender transition. b. Counseling that provides an individual with acceptance, support, and understanding without seeking to change an individual’s sexual orientation or gender identity. c. Counseling that facilitates an individual’s coping, social support, and identity exploration and development, including counseling in the form of sexual orientation-neutral interventions or gender identity-neutral interventions provided for the purpose of preventing or addressing unlawful conduct or unsafe sexual practices, without seeking to change an individual’s sexual orientation or gender identity. (4) “Division” means the Division of Professional Regulation. (5) “Electronic prescription” means a prescription that is generated on an electronic application and transmitted as an electronic data file. (6) “Executive Director” means the Executive Director of the Board of Medical Licensure and Discipline. (7) “Fertility treatment” means any test, procedure, medication, surgery, or service to address or enhance an individual’s ability to reproduce or get pregnant, including: a. In vitro fertilization. b. Intrauterine insemination. c. Ovulation induction. d. Embryo biopsy. e. Cryopreservation and thawing of eggs, sperm, and embryos. f. Cryopreservation of testicular or ovarian tissue. g. Storage or disposal of oocytes, sperm, embryos, or tissue. (8) “Healthcare institution” means a facility or agency licensed, certified, or otherwise authorized by law to provide, in the ordinary course of business, treatments, services, or procedures to maintain, diagnose, or otherwise affect a person’s physical or mental condition. (9) “Healthcare services” means any assessment, diagnosis, treatment, procedure, prescription, test, medication, advice, or other service by a healthcare professional who is licensed, certified, or otherwise legally authorized to provide care in this State, acting within the scope of that authorization. “Healthcare services” includes primary care, preventive care, the prescribing or administration of prescription drugs, therapeutic care, reproductive health services, mental health care, and surgical services. (10) “Housing status” means as defined in § 204 of Title 19. (11) “Medical group” means 1 or more physicians or other health-care practitioners who work together under the name of a professional corporation, a limited liability partnership, or other legal entity. (12) “Medicine” means the science of restoring or preserving health and includes allopathic medicine and surgery, osteopathic medicine and surgery, and all the respective branches of the foregoing. (13) “Physician” means an allopathic doctor of medicine and surgery or a doctor of osteopathic medicine and surgery who is registered and certified to practice medicine pursuant to this chapter. (14) “Practice of medicine” or “practice medicine” includes: a. Advertising, holding out to the public, or representing in any manner that one is authorized to practice medicine in this State; b. Offering or undertaking to prescribe, order, give, or administer any drug or medicine for the use of another person; c. Offering or undertaking to prevent or to diagnose, correct, and/or treat in any manner or by any means, methods, or devices a disease, illness, pain, wound, fracture, infirmity, defect, or abnormal physical or mental condition of another person, including the management of pregnancy and parturition; d. Offering or undertaking to perform a surgical operation upon another person; e. Rendering a written or otherwise documented medical opinion concerning the diagnosis or treatment of a person or the actual rendering of treatment to a person within the State by a physician located outside the State as a result of transmission of the person’s medical data by electronic or other means from within the State to the physician or to the physician’s agent; f. Rendering a determination of medical necessity or a decision affecting or modifying the diagnosis and/or treatment of a person; g. Using the designation Doctor, Doctor of Medicine, Doctor of Osteopathy, physician, surgeon, physician and surgeon, Dr., M.D., or D.O., or a similar designation, or any combination thereof, in the conduct of an occupation or profession pertaining to the prevention, diagnosis, or treatment of human disease or condition, unless the designation additionally contains the description of another branch of the healing arts for which one holds a valid license in the State. For the purposes of this chapter, in order that the full resources of the State are available for the protection of persons using the services of physicians, the act of the practice of medicine occurs where a person is located at the time a physician practices medicine upon the person. (15) “Protective hairstyle” includes braids, locks, and twists. (16) “Race” includes traits historically associated with race, including hair texture and a protective hairstyle. (17) “Registration” means the entry of a certificate to practice medicine into the records of the Board of Medical Licensure and Discipline pursuant to the regulations of the Board. (18) “Reproductive health services” are healthcare services and include all of the following: a. “Abortion” as defined in § 1782 of this title. b. “Termination of pregnancy” as authorized in § 1790 of this title. c. Emergency contraception that is approved by the Federal Drug Administration and available over-the-counter, with a prescription, or dispensed consistent with the requirements of Chapter 25 of this title. d. Services relating to pregnancy or the termination of pregnancy including medical, surgical, counseling, or referral services. e. Fertility treatment. (19) “Store and forward transfer” means the transmission of a patient’s medical information either to or from an originating site or to or from the provider at the distant site, but does not require the patient being present nor must it be in real time. (20) “Substantially related” means the nature of criminal conduct for which a person was convicted has a direct bearing on the person’s fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of medicine, the work of a physician associate, of the practice of respiratory care. (21) “Unauthorized practice of medicine” means the practice of medicine as defined in this section by a person not authorized under this chapter to perform an act set forth in that subsection, unless excepted by § 1703 of this title. (22) “Viability” means the point in a pregnancy when, in a physician’s good faith medical judgment based on the factors of a patient’s case, there is a reasonable likelihood of the fetus’s sustained survival outside the uterus without the application of extraordinary medical measures.

Del. Code tit. 24, § 1703 Nonapplicability of certain provisions [For application of this section, see 85 Del. Laws, c. 253, § 23].

Provisions of this chapter pertaining to the practice of medicine do not apply to: (1) A person providing service in an emergency, where no fee or other consideration is contemplated, charged, or received; (2) Physicians of any civilian or military branch of the United States government in the discharge of their official duties; (3) Advanced practice nurses, chiropodists, chiropractors, dental hygienists, dentists, emergency medical technicians, optometrists, pharmacists, physical therapists, physician associates, podiatrists, practical nurses, professional nurses, psychologists, respiratory care practitioners, veterinarians, or persons engaged in other professions or occupations who are certified, licensed, or registered according to law and are acting within the scope of the activity for which they are certified, licensed, or registered; (4) A person administering a lawful domestic or family remedy to a member of that person’s family; (5) A person fully certified, licensed, or otherwise authorized to practice medicine in another state of the United States who briefly renders emergency medical treatment or briefly provides critical medical service at the specific lawful direction of a medical institution or federal agency that assumes full responsibility for the treatment or service; (6) A person who has earned a doctorate degree from a recognized college or university and who uses the designation of “Dr.” in connection with that person’s name or calls oneself “Doctor”, except in matters related to medicine or health, in which case the type of doctorate held must be specified; (7) The mechanical application of glasses; (8) The practice of massage; (9) The business of barbering, cosmetology, and manicuring; (10) The practice of ritual circumcision performed pursuant to the requirements or tenets of a religion; provided, however, that a person certified and registered to practice medicine in this State certifies in writing to the Board that, in the person’s opinion, the circumcision practitioner has sufficient knowledge and competence to perform a ritual circumcision according to accepted medical standards; (11) The practice of healing by spiritual means in accordance with the tenets and practice of a religion by an accredited practitioner of the religion. In the practice of healing by spiritual means, an accredited practitioner may not use medical titles or other designations which imply or designate that the practitioner is certified to practice medicine in this State. A person engaged in the practice of healing by spiritual means may not perform surgical operations or prescribe medications, nor may a pharmacist or pharmacy honor a prescription drawn by the person. A person engaged in the practice of healing by spiritual means must observe all state and federal public health laws; (12) A physician from another state or jurisdiction who is in this State to testify in a judicial or quasi judicial proceeding; (13) The performing of delegated medical acts pursuant to subchapter VI of this chapter by a person who is licensed by the Board as a physician associate; (14) A person rendering medical, surgical, or other health services who is functioning as a member of an organized emergency program which has been approved by the Board of Medical Licensure and Discipline; who has successfully completed an emergency medical course; and who is acting under the supervision and control of a person certified and registered to practice medicine in this State or in a state contiguous to this State; (15) A licensed registered nurse making a pronouncement of death and signing all forms or certificates registering the death as permitted or required by the State, but only if the nurse is an attending nurse caring for a terminally ill patient: a. In the patient’s home or place of residence as part of a hospice program or a certified home healthcare agency program; b. In a skilled nursing facility; c. In a residential community associated with a skilled nursing facility; d. In an extended care facility; or e. In a hospice; and only if the attending physician of record has agreed in writing to permit the attending licensed registered nurse to make a pronouncement of death in that case; (16) The provisions of subchapter II, Chapter 27 of Title 16, the Uniform Anatomical Gift Act; (17) A medical student who is engaged in training; (18) A person performing health care acts pursuant to Chapter 94 of Title 16 and § 1921(a) of this title; (19) Notwithstanding the provisions of § 1702(14)e. of this title, a physician licensed in another state or the District of Columbia may render a written or otherwise documented medical opinion to a person covered by the State Group Health Insurance Program pursuant to any second opinion or diagnosis evaluation program offered by the State Group Health Insurance Program without obtaining a certificate to practice medicine in this State.

Del. Code tit. 24, § 1704 State requirement for services of a physician or surgeon.

If a law, rule, or regulation of this State requires the services or qualifications of a physician or surgeon, the requirement may be met only by a person registered and certified to practice medicine under this chapter.

Del. Code tit. 24, § 1705 Accreditation of facilities where office-based surgeries are performed.

No person licensed under this chapter shall perform any office-based surgery, as defined in § 122(3)y. of Title 16, in a facility unless such facility is accredited or licensed in accordance with § 122(3)z. of Title 16. For purposes of this section, “facility” and “office-based surgery” mean as defined in § 122(3)y. of Title 16.

Del. Code tit. 24, § 1710 Composition [For application of this section, see 85 Del. Laws, c. 253, § 23] [Effective until July 17, 2028].

(a) The Board of Medical Licensure and Discipline has the sole authority in this State to issue certificates to practice medicine and is the State’s supervisory, regulatory, and disciplinary body for the practice of medicine. The Board also has the sole authority in this State to issue authorizing documents to practice other specified professions or occupations regulated by this chapter, and to supervise, regulate, and discipline members of those professions and occupations. (b) The Board consists of 16 voting members appointed by the Governor, which shall be composed of the following members: (1) Eight persons certified and registered to practice medicine in this State, at least 1 of whom is an osteopathic physician, as follows: a. Four have their primary place of practicing medicine in New Castle County; b. Two shall have their primary place of practicing medicine in Kent County; c. Two shall have their primary place of practicing medicine in Sussex County. (2) Five public members. (3) Two physician associates recommended by the Regulatory Council for Physician Associates. (4) The Director of the Division of Public Health or, if the Director is not a licensed physician or advanced practice registered nurse, a licensed physician or advanced practice registered nurse designated by the Director and employed by the Division. (c) A public member, except a physician associate, may not be nor may ever have been certified, licensed, or registered pursuant to this chapter; may not be the spouse of someone certified, licensed, or registered pursuant to this chapter; at the time of appointment may not be a member of the immediate family of someone certified, licensed, or registered pursuant to this chapter. (d) The Medical Society of Delaware and the Delaware State Osteopathic Medical Society may submit lists of their resident members and any recommendations to the Governor by January 1 of each year under the seal of and signed by the Secretary of the Society to aid the Governor in the appointment of new members to the Board. (e) An appointment to the Board to succeed a member whose term has expired shall be for a 3-year term. Vacancies occurring for any cause other than expiration of term shall be filled by the Governor for the unexpired term as provided in this subsection. (f) A physician-appointee to the Board must be a certified and registered physician in good standing, and must have practiced medicine under the laws of this State for a period of not less than 5 years prior to the physician-appointee’s appointment to the Board. (g) The Governor shall fill vacancies on the Board and, after a hearing, may remove a member of the Board for cause due to the member’s neglect of the duties required by this chapter, or on the recommendation of the Board, after a hearing, due to the member’s unprofessional or dishonorable conduct. (h) A member of the Board may not serve more than 3 full, consecutive 3-year terms, which is not diminished by serving an unexpired term. Upon serving 3 full, consecutive 3-year terms, a former member is eligible for reappointment to the Board no earlier than 1 year after the expiration of the last term served on the Board by the former member. (i) (1) While serving on the Board, a member may not be an officer of any state or local allopathic or osteopathic medical society. (2) While serving on the Board, a member of the Board may not be a member of the board of directors of a professional review organization. (j) Each member of the Board shall be compensated at an appropriate and reasonable level as determined by the Division of Professional Regulation not more than $100 for each meeting attended, and not more than a total of $1,500 for meetings attended in a calendar year, and may be reimbursed for all expenses involved in each meeting, including travel, according to Division policy.

Del. Code tit. 24, § 1711 Organization.

(a) The Board annually shall elect from among its members a president, a vice-president, and a secretary, and such other officers as it considers necessary, 2 of whom may be the same person. (b) The Board may, with the concurrence of the Director of the Division, set job duties for the Board’s Executive Director and other necessary staff. The Executive Director may not be a Board member. The Executive Director and other necessary staff are employees of the Division. (c) The Board, with the approval of the Division, shall establish and maintain an office within this State. (d) The Board shall meet at least 8 times a year at a public place and at a time as the Board determines, subject to guidelines established or approved by the Division of Professional Regulation. (e) Unless otherwise provided in this chapter, meetings of the Board are open to the public and may be closed to the public only in accordance with the provisions contained in § 10004 of Title 29.

Del. Code tit. 24, § 1712 Quorum.

(a) A quorum for the transaction of business consists of 9 members of the Board entitled to vote. An affirmative vote of at least 5 members of the quorum is required to take any action that the Board has the power to take, unless otherwise expressly provided in this chapter, including the express provisions in subsection (b) of this section. (b) An affirmative vote of at least 7 members of the Board present and voting at a meeting is required to adopt a regulation which can deprive a physician of the physician’s certificate to practice medicine or subject a physician to disciplinary action.

Del. Code tit. 24, § 1713 Powers and duties of the Board [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) The Board has the following powers and duties, in addition to other powers and duties set forth elsewhere in this chapter: (1) To investigate, through the Executive Director, the character of each applicant for a certificate to practice medicine, or for a certificate, license, or other authorizing document to practice any other profession or occupation regulated by this chapter, to determine if the applicant has previously engaged in unprofessional conduct pursuant to § 1731(b) of this title, and to investigate the physical and mental capability of physicians to engage in the practice of medicine, or of members of other professions or occupations regulated by this chapter to engage in the practice of their professions or occupations, with reasonable skill and safety to patients pursuant to § 1731(c) of this title; (2) To conduct or approve of professional or occupational examinations as it deems necessary and proper to determine the professional or occupational qualifications of each person who applies for a certificate to practice medicine in this State, or who applies for a certificate, license, or other authorizing document to practice any other profession or occupation regulated under this chapter; (3) To investigate, through the Executive Director, complaints or charges of unprofessional conduct against the holder of a certificate to practice medicine, or such complaints or charges against the holder of any certificate, license, or other authorizing document issued under this chapter; (4) To investigate, through the Executive Director, complaints and charges of the inability of a person to practice medicine, or to practice any other profession or occupation regulated under this chapter, with reasonable skill or safety to patients due to the person’s physical, mental, or emotional illness or incompetence, including but not limited to deterioration through the aging process, or loss of motor skill, or excessive use or abuse of drugs, including alcohol; (5) To investigate, through the Executive Director, complaints of the unauthorized practice of medicine or the unauthorized practice of any other profession or occupation regulated under this chapter; (6) To levy fines not to exceed $50,000, and to grant, deny, restrict, revoke, suspend, reinstate, or reissue a certificate to practice medicine or a certificate, license, or other authorizing document to practice any profession or occupation regulated under this chapter; (7) To issue subpoenas, compel the attendance of witnesses, and administer oaths; (8) To require the production of and receive information regarding changes in hospital privileges as a result of disciplinary or other adverse action taken by a hospital, or regarding disciplinary or other adverse action taken by a medical society against any person certified under this chapter to practice medicine; (9) To reprimand, censure, take other appropriate disciplinary action, or restrict professional or occupational activities with respect to any person certified to practice medicine in this State or any other person certified, licensed, or otherwise authorized to practice a profession or occupation regulated under this chapter; (10) To take depositions or cause depositions to be taken, as needed in any investigation, hearing, or proceeding; (11) To hold hearings; (12) To promulgate rules and regulations not inconsistent with or beyond the scope of this chapter or other laws of this State for carrying out the powers and duties required by this chapter; (13) By resolution passed by a majority of the members of the Board, to designate 1 or more committees, with each committee to include 1 or more of the members of the Board and such other person or persons as may be appropriate; provided, however, that a committee may not levy a fine, or grant or refuse to grant, restrict, revoke, suspend, reinstate, or reissue a certificate to practice medicine or a certificate, license, or other authorizing document to practice another profession or occupation issued under this chapter; (14) To designate records of the Board confidential and exempt from public disclosure, in accordance with § 10002 of Title 29; (15) To designate 3 members of the Board, through the Executive Director, to act as a hearing panel for the purpose of hearing charges of unprofessional conduct as set forth in § 1731(b) of this title or charges of the inability to practice medicine as set forth in § 1731(c) of this title, or for the purpose of making determinations of fact in connection with the temporary suspension of a certificate to practice medicine pursuant to § 1738 of this title, or for necessary purposes relating to disciplinary or other action against the holder of a certificate, license, or other authorizing document issued under this chapter; (16) To designate, through the Executive Director, any person qualified by relevant experience as an examiner for the purpose of hearing any alleged charges of the inability to practice medicine as set forth in § 1731(c) of this title, or for the purpose of making determinations of fact in connection with the temporary suspension of a certificate to practice medicine pursuant to § 1738 of this title, or for necessary purposes relating to disciplinary or other action against the holder of a certificate, license, or other authorizing document issued under this chapter; (17) To perform duties regarding emergency medical services systems and paramedic services set forth in Chapters 97 and 98 of Title 16; (18) To utilize licensed medical professionals who are not Board members as co-investigators when a complaint’s allegations implicate unique subject matters. The co-investigator who is not a Board member must possess particular expertise in the unique subject matter that is at issue when a co-investigator is needed under this paragraph. (b) A member of the Board or a member of any committee designated by the Board pursuant to paragraph (a)(13) of this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, arising from any act or omission under the authority of this chapter so long as the member acted in good faith and without gross or wanton negligence, with good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant. (c) A member of the Board may not discriminate, by reason of gender, race, color, creed, religion, age, disability, national origin, housing status, or any other basis protected under Chapter 45 of Title 6, against a person holding or applying for a certificate to practice medicine, or for an authorizing document to practice another occupation or profession pursuant to this chapter. (d) Continuing education. — (1) The Board shall provide by rule or regulation for continuing education for persons certified to practice medicine or other professions or occupations pursuant to this chapter. (2) For professionals who are renewing their license in 2027, the Board must require, for that renewal only, that the professional have completed at least 2 hours of the total required during that reporting period of continuing education dedicated to the diagnosis, treatment, or care of patients with Alzheimer’s disease or other dementias. (3) For professionals renewing their license after 2027, the Board must require that the professional have completed at least 2 hours of the total required during that reporting period of continuing education dedicated to the diagnosis, treatment, or care of patients with Alzheimer’s disease or other dementias. (4) A professional is exempt from the requirement of paragraph (d)(3) of this section if the professional previously completed in a prior reporting period the continuing education required by this section. The professional must provide a sworn statement or attestation in a form determined by the Division of Professional Regulation that this continuing education was previously completed in a prior reporting period. (5) A professional is exempt from the requirement of paragraph (d)(2) or (d)(3) of this section if the professional does not provide health-care services to or have direct patient interactions with adults age 26 or older. The professional must provide a sworn statement or attestation in a form determined by the Division of Professional Regulation that the professional is exempt under this paragraph from the continuing education required by paragraph (d)(2) or (d)(3) of this section. (6) A professional is exempt from the requirement of paragraph (d)(2) or (d)(3) of this section if the professional does not provide health-care services to anyone within the State. The professional must provide a sworn statement or attestation in a form determined by the Division of Professional Regulation that the professional is exempt under this paragraph from the continuing education required by paragraph (d)(2) or (d)(3) of this section. (7) Any training on Alzheimer’s disease or other dementias previously applied to meet this requirement or any other Delaware state licensure or education requirement, professional accreditation or certification requirement, or health-care institutional practice agreement may count toward the continuing education requirement under paragraph (d)(3) of this section. (e) The Board shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of medicine, the work of a physician associate, the practice of respiratory care, the practice of acupuncture, the work of a genetic counselor, the practice of polysomnography, or midwifery. (f) The Board shall promulgate rules and regulations establishing guidelines for the imposition of disciplinary sanctions against persons certified or licensed to practice medicine or other professions or occupations regulated by this chapter.

Del. Code tit. 24, § 1714 Fees.

The amount of a fee imposed under this chapter by the Division of Professional Regulation must approximate and reasonably reflect the reasonable projected costs of services or activities provided by the Board, as well as the proportional expenses incurred by the Division for services or activities provided on behalf of the Board. A separate fee may be charged for each service or activity, but a fee may not be charged for a purpose not specified in this chapter. The application fee for a certificate to practice medicine, or for a certificate, license, or other authorizing document to practice any other profession or occupation regulated by this chapter, may not be combined with any other fee or charge. At the beginning of each licensure biennium, the Division, or another State agency acting in its behalf, shall compute and set the fee for each separate service or activity that the Board or the Division expects to provide during that licensure biennium.

Del. Code tit. 24, § 1715 Records [For application of this section, see 85 Del. Laws, c. 253, § 23].

The Division of Professional Regulation shall keep a register of all approved applications for certificates to practice medicine, approved applications for authorization to practice any profession or occupation regulated under this chapter, for registrations and renewal of registrations of certificates to practice medicine, for licenses and renewals of licenses to practice as physician associates, for licenses and renewals of licenses to practice respiratory therapy, and for all other certificates, licenses, registrations, or other authorizing documents to practice any profession or occupation regulated under this chapter and their renewals, granted by the Board. In addition, the Director shall maintain complete records relating to meetings of the Board, examinations, rosters, changes and additions to the Board’s rules and regulations, complaints, hearings, and such other documents as the Board determines. Records of Board proceedings kept by the Division are prima facie evidence of the proceedings of the Board. An applicant, certificate holder, registrant, or licensee must notify the Division of Professional Regulation of a change in his or her address or in any other information on his or her application, registration, or renewal form within 15 days of the change.

Del. Code tit. 24, § 1720 Certification requirements to practice medicine.

(a) A person may not practice medicine in this State unless the person: (1) Has a certificate to practice medicine issued by the Board of Medical Licensure and Discipline; (2) Registers the certificate to practice medicine and renews it biennially; and (3) If required, has an occupational license pursuant to Part III of Title 30. (b) To receive a certificate to practice medicine in this State, an applicant for a certificate must: (1) Have a working ability to read, write, speak, understand, and be understood in the English language; (2) Possess the following educational credentials: a. A degree of Doctor of Medicine or Doctor of Osteopathy, or an equivalent degree, from a legally incorporated medical college or school located in the United States or Canada, which medical college or school has been approved by the appropriate accrediting body of the American Medical Association or the American Osteopathic Association; or b. A degree of Doctor of Medicine or Doctor of Osteopathy, or an equivalent degree, from a legally incorporated medical college or school located in a country other than the United States or Canada, medical college or school which is listed in the International Medical Education Directory (IMED), along with documentary proof that the applicant successfully passed the examination administered by the Educational Commission for Foreign Medical Graduates and the Federation of State Medical Boards; or c. A degree of Doctor of Medicine or Doctor of Osteopathy, or an equivalent degree, from a legally incorporated medical college or school located in a country other than the United States or Canada, which medical college or school is not listed in the International Medical Education Directory (IMED), but the applicant has completed 3 years of postgraduate training in a residency program which has been approved by the Accreditation Council for Graduate Medical Education and has successfully passed the examination administered by the Educational Commission for Foreign Medical Graduates and the Federation of State Medical Boards; d. Documentary proof that all clinical rotations served by the applicant in the United States or Canada as part of training received in a medical college or school were conducted in institutions that are formal parts, such as a primary hospital, of a medical college or school or that have formal affiliation with a medical college or school approved by the appropriate accrediting body of the American Medical Association or the American Osteopathic Association, or that the clinical rotations were served in hospitals which had, at the time the rotations were served, a residency training program approved by the Accreditation Council for Graduate Medical Education in the subject matter of the clinical rotation; (3) Have satisfactorily completed an internship or equivalent training in an institution, which internship or equivalent training and institution are approved by the Board; (4) Submit to the Board a sworn or affirmed statement that the applicant: a. Has not been convicted of or has not admitted under oath to having committed a crime substantially related to the practice of medicine, provided however, that a waiver may be available pursuant to subsection (e) of this section; b. Has not been professionally penalized for or convicted of drug addiction; c. Has not had the applicant’s license or certificate or other authorizing document to practice allopathic medicine or osteopathic medicine in any other state, territory, or foreign nation revoked, suspended, restricted, limited, or subjected to disciplinary or other action by the certifying or licensing authority thereof, or an application to practice denied; d. Has not been removed, suspended, expelled, or disciplined by any professional medical association or society when the removal, suspension, expulsion, or discipline was based upon what the association or society found to be unprofessional conduct, professional incompetence, or professional malpractice; e. Has not been disciplined by a licensed hospital or by the medical staff of the hospital, including the removal, suspension, or limitation of hospital privileges, the nonrenewal of privileges for cause, the resignation of privileges under pressure of investigation or other disciplinary action, if the discipline was based upon what the hospital or medical staff found to be unprofessional conduct, professional incompetence, or professional malpractice; f. Has not engaged in the practice of medicine without a certificate or license or other authorization to practice medicine; g. Has not unlawfully prescribed narcotic drugs; h. Has not wilfully violated the confidence of a patient, except under legal requirement; i. Has not been professionally penalized or convicted of fraud; j. Has reviewed and acknowledges the applicant’s own duties to report unprofessional conduct under the Medical Practice Act and to report child abuse or neglect under § 903 of Title 16, or any successors thereto. (5) Submit to the Board a sworn or affirmed statement that the applicant is, at the time of application, physically and mentally capable of engaging in the practice of medicine according to generally accepted standards, and submit to such examination as the Board may deem necessary to determine the applicant’s capability; (6) Submit, at the applicant’s expense, fingerprints and other necessary information in order to obtain the following: a. A report of the applicant’s entire criminal history record from the State Bureau of Identification or a statement from the State Bureau of Identification that the State Central Repository contains no such information relating to that person. b. A report of the applicant’s entire federal criminal history record pursuant to the Federal Bureau of Investigation appropriation of Title II of Public Law 92-544 (28 U.S.C. § 534). The State Bureau of Identification shall be the intermediary for purposes of this section and the Board of Medical Licensure and Discipline shall be the screening point for the receipt of said federal criminal history records. c. An applicant may not be certified to practice medicine until the applicant’s criminal history reports have been produced. An applicant whose record shows a prior criminal conviction for an offense that is substantially related to the practice of medicine, may not be certified by the Board unless a waiver is granted pursuant to subsection (e) of this section. The State Bureau of Identification may release any subsequent criminal history to the Board. (7) Pass the professional examination pursuant to § 1721 of this title, unless excepted under § 1722 of this title or waived as provided in subsection (e) of this section. (8) [Repealed.] (c) An applicant for a certificate to practice medicine in this State must submit to the Board an application in writing in such form as the Board requires. (d) An applicant for a certificate to practice medicine in this State must fulfill the requirements of subsection (b) of this section in accord with the form and manner required by the Board in its rules and regulations. The applicant must also pay the application fee set by the Division, and, unless an exception in § 1722 of this title applies, the applicant must pass a professional examination pursuant to § 1721 of this title. (e) The Board, by the affirmative vote of 9 of its members, may waive any of the requirements of this section if it finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications, and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing medicine in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a criminal conviction other than a conviction of a felony sexual offense, the Board shall grant a waiver if it determines, after consideration of the factors set forth in § 8735(x)(3) of Title 29, that granting a waiver would not create an unreasonable risk to public safety. A waiver may not be granted to any person who is convicted of a felony sexual offense. The time limitation set forth in § 8735(x)(4) of Title 29 does not apply to a felony sexual offense. (5) [Repealed.] (f) In determining if an applicant qualifies for certification to practice medicine, the Board may rely upon relevant decisions made by the appropriate authority in other states and may not permit a collateral attack upon those decisions. (g) Notwithstanding any language to the contrary, the Board shall not issue a license to an applicant until first verifying that an applicant is not listed on either the Adult Abuse Registry or the Child Protection Registry as being substantiated for abuse or neglect. (h) An applicant for initial or renewal certification to practice medicine in this State must disclose whether the applicant has ever been the subject of an investigation by any licensing authority, medical association, hospital or other healthcare institution. The Board may require an applicant to provide sufficient documentation to enable the Board to determine whether investigation or a diagnostic mental or physical examination is necessary to determine the applicant’s qualifications for certification to practice medicine in this State. Any such investigation or diagnostic mental or physical examination shall be conducted pursuant to § 1732 of this title. (i) All individuals licensed to practice under this chapter shall be required to be fingerprinted by the State Bureau of Identification, at the licensee’s expense, for the purposes of performing subsequent criminal background checks. Licensees who received their initial license to practice on or before July 1, 2007, shall submit by January 1, 2012, at the applicant’s expense, fingerprints and other necessary information in order to obtain a criminal background check. (j) The Board may issue an administrative medicine license to a physician who meets all qualifications for licensure, including payment of a fee set by the Division of Professional Regulation, except that an applicant for an administrative medicine license shall not be required to show that the applicant has been engaged in the active practice of medicine, as defined in the Board’s regulations. Administrative medicine licensees may not provide medical or clinical services to or for patients and shall attest to understanding this on the application. (k) A nonhuman entity, including an agent powered by artificial intelligence, may not be certified to practice medicine in this State. ( l ) A nonhuman entity, including an agent powered by artificial intelligence, may not use any of the following titles: (1) Doctor or the abbreviation “Dr.” (2) Physician or surgeon. (3) Medical doctor or the abbreviation “MD.” (4) Doctor of osteopathy or the abbreviation “DO.”

Del. Code tit. 24, § 1721 Professional examination.

(a) The Board shall require written and/or clinical professional examination of each applicant for a certificate to practice medicine in accordance with the Board’s rules and regulations. (b) A professional examination issued pursuant to this section must be in the English language, must be comprehensive in character, and must be designed to determine an applicant’s fitness to practice medicine. It must cover those general subjects and topics, a knowledge of which is commonly and generally required of candidates for the degree of Doctor of Medicine or Doctor of Osteopathy conferred by approved medical colleges or schools in the United States. (c) The Board shall include in its rules and regulations the number of times and the conditions under which an applicant who has failed 1 or more professional examinations conducted pursuant to this section may again apply for a certificate to practice medicine under this chapter.

Del. Code tit. 24, § 1722 Waiver of professional examination for temporary certification, for hospital or institution staff, for physicians licensed in another jurisdiction, and for physicians passing an alternative exam.

(a) The Board may adopt rules and regulations that waive the professional examination required pursuant to § 1721 of this title for the issuance of a certificate to practice medicine in the following cases: (1) The applicant for whom the examination is to be waived is licensed, certified, registered, or otherwise legally qualified to practice medicine in another state of the United States or in another jurisdiction, and seeks a temporary certificate to practice medicine for not less than 2 weeks nor more than 3 months for the purpose of taking charge of the practice of a person certified and registered to practice medicine in this State during the person’s temporary illness or absence from this State. The Board may, in its discretion, extend a temporary certificate to practice medicine pursuant to this paragraph for an additional 3 months, but not longer. A temporary certificate may be issued pursuant to this paragraph to an applicant by the Board upon the written request of a person certified and registered to practice medicine in this State and upon the payment of a fee established for such purpose by the Division of Professional Regulation. The written request must contain an affirmation that the purpose of the temporary certificate is to allow the applicant to take charge of the practice of a person certified and registered to practice medicine in this State during the person’s temporary illness or absence from the State; (2) The applicant for whom the examination is to be waived: a. Is employed in this State as an intern, resident, house physician, or fellow in a hospital accredited by the Joint Commission on the Accreditation of Hospitals or by the American Osteopathic Hospital Association; or b. Is a staff physician employed in a governmental institution in this State and is applying for a certificate to practice medicine for a period of time not to exceed the length of time of employment in the hospital or governmental institution. A certificate issued pursuant to this paragraph is subject to yearly renewal and restricts the applicant to practice only in the hospital or institution where the applicant is employed; (3) The applicant for whom the examination is to be waived is licensed, certified, registered, or otherwise legally authorized to practice medicine by competent authority in any other of the United States or in any other jurisdiction approved by the Board. (b) When a certificate to practice medicine is issued to an applicant pursuant to this section and the applicant registers with the Board and obtains an occupational license pursuant to Chapter 23 of Title 30, the applicant may practice medicine in this State, but only for the time and only under the conditions, if any, specified in the certificate.

Del. Code tit. 24, § 1723 Issuance of certificate to practice; registration and registration renewal; reactivating inactive status.

(a) The Board shall issue a certificate to practice medicine in this State and register the certificate for an applicant who meets the requirements of this chapter. (b) The Division shall keep a current register of all persons certified to practice medicine in this State. Each such person shall inform the Division of any change of current address and telephone number within 15 days of the change. (c) The registration of a certificate to practice medicine must be renewed biennially, through a procedure determined by the Division. The procedure must include payment of an appropriate registration renewal fee; submission of a renewal form provided by the Division; submission of the materials required by § 1720(b)(4), (b)(5), and (g), of this title unless waived pursuant to § 1720(e) of this title; proof that the certified person has met the continuing medical education requirements established by the Board; and the period of time within which a person certified to practice medicine in this State may renew the certified person’s registration without penalty, notwithstanding the fact that the person failed to renew the person’s registration on or before the renewal date; and the penalty for failure to renew registration in a timely manner. The procedure must also include evidence of completion of training on the recognition of child sexual and physical abuse, exploitation and domestic violence, and the reporting obligations under the Medical Practice Act and § 903 of Title 16, and any successors thereto, and any other mandatory reporting obligations required by the Board. Such trainings shall be coordinated under §§ 911 and 931(b)(4) of Title 16 to ensure consistent trainings across disciplines. (d) The Board may establish, by class and not by individual, requirements for continuing education or reexamination, or both, for a person issued a certificate to practice medicine, or issued any authorized document to practice another profession or occupation regulated under this chapter, who is on inactive status and wishes to reactivate that person’s status. (e) The Division shall review the criminal history of all individuals licensed to practice medicine on a periodic basis, at a minimum, once every 6 months.

Del. Code tit. 24, § 1724 Temporary emergency certificate during a public emergency.

The Board may issue a temporary emergency certificate to practice medicine for a period of time not to exceed 12 months, but renewable at the discretion of the Board, to a person whom it finds qualified to practice medicine in this State. A temporary emergency certificate may be issued only during a public emergency declared by the President of the United States or the Governor of the State. When an occupational license is issued by the Director of Revenue pursuant to Chapter 23 of Title 30, if such license is required, and the temporary emergency certificate is registered by the Board, the holder of the temporary emergency certificate may, during the term specified on the certificate unless sooner revoked, practice medicine in this State, subject to all the laws of this State and to the regulations and restrictions which the Board may adopt, including, but not limited to, location limitations and limitations on the nature of the practice of medicine within the State.

Del. Code tit. 24, § 1725 Temporary certificate pending certification.

The Executive Director of the Board, with the approval of a physician member of the Board, may issue a temporary certificate pending certification to practice medicine for a period of time not to exceed 3 months to a person otherwise qualified to practice medicine who has applied for certification to practice medicine. When an occupational license is issued by the Director of Revenue pursuant to Chapter 23 of Title 30, if such license is required, and the temporary certificate pending certification is registered by the Board, the holder of the temporary certificate pending certification may, during the time specified on the certificate unless sooner revoked, practice medicine in this State, subject to all the laws of this State and to the regulations and restrictions which the Board may adopt, including, but not limited to, location limitations and limitations on the nature of the practice of medicine within the State.

Del. Code tit. 24, § 1726 Notice of certification required.

The Executive Director of the Board shall, immediately upon issuing a certificate to practice medicine pursuant to § 1722, § 1723, or § 1724 of this title, make available to the director of the Division of Public Health of the Department of Health and Social Services the full name and address of the person to whom the certificate was issued and the date thereof, and, in the case of the issuance of a certificate pursuant to § 1722 or § 1724 of this title, the length of time for which the certificate authorizes the practice of medicine and the limitation on the authorization, if any.

Del. Code tit. 24, § 1727 Consulting physicians from other states.

This chapter does not prevent a person who is certified, licensed, or otherwise authorized to practice medicine in another state or in a foreign country from engaging in a consultation with a person certified and registered to practice medicine in this State.

Del. Code tit. 24, § 1728 Medical personnel for visiting sports teams.

(a) Notwithstanding any other provision of this chapter or other law, a physician who is certified, licensed, or otherwise authorized to practice medicine in another state or country shall be exempt from the certification and registration requirements of this chapter while practicing medicine in this State if all of the following conditions are met: (1) The physician has a written or oral agreement with a sports team to provide general or emergency care to the team members, coaching staff, and families traveling with the team for a specific sporting event to take place in this State; and (2) The physician may not practice medicine with respect to any person residing or present in this State other that a person described in paragraph (a)(1) of this section, unless providing medical care pursuant to § 6801 of Title 16; (b) The exemption shall remain in force while the physician is traveling with the team, but shall be no longer than 10 days per individual sporting event. The Executive Director of the Board may grant a physician additional time for exemption, up to 20 additional days per sporting event, upon prior request by the physician. The total number of days a physician may be exempt, including additional time granted upon request, may not exceed 30 days per sporting event. (c) A physician exempt from the certification and licensure requirements under this section is not authorized to practice medicine at any health care facility, as defined in Chapter 93 of Title 16, in the State.

Del. Code tit. 24, § 1729 Home health-care orders from out-of-state physicians.

(a) Notwithstanding any other provision of this chapter or other law, a physician who is certified, licensed, or otherwise authorized to practice medicine in another state shall be exempt from the certification and registration requirements of this chapter in order to prescribe home health-care services provided by a home health-care agency licensed pursuant to Title 16 to a patient who resides in this State. (b) The prescription of home health-care services under this section must first be made pursuant to an in-person physical examination of the patient performed within the jurisdictional boundaries of the state in which the prescribing physician is certified, licensed or otherwise authorized to practice medicine.

Del. Code tit. 24, § 1730 Duty to report unprofessional conduct and inability to practice medicine.

(a) Every person to whom a certificate to practice medicine is issued has a duty to report to the Board if that person is treating professionally another person who possesses a certificate to practice medicine for a condition defined in § 1731(c) of this title, if, in the reporting person’s opinion, the person being treated may be unable to practice medicine with reasonable skill or safety. A person reporting to the Board or testifying in any proceeding as a result of making a report pursuant to this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant. A person reporting to the Board shall include the information required by the Board in accordance with its current guidance, which may be promulgated by regulation as required. The Board’s guidance, including any template reports that the Board may develop in consultation with the Division, must be communicated to physicians and made available to the public. (b) (1) Every person to whom a certificate to practice medicine is issued and health care facility as defined in § 1740 of this title has a duty to report to the Board within 30 days: a. Any partial or full removal of hospital privileges based on adverse events, unprofessional conduct or competency issues; and b. Any disciplinary action taken by a medical society against that person; and c. Any reasonably substantiated incidents involving violence, threat of violence, abuse, or neglect by a person toward any other person. (2) Every person certified to practice medicine in this State shall report to the Board within 30 days any civil or criminal investigation in any jurisdiction which concerns that person’s certification or license or other authorization to practice medicine. The Board may require an applicant to provide sufficient documentation to enable the Board to determine whether to investigate, pursuant to § 1732 of this title, or whether there are grounds for discipline under § 1731(b) of this title. (c) Every person to whom a certificate to practice medicine is issued has a duty to report to the Board, within 60 days, all information concerning medical malpractice claims settled or adjudicated to final judgment, as provided in Chapter 68 of Title 18, and, within 30 days, all information required to be reported under § 1731A(f) of this title. (d) Every person to whom a certificate to practice medicine is issued has a duty to report, within 30 days of the day each such person becomes aware, of the existence of a report to the Department of Services for Children, Youth and Their Families under Chapter 9 of Title 16 against that person concerning child abuse or neglect or a report to the Division of Health Care Quality under Chapter 85 of Title 11 against that person concerning adult abuse, neglect, mistreatment, or financial exploitation.

Del. Code tit. 24, § 1731 Unprofessional conduct and inability to practice medicine.

(a) A person to whom a certificate to practice medicine in this State has been issued may be disciplined by the Board for unprofessional conduct, as defined in subsection (b) of this section, by means of levying a fine, or by the restriction, suspension, or revocation, either permanent or temporary, of that person’s certificate to practice medicine, or by other appropriate action, which may include a requirement that a person who is disciplined must complete specified continuing education courses. The Board shall permanently revoke the certificate to practice medicine in this State of a person who is convicted of a felony sexual offense. (b) “Unprofessional conduct” includes any of the following acts or omissions: (1) The use of any false, fraudulent, or forged statement or document or the use of any fraudulent, deceitful, dishonest, or unethical practice in connection with a certification, registration, or licensing requirement of this chapter, or in connection with the practice of medicine or other profession or occupation regulated under this chapter; (2) Conduct that would constitute a crime substantially related to the practice of medicine; (3) Any dishonorable, unethical, or other conduct likely to deceive, defraud, or harm the public; (4) The practice of medicine or other profession or occupation regulated under this chapter under a false or assumed name; (5) The practice of medicine or other profession or occupation regulated under this chapter without a certificate or other authorizing document or renewal of such document, unless otherwise authorized by this chapter; (6) The use, distribution, or issuance of a prescription for a dangerous or narcotic drug, other than for therapeutic or diagnostic purposes; (7) Advertising of the practice of medicine or other profession or occupation regulated under this chapter in an unethical or unprofessional manner; (8) Solicitation or acceptance of a fee from a patient or other person by fraudulent representation that a manifestly incurable condition, as determined with reasonable medical certainty, can be permanently cured; (9) Knowing or intentional performance of an act which, unless authorized by this chapter, assists an unauthorized person to practice medicine or other profession or occupation regulated under this chapter; (10) The failure to provide adequate supervision to an individual working under the supervision of a person who is certified and registered to practice medicine; (11) Misconduct, including but not limited to sexual misconduct, incompetence, or gross negligence or pattern of negligence in the practice of medicine or other profession or occupation regulated under this chapter; (12) Wilful violation of the confidential relationship with or confidential communications of a patient; (13) Wilful failure to report to the Board as required by § 1730(a) of this title; (14) Wilful failure to report to the Board as required by § 1730(b) of this title; (15) Wilful failure to report to the Board as required by § 1730(c) of this title; (16) Unjustified failure upon request to divulge information relevant to the authorization or competence of a person to practice medicine or other profession or occupation regulated under this chapter to the Board, to any committee thereof, to the Executive Director, or to anyone designated by the Executive Director to request such information; (17) The violation of a provision of this chapter or the violation of an order or regulation of the Board related to medical procedures or to the procedures of other professions or occupations regulated under this chapter, the violation of which more probably than not will harm or injure the public or an individual; (18) Charging a grossly exorbitant fee for professional or occupational services rendered; (19) Suspension or revocation of a certificate to practice medicine or of the authorizing document to practice another profession or occupation regulated under this chapter, or other disciplinary action taken by the regulatory authority in another state or territory. In making its determination, the Board may rely upon decisions made by the appropriate authorities in other states and may not permit a collateral attack on those decisions; (20) Signing the death certificate of a person prior to the actual time of death of the person; (21) A violation of §1764A of this title; (22) Wilful failure to report to the Board when required by §1731A of this title; (23) Wilful failure to comply with §1769B of this title; (24) Engaging in conversion therapy with a child; and (25) Referring a child to a provider in another jurisdiction to receive conversion therapy. (26) “Unprofessional conduct” under this subsection does not include the performance, recommendation, or provision of any healthcare service that is lawful in this State even if such performance, recommendation, or provision is for a person who resides in a state where such performance, recommendation, or provision is illegal or considered to be unprofessional conduct or the unauthorized practice of medicine. (c) A certificate to practice medicine is subject to restriction, suspension, or revocation, either temporarily or permanently, in case of the inability of a physician to practice medicine with reasonable skill or safety to patients by reason of a mental or physical disability or serious health condition that prevents the physician’s ability to practice medicine in a fully competent and professional manner with reasonable skill and safety to patients. For purposes of this section, a mental or physical disability or serious health condition does not prevent a physician’s ability to practice medicine with reasonable skill and safety when the condition is reduced or ameliorated because of ongoing treatment, with or without medication, or participation in a monitoring program or because of the field of practice, the setting, or the manner of the physician’s current medical practice. (1)-(3) [Repealed.] (d) The Board may establish, by class and not by individual, requirements for continuing education and/or reexamination as a condition for renewal of registration and for recertification to practice medicine or other profession or occupation regulated under this chapter, or as a condition to continue to practice medicine or other profession or occupation regulated under this chapter after disciplinary sanctions are imposed or after inability to practice with reasonable skill or safety to patients has been determined. (e) A person who files a complaint with the Board or any of its members, the Executive Director, or the Division, or who provides information to the Board or any of its members, the Executive Director, or the Division regarding a complaint, or who testifies as a witness at a hearing before the Board or any of its hearing panels or committees concerning unprofessional conduct by a person certified to practice medicine or other profession or occupation regulated under this chapter in this State or concerning the inability of a person certified to practice medicine or other profession or occupation regulated under this chapter for the reasons set forth in subsection (c) of this section, may not be held liable in any cause of action arising out of the filing of the complaint, the providing of information, or the giving of testimony, provided that the person does so in good faith and without gross or wanton negligence. (f) The provisions of this section apply to any person to whom a certificate, license, or other authorizing document to practice a profession or occupation has been issued pursuant to this chapter.

Del. Code tit. 24, § 1731A Duty to report.

(a) Any person may report to the Board information that the reporting person reasonably believes indicates that a person certified and registered to practice medicine in this State is or may be guilty of unprofessional conduct or may be unable to practice medicine with reasonable skill or safety to patients by reason of a mental or physical disability or serious health condition that prevents a physician’s ability to practice medicine in a fully competent and professional manner with reasonable skill and safety to patients. For purposes of this section, a mental or physical disability or serious health condition does not prevent a physician’s ability to practice medicine with reasonable skill and safety when the condition is reduced or ameliorated because of ongoing treatment, with or without medication, or participation in a monitoring program or because of the field of practice, the setting, or the manner of the physician’s current medical practice. The following have an affirmative duty to report, and must report, such information to the Board in writing within 30 days of becoming aware of the information: (1) All persons certified to practice medicine under this chapter; (2) All certified, registered, or licensed healthcare providers; (3) The Medical Society of Delaware; (4) All healthcare institutions in the State; (5) All state agencies other than law-enforcement agencies; (6) All law-enforcement agencies in the State, except that such agencies are required to report only new or pending investigations of alleged criminal conduct specified in § 1731(b)(2) of this title, and are further required to report within 30 days of the close of a criminal investigation or the arrest of a person licensed under this chapter. (b) If a person certified and registered to practice medicine in this State voluntarily resigns from the staff of a healthcare institution, or voluntarily limits that person’s own staff privileges at a healthcare institution, or fails to reapply for hospital or staff privileges at a healthcare institution, the healthcare institution and the person shall promptly report in writing such conduct to the Board if the conduct occurs while the person is under formal investigation by the institution or a committee thereof for any reason related to possible unprofessional conduct or possible inability to practice medicine by reason of a mental or physical disability or serious health condition that prevents the physician’s ability to practice medicine with reasonable skill and safety under § 1731(c) of this title. (c) Upon receiving a report pursuant to subsection (a) or (b) of this section, or on its own motion, the Board shall investigate any evidence which appears to show that the person reported is or may be guilty of unprofessional conduct or may be unable to practice medicine with reasonable skill or safety to patients by reason of a mental or physical disability or serious health condition that prevents the physician’s ability to practice medicine with reasonable skill and safety under § 1731(c) of this title. (d) When an investigation is necessary pursuant to subsection (c) of this section, the Executive Director, with the approval of the assisting Board members who must be or must include a physician and a public member when the investigation relates to the quality of medical care provided by a physician or to the competency of a physician to engage safely in the practice of medicine, has the authority to inquire from any organization which undertakes physician peer review or physician quality assurance evaluations whether or not there has been any peer review, quality assurance, or similar process instituted involving the physician under investigation. The Executive Director may, by subpoena, compel the production of a list of the medical records reviewed during the peer review process, a list of the quality assurance indicators, and/or a list of other issues which were the basis for the peer review, quality assurance, or similar process. The lists produced must identify each item with a unique medical identifier to replace the patient’s name and specific identifying information. If necessary, after receiving the lists the Executive Director may, by subpoena, compel the production of the relevant medical records. However, the individual, hospital, organization, or institution shall remove the patient’s name and specific identifying information from the records prior to complying with the subpoena. If, after having reviewed the records produced, an assisting physician Board member and an assisting public Board member consider it necessary, the Executive Director may, by subpoena, compel the production of the patient’s name. The Board shall take reasonable steps to protect the identity of the patient in so far as such protection does not, in the opinion of the Board, adversely affect the Board’s ability to protect the public interest. An individual, hospital, organization, or institution that furnishes information to the Board pursuant to a subpoena issued pursuant to this subchapter with respect to any patient is not solely by reason of furnishing the information liable in damages to any person or subject to any other recourse, civil or criminal. (e) The Board shall promptly acknowledge all reports received under this section. Individuals or entities reporting under this section must be promptly informed of the Board’s final disposition of the reported matters. (f) Malpractice insurance carriers and insured persons certified to practice medicine in this State shall file with the Board a report of each final judgment, settlement, or award against the insured persons. A person not covered by a malpractice insurance carrier shall also file a report with the Board. A report required to be filed under this subsection must be made to the Board within 30 days of a final judgment, settlement, or award. (g) An individual, institution, agency, or organization required to report under this section who does so in good faith is not subject to civil damages or criminal prosecution for reporting. (h) The Executive Director shall initially review every report made to the Board under this subchapter. The Executive Director may defer the investigation of a report pending a reported licensee’s evaluation and treatment for substance abuse or for physical or mental illness, provided sufficient safeguards exist to protect the licensee’s patients and the public. Safeguards may include a verifiable, voluntary cessation of the practice of medicine or a limited or monitored practice. Upon completion of the reported licensee’s evaluation and treatment, the Executive Director may resume investigation of the report pursuant to the requirements of this chapter. If the Executive Director determines that a deferral is warranted, the case shall be summarized and placed before the Board for its information. (i) Pursuant to the authority conferred herein and by § 1713 of this title, the Board shall have the authority to impose a fine, not to exceed $10,000 for the first violation, and not to exceed $50,000 for any subsequent violation, on any person, any healthcare provider, any healthcare institution, and the Medical Society of Delaware for violation of any duty imposed by this chapter, and said fine shall be imposed pursuant to the procedures of this chapter. (j) Upon receiving a complaint involving potential criminal conduct, the Board shall promptly report the complaint to appropriate law-enforcement agencies, including the Delaware Department of Justice.

Del. Code tit. 24, § 1731B Counseling; letter of concern.

(a) If the Executive Director and the President of the Board, or a member of the Board designated by the President to assist in an investigation concerning a person certified to practice medicine, determine after the investigation that a violation of this chapter or of regulations enacted pursuant to this chapter which warrants formal disciplinary action has not occurred, but that an act or omission of the person is a matter of concern and that the person’s practice may be improved if the person is made aware of the concern, the Executive Director, with the concurrence of the President or the assisting Board member, may issue a nondisciplinary, confidential letter of concern regarding the person’s act or omission. (b) If a person certified to practice medicine receives a total of 3 letters of concern and/or letters of counseling pursuant to this section, the Executive Director may reasonably require a formal assessment of professional competency pursuant to § 1732(d) of this title to assess the person’s continued ability to protect the health and safety of the person’s present or prospective patients.

Del. Code tit. 24, § 1732 Investigations of complaints; Executive Director authority.

(a) All complaints of unprofessional conduct, unauthorized practice of medicine, or medical malpractice shall be referred to the Division of Professional Regulation to be investigated. Complaints alleging potential sexual misconduct by a licensee should be afforded priority by the Division. The Division of Professional Regulation shall formulate charges, if circumstances warrant, by bringing a formal complaint against a person to whom a certificate to practice medicine or otherwise licensed or registered in this State has been issued. (b) The Executive Director shall initiate investigations concerning inability to practice medicine with reasonable skill or safety to patients. The Executive Director with the Board president or the president’s designee, shall, after reviewing the results of the investigation, determine whether the person to whom a certificate to practice medicine has been issued is able to practice medicine with reasonable skill and safety to patients, either on a restricted or unrestricted basis. If the Executive Director reasonably believes that a diagnostic mental or physical examination of the person under investigation is necessary, the Executive Director shall order the person to submit to an examination at the person’s expense to be conducted by a physician or agency designated by the Executive Director. Every person to whom a certificate to practice medicine has been issued is deemed to have given that person’s own consent to submit to a diagnostic mental or physical examination when so directed by the Executive Director, and to have waived all objections to the admissibility of the examination report to the Board. A person who submits to a diagnostic mental or physical examination as ordered by the Executive Director has the right to designate another physician to be present at the examination and to submit an independent report on the examination to the Board. (c) To assist in an investigation of alleged unprofessional conduct, or medical malpractice, or of inability to practice medicine with reasonable skill or safety to patients, the Executive Director, on behalf of the Board, may, by subpoena, compel the production of necessary patient medical records of and patient medical records reviewed by all hospitals, organizations, and healthcare institutions located in the State and by all quality assurance, peer review, and other similar committees, including the records of the Medical Society of Delaware and its committees. A subpoena issued under this subsection is subject to the subpoena restrictions in § 1731A(d) of this title. The Board shall take reasonable steps to protect the identity of the patient in so far as such protection does not, in the opinion of the Board, adversely affect the Board’s ability to protect the public interest. (d) In addition to or in lieu of a diagnostic evaluation, the Executive Director may require an applicant for or the holder of a certificate to practice medicine, at the applicant or certificate holder’s expense, to complete a formal assessment of professional competency if the Executive Director, after consultation with the President of the Board and at least 1 other physician member of the Board, determines that a formal assessment is warranted to protect the health and safety of present or prospective patients. A formal assessment must be performed by the assessment center established by the Federation of State Medical Boards and the National Board of Medical Examiners, or by another assessment center as the Executive Director directs. A formal assessment may not be required of an applicant or certificate holder by the Executive Director without the written concurrence of the President of the Board and at least 1 other physician member of the Board that the assessment is warranted pursuant to this subsection. (e) When a complaint is made by a law-enforcement agency or employee thereof and involves allegations of criminal activity, the Division of Professional Regulation and the Executive Director shall suspend any new or pending investigation upon a written request to do so by the Delaware Department of Justice or a federal law-enforcement authority. Such written request shall suspend the duty to investigate pursuant to this section, duty to regularly advise the complainant under § 8735 of Title 29, and any other duties that would interfere with the ability of law enforcement to investigate the allegations successfully. The suspension shall remain in effect until the Delaware Department of Justice or federal law enforcement informs the Executive Director in writing that action by the Division of Professional Regulation will not interfere with a pending law-enforcement investigation.

Del. Code tit. 24, § 1734 Hearings.

(a) [Repealed.] (b) Open hearings. — A hearing on a complaint conducted by a hearing panel or examiner is open to the public, except the Board may conduct executive session for deliberations and purposes permitted by § 10004 of Title 29. A formal hearing on a complaint before the Board is open to the public in accordance with the provisions of § 10004 of Title 29. (c)-(h) [Repealed.] (i) Hearings shall be conducted pursuant to the Administrative Procedures Act [Chapter 101 of Title 29]. Upon receiving a decision and order the Executive Director shall file the required disciplinary action reports to data banks.

Del. Code tit. 24, § 1735 Revocation or suspension of certificate.

(a) If the Board determines pursuant to this subchapter that a fine and/or the restriction, suspension, or revocation of a certificate to practice medicine and/or any other disciplinary action or other action is warranted, an order describing the Board’s action must be served personally or sent by certified mail, return receipt requested, to the certificate holder. In addition, copies of the order must be filed in the office of the Board, in the Division of Professional Regulation, in the Division of Public Health of the Department of Health and Social Services, and with the Director of Revenue. Upon receipt of an order of the Board revoking or suspending a certificate to practice medicine, the Director of Revenue shall forthwith revoke or suspend the occupational license to practice medicine issued by the Director and comply with any terms of the order applicable to the Division of Revenue. (b) The Director of Revenue may not issue an occupational license or a license renewal to any person whose certificate to practice medicine has been revoked or suspended by the Board, unless issuance is in conformity with the terms and conditions of the order of revocation or suspension, or in conformity with any order of reinstatement issued by the Board, or in accordance with a final judgment in any proceeding for review instituted under this chapter.

Del. Code tit. 24, § 1736 Appeal procedures.

(a) A person against whom a decision of the Board has been rendered may appeal the decision to the Superior Court in the county in which the offense occurred. (b) An appeal pursuant to this section must be filed within 30 days after the day the written decision and order of the Board is issued. (c) An appeal pursuant to this section is on the record of the Board hearing, without a trial de novo. (d) A Board action revoking, suspending, or otherwise restricting a person’s certificate to practice medicine is not stayed upon appeal unless so ordered by the Superior Court. (e) A person whose certificate to practice medicine has been suspended or otherwise restricted may, after the expiration of 90 days from the decision of the Superior Court, or of the Supreme Court if the decision of the Superior Court is appealed, or after 90 days from the decision and order of the Board if no appeal is taken, apply to the Board to have the certificate reinstated or reissued for good cause shown.

Del. Code tit. 24, § 1737 Confidentiality of records.

Release of records of the Board is governed by the provisions of the Freedom of Information Act, Chapter 100 of Title 29.

Del. Code tit. 24, § 1738 Temporary suspension pending hearing.

(a) In the event of a formal or informal complaint concerning the activity of a person certified to practice medicine that presents a clear and immediate danger to the public health, the Board may temporarily suspend the person’s certificate to practice medicine, pending a hearing, upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Board President or the Board President’s designee. An order temporarily suspending a certificate to practice medicine may not be issued unless the person or the person’s attorney received at least 24 hours’ written or oral notice before the temporary suspension so that the person or the person’s attorney can file a written response to the proposed suspension. The decision as to whether to issue the temporary order of suspension will be decided on the written submissions. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended person requests a continuance of the hearing date. If the temporarily suspended person requests a continuance, the order of temporary suspension remains in effect until the hearing panel convenes and a decision is rendered. (b) A person whose certificate to practice medicine has been temporarily suspended pursuant to this section must be notified of the temporary suspension immediately and in writing. Notification consists of a copy of the complaint and the order of temporary suspension pending a hearing personally served upon the person or sent by certified mail, return receipt requested, to the person’s last known address. (c) A person whose certificate to practice medicine has been temporarily suspended pursuant to this section may request an expedited hearing. The Board shall schedule the hearing on an expedited basis, provided that the Board receives the request within 5 calendar days from the date on which the person received notification of the decision to temporarily suspend the person’s certificate to practice medicine. (d) As soon as possible after the issuance of an order temporarily suspending a person’s certificate to practice medicine pending a hearing, the Board shall appoint a 3-member hearing panel consisting of 2 physician members and 1 public member of the Board if practicable. After notice to the person pursuant to subsection (b) of this section, the hearing panel shall convene within 60 days of the date of the issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If the person requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Board. The 3-member panel shall proceed to a hearing in accordance with the procedures set forth in § 1734 of this title and shall render a decision within 30 days of the hearing. (e) In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board, under § 8735 of Title 29, deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended person requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board.

Del. Code tit. 24, § 1739 Protection from liability.

Pursuant to the State Early Opt-in provision of 42 U.S.C. § 11111(c)(2), the protection from liability set forth in 42 U.S.C. § 11111(a) applies to professional review actions, as defined in 42 U.S.C. § 11151, commenced on or after Sept. 10, 1988.

Del. Code tit. 24, § 1740 Health care facilities reporting requirements.

(a) Definitions. — (1) “Direct access” means the opportunity to have personal contact with persons receiving care during the course of one’s assigned or professional duties. (2) “Health care facility” means any custodial or residential facility or other facility where health, nutritional or personal care is provided for persons including nursing homes, assisted living facilities, long-term care facilities, hospitals, health care agencies, birth centers, emergency centers, surgical centers, and adult and child day care facilities. This term also includes any business, professional association, or other business entity where 2 or more physicians practice together. (3) “Person seeking certification” means any person seeking an initial certificate to practice medicine from the Board of Medical Licensure and Discipline. (b) Service letter. — (1) The Board of Medical Licensure and Discipline shall not issue a certificate to practice medicine without first obtaining 1 or more service letters regarding the applicant, provided that person has previously practiced medicine. The service letter obtained must include a service letter from all health care facilities where that person currently has direct access to patients, and where that person has admitting or staff privileges. In addition, if a person seeking certification had direct access to patients or staff or admitting privileges at a health care facility within the past 3 years, the Board of Medical Licensure and Discipline shall also obtain a service letter from each such facility. If a person seeking certification has not previously had direct access to patients or was self-employed or 1 or more of the health-care facilities where that person had direct access to patients no longer exists, then the Board must require the person to provide letters of reference from 2 physicians who are familiar with the person, but who are not relatives of the person. (2) For purposes of this subsection, the required service letter shall be in a form provided by the Board of Medical Licensure and Discipline. Notwithstanding any law or provision to the contrary, the form shall be signed by a responsible physician at the current or previous health care facility and shall contain information about the scope of that persons practice and relationship to the facility, the duration of that relationship, and any reasonably substantiated incidents involving violence, threat of violence, abuse, or neglect by the person seeking certification toward any other person, including any disciplinary action taken as a result of such conduct. (3) Any health care facility that is required to provide a service letter for the purpose stated above shall obtain a statement signed by the person seeking certification wherein the person authorizes a full release permitting the Board of Medical Licensure and Discipline to obtain any and all information pertaining to the facts of the person’s current or previous relationship with the facility. (4) In addition to the requirements of § 1720 of this title, the Board shall obtain a statement signed by the person seeking certification wherein the person attests that the information provided regarding current and past relationships to health care facilities represent a full and complete disclosure of the person’s current and previous contacts with health care facilities. Any person seeking certification who fails to make a full and complete disclosure of such information shall be subject to a civil penalty of $5,000. Any person who wilfully fails to make a full and complete disclosure shall not be issued a certificate to practice medicine. (5) Any health care facility receiving the Board’s written request for a service letter shall provide the service letter within 10 business days from the day the request is received. Any health care facility that fails to make a full and complete disclosure of information, pursuant to this section and § 1730(b)(1)c. of this title, as required, shall be subject to a civil penalty of $10,000 for each such violation. (6) Any health care facility providing information about a person seeking licensure as required by this section shall be immune from claims, suits, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant. (7) The requirements of this section shall be in addition to any requirements of § 708 of Title 19. (8) The Division of Professional Regulation shall investigate and seek civil penalties against persons seeking certification and health care facilities that violate the provision of this section. (9) Notwithstanding the foregoing, the Board may issue a certificate to practice medicine to an applicant who was employed out of State or country within the past 5 years, where completed service letters have not been received from all health care facilities, provided all other requirements of this chapter are met and provided requests were made to such facilities and the Board determines that all possible efforts were made to obtain the required service letter. Applicants to which this paragraph applies shall obtain letters of reference from 2 qualified physicians who are familiar with the person, who are not relatives of the person.

Del. Code tit. 24, § 1741 Complaints of unsanitary or unsafe conditions.

(a) A person certified or licensed under this chapter may be disciplined by the Board for maintaining a facility in an unsanitary or unsafe condition, by means of levying a fine, or by the restriction, suspension, or revocation, either permanent or temporary, of that person’s certificate or license, or by other appropriate action, which may include a requirement that a person who is disciplined must complete specified continuing education courses. For purposes of this section, “facility” shall have the same meaning as defined in § 122(3)y.3.C. of Title 16. (b) The Division shall have the authority to conduct inspections upon receipt of any complaint in connection with subsection (a) of this section or upon the occurrence of an adverse event as defined in § 122(3)y.3.A. of Title 16 and, as applicable, to refer such information to the Department of Health and Social Services pursuant to § 122(3)y. of Title 16. In connection herewith, the Division may share information with the Department of Health and Social Services in accordance with applicable law.

Del. Code tit. 24, § 1760 Determination of death.

(a) An individual who has sustained either: (1) Irreversible cessation of circulatory and respiratory functions or (2) Irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death pursuant to this section must be made in accordance with accepted medical standards. (b) A determination of death pursuant to this section may be made by a person certified to practice medicine under this chapter by either: (1) Personal examination of the individual believed to be dead, or (2) The use of information provided by an EMT-P (paramedic) using telemetric or transtelephonic means in accordance with protocols approved by the Board of Medical Licensure and Discipline, following recommendations of the Board’s Advanced Life Support Committee. (c) This section must be applied and construed to effectuate its general purpose to make uniform the law with respect to the determination of death among states enacting it. (d) This section may be cited as the “Uniform Determination of Death Act”.

Del. Code tit. 24, § 1761 Physician discontinuing business, leaving the State, or terminating a patient-physician relationship; death of a physician; change of physician and transfer of patient records; patient access to records.

(a) (1) A person certified to practice medicine under this chapter who is discontinuing a medical-practice business in this State, who is leaving this State, or terminating a patient-physician relationship for any reason and who is not transferring patient records to another person certified to practice medicine shall notify that person’s affected patients of record no less than 30 days prior to the discontinuation of physician services. (2) The notice required under paragraph (a)(1) of this section must include all of the following: a. How the patient can obtain the patient’s records. b. The name, phone number, and address of other health-care providers in the area who may be available to accept new patients who require that medical care. c. The date the physician will discontinue services. (3) The notice required under paragraph (a)(1) of this section must be provided by all of the following: a. If the patient is enrolled to receive messages through an electronic medical record system, an electronic message through that system. b. A letter sent by first-class mail. (4) Any patient records that have not been procured within 7 years after the person discontinues business, leaves the State, or terminates a patient-physician relationship for any other reason may be permanently disposed of in a manner that ensures confidentiality of the records. (5) When a physician is closing a medical practice and patient medical records will no longer be available at the physician’s place of business, the physician shall provide to the Board of Medical Licensure and Discipline notice of how former patients may obtain medical records. (b) (1) If a person certified to practice medicine under this chapter dies and has not transferred patient records to another person certified to practice medicine and has not made provisions for a transfer of patient records to occur upon the person’s death, a personal representative of the person’s estate shall notify the person’s patients of record by publishing a notice to that effect in a newspaper of general circulation in the area where the person practiced. The notice must be published at least 1 time per month over a 3-month period after the person’s death and must explain how a former patient can procure the patient’s patient records. (2) A personal representative of the person’s estate shall notify all former patients who have not requested their records 30 days after publication in a newspaper by all of the following: a. If the patient is enrolled to receive messages through an electronic medical record system, an electronic message through that system. b. A letter sent by first-class mail. (3) Any patient records that have not been procured within 7 years after the death of the person may be permanently disposed of in a manner that ensures confidentiality of the records. (4) The personal representative of the person’s estate shall provide the Board of Medical Licensure and Discipline notice of how former patients may obtain medical records. (c) If a patient changes from the care of 1 person certified to practice medicine to another person certified to practice medicine, the former person shall transfer a copy of the records of the patient to the current person upon the request of either the current person or the patient. The former person may charge for the reasonable expenses of copying the patient’s records, according to a payment schedule established by the Board of Medical Licensure and Discipline. The actual cost of postage or shipping may also be charged if the records are mailed. Alternatively, if the patient and current person agree, the former person may forward to the current person a summary of the patient’s record, in lieu of transferring the entire record, at no charge to the patient. If a patient changes care from 1 person certified to practice medicine to another and fails to notify the former person, or leaves the care of the former person for a period of 7 years from the last entry date on the patient’s record and fails to notify the former person, or fails to request the transfer of records to the current person, then the former person shall maintain the patient’s records for a period of 7 years from the last entry date in the patient’s medical record, after which time the records may be permanently disposed of in a manner that insures confidentiality of the records. (d) Patients, on their own behalf, shall have the right to obtain a copy of their medical records from any person certified to practice medicine according to a payment schedule established by the Board of Medical Licensure and Discipline. The actual cost of postage or shipping may also be charged if the records are mailed. (e) This section does not apply to a person certified to practice medicine who has seen or treated a patient on referral from another person certified to practice medicine and who has provided a copy of the record of the diagnosis and/or treatment to the other person, or to a hospital or an agency which has provided treatment for the patient. (f) A person certified to practice medicine or the personal representative of the estate of such person who disposes of patient records in accordance with the provisions of this section is not liable for any direct or indirect loss suffered as a result of the disposal of a patient’s records. (g) Any person certified to practice medicine in this State who violates this section may be found by the Board to have committed unprofessional conduct, and any aggrieved patient or the patient’s personal representative may bring a civil action for damages or injunctive relief, or both, against the violator. (h) Charges for copies of such records not susceptible to photostatic reproduction, such as radiology films, models, photographs or fetal monitoring strips shall be the full cost of such reproduction. (i) Payment of all costs may be required by the provider or its third-party release-of-information service prior to the copies of the records being furnished. This subsection shall not apply to copies of the records requested in order to make or complete an application for a disability benefits program. (j) The Board of Medical Licensure and Discipline shall review fees yearly. (k) The actual cost of shipping may also be charged if the copies of the records are mailed or shipped to the requester. ( l ) A person certified to practice medicine shall have 45 days from the closure of the record or the assembly of a complete record to fulfill a request for medical records unless a faster response is medically necessary.

Del. Code tit. 24, § 1761A Appointment of a custodian of patient records.

(a) If the Board receives a formal or informal complaint concerning access to patient records as a result of a physician’s physical or mental incapacity, or abandonment or involuntary discontinuation of a medical-practice business in this State, the Board may temporarily or permanently appoint a person or entity as custodian of the physician’s patient records, in accordance with the procedures set forth in § 1732 of this title. (b) The custodian of patient records appointed under this section shall notify the physician’s patients of record to that effect by publishing notice in a newspaper of daily circulation in the area where the physician practiced. The notice must be published at least 1 time per month over a 3-month period after the appointment of the custodian and must explain how a patient can procure that patient’s records. All patients who have not requested their records 30 days after such publication must be notified by first-class mail by the custodian to permit the patients to procure their records. Any patient records that have not been procured within 7 years after the appointment of the custodian may be permanently disposed of in a manner that ensures confidentiality of the records. (c) A custodian of patient records appointed under this section who disposes of patient records in accordance with the provisions of this section is not liable for any direct or indirect loss suffered as a result of the disposal of a patient’s records. (d) The Board shall establish a registry of physicians and healthcare entities who are willing to serve as records custodians.

Del. Code tit. 24, § 1762 Reports of treatment of certain wounds, injuries, poisonings, or other conditions; failure to report; penalty.

(a) Every person certified to practice medicine who attends to or treats a stab wound; poisoning by other than accidental means; or a bullet wound, gunshot wound, powder burn, or other injury or condition arising from or caused by the discharge of a gun, pistol, or other firearm, or when such injury or condition is treated in a hospital, sanitarium, or other institution, the person, manager, superintendent, or other individual in charge shall report the injury or condition as soon as possible to the appropriate police authority where the attending or treating person was located at the time of treatment or where the hospital, sanitarium, or institution is located. This section does not apply to wounds, burns, poisonings, or injuries or conditions received by a member of the armed forces of the United States or the State while engaged in the actual performance of duty. A person who fails to make a report required by this section shall be fined not less than $100 nor more than $2,500. (b) A person certified to practice medicine or other individual who makes a report pursuant to this section is immune from liability for the report, provided that the person or other individual acted in good faith and without gross or wanton negligence.

Del. Code tit. 24, § 1763 Reports of persons who are subject to losses of consciousness; limitation on use; failure; penalty [Repealed].

Del. Code tit. 24, § 1764 State revenue.

The provisions of this chapter may not be construed to interfere with the operation of the provisions of Title 29 relating to state licenses and taxes.

Del. Code tit. 24, § 1764A Prescription requirements.

(a) No written prescription shall be prescribed if it does not contain the following information clearly written, clearly hand printed, electronically printed, or typed: (1) The name, address and phone number of the prescriber; (2) The name and strength of the drug prescribed; (3) The quantity of the drug prescribed; (4) The directions for use of the drug; (5) Date of issue. (b) Notwithstanding any other provision of this section or any other law to the contrary, no person licensed under this chapter shall issue any prescription unless such prescription is made by electronic prescription from the person issuing the prescription to a pharmacy in accordance with regulations established by the Board, except for prescriptions issued: (1) By a veterinarian. (2) In circumstances where electronic prescribing is not available due to temporary technological or electrical failure, as set forth in regulation established by the Board. (3) By a practitioner to be dispensed by a pharmacy located outside the State, as set forth in regulations established by the Board. (4) When the prescriber and dispenser are the same entity. (5) That include elements that are not supported by the most recently implemented version of the National Council for Prescription Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard. (6) By a practitioner for a drug that the Federal Food and Drug Administration requires the prescription to contain certain elements that are not able to be prescribed with electronic prescribing. (7) By a practitioner allowing for the dispensing of a nonpatient specific prescription pursuant to a standing order, approved protocol for drug therapy, collaborative drug management or comprehensive medication management, in response to a public health emergency, or other circumstances where the practitioner may issue a nonpatient specific prescription. (8) By a practitioner prescribing a drug under a research protocol. (9) By practitioners who have received a waiver or a renewal thereof for a specified period determined by the Board, not to exceed 1 year, from the requirement to use electronic prescribing, pursuant to regulations established by the Board, due to economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance demonstrated by the practitioner. (10) By a practitioner under circumstances where, notwithstanding the practitioner’s present ability to make an electronic prescription as required by this subsection, such practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient’s medical condition. (c) A pharmacist who receives a written, oral or faxed prescription is not required to verify that the prescription properly falls under 1 of the exceptions under subsection (b) of this section, from the requirement to electronically prescribe. Pharmacists may continue to dispense medications from otherwise valid written, oral or fax prescriptions that are otherwise legal.

Del. Code tit. 24, § 1765 Construction of chapter relating to the ADA.

This chapter may not be construed to conflict with, replace, restrict, or supersede applicable provisions of the Americans with Disabilities Act (ADA) [42 U.S.C. § 12101 et seq. If a provision of this chapter is in conflict with an applicable provision of the ADA, the applicable provision of the ADA controls the interpretation of the chapter.

Del. Code tit. 24, § 1766 Penalties [See conflicting amendment, unable to be implemented, in 75 Del. Laws, c. 161, § 5.]

(a) A person who practices or attempts to practice medicine contrary to the provisions of this chapter is guilty of a class F felony and shall be fined not less than $1000 nor more than $5000 or imprisoned not more than 3 years, or both. (b) A person who terminates or attempts to terminate or assists in the termination of a human pregnancy otherwise than by birth, except in accordance with subchapter IX of this chapter, is guilty of a class C felony and shall be fined not more than $5,000 and imprisoned not less than 2 nor more than 10 years. (c) A person who violates a provision of this chapter for which a penalty is not specified is guilty of a class B misdemeanor. (d) The Attorney General of this State or a deputy attorney general shall enforce the provisions of this chapter. (e) The Superior Court has exclusive original jurisdiction over violations of the criminal provisions of this chapter.

Del. Code tit. 24, § 1767 Emergency care at the scene of an emergency.

A person certified to practice medicine under this chapter who, in good faith and without gross or wanton negligence, renders emergency care at the scene of an emergency is not liable for civil damages as a result of any acts or omissions in rendering the emergency care.

Del. Code tit. 24, § 1768 Immunity of boards of review; confidentiality of review board record.

(a) The Board of Medical Licensure and Discipline and the Medical Society of Delaware, their members, and the members of any committees appointed by the Board or Society; the members of any committee appointed by a certified health maintenance organization; members of hospital and osteopathic medical society committees; members of a professional standards review organization established under federal law; and members of other peer review committees or organizations whose function is the review of medical records, medical care, and physicians’ work, with a view to the quality of care and utilization of hospital or nursing home facilities, home visits, and office visits, are immune from claim, suit, liability, damages, or any other recourse, civil or criminal, arising from any act, omission, proceeding, decision, or determination undertaken or performed, or from any recommendation made, so long as the person acted in good faith and without gross or wanton negligence in carrying out the responsibilities, authority, duties, powers, and privileges of the offices conferred by law upon them, with good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant. (b) Unless otherwise provided by this chapter, the records and proceedings of committees and organizations described in subsection (a) of this section are confidential and may be used by those committees or organizations and the members thereof only in the exercise of the proper functions of the committee or organization. The records and proceedings are not public records and are not available for court subpoena, nor are they subject to discovery. A person in attendance at a meeting of any such committee or organization is not required to testify as to what transpired at the meeting. A person certified to practice medicine, or a hospital, organization, or institution furnishing, in good faith and without gross or wanton negligence, information, data, reports, or records to such a committee or organization or a member thereof with respect to any patient examined or treated by a person certified to practice medicine or examined, treated, or confined in the hospital or institution is not, by reason of furnishing such information, data, reports, or records, liable in damages to any person or subject to any other recourse, civil or criminal. Nothing in this subsection prevents the Board from providing information, data, reports, or records in its possession to a medical, osteopathic, or other licensing board of any other state or territory of the United States regarding a person who is certified to practice medicine under this chapter, or otherwise regulated by this chapter, or who has been certified under this chapter or who has attempted to be certified under this chapter. The Board shall take reasonable steps to protect the identity of the patient in so far as such protection does not, in the opinion of the Board, adversely affect the Board’s ability to protect the public interest. The Board and its members and employees are not liable in any cause of action arising out of the providing of information, data, reports, or records provided that the person has acted in good faith and without gross or wanton negligence. This section may not be construed to create a privilege or right to refuse to honor a subpoena issued by or on behalf of the Board of Medical Licensure and Discipline pursuant to § 1731A(d) of this title, or issued by the Attorney General pursuant to § 2504(4) of Title 29, nor may it be construed to limit access to records by rights-protection agencies whose access is authorized by federal law. Notwithstanding the foregoing, in cases in which any disciplinary action by the Board was issued, the formal complaints prepared by the Delaware Department of Justice and the results of the hearings are not confidential and are public records except insofar as they contain confidential patient information or are otherwise subject to an exception under Chapter 100 of Title 29.

Del. Code tit. 24, § 1769 Disclosure of laboratory costs.

A person certified to practice medicine who bills patients or third-party payors for individual tests or test series administered by any private or hospital clinical laboratory shall disclose on the bill the name of the laboratory, the amount or amounts charged by the laboratory for individual tests or test series and the amount of any procurement or processing charge made by the person certified to practice medicine for each test or test series. A test or test series performed at a state laboratory or at another laboratory at which no charge is made must be noted on the bill.

Del. Code tit. 24, § 1769A Required warning to pregnant women of possible effects of using alcohol, cocaine, or other narcotics.

(a) A person certified to practice medicine who treats, advises, or counsels pregnant women for matters relating to the pregnancy shall post warnings and give written and verbal warnings to all pregnant women regarding possible problems, complications, and injuries to themselves and/or to the fetus from the consumption or use of alcohol or cocaine, marijuana, heroin, and other narcotics during pregnancy. (b) A person who treats, advises, or counsels pregnant women pursuant to subsection (a) of this section and who is certified to practice medicine may designate a licensed nurse to give the warnings required by this section. (c) The Director of the Division of Public Health shall prescribe the form and content of the warnings required pursuant to this section.

Del. Code tit. 24, § 1769B Treatment or examination of minors.

(a) A parent, guardian or other caretaker, or an adult staff member, shall be present when a person licensed to practice medicine under this chapter provides outpatient treatment to a minor patient who is disrobed or partially disrobed or during an outpatient physical examination involving the breasts, genitalia or rectum, regardless of sex of the licensed person and patient, except when rendering care during an emergency. When using an adult staff member to observe the treatment or examination, the adult staff member shall be of the same gender as the patient when practicable. The minor patient may decline the presence of a third person only with consent of a parent, guardian or other caretaker. The minor patient may request private consultation with the person licensed to practice medicine without the presence of a third person after the physical examination. Every hospital and long-term care facility that provides treatment to minors shall develop and implement policies regarding the treatment of minor patients that are consistent with the purposes of this section and will submit those policies for approval by the Department of Health and Social Services. Violations of approved policies will be treated as a violation of this section. (b) When a minor patient is to be disrobed, partially disrobed or will undergo a physical examination involving the breasts, genitalia or rectum, a person licensed to practice medicine under this chapter shall provide notice to the person providing consent to treatment of the rights under this section. The notice shall be provided in written form or be conspicuously posted in a manner in which minor patients and their parent, guardian or other caretaker are made aware of the notice. In circumstances in which the posting or the provision to the patient of the written notice would not convey the right to have a chaperone present, the person licensed to practice medicine shall use another means to ensure that the patient or person understands the right under this section. (c) For the purposes of this section, “minor” is defined as a person 15 years of age or younger, “adult staff member” is defined as a person 18 years of age or older who acting under the direction of the licensed person or the employer of the licensed person or who is otherwise licensed under this chapter, “hospital” has the meaning prescribed by Chapter 10 of Title 16, and “long-term care facility” has the meaning prescribed by Chapter 11 of Title 16. (d) The person licensed under this chapter that provides outpatient treatment to a minor pursuant to this section shall, contemporaneously with such treatment, note in the child’s medical record the name of each person present when such treatment is being provided.

Del. Code tit. 24, § 1769C Physician practices with multiple offices.

If a physician practice has multiple offices, a physician member of that practice shall visit each office periodically, as frequently as needed but at least once per month, for purposes of ensuring that the office is managed properly and patient care is appropriate.

Del. Code tit. 24, § 1770 The Regulatory Council for Physician Associates [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) The Regulatory Council for Physician Associates (Council) shall consist of 7 voting members, 1 of whom is a physician member appointed by the Board, 1 of whom is a physician who regularly collaborates with physician associates appointed by the Board, and 1 of whom is a pharmacist appointed by the Board of Pharmacy. The remaining 4 members, recommended by the Council and appointed by the Board, must be practicing physician associates, subject to the same causes for removal as a physician member of the Board except that the requirement for certification and registration to practice medicine is replaced by licensure to practice medicine as a physician associate. The Council may elect officers as necessary and recommend Council members to the Governor for appointment to the Board. (b) Each Council member must be appointed for a term of 3 years and may succeed oneself for 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a member whose term of office has expired remains eligible to serve until replaced by the Board. A person who has never served on the Council may be appointed for 2 consecutive terms, but that person is thereafter ineligible for appointment to the Council except as hereinafter provided. A person who has twice been appointed to the Council or who has served on the Council for 6 years within any 9-year period may not again be appointed until an interim period of at least 1 year has expired since the person last served. The members of the Council are to be compensated at an appropriate and reasonable level as determined by the Division of Professional Regulation and may be reimbursed for meeting-related travel expenses at the State’s approved rate. A member serving on the Council may not be an elected officer or a member of the board of directors of any professional association of physician associates. (c) The Council, in accordance with the Administrative Procedures Act [Chapter 101 of Title 29], shall promulgate rules and regulations governing the practice of physician associates, subject to approval of the Board. The Board must approve or disapprove any proposed rule or regulation within 60 days of submission by the Council. If the Board fails to approve or disapprove the proposed rules or regulations within 60 days, the proposed rule or regulation is deemed approved by the Board. (d) The Council must meet at least on a quarterly basis and at other such times as license applications are pending. The Council shall evaluate the credentials of all applications for licensure as a physician associate in this State, in order to determine whether the applicant meets the qualifications for licensure set forth in this chapter. The Council shall present to the Board the names of individuals qualified for licensing, shall review and consider disciplinary complaints and recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations. (e) The Regulatory Council for Physician Associates, by the affirmative vote of 4 of its members and with the approval of the Board within 30 days of the vote, may waive the quarterly meeting requirements of this subchapter.

Del. Code tit. 24, § 1770A Physician associates; definitions [For application of this section, see 85 Del. Laws, c. 253, § 23] [Effective until fulfillment of the contingency in 85 Del. Laws, c. 459, § 4].

For purposes of this subchapter: (1) “Collaborating physician” means a physician licensed by the Board who practices with a physician associate using a Collaborative Agreement. (2) “Collaboration” or “collaborating” means a process in which the physician who oversees patient services and the physician associate jointly contribute to the healthcare and medical evaluation and treatment or management of patients with each performing actions the physician and physician associate is individually licensed for and has the education, training, and experience to perform. The collaborating physician must be available for consultation with the physician associate during the time of the patient encounter with the physician associate, if necessary to provide advice on the ongoing care of the patient. The constant physical presence of the collaborating physician is not required on-site in the practice setting, provided that the collaborating physician is readily accessible by some form of electronic communication. (3) “Collaborative agreement” means a written document expressing an arrangement of collaboration between a licensed physician and a physician associate. (4) “Independent practice” means practice and prescribing by a licensed physician associate who is not subject to a collaborative agreement to the full extent of the physician associate’s education, training, and experience. (5) “Physician assistant,” “physician associate,” or “PA” means an individual who meets all of the following: a. Has graduated from a physician assistant, physician associate, or surgeon assistant program which is accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or, before 2001, by the Committee on Allied Health Education and Accreditation (CAHEA) of the American Medical Association (AMA), or a successor agency acceptable to and approved by the Board, or has passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants before 1986. c. Has passed a national certifying examination acceptable to the Regulatory Council for Physician Associates and approved by the Board. d. Is licensed under this chapter to practice medicine as a physician associate. e. Has completed any continuing education credits required by rules and regulations developed under this chapter. f. [Repealed.]

Del. Code tit. 24, § 1771 Physician’s role in collaborating with a physician associate [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) A collaborating physician must be available for consultation with the physician associate. It is the obligation of each team of physicians and physician associates to ensure that the physician associate’s scope of practice is identified, and is appropriate to the physician associate’s level of education, training, and experience, that the relationship of, and access to, the collaborating physician is defined, and that a process for evaluation of the physician associate’s performance is established. (b) Each physician-physician associate team, hospital, clinic, medical group, or other healthcare facility is responsible for creating a written collaborative agreement, which must be kept on file at the primary location where the physician associate provides care, describing the information required by subsection (a) of this section. The written collaborative agreement shall be made available to the Board or the Council upon request. (c) [Repealed.] (d) A collaborating physician may not be involved in patient care in name only and must be involved in active patient care on a regular basis. (e) A collaborating physician may not assign medical acts to a physician associate that exceed the physician’s license. (f) A collaborating physician may not at any given time collaborate with more than 4 physician associates, unless a regulation of the Board increases or decreases the number. This limit does not apply to physicians and physician associates who practice in the same physical office or facility building, such as an emergency department so long as there is active, physician coverage. (g) A physician who collaborates with a physician associate in violation of the provisions of this subchapter or of regulations adopted pursuant to this subchapter is subject to disciplinary action by the Board of Medical Licensure and Discipline for permitting the unauthorized practice of medicine. (h) Hospitals, clinics, medical groups and other healthcare facilities may employ physician associates subject to subsection (f) of this section. (i) If the collaborating physician is not routinely present the physician must assure that the means and methods of collaboration are adequate to assure appropriate patient care. This may include telecommunication, chart review, or other methods of communication and oversight that are appropriate to the care setting and the education, training, and experience of the physician associate.

Del. Code tit. 24, § 1772 Prohibited acts by a physician associate [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) A physician associate may not maintain or manage a location that does not have oversight by the physician associate’s collaborating physician. (b)-(d) [Repealed.] (e) Nothing in this chapter may be construed to authorize a physician associate with less than 6,000 hours of postgraduate clinical practice to practice independent of a collaborating physician. (f) Except as otherwise provided in this chapter or in a medical emergency, a physician associate may not perform any medical act without a collaborative agreement. (g) A physician associate may not practice as a member of any other health profession regulated under this code unless the physician associate is certified, licensed, registered, or otherwise authorized to practice the other profession. (h) A physician associate may not practice as a member of any other health profession regulated under this Code unless the means and methods of collaboration are adequate to assure appropriate patient care. This may include telecommunication, chart review, or other methods of communication and oversight that are appropriate to the care setting and the education, training, and experience of the physician associate. (i) A Delaware licensed physician associate with more than 6,000 postgraduate clinical practice hours who has been granted independent practice authority is not subject to this section and must collaborate with, consult with, or refer to the appropriate member of the healthcare team as indicated by the patient’s condition, and the education, experience, and competency of the physician associate. (j) Any Delaware-licensed physician associate with more than 6,000 postgraduate clinical practice hours who intends to practice without a collaborative agreement must apply to the Regulatory Council for Physician Associates for independent practice authority.

Del. Code tit. 24, § 1773 Regulation of physician associates [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) The Council must adopt rules and regulations which address the following: (1) The licensing of physician associates to allow the following: a. The practice of medicine within the education, training, and experience of physician associates. b. The performance of medical services within the education, training, and experience of physician associates. (2) Medical acts provided by physician associates to include all of the following: a. The performance of complete patient histories and physical examinations. b. The recording of patient progress notes in an in-patient or out-patient setting. c. The ordering, relaying, transcribing, or executing of specific diagnostic or therapeutic orders or procedures. d. Medical acts of diagnosis and prescription of therapeutic drugs and treatments; and referral of patients to specialists as needed. e. Prescriptive authority for therapeutic drugs and treatments within the scope of physician associate practice. The physician associate’s prescriptive authority and authority to practice as a physician associate are subject to biennial renewal upon application to the Physician Associate Regulatory Council. f. The use of telemedicine as defined in this chapter and, as further described in regulation, the use of and participation in telehealth. g. Pronouncing death and completing and signing a medical certification of death. (3) The verification of postgraduate clinical practice hours for physician associates with more than 6,000 postgraduate clinical practice hours. (4) Independent practice within a setting with at least 1 licensed Delaware physician. — Creating an application form for physician associates with more than 6,000 postgraduate clinical practice hours to request independent practice authority for physician associates who intend to practice in a setting with at least 1 licensed Delaware physician in the group, practice, or health system. The application form must require a physician associate to provide at least the physician associate’s name, license number, physical location of practice, mailing address, phone number, primary area of medical practice, and proof of required postgraduate clinical practice hours. (5) Independent practice within a setting without at least 1 licensed Delaware physician. — Creating an application form for physician associates with more than 6,000 postgraduate clinical practice hours to request independent practice authority for physician associates who intend to practice in a setting without at least 1 licensed Delaware physician in the group, practice, or health system. The application form must require a physician associate to provide at least the physician associate’s name, license number, physical location of the practice, mailing address, phone number, primary area of medical practice, proof of required postgraduate clinical practice hours, and proof that the physician associate has had training which aligns to the physician associate’s practice areas. (6) Changes to practice area for independent practice within a setting without at least 1 licensed Delaware physician. — Creating an application form and process for physician associates in the group, practice, or health system, that have been granted independent practice authority, to notify the Physician Associates Regulatory Council prior to a change of the physician associate’s practice area and provide proof the physician associate has had training that aligns to the new practice area. (7) The conditions under which a physician associate who is denied a waiver of the collaborative agreement requirement may reapply. (b) (1) The Board, in conjunction with the Regulatory Council for Physician Associates, must suspend, revoke, or restrict the license of a physician associate or take disciplinary action or other action against a physician associate for engaging in unprofessional conduct as defined in § § 1731(b) of this title; or for the inability to render medical acts with reasonable skill or safety to patients because of the physician associate’s physical, mental, or emotional illness or incompetence, including but not limited to: deterioration through the aging process, or loss of motor skills, or excessive use of drugs, including alcohol; or for representing oneself as a physician, or for knowingly allowing oneself to be represented as a physician; for failing to report in writing to the Board within 30 days of becoming aware of any physician, physician associate, or healthcare provider who the licensee reasonably believes has engaged in unprofessional conduct as defined in § § 1731(b) of this title or is unable to act with reasonable skill or safety to patients because of the physician’s, physician associate’s, or other healthcare provider’s physical, mental, or emotional illness or incompetence, including but not limited to deterioration through the aging process, or loss of motor skills, or excessive use of drugs, including alcohol, or for failing to report child abuse and neglect as required by § § 903 of Title 16. The license of any physician associate who is convicted of a felony sexual offense must be revoked. Disciplinary action or other action undertaken against a physician associate must be in accordance with the procedures, including appeal procedures, applicable to disciplinary actions against physicians pursuant to subchapter IV of this chapter, except that a hearing panel for a complaint against a physician associate consists of 3 unbiased members of the Regulatory Council, the 3 members being 2 physician associate members and 1 physician or pharmacist member if practicable. A person reporting or testifying in any proceeding as a result of making a report pursuant to this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant. (2) a. If the Board or the Regulatory Council for Physician Associates receives a formal or informal complaint concerning the activity of a physician associate and the Regulatory Council members reasonably believe that the activity presents a clear and immediate danger to the public health, the Regulatory Council may issue an order temporarily suspending the physician associate’s license to practice pending a hearing upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Council Chair or the Chair’s designee. An order temporarily suspending a license to practice may not be issued by the Council unless the physician associate or the physician associate’s attorney received at least 24 hours’ written or oral notice prior to the temporary suspension so that the physician associate or the physician associate’s attorney can be heard in opposition to the proposed suspension. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended physician associate requests a continuance of the hearing date. If the physician associate requests a continuance, the order of temporary suspension remains in effect until the hearing panel convenes and a decision is rendered. b. A physician associate whose license to practice has been temporarily suspended pursuant to this section must be notified of the temporary suspension immediately and in writing. Notification consists of a copy of the complaint and the order of temporary suspension pending a hearing personally served upon the physician associate or sent by certified mail, return receipt requested, to the physician associate’s last known address. c. A physician associate whose license to practice has been temporarily suspended pursuant to this section may request an expedited hearing. The Council shall schedule the hearing on an expedited basis, provided that the Council receives the request within 5 calendar days from the date on which the physician associate received notification of the decision of the Council, with the approval of the Board, to temporarily suspend the physician associate’s license to practice. d. As soon as possible after the issuance of an order temporarily suspending a physician associate’s license to practice pending a hearing, the Executive Director must appoint a 3-member hearing panel. After notice to the physician associate pursuant to paragraph (b)(2)b. of this section, the hearing panel shall convene within 60 days of the date of the issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If the physician associate requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Council. The 3-member panel must proceed to a hearing and shall render a decision within 30 days of the hearing. e. In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended physician associate requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board. (c) The Board or the Regulatory Council for Physician Associates may not impose any sanction under subsection (b) of this section for the performance, recommendation, or provision of any healthcare service that is lawful in this State even if such performance, recommendation, or provision is for a person who resides in a state where such performance, recommendation, or provision is illegal or considered to be unprofessional conduct or the unauthorized practice of a physician associate. (d) A nonhuman entity, including an agent powered by artificial intelligence, may not be licensed as a physician associate in this State. A nonhuman entity, including an agent powered by artificial intelligence, may not use the title physician associate or the abbreviation “PA.” (e) A physician associate may be designated as the primary care provider by an insurer or healthcare services corporation. (f) A physician associate must collaborate with, consult with, and refer to the appropriate member of the healthcare team as indicated by the patient’s condition, and the education, experience, and competencies of the physician associate. (g) Physician associates must be authorized to bill for and receive direct payment for the medically-necessary services they deliver. (1) To ensure accountability and transparency for patients, payers, and the healthcare system, when appropriate, a physician associate must also be identified as the rendering professional in the billing and claims process when the physician associate delivers medical or surgical services to patients. (2) No insurance company or third-party payer may impose a practice, education, or collaboration requirement that is inconsistent with or more restrictive than physician associate state law or regulation.

Del. Code tit. 24, § 1773A Participation in disaster or emergency care [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) A physician associate licensed in this State or licensed or authorized to practice in any other U.S. jurisdiction or credentialed as a physician associate by a federal employer who is responding to a need for medical care created by an emergency or a state or local disaster (excluding an emergency which occurs in that person’s place of employment or practice) may render such care that the physician associate is able to provide without collaboration pursuant to § 1770A of this title or with such collaboration as is available. (b) Any physician who collaborates with a physician associate providing medical care in response to such an emergency or state or local disaster shall not be required to meet the requirements set forth in this subchapter for a collaborating physician. (c) A person licensed as a physician associate under this chapter who, in good faith and without gross or wanton negligence, renders emergency care at the scene of an emergency, excluding an emergency which occurs in that person’s place of employment or practice, shall not be liable for civil damages as a result of any acts or omissions in rendering the emergency care.

Del. Code tit. 24, § 1774 Temporary licensing of physician associates [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) Notwithstanding any provision of this subchapter to the contrary, the Executive Director, with the approval of a Council member, may grant a temporary license to an individual who has graduated from a physician or surgeon assistant or associate program which has been accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or, prior to 2001, by the Committee on Allied Health Education and Accreditation (CAHEA) of the American Medical Association (AMA) or a successor agency and who otherwise meets the qualifications for licensure but who has not yet taken a national certifying examination, provided that the individual is registered to take and takes the next scheduled national certifying examination. A temporary license granted pursuant to this subsection is valid until the results of the examination are available from the certifying agency. If the individual fails to pass the national certifying examination, the temporary license granted pursuant to this subsection must be immediately rescinded until the individual successfully qualifies for licensure pursuant to this subchapter. (b) An individual who is temporarily licensed pursuant to this section may not have a prescriptive practice and may not perform medical acts except in the physical presence of the individual’s collaborating physician.

Del. Code tit. 24, § 1774A Fees set by Board [For application of this section, see 85 Del. Laws, c. 253, § 23].

The Division of Professional Regulation shall establish fees for licensing physician associates, for renewing licenses on a biennial basis, and for other regulatory purposes. The fees must approximate the costs reasonably necessary to defray the actual expenses of the Board and the regulatory council, as well as the proportional expenses incurred by the Division in administering the issuance and renewal of licenses, and other regulation of physician associates.

Del. Code tit. 24, § 1774B Prohibited acts; penalties; enforcement [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) A person may not practice as a physician associate, physician assistant, or PA in this State or represent that the person is a physician associate, physician assistant, or PA or knowingly allow oneself to be represented as a physician associate, physician assistant, or PA unless the person is licensed under this subchapter, except as otherwise provided in this chapter. (b) A person who, contrary to the provisions of this subchapter, practices or attempts to practice as a physician associate, physician assistant, or PA within the State or represents that the person is a physician associate, physician assistant, or PA or knowingly allows oneself to be represented as a physician associate, physician assistant, or PA shall be fined not less than $500 nor more than $2,000 or imprisoned not more than 1 year, or both. (c) The Attorney General of this State or a deputy attorney general shall enforce the provisions of this subchapter.

Del. Code tit. 24, § 1774C Procedure or action not prescribed [For application of this section, see 85 Del. Laws, c. 253, § 23].

This subchapter governs the practice of physician associates. If a procedure or action is not specifically prescribed in this subchapter, but is prescribed in the subchapters relating to the practice of medicine, and the procedure or action would be useful or necessary for the regulation of physician associates, the Board or Council may, in its discretion, proceed in a manner prescribed for physicians in the practice of medicine.

Del. Code tit. 24, § 1774D Inactive license; return to clinical practice [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) Any physician associate who notifies the Board in writing on forms prescribed by the Board may elect to place that physician associate’s license on inactive status. A physician associate whose license is inactive shall be excused from payment of renewal fees and shall not practice as a physician associate. Any licensee who engages in practice while that licensee’s license is inactive shall be considered to be practicing without a license, which shall be grounds for discipline under § § 1774B of this title. A physician associate whose license has been inactive for 3 years or less may reactivate the license by paying the renewal fee pursuant to § § 1774A of this title and meeting the requirements for ordinary license renewal as determined by the Board. (b) If a physician associate whose license has been on inactive status for in excess of 3 years and who has not practiced as a physician associate in any jurisdiction of the United States for over 3 years requests to reactivate the license, the Board may grant a re-entry license and may, after consultation with the Council, impose additional practice and collaboration requirements for the re-entry license. A re-entry license granted under this subsection shall be valid for no longer than 6 months and may be renewed only once at the Board’s discretion. In the month immediately preceding the month during which the re-entry license will expire, a physician associate may apply to the Board for a full license as a physician associate. The Board shall grant a full license to a physician associate who meets all qualifications for licensure and whom the Board determines is qualified to practice. If the Board determines that a physician associate is still not qualified to receive a full license at the conclusion of the re-entry license period, the Board may only once renew the re-entry license. If the Board elects to renew a re-entry license instead of issuing a full license, the Board shall provide to the physician associate a written explanation for that decision when issuing the renewed re-entry license. Additional practice requirements that the Board may choose to impose as a condition of a re-entry license may include any of the following: (1) Requiring the collaborating physician to be physically on-site while the physician associate is practicing. (2) Requiring the collaborating physician to review and countersign a portion of patient charts for patients seen by the physician associate. (3) Requiring the physician associate to possess current certification from the NCCPA. (4) Requiring the physician associate to take a review course or to complete a specified amount of Category 1 CME, as determined by the Council and agreed upon by the Board as appropriate. (5) Requiring documentation of a specific minimum number of clinical practice hours performed under the re-entry license. (6) Requiring the physician associate to have a collaborative agreement with a physician for a specified number of hours. (c) Subsection (b) of this section also applies to a physician associate who has not placed the physician associate’s license on inactive status in this State but who has previously practiced as a physician associate in another jurisdiction of the United States and has not actively engaged in clinical practice for a period in excess of 3 years immediately prior to applying for a license under this subchapter.

Del. Code tit. 24, § 1774E Participation in charitable and voluntary care [For application of this section, see 85 Del. Laws, c. 253, § 23].

A physician associate licensed in this State, or licensed or authorized to practice in any other U.S. jurisdiction, or who is credentialed by a federal employer or meets the licensure requirements of their requisite federal agency as a physician associate may volunteer to render such medical care the physician associate is able to provide at public or community events and facilities without a collaborating physician as defined in this chapter or with such collaborating physicians as may be available. Such medical care must be rendered without compensation or remuneration.

Del. Code tit. 24, § 1774F Physician associates; applicability of name change [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) As of May 12, 2026, the title of “physician assistant” in Delaware is changed to “physician associate.” This change is not intended to change any rights or privileges of those who have been or continue to hold themselves out to be a “physician assistant” and any provision of law that says “physician assistant” also means “physician associate.” (b) This name change does not alter, affect, or impact any billing, reimbursement, or payment policies currently in place for a physician assistant. All billing practices, insurance reimbursement policies, and agreements that apply to physician assistants continue to apply in the same manner to physician associates. No insurer may deny reimbursement for services rendered by a physician associate solely as a result of this name change.

Del. Code tit. 24, § 1774G Dry needling practice; referral [Effective upon fulfillment of the contingency in 85 Del. Laws, c. 459, § 4].

(a) A physician associate may perform dry needling, but may not advertise or in any other way hold themselves out as an acupuncturist unless the physician associate is a licensed acupuncturist. (b) The Board must establish, by rule and regulation, training and practice standards for dry needling by physician associates.

Del. Code tit. 24, § 1775 Respiratory Care Advisory Council.

(a) The Respiratory Care Advisory Council (Council) consists of 7 members, 1 of whom is a physician member of the Board of Medical Licensure and Discipline. The remaining 6 council members are individuals trained in respiratory care who have been licensed and primarily employed in the practice of respiratory care in this State for at least 2 of the 3 years immediately prior to appointment. The Council may elect officers as necessary. (b) Each Council member is appointed by the Board for a term of 3 years, and may succeed himself or herself for 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a Council member whose term of office has expired remains eligible to participate in Council proceedings until replaced by the Board. A person who has never served on the Council may be appointed to the Council for 2 consecutive terms, but the person is thereafter ineligible for appointment to the Council except as hereinafter provided. A person who has been twice appointed to the Council or who has served on the Board for 6 years within any 9-year period may not again be appointed to the Council until an interim period of at least 1 year has expired since the person last served. A member serving on the Council may not be an elected officer or a member of the board of directors of any professional association of respiratory care practitioners. (c) The Council shall promulgate rules and regulations governing the practice of respiratory care, after public hearing and subject to the approval of the Board of Medical Licensure and Discipline. The Board must approve or reject within 60 days proposed rules or regulations submitted to it by the Council. If the Board fails to approve or reject the proposed rules or regulations within 60 days, the proposed rules or regulations are deemed to be approved by the Board. (d) The Council shall meet quarterly, and at such other times as license applications are pending. The Council shall, from time to time, present to the Board the names of individuals qualified to be licensed or qualified to receive temporary licenses, and shall recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations.

Del. Code tit. 24, § 1776 Respiratory care practitioners.

(a) As used in this subchapter: (1) “Respiratory care” means the allied health profession, under the direction of a person certified to practice medicine, which is responsible for direct and indirect services in the treatment, management, diagnostic testing, control, and care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. Respiratory care includes inhalation therapy and respiratory therapy. (2) “Respiratory care practitioner” or “RCP” means an individual who practices respiratory care in accord with the requirements of this subchapter. (b) A respiratory care practitioner works under the general supervision of a person certified to practice medicine, whether by direct observation and monitoring, by protocols approved by a person certified to practice medicine, or by orders written or verbally given by a person certified to practice medicine. A respiratory care practitioner may evaluate patients and make decisions within parameters defined by a person certified to practice medicine and by the Board of Medical Licensure and Discipline. The work performed by a respiratory care practitioner includes: (1) Collecting samples of blood, secretions, gases, and body fluids for respiratory evaluations. (2) Measuring cardiorespiratory volumes, flows, and pressures. (3) Administering pharmacological agents, aerosols, and medical gases via the respiratory route. (4) Inserting and maintaining airways, natural or artificial, for the flow of respiratory gases. (5) Controlling the environment and ventilatory support systems such as hyperbaric chambers and ventilators. (6) Resuscitating individuals with cardiorespiratory failure. (7) Maintaining bronchopulmonary hygiene. (8) Researching and developing protocols in respiratory disorders. (9) Performing pulmonary function studies. (10) The use of telemedicine as defined in this chapter and, as further described in regulation, the use of and participation in telehealth. (11) Management of extracorporeal membrane oxygenation (ECMO), extracorporeal carbon dioxide removal (ECCO2R) and associated integrated therapies. “Associated integrated therapies” means any clinical interventions, equipment, or procedures that are functionally or technically integrated with ECMO or ECCO2R systems, including renal replacement therapy, mechanical ventilation, and anticoagulation management. (c) Nothing in this subchapter is intended to limit, preclude, or otherwise interfere with the professional activities of other individuals and healthcare providers formally trained and licensed by the State. (d) An individual who is licensed pursuant to this subchapter, who is not being investigated or sanctioned in relation to unprofessional conduct or physical, mental, emotional, or other impairment, and who has passed an examination that includes the subject matter of 1 or more of the professional activities included in subsection (b) of this section may not be prohibited from performing those professional activities passed in the examination, provided that the testing body that administered the examination is approved by the Board.

Del. Code tit. 24, § 1777 Licensure.

(a) The requirements for licensure by the Board as a respiratory care practitioner are: (1) The applicant must successfully complete a national qualifying examination with a passing grade that leads to a credential conferred by the National Board for Respiratory Care, Inc. (NBRC), or its successor organization, as a certified respiratory therapist (CRT) and/or as a registered respiratory therapist (RRT); or (2) The applicant must possess a current license in a state which has licensing requirements equal to or exceeding the requirements of this subchapter, and there may not be any outstanding or unresolved complaints pending against the applicant; (3) The applicant: a. May not have been assessed any administrative penalties regarding the applicant’s practice of respiratory care, including but not limited to fines, formal reprimands, license suspension or revocation (except for license suspension or revocation for nonpayment of license renewal fees), and probationary limitations; and b. May not have entered into a consent agreement which contains conditions placed by a Board or other authority on the applicant’s professional conduct or practice, including the voluntary surrender of the applicant’s license while under investigation for misconduct. However, the Board may, after a hearing, waive the requirement of paragraph (a)(3)a. of this section if the administrative penalty prevents the issuance of a license; (4) The applicant may not have an impairment related to the current use of drugs or alcohol which substantially impairs the practice of respiratory care with reasonable skill and safety; (5) The applicant may not have been convicted of or may not have admitted under oath to having committed a crime substantially related to the practice of respiratory care. “Substantially related” means that the nature of the criminal conduct for which the person was convicted or to which the person admitted under oath has a direct bearing on the person’s fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of respiratory care. The Board shall promulgate regulations specifically identifying the crimes which are substantially related to the practice of respiratory care; (6) The applicant may not have a criminal conviction record or a pending criminal charge for a crime that is substantially related to the practice of respiratory care. An applicant who has a criminal conviction record or a pending criminal charge must arrange for information about the record or charge to be provided directly to the Board by the appropriate authorities. (b) Waiver of requirements. — The Respiratory Care Advisory Council, by the affirmative vote of 5 of its members and with the approval of the Board within 30 days of the vote, may waive any of the requirements of subsection (a) of this section if its finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications, and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing respiratory care in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a conviction, if, after consideration of the factors set forth in § 8735(x)(3) of Title 29, the Board determines that granting a waiver would not create an unreasonable risk to public safety, the Board shall grant a waiver of paragraphs (a)(5) and (a)(6) of this section. (5) [Repealed.] (c) License denial. — If it appears to the Board that an applicant has been intentionally fraudulent or that an applicant has intentionally submitted, or intentionally caused to be submitted, false information as part of the application process, the Board may not issue a license to the applicant and must report the incident of fraud or submitting false information to the Office of the Attorney General for further action. (d) Temporary license. — The Executive Director of the Board, with the approval of a member of the Council, may issue a temporary permit to an applicant for licensure who has presented a completed application to the Board. A temporary permit issued under this paragraph is valid for a period of not more than 90 days and may not be renewed. Only 1 temporary permit may be issued under this paragraph. (e) License suspension, revocation, or nonrenewal. — (1) The Council, after appropriate notice and hearing, may recommend to the Board of Medical Licensure and Discipline that the Board revoke, suspend, or refuse to issue a license, or place the licensee on probation, or otherwise discipline a licensee found guilty of unprofessional conduct. Unprofessional conduct includes, but is not limited to, fraud, deceit, incompetence, gross negligence, dishonesty, or other behavior in the licensee’s professional activity which is likely to endanger the public health, safety, or welfare. The Council and Board may take necessary action against a respiratory care practitioner who is unable to render respiratory care services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness, or the excessive use of drugs, including alcohol. Disciplinary action or other action taken against a respiratory care practitioner must be in accordance with the procedures for disciplinary and other actions against physicians, including appeals as set forth in subchapter IV of this chapter, except that a hearing panel for a complaint against a respiratory care practitioner consists of 3 unbiased members of the Regulatory Council, the 3 members being the chair of Council and 2 other members, if practicable. (2) a. If the Board or the Respiratory Care Advisory Council receives a formal or informal complaint concerning the activity of a respiratory care practitioner and the Council members reasonably believe that the activity presents a clear and immediate danger to the public health, the Council may issue an order temporarily suspending the respiratory care practitioner’s license to practice pending a hearing upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of this Council Chair or the Chair’s designee. An order temporarily suspending a license to practice may not be issued by the Council unless the respiratory care practitioner or the respiratory care practitioner’s attorney received at least 24 hours’ written or oral notice prior to the temporary suspension so that the respiratory care practitioner or the respiratory care practitioner’s attorney can be heard in opposition to the proposed suspension. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended respiratory care practitioner requests a continuance of the hearing date. If the respiratory care practitioner requests a continuance, the order of temporary suspension remains in effect until the hearing panel convenes and a decision is rendered. b. A respiratory care practitioner whose license to practice has been temporarily suspended pursuant to this section must be notified of the temporary suspension immediately and in writing. Notification consists of a copy of the complaint and the order of temporary suspension pending a hearing personally served upon the respiratory care practitioner or sent by certified mail, return receipt requested, to the respiratory care practitioner’s last known address. c. A respiratory care practitioner whose license to practice has been temporarily suspended pursuant to this section may request an expedited hearing. The Council shall schedule the hearing on an expedited basis, provided that the Council receives the request within 5 calendar days from the date on which the respiratory care practitioner received notification of the decision of the Council, with the approval of the Board, to temporarily suspend the respiratory care practitioner’s license to practice. d. As soon as possible after the issuance of an order temporarily suspending a respiratory care practitioner’s license to practice pending a hearing, the Council President shall appoint a 3-member hearing panel. After notice to the respiratory care practitioner pursuant to paragraph (e)(2)b. of this section, the hearing panel shall convene within 60 days of the date of the issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If the respiratory care practitioner requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Council. The 3-member panel shall proceed to a hearing and shall render a decision within 30 days of the hearing. e. In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended respiratory care practitioner requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board.

Del. Code tit. 24, § 1777A Procedure or action not prescribed.

This subchapter governs the practice of respiratory care practitioners. If a procedure or action is not specifically prescribed in this subchapter, but is prescribed in the subchapters relating to the practice of medicine, and the procedure or action would be useful or necessary for the regulation of respiratory care practitioners, the Board may, in its discretion, proceed in a manner prescribed for physicians in the practice of medicine.

Del. Code tit. 24, § 1778 Fees; license renewal.

The Division of Professional Regulation shall establish reasonable fees for licensing respiratory care practitioners and for biennial license renewal. A licensee, when renewing a license, shall provide documentation of continuing education related to respiratory care pursuant to the continuing education requirements for respiratory care practitioners established by the Advisory Council.

Del. Code tit. 24, § 1779 Prohibited acts; penalties; enforcement.

(a) A person may not practice respiratory care in this State or represent that the person is a respiratory care practitioner or knowingly allow himself or herself to be represented as a respiratory care practitioner unless the person is licensed under this subchapter, except as otherwise provided in this chapter. (b) A person who, contrary to the provisions of this subchapter, practices or attempts to practice respiratory care within the State or represents that the person is a respiratory care practitioner or knowingly allows himself or herself to be represented as a respiratory care practitioner shall be fined not less than $500 nor more than $2,000 or imprisoned not more than 1 year, or both. (c) The Office of the Attorney General is charged with the enforcement of this subchapter. (d) Notwithstanding the provisions of subsection (a) of this section, a respiratory therapist having a current license issued in another state or the District of Columbia may provide respiratory care within their scope of practice in connection with the interstate transport of a patient without obtaining a license to practice respiratory care in this State. This exemption is limited to the immediate transport need.

Del. Code tit. 24, § 1779A Duty to report conduct that constitutes grounds for discipline or inability to practice.

(a) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other health-care provider has engaged in or is engaging in conduct that would constitute grounds for disciplinary action under this chapter or the other health-care provider’s licensing statute. (b) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other health-care provider may be unable to practice with reasonable skill and safety to the public by reason of: mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive abuse of drugs, including alcohol. (c) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation any information that the reporting person reasonably believes indicates that a person certified and registered to practice medicine in this State is or may be guilty of unprofessional conduct or may be unable to practice medicine with reasonable skill or safety to clients by reason of: mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive use or abuse of drugs, including alcohol. (d) All reports required under subsections (a), (b) and (c) of this section must be filed within 30 days of becoming aware of such information. A person reporting or testifying in any proceeding as a result of making a report pursuant to this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant.

Del. Code tit. 24, § 1780 Short title.

This subchapter shall be known and may be cited as the “Parental Notice of Abortion Act.”

Del. Code tit. 24, § 1781 Legislative purpose and findings.

(a) The General Assembly of the State finds as fact that: (1) Immature minors often lack the ability to make fully informed choices that take into account both immediate and long-range consequences; (2) The physical, emotional, and psychological consequences of teen pregnancy are serious and can be lasting, particularly when the patient is immature; (3) The capacity to become pregnant and the capacity for mature judgment concerning how to choose among the alternatives for managing that pregnancy are not necessarily related; (4) Parents ordinarily possess information essential to enable a physician to exercise the physician’s best medical judgment concerning the child; (5) Parents who are aware that their minor daughter has had an abortion can ensure that she receives adequate medical attention after the abortion; (6) Parental consultation is usually desirable and in the best interest of their minor children and parents ordinarily act in the best interest of their minor children; and (7) Parental involvement legislation enacted in other states has been shown to have significant impact in reducing abortion, birth and pregnancy rates among minors. (b) It is the intent of the General Assembly of the State in enacting this parental notice provision to further the important and compelling State interests of: (1) Protecting minors against their own immaturity; (2) Fostering the family structure and preserving it as a viable social unit; (3) Protecting the rights of parents to rear children who are members of their household; and (4) Protecting the health and safety of minor children.

Del. Code tit. 24, § 1782 Definitions.

For purposes of this subchapter, the following definitions will apply. (1) “Abortion” means the use of any instrument, medicine, drug or any other substance or device to terminate the pregnancy of a woman known to be pregnant, with an intention other than to increase the probability of a live birth, to preserve the life or health of the child after live birth, or to remove a dead fetus. (2) “Coercion” means restraining or dominating the choice of a minor female by force, threat of force, or deprivation of food and shelter. (3) “Emancipated minor” means any minor female who is or has been married or has, by court order or otherwise, been freed from the care, custody and control of her parents or any other legal guardian. (4) “Licensed mental health professional” means a person licensed under the Division of Professional Regulation of the State as a: (a) Psychiatrist; (b) Psychologist; or (c) Licensed professional counselor of mental health. (5) “Medical emergency” means that condition which, on the basis of the physician or other medically authorized person’s good faith clinical judgment, so complicates the medical condition of the pregnant minor as to necessitate the immediate abortion of her pregnancy to avert her death or for which delay will create serious risk of substantial and irreversible impairment of a major bodily function. (6) “Minor” means a female person under the age of 16.

Del. Code tit. 24, § 1783 Notice required.

No physician or other medically authorized person shall perform an abortion upon an unemancipated minor until complying with the following notification provisions: (1) No physician or other medically authorized person shall perform an abortion upon an unemancipated minor unless the physician, medically authorized person, or an agent of the physician or of the medically authorized person has given at least 24 hours actual notice to one or both parents (either custodial or noncustodial), a grandparent, a licensed mental health professional (who shall not be an employee or under contract to an abortion provider except employees or contractors of an acute care hospital) or to the legal guardian of the pregnant minor of the intention to perform the abortion, or unless the physician, medically authorized person, or an agent of the physician or of the medically authorized person has received a written statement or oral communication from another physician or medically authorized person, hereinafter called the “referring physician or medically authorized person,” certifying that the referring physician or medically authorized person has given such notice. If the person contacted pursuant to this subsection is not the parent or guardian, the person so contacted must explain to the minor the options available to her include adoption, abortion and full-term pregnancy, and must agree that it is in the best interest of the minor that a waiver of the parental notice requirement be granted. Any licensed mental health professional so contacted shall certify that the professional has performed an assessment of the specific factors and circumstances of the minor subject to the evaluation including but not limited to the age and family circumstances of the minor and the long-term and short-term consequences to the minor of termination or continuation of the pregnancy. a. No physician or other abortion provider shall charge a referral fee to a person authorized under this section to receive notice; nor shall a person authorized under this section to receive notice charge a referral fee to a physician or other abortion provider. b. Nothing in this section shall affect the obligations of a person pursuant to other provisions of this Code to report instances of child abuse to the appropriate government agencies. (2) A minor may petition the Family Court (“Court”) of any county of this State for a waiver of the notice requirement of this section pursuant to the procedures of § 1784 of this title. A physician who has received a copy of a court order granting a waiver application under § 1784 of this title shall not, at any time, give notice of the minor’s abortion to any person without the minor’s written permission.

Del. Code tit. 24, § 1784 Application for waiver of parental notice requirement; grounds; timeliness of decision; notice of decision; appeals; costs.

(a) The Court shall consider waiving the notice requirement of § 1783 of this title upon the proper application of a minor. The application shall be in writing, signed by the minor, and verified by her oath or affirmation before a person authorized to perform notarial acts. It shall designate: (1) The minor’s name and residence address; (2) A mailing address where the Court’s order may be sent and a telephone number where messages for the minor may be left; (3) That the minor is pregnant; (4) That the minor desires to obtain an abortion; (5) Each person for whom the notice requirement is sought to be waived; and (6) The particular facts and circumstances which indicate that the minor is mature and well-informed enough to make the abortion decision on her own and/or that it is in the best interest of the minor that notification pursuant to § 1783 of this title be waived. (b) The Court, by a judge, shall grant the written application for a waiver if the facts recited in the application establish that the minor is mature and well-informed enough to make the abortion decision on her own or that it is in the best interest of the minor that notification pursuant to § 1783 of this title be waived. The Court shall presume that married parents not separated and grandparents are complete confidants, such that, on application to waive the notice requirement as to either, grounds to waive the notice requirement as to one parent or grandparent shall constitute grounds to waive the notice requirement as to the spouse thereof. (c) If the Court fails to rule within 5 calendar days of the time of the filing of the written application, the application shall be deemed granted; in which case, on the sixth day, the Court shall issue an order stating that the application is deemed granted. (d) The Court shall mail 3 copies of any order to the mailing address identified in the application on the day the order issues, shall attempt to notify the minor by telephone on the day the order issues, and if so requested, shall make copies of the order available at Court chambers for the minor. (e) An expedited appeal to the Supreme Court shall be available to any minor whose petition is denied by a judge of the Family Court. Notice of intent to appeal shall be given within 2 days of the receipt of actual notice of the denial of the petition. The Supreme Court shall advise the minor that she has a right to court-appointed counsel and shall provide her with such counsel upon request, at no cost to the minor. The Supreme Court shall expedite proceedings to the extent necessary and appropriate under the circumstances. The Supreme Court shall notify the minor of its decision consistent with subsection (d) of this section. (f) No court shall assess any fee or cost upon a minor for any proceeding under this section. (g) Each Court shall provide by rule for the confidentiality of proceedings under this subchapter, but shall continue to initiate investigations into any allegations of past abuse where otherwise appropriate, without disclosing that an application under this subchapter was the source of the information prompting the investigation.

Del. Code tit. 24, § 1785 Short form of affidavit and application for waiver of parental notice requirement.

The following shall be sufficient form of affidavit and application for waiver of parental notice requirement under this subchapter: IN THE FAMILY COURT OF THE STATE OF DELAWARE IN AND FOR (NAME OF COUNTY) COUNTY IN THE MATTER ) AFFIDAVIT AND ) APPLICATION FOR (NAME OF MINOR APPLICANT), ) WAIVER OF NOTICE ) OF ) ABORTION STATE OF DELAWARE ) ) __________ COUNTY, SS: ) BE IT REMEMBERED that on this ________ day of ________________ , A.D. ________ before me, (name of person authorized to perform notarial acts), personally appeared (name of minor applicant/affiant) who, being by me duly sworn or affirmed, depose and say: (1) That the minor applicant resides at (minor’s address); (2) That the Court may send its order to (mailing address designated by applicant minor) and leave telephone messages for the applicant minor at (phone number designated by applicant minor); (3) That the minor applicant is pregnant; (4) That the minor applicant desires to obtain an abortion; (5) That the minor applicant desires that the Court waive the notice requirement of § 1783 of Title 24; (6) That the minor applicant believes that she is mature and well-informed enough to make the abortion decision on her own and/or it would be in her best interest that a waiver of notice be granted because (state reasons why mature and well-informed enough and/or waiver of notice is in best interest based upon the applicant’s age and family circumstances and the long-term and short-term consequences to the applicant of termination or continuation of the pregnancy). WHEREFORE, this minor applicant intends to submit this affidavit and application for waiver of notice of abortion to the Family Court, and pray that an order be issued waiving the notification requirement of § 1783 of Title 24 as to the following persons: (identify each such person). ________________ Minor applicant/affiant SWORN TO or affirmed and subscribed before me by the minor applicant/affiant this ________ day of ________________ , A.D. ________ . ________________ (Notary)

Del. Code tit. 24, § 1786 Coercion prohibited.

No parent, guardian, or other person shall coerce a minor to undergo an abortion or to continue a pregnancy. Any minor who is threatened with such coercion may apply to a court of competent jurisdiction for relief. The court shall provide the minor with counsel, give the matter expedited consideration, and grant such relief as may be necessary to prevent such coercion. Should a minor be denied the financial support of her parents or legal guardian by reason of her refusal to undergo abortion or to continue a pregnancy, she shall be considered emancipated for purposes of eligibility for assistance benefits.

Del. Code tit. 24, § 1787 Medical emergency exception.

The requirements of § 1783, § 1784 and § 1786 of this title shall not apply when, in the best medical judgment of the physician or other medically authorized person, based on the facts of the case, a medical emergency exists that so complicates the pregnancy as to require an immediate abortion.

Del. Code tit. 24, § 1788 Counseling to affected persons.

The Division of Prevention and Behavioral Health Services, Department of Services for Children, Youth and Their Families, shall offer counseling and support to any minor who is pregnant and is considering filing or has filed an application under this subchapter, if the minor requests such services. Notwithstanding any contrary statute, no notification of the request for or provision of such services to the minor shall be provided to any person, nor shall the consent of any person thereto be required.

Del. Code tit. 24, § 1789 Penalty and criminal jurisdiction.

(a) Any person who intentionally performs an abortion with knowledge that, or with reckless disregard as to whether, the person upon whom the abortion has been performed is an unemancipated minor, and who intentionally or knowingly fails to conform to any requirement of this subchapter, shall be guilty of a class A misdemeanor. (b) The Superior Court shall have exclusive jurisdiction of violations of this section.

Del. Code tit. 24, § 1789A Notice and avoidance of liability.

In any prosecution pursuant to § 1789 of this title, the State shall prove beyond a reasonable doubt that the physician (or other medically authorized person) who performed the abortion did not have a good faith belief on that physician’s part that actual notice was given by such physician (or other medically authorized person), that physician’s agent, or the referring physician or another medically authorized person to a person listed in § 1783(1) of this title as qualified to receive notice. In any civil case, the plaintiff must prove the absence of such a good faith belief by clear and convincing evidence.

Del. Code tit. 24, § 1789B Civil damages available.

Failure to give notice pursuant to the requirements of this subchapter is prima facie evidence of interference with family relations in appropriate civil actions. The law of this State shall not be construed to preclude the award of punitive damages in any civil action relevant to violations of this subchapter. Nothing in this subchapter shall be construed to limit the common law rights of parents.

Del. Code tit. 24, § 1790 Termination of pregnancy before viability not prohibited; termination of pregnancy after viability limited [For application of this section, see 85 Del. Laws, c. 253, § 23].

(a) Any of the following may terminate, assist in the termination of, or attempt the termination of a human pregnancy before viability: (1) A physician. (2) A physician associate with a collaborative agreement with an appropriately-trained physician. (3) A certified nurse midwife or certified nurse practitioner who demonstrates knowledge and competency including successful completion of a training or certification approved by the Board of Nursing. (b) A physician may not terminate, attempt to terminate, or assist in the termination or attempt at termination of a human pregnancy otherwise than by birth after viability, unless, in the good faith medical judgment of the physician, the termination is necessary for the protection of the woman’s life or health or in the event of a fetal anomaly for which there is not a reasonable likelihood of the fetus’s sustained survival outside the uterus without extraordinary medical measures. (c) A physician associate or an advanced practice registered nurse may prescribe medication for the termination of pregnancy including Mifeprex, Mifepristone, and Misoprostol.

Del. Code tit. 24, § 1791 Refusal to perform or submit to medical procedures.

(a) No person shall be required to perform or participate in medical procedures which result in the termination of pregnancy; and the refusal of any person to perform or participate in these medical procedures shall not be a basis for civil liability to any person, nor a basis for any disciplinary or other recriminatory action against the person. (b) No hospital, hospital director or governing board shall be required to permit the termination of human pregnancies within its institution, and the refusal to permit such procedures shall not be grounds for civil liability to any person, nor a basis for any disciplinary or other recriminatory action against it by the State or any person. (c) The refusal of any person to submit to an abortion or to give consent shall not be grounds for loss of any privileges or immunities to which such person would otherwise be entitled, nor shall submission to an abortion or the granting of consent be a condition precedent to the receipt of any public benefits.

Del. Code tit. 24, § 1792 Assistance or participation in an unlawful termination of human pregnancy.

No person shall, unless the termination of a human pregnancy has been authorized pursuant to § 1790 of this title: (1) Sell or give, or cause to be sold or given, any drug, medicine, preparation, instrument or device for the purpose of causing, inducing or obtaining a termination of such pregnancy; or (2) Give advice, counsel or information for the purpose of causing, inducing or obtaining a termination of such pregnancy; or (3) Knowingly assist or cause by any means whatsoever the obtaining or performing of a termination of such pregnancy.

Del. Code tit. 24, § 1795 Live birth following abortion.

(a) In the event an abortion or an attempted abortion results in the live birth of a child, the person performing or inducing such abortion or attempted abortion and all persons rendering medical care to the child after its birth must exercise that degree of medical skill, care and diligence which would be rendered to a child who is born alive as the result of a natural birth. (b) Nothing found in this section shall be deemed to preclude prosecution under any other applicable section of the Delaware Code for knowing or reckless conduct which is detrimental to the life or health of an infant born as a result of a procedure designed to terminate pregnancy. Anyone who knowingly violates this section shall be guilty of a class A misdemeanor.

Del. Code tit. 24, § 1796 Acupuncture Advisory Council.

(a) The Acupuncture Advisory Council (Council) consists of 5 voting members, and 1 ex officio member. The 5 voting members shall consist of 1 physician member of the Board of Medical Licensure and Discipline who possesses knowledge of acupuncture and 4 Council members licensed and trained in acupuncture or acupuncture and eastern medicine who have been primarily employed in the practice of acupuncture or acupuncture and eastern medicine in this State for at least 3 years immediately prior to appointment. The ex officio member shall be a Delaware physician who has expertise in acupuncture or acupuncture and eastern medicine. The Council may elect officers as necessary. (b) Each Council member is appointed by the Board of Medical Licensure and Discipline for a term of 3 years, and may succeed himself or herself for 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a Council member whose term of office has expired remains eligible to participate in Council proceedings until replaced by the Board. A person who has never served on the Council may be appointed to the Council for 2 consecutive terms, but the person is thereafter ineligible for appointment to the Council except as hereinafter provided. A person who has been twice appointed to the Council or who has served on the Council for 6 years within any 9-year period may not again be appointed to the Council until an interim period of at least 1 year has expired since the person last served. A member, other than the ex officio member, serving on the Council may not be an elected officer or a member of the board of directors of any professional association of acupuncture practitioners. The members of the Council are compensated at an appropriate and reasonable level as determined by the Division and may be reimbursed for meeting-related travel expenses at the State’s current approved rate. (c) The Council shall promulgate rules and regulations governing the practice of acupuncture and eastern medicine, after public hearing and subject to the approval of the Board of Medical Licensure and Discipline. The Board must approve or reject within a reasonable amount of time proposed rules or regulations submitted to it by the Council. (d) The Council shall meet quarterly, and at such other times as license applications are pending. The Council shall present to the Board the names of individuals qualified to be licensed and shall recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations. The Board shall approve or reject these recommendations within a reasonable time period.

Del. Code tit. 24, § 1797 Acupuncture practitioners.

(a) As used in this subchapter: (1) “Acupuncture” is the stimulation of points on the body by the insertion and manipulation of acupuncture needles using both traditional and modern scientific methods of evaluation and point selection. It also refers to a form of health care, based on a theory of energetic physiology that describes and explains the interrelationship of the body organs or functions with an associated acupuncture point or combination of points located on “channels” or “meridians”. Acupuncture points shall include the classical points defined in authoritative acupuncture texts and special groupings of acupuncture points elicited using generally accepted diagnostic techniques of eastern medicine and selected for stimulation in accord with its principles and practices. Acupuncture points are stimulated in order to restore the normal function of the aforementioned organs or sets of functions. Acupuncture shall also include the ancillary techniques of eastern medicine including moxibustion, acupressure or other forms of manual meridian therapy and recommendations that include eastern dietary therapy, supplements and lifestyle modifications. (2) “Board” means the Board of Medical Licensure and Discipline. (3) “Council” means the Acupuncture Advisory Council. (4) “Eastern medicine” means the practice of acupuncture, Chinese herbology and Asian bodywork therapy as part of a comprehensive health-care system encompassing a variety of traditional health-care therapies that have been used for more than 3,000 years to diagnose and treat illness, prevent disease and improve well-being. (5) “License” means, unless the context requires otherwise, a license issued by the Board to practice acupuncture. (6) a. “Practice of acupuncture” means the use of needles with or without electrical stimulation for the purpose of normalizing energetic physiological functions including pain control, and for the promotion, maintenance, and restoration of health. b. Needles used in the practice of acupuncture shall only be pre-packaged, single use, sterile acupuncture needles. These needles shall only be used on an individual patient in a single treatment session and disposed of according to federal standards for biohazard waste. (7) “Practice of eastern medicine” includes the practice of acupuncture and further means making recommendations or prescriptions based in eastern dietary therapy, supplements and lifestyle modifications according to the principles of eastern medicine. Eastern dietary therapy shall be defined as recommending, advising or furnishing nonfraudulent information about herbs, vitamins, minerals, amino acids, carbohydrates, sugars, enzymes, food concentrates, foods, other food supplements, or dietary supplements. For purposes of this paragraph, “fraud” shall be defined as an intentional misrepresentation for financial gain. Legitimate disagreement about the role of the above-listed nutrients and foods as they apply to human nutrition shall not, in and of itself, constitute fraud. These supplemental techniques may be used within the public domain or by another licensed or registered healthcare or bodywork professional, according to state law or regulation. (b) Nothing in this subchapter shall limit, preclude, or otherwise interfere with the professional activities of other individuals and healthcare providers who are allowed to perform acupuncture. This includes chiropractic, medical and osteopathic physicians. (c) An individual who is licensed pursuant to this subchapter, who is not being investigated or sanctioned in relation to unprofessional conduct or physical, mental, emotional, or other impairment, may not be prohibited from performing those professional activities included in this section.

Del. Code tit. 24, § 1798 Licensure.

(a) All applicants must meet the following requirements for licensure by the Board as an acupuncture and eastern medicine practitioner: (1) Achievement of a Diplomate in Oriental Medicine from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or its equivalent as recognized by the Council and approved by the Board, or an organization that is recognized as equivalent to the NCCAOM by the Council and approved by the Board; and (2) Completion of a course or evidence of passing an examination in clean needle technique; (3) An applicant for whom English is a second language shall demonstrate the ability to communicate in the English language as determined by regulations as recommended by the Council and approved by the Board; (4) The applicant: a. May not have been assessed any administrative penalties regarding the applicant’s practice of acupuncture, including but not limited to fines, formal reprimands, license suspension or revocation (except for license suspension or revocation for nonpayment of license renewal fees) and probationary limitations; and b. May not have entered into a consent agreement which contains conditions placed by a board or other authority on the applicant’s professional conduct or practice, including the voluntary surrender of the applicant’s license while under investigation for misconduct. However, the Board may, after a hearing, waive the requirement of paragraph (a)(4)a. of this section if the administrative penalty prevents the issuance of a license; (5) The applicant may not have an impairment related to the current use of drugs or alcohol which substantially impairs the practice of acupuncture with reasonable skill and safety; (6) The applicant may not have been convicted of or may not have admitted under oath to having committed a crime substantially related to the practice of acupuncture. “Substantially related” means that the nature of the criminal conduct for which the person was convicted or to which the person admitted under oath has a direct bearing on the person’s fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of acupuncture. The Board shall promulgate regulations specifically identifying the crimes which are substantially related to the practice of acupuncture; (7) Meet any other qualifications that the Board establishes in regulations. (b) All applicants must meet the following requirements for licensure by the Board as an acupuncture practitioner: (1) Achievement of a Diplomate in Acupuncture from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or its equivalent as recognized by the Council and approved by the Board, or an organization that is recognized as equivalent to the NCCAOM by the Council and approved by the Board; and (2) Completion of a course or evidence of passing an examination in clean needle technique; (3) An applicant for whom English is a second language shall demonstrate the ability to communicate in the English language as determined by regulations as recommended by the Council and approved by the Board; (4) The applicant: a. May not have been assessed any administrative penalties regarding the applicant’s practice of acupuncture, including but not limited to fines, formal reprimands, license suspension or revocation (except for license suspension or revocation for nonpayment of license renewal fees) and probationary limitations; and b. May not have entered into a consent agreement which contains conditions placed by a board or other authority on the applicant’s professional conduct or practice, including the voluntary surrender of the applicant’s license while under investigation for misconduct. However, the Board may, after a hearing, waive the requirement of paragraph (a)(4)a. of this section if the administrative penalty prevents the issuance of a license; (5) The applicant may not have an impairment related to the current use of drugs or alcohol which substantially impairs the practice of acupuncture with reasonable skill and safety; (6) The applicant may not have been convicted of or may not have admitted under oath to having committed a crime substantially related to the practice of acupuncture. “Substantially related” means that the nature of the criminal conduct for which the person was convicted or to which the person admitted under oath has a direct bearing on the person’s fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of acupuncture. The Board shall promulgate regulations specifically identifying the crimes which are substantially related to the practice of acupuncture; (7) Meet any other qualifications that the Board establishes in regulations. (8) An acupuncturist who obtains licensure pursuant to this section may go on to become a licensed acupuncture and eastern medicine practitioner by achieving a Diplomate in Oriental Medicine from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or its equivalent as recognized by the Council and approved by the Board, or an organization that is recognized as equivalent to the NCCAOM by the Council and approved by the Board. (c) Waiver of requirements. — The Acupuncture Advisory Council, by the affirmative vote of 3 of its members and with the approval of the Board within a reasonable period of time from the vote, may waive any of the requirements of subsection (a) of this section if it finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing acupuncture in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a conviction, if, after consideration of the factors set forth in § 8735(x)(3) of Title 29, the Council determines that granting a waiver would not create an unreasonable risk to public safety, the Council shall waive paragraph (a)(6) and (b)(6) of this section. (5) [Repealed.] (d) License denial. — If it appears to the Board that an applicant has been intentionally fraudulent or that an applicant has intentionally submitted, or intentionally caused to be submitted, false information as part of the application process, the Board may not issue a license to the applicant and must report the incident of fraud or submitting false information to the Office of the Attorney General for further action. (e) Temporary license. — The Executive Director of the Board, with the approval of a Council member, may issue a temporary permit to an applicant for licensure who has presented a completed application to the Board. A temporary permit issued under this subsection is valid for a period of not more than 90 days and may not be renewed. Only 1 temporary permit may be issued under this subsection. (f) License suspension, revocation, or nonrenewal. — (1) The Council, after appropriate notice and hearing, may recommend to the Board of Medical Licensure and Discipline that the Board revoke, suspend, or refuse to issue a license, or place the licensee on probation, or otherwise discipline a licensee found guilty of unprofessional conduct. Unprofessional conduct includes, but is not limited to, fraud, deceit, incompetence, gross negligence, dishonesty, or other behavior in the licensee’s professional activity which is likely to endanger the public health, safety, or welfare. The Council may recommend and Board may take necessary action against a licensee who is unable to render acupuncture or eastern medicine services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness, or the excessive use of drugs including alcohol. Disciplinary action or other action taken against a licensee must be in accordance with the procedures for disciplinary and other actions against physicians, including appeals as set forth in subchapter IV of this chapter except that a hearing panel for a complaint against a licensee consists of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Acupuncture Advisory Council; and if no conflict exists, 1 of the 2 Acupuncture Advisory Council members shall be the Chair of the Acupuncture Advisory Council. The Chair of the hearing panel shall be 1 of the Council panel members. (2) a. If the Board or the Acupuncture Advisory Council receives a formal or informal complaint concerning the activity of a licensee and the Board or Council members reasonably believe that the activity presents a clear and immediate danger to the public health, the Council may issue an order temporarily suspending the licensee’s license to practice pending a hearing upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Council Chair or the Chair’s designee. An order temporarily suspending a license to practice may not be issued by the Board, unless the licensee or the licensee’s attorney received at least 24 hours’ written or oral notice prior to the temporary suspension so that the licensee or the licensee’s attorney can be heard in opposition to the proposed suspension. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended licensee requests a continuance of the hearing date. If the licensee requests a continuance, the order of temporary suspension remains in effect until the hearing panel convenes and a decision is rendered. b. A licensee whose license to practice has been temporarily suspended pursuant to this section must be notified of the temporary suspension immediately and in writing. Notification consists of a copy of the complaint and the order of temporary suspension pending a hearing personally served upon the licensee or sent by certified mail, return receipt requested, to the licensee’s last known address. c. A licensee whose license to practice has been temporarily suspended pursuant to this section may request an expedited hearing. The Council shall schedule the hearing on an expedited basis, provided that the Council receives the request within 5 calendar days from the date on which the licensee received notification of the decision of the Board, to temporarily suspend the licensee’s license to practice. d. As soon as possible after the issuance of an order temporarily suspending a licensee’s license to practice pending a hearing, the Council Chair shall appoint a 3-member hearing panel consisting of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Acupuncture Advisory Council; and if no conflict exists, 1 of the 2 Acupuncture Advisory Council members shall be the Chair of the Acupuncture Advisory Council. The Chair of the hearing panel shall be 1 of the Council panel members. After notice to the licensee pursuant to paragraph (f)(2)b. of this section, the hearing panel shall convene within 60 days of the date of the issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If a licensee requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Council. The 3-member panel shall proceed to a hearing and shall render a decision within 30 days of the hearing. e. In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board, deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended licensee requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board.

Del. Code tit. 24, § 1798A Procedure or action not described.

This subchapter governs the practice of acupuncture and eastern medicine practitioners. If a procedure or action is not specifically prescribed in this subchapter, but is prescribed in the subchapters relating to the practice of medicine, and the procedure or action would be useful or necessary for the regulation of acupuncture and eastern medicine practitioners, the Board may, in its discretion, proceed in a manner prescribed for physicians in the practice of medicine.

Del. Code tit. 24, § 1799 Fees; license renewal.

The Division of Professional Regulation shall establish reasonable fees for licensing and for biennial license renewal. A licensee, when renewing a license, shall provide documentation of continuing education related to acupuncture pursuant to the continuing education requirements for acupuncture practitioners established by the Acupuncture Advisory Council.

Del. Code tit. 24, § 1799AA Issuance and renewal of licenses; fees.

(a) The Division of Professional Regulation shall establish reasonable fees for licensing polysomnographers and for biennial license renewal. (b) The Board shall issue a license to each applicant who meets the requirements of this subchapter for licensure as a polysomnographer and who pays the established fees. (c) Each license shall be renewed biennially, in such manner as is determined by the Division and upon payment of the appropriate fee and submission of a renewal form provided by the Division, and proof that the licensee has met the continuing education requirements established by § 1799Z of this title. (d) The Council, in its rules and regulation, shall determine the period of time within which a licensee may still renew the licensee’s license and determine late fees associated with the license renewal, notwithstanding the fact that such licensee has failed to renew on or before the renewal date, provided, however that such period shall not exceed 1 year. (e) A licensee, upon written request, may be placed in an inactive status for no more than 5 years. Such person, who desires to reactivate that person’s license, shall complete a board-approved application form, obtain an updated certified criminal background check, submit a renewal fee, and proof of fulfillment of continuing education requirements in accordance with the rules and regulation of the Council.

Del. Code tit. 24, § 1799B Exemptions.

(a) Acupuncture or supplemental or eastern medicine techniques may be performed by a student, trainee or visiting teacher who is designated as a student, trainee or visiting teacher while participating in a course of study or training under supervision of a licensed acupuncturist or acupuncture and eastern medicine practitioner in a program that the Council has recommended to the Board for approval. This includes continuing education programs and any acupuncture or eastern medicine programs that are a recognized route to certification as an acupuncturist by the NCCAOM or any Board-approved agency. (b) Any herbalist, retailer or other person who does not hold himself or herself out to be a licensed acupuncturist shall not be limited by this subchapter.

Del. Code tit. 24, § 1799BB Grounds for discipline, sanctions, or penalties.

(a) The following conditions and actions of a polysomnographer may result in disciplinary action as set forth in subsection (b) of this section if, after a hearing, the Board finds that an applicant or polysomnographer: (1) Has employed or knowingly cooperated in fraud or material deception in order to be licensed: or (2) Has engaged in illegal, incompetent or negligent conduct in the provision of polysomnography; or (3) Has, in the practice of the profession, knowingly engaged in an act of consumer fraud or deception; or (4) Has violated the code of ethics as established by the AASM, BRPT or and other organization approved by the Council; or (5) Has violated a lawful provision of this subchapter or any lawful rule or regulation established hereunder; or (6) Has been convicted of a crime substantially related to the practice of polysomnography as determined by the Board in its rules and regulations; or (7) Has been convicted of a sexual felony offense. (b) Persons licensed under this subchapter who have been determined to be in violation of this subchapter shall be subject to the following disciplinary actions: (1) Issuance of a letter of reprimand. (2) Censure. (3) Placement on probationary status. (4) Denial of license. (5) Suspension of license. (6) Revocation of license. (7) Impose a monetary penalty not to exceed $500 for each violation. (c) As a condition of reinstatement of a suspended license or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized under this subchapter.

Del. Code tit. 24, § 1799C Renewal.

Licenses must be renewed biennially and every licensee for renewal shall be required to complete continuing education credits as determined by regulation. The Board shall determine acceptable sources of continuing education credits as recommended by the Council.

Del. Code tit. 24, § 1799CC Unauthorized practice of polysomnography.

Whoever engages in the practice of polysomnography or attempts to engage in the practice of polysomnography contrary to the provisions of this subchapter shall be guilty of a class G felony and shall be fined not less than $500 and not more than $1,500, or imprisoned not more than 2 years, or both.

Del. Code tit. 24, § 1799D Reciprocal licensing.

All applicants for reciprocal licensing must possess a current license in another state which has licensing requirements equal to or exceeding the requirements of this subchapter, and there may not be any outstanding or unresolved complaints against the applicant.

Del. Code tit. 24, § 1799DD Procedure or action not described.

This subchapter governs the practice of polysomnography. If a procedure or action is not specifically prescribed in the subchapter, but is prescribed in the subchapters relating to the practice of medicine, and the procedure or action would be useful or necessary for the regulation of polysomnographic practitioners, the Board may, in its discretion, proceed in a manner prescribed for physicians in the practice of medicine.

Del. Code tit. 24, § 1799E Prohibited acts; penalties; enforcement.

(a) No person in this State shall use the title “licensed acupuncturist” or “L. Ac.,” or use in connection with that person’s name any letters, words or symbols indicating or implying that the person is a licensed acupuncturist, or advertise services under the description of “licensed acupuncturist”, unless that person holds a license as an acupuncturist issued pursuant to this subchapter. Nothing in this subsection shall be construed to prevent a person from providing care or performing or advertising services within the scope of that person’s license. (b) No person in this State shall use the title “eastern medicine practitioner” or use in connection with that person’s name any letters, words, or symbols indicating or implying that the person is a licensed eastern medicine practitioner, or advertise services under the description of “licensed eastern medicine practitioner,” unless that person holds a license issued pursuant to this subchapter. Nothing in this subsection shall be construed to prevent a person from providing care or performing or advertising services within the scope of that person’s license. (c) A person who, contrary to the provisions of this subchapter, practices or attempts to practice acupuncture within the State or represents that the person is an acupuncture practitioner or knowingly allows himself or herself to be represented as an acupuncture practitioner shall be fined not less than $500 nor more than $2,000 or imprisoned not more than 1 year, or both. (d) The Office of the Attorney General is charged with the enforcement of this subchapter.

Del. Code tit. 24, § 1799EE Duty to report conduct that constitutes grounds for discipline or inability to practice.

(a) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other healthcare provider has engaged in or is engaging in conduct that would constitute grounds for disciplinary action under this chapter or the other healthcare provider’s licensing statute. (b) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other healthcare provider may be unable to practice with reasonable skill and safety to the public by reason of mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive abuse of drugs, including alcohol. (c) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation any information that the reporting person reasonably believes indicates that a person certified and registered to practice medicine in this State is or may be guilty of unprofessional conduct or may be unable to practice medicine with reasonable skill or safety to patients by reason of mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive use or abuse of drugs, including alcohol. (d) All reports required under subsections (a), (b) and (c) of this section must be filed within 30 days of becoming aware of such information. A person reporting or testifying in any proceeding as a result of making a report pursuant to this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant.

Del. Code tit. 24, § 1799F Acupuncture detoxification specialist (ADS); license required.

(a) An individual who is not licensed as an acupuncturist under this subchapter shall not practice as an acupuncture detoxification specialist using the National Acupuncture Detoxification Association (NADA) or equivalent organization’s auricular point protocol for the purpose of preventing and treating alcoholism, nicotine dependency, substance abuse, or chemical dependency in the State without first obtaining a license issued by the Board upon the recommendation of the Council. Applications for licensure shall be upon written forms provided by the Council and Board and upon payment of a fee established by the Division of Professional Regulation. An applicant for a license to practice as an acupuncture detoxification specialist pursuant to the NADA or equivalent organization auricular point protocol in Delaware must meet the following criteria: (1) Has successfully completed the NADA auricular point protocol training program or an equivalent training program satisfactory to the Council and Board for the treatment of alcoholism, nicotine dependency, substance abuse, or chemical dependency that meets or exceeds the standards of training set by the NADA including instruction in clean needle technique; (2) Must provide evidence of a current license or certificate in good standing in a health-care related profession as approved by the Council and the Board; and (3) Is in good standing as defined in § 1798(a)(4)-(7) of this title. (b) Waiver of requirements. — The Acupuncture Advisory Council, by the affirmative vote of 3 of its members and with the approval of the Board, may waive the requirements of subsection (a) of this section if it finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing as an acupuncture detoxification specialist in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a crime substantially related to the practice of acupuncture, more than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term “sentence” includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, “sentence” does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service. (c) ADS are prohibited from needling any body acupuncture points and may not advertise themselves as acupuncturists. (d) ADS shall be subject to the disciplinary provisions of § 1798(f) of this title. (e) Each license shall be renewed biennially, in such manner as is determined by the Division, and upon payment of the appropriate fee and submission of a renewal form provided by the Division and proof of continued competency as established in the Board’s regulations.

Del. Code tit. 24, § 1799FF Definitions.

As used in this subchapter: (1) “Board” means the Board of Medical Licensure and Discipline. (2) “Certified midwife” or “CM” means a practitioner who has received certification by the American Midwifery Certification Board or its equivalent or successor. (3) “Certified professional midwife” or “CPM” means a practitioner who has received certification by the North American Registry of Midwives (NARM) or its equivalent or successor. (4) “Client” means a woman under the care of a midwife and, when applicable in the context of care, the newborn. (5) “Council” means the Midwifery Advisory Council. (6) “Home birth” means a birth outside of a hospital or an otherwise accredited or licensed hospital or medical facility. (7) “License” means, unless the context requires otherwise, a license issued by the Board to practice midwifery. (8) “Midwife” means a person who practices midwifery. (9) “Midwifery” means the practice of providing supervision, care, and advice to a client during prepartum, pregnancy, labor, and the postpartum periods, and conducting deliveries on the midwife’s own responsibility or in collaboration with a licensed physician, or licensed Delaware health-care delivery system. The licensed practice of midwifery includes taking certain safety measures and identifying the physical, social and emotional needs of the client. The practice of midwifery requires that level of education, experience, knowledge, and skill ordinarily expected of an individual who meets the requirements for licensure pursuant to this chapter. In order to practice midwifery in the State, a midwife must be licensed pursuant to this chapter. For the purposes of this chapter, “midwifery” does not include the practice of certified nurse midwives, as defined in Chapter 19 of this title, nor does it include the practice of a person licensed to practice medicine pursuant to this chapter. (10) “Midwifery student” means a person who is enrolled in an accredited educational program and who may provide midwifery services as a part of that person’s educational program. (11) “Practice of a certified midwife” means the management of women’s health care, pregnancy, childbirth, postpartum care for newborns, family planning, and gynecological services consistent with the Standards of Practice of the American College of Nurse-Midwives and the education, training, and experience of the certified midwife. (12) “Practice of a certified professional midwife” means the provision of continuous care for women throughout the childbearing cycle which CPMs are qualified to provide. The CPM credential requires knowledge about and experience in out-of-hospital settings. The scope of practice of the licensed CPM is further derived from the North American Registry of Midwives Job Analysis, state laws and regulations, and individual practice guidelines developed according to acquired professional skills and knowledge.

Del. Code tit. 24, § 1799G Statement of purpose.

The intent of the General Assembly in enacting this subchapter is to establish minimum standards of education, experience and examination for professional genetic counselors so that the public can readily identify those who meet these minimum standards. In enacting this subchapter the General Assembly intends to provide a licensure process for professional genetic counselors, a scope of practice for genetic counselor services, and to establish “licensed genetic counselor” as the state-recognized legal title for professional genetic counselors. It is also the intent of the General Assembly in enacting this subchapter to assure consumers the right to choose from whom they receive information and advice. Recognition of these goals will protect the health of the public by broadening access to appropriate genetic counseling.

Del. Code tit. 24, § 1799GG Subchapter exemptions and limitations.

(a) Nothing in this subchapter shall limit, preclude, or otherwise interfere with the professional activities of other individuals and health-care providers who are allowed to practice obstetrics and gynecology, nor shall this subchapter apply to certified nurse midwives as defined by Chapter 19 of this title. (b) Nothing in this subchapter shall prohibit or restrict the directly supervised practice of midwifery by a midwifery student pursuing a course of study leading to a credential in midwifery or an equivalent major, as recommended by the Council and approved by the Board, from an accredited school or program recommended by the Council and approved by the Board, if the activities and services constitute a part of a supervised course of study and if the midwifery student is under the direct supervision of a midwife licensed under this subchapter and is designated by a title that clearly indicates the person’s status as a student, provided this course of study shall not exceed 5 years unless the Council recommends and the Board provides written approval for an extension.

Del. Code tit. 24, § 1799H Definitions.

As used in this subchapter: (1) “ABGC” shall mean the American Board of Genetic Counseling or an organization that is recognized as equivalent. (2) “ABMGG” shall mean the American Board of Medical Genetics and Genomics or an organization that is recognized as equivalent. (3) “Active candidate status” or “ACS” shall be conveyed by the ABGC. (4) “Board” shall mean the Board of Medical Licensure and Discipline. (5) “Genetic counselor” means an individual who engages in the competent practice of genetic counseling. (6) “Genetic test” means as defined in § 1201 of Title 16. (7) “L.G.C.” shall be the abbreviation for the title “licensed genetic counselor”. (8) “License” shall mean any document which indicates that a person is currently licensed by the Board of Medical Licensure and Discipline to practice genetic counseling. (9) “NSGC” means the National Society of Genetic Counselors or an organization that is recognized as equivalent. (10) The “practice of genetic counseling” shall include any or all of the following activities: a. Obtaining and interpreting individual, family and medical development histories; b. Determining the mode of inheritance and risk of transmission of genetic conditions; c. Discussing the inheritance, features, natural history, means of diagnosis; d. Identifying, coordinating, and ordering of genetic tests, and explaining genetic laboratory tests and other diagnostic studies; provided however, that if in the course of providing a genetic counseling service to any client, a genetic counselor finds any indication of disease or condition that requires medical assessment, the genetic counselor shall refer a client to a physician licensed to practice medicine; e. Assessing psychosocial factors, recognizing social, educational, and cultural issues; f. Evaluating the client’s or family’s responses to the condition or risk of recurrence and provide client-centered counseling and anticipatory guidance; g. Communicating genetic information to clients in an understandable manner; h. Facilitating informed decision making about testing and management alternatives; i. Identifying and effectively utilizing community resources that provide medical, educational, financial, and psychosocial support and advocacy; j. Providing accurate written documentation of medical, genetic, and counseling information for families and health care professionals; and k. The use of telemedicine as defined in this chapter and, as further described in regulation, the use of and participation in telehealth.

Del. Code tit. 24, § 1799HH Midwifery Advisory Council.

(a) The Board of Medical Licensure and Discipline shall form the Midwifery Advisory Council (Council) which consists of 7 voting members. The members shall consist of: 4 midwives, 2 CMs and 2 CPMs, whenever possible; 1 certified nurse midwife (CNM) as described in Chapter 19 of this title; 1 practicing obstetrician with hospital admitting privileges who is a member of the American Congress of Obstetricians and Gynecologists and certified by the American Board of Obstetrics and Gynecology; and 1 practicing pediatrician with hospital admitting privileges and certification from the American Board of Pediatrics. The inaugural midwife members shall be licensed pursuant to this subchapter no later than October 1, 2016, and all midwife members thereafter shall be licensed pursuant to this subchapter. The Council may elect officers as necessary. The Chair of the Council shall be a midwife in good standing. The members of the Council shall be compensated at an appropriate and reasonable level as determined by the Division of Professional Regulation and may be reimbursed for meeting-related travel expenses at the State’s current approved rate. (b) Members shall be appointed so that the terms of 4 members, including no more than 2 midwives, shall expire 2 years after the initial appointment and that the terms of the remaining 3 members shall expire 3 years after the initial appointment. Thereafter, members are each appointed by the Board of Medical Licensure and Discipline for a term of 3 years, subject to removal by the Governor for neglect of duty, malfeasance, or misfeasance in office, and may succeed himself or herself for 1 additional 3-year term; provided, however, that if a member is initially appointed to fill a vacancy, the member may succeed himself or herself for only 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a council member whose term of office has expired remains eligible to participate in council proceedings until replaced by the Board. A person who has been twice appointed to the Council or who has served on the Council for 6 years within any 9-year period may not again serve until an interim period of at least 1 year has expired since the person last served. (c) The Council shall promulgate rules and regulations governing the practice of midwifery, the scope of practice of CMs and the scope of practice of CPMs, after public hearing and subject to the approval of the Board of Medical Licensure and Discipline. The Board must approve or reject proposed rules or regulations submitted to it by the Council within 60 days. If the Board fails to approve or reject the proposed rules or regulations within 60 days, the proposed rules or regulations are deemed to be approved by the Board. Such rules and regulations shall include, but not be limited to: (1) Procedures for the examination of applicants and issuance of licenses to those applicants it finds qualified; (2) Licensing and licensing renewal requirements; (3) Standards for education, and training programs and the procedures for denial, revocation, or suspension of such program for failure to meet or maintain the standards; (4) Continuing education requirements for licensed midwives; (5) Description of the responsibilities of the midwife toward the client and her newborn in the antepartum, intrapartum, and the postpartum periods, including newborn assessment and screening consistent with existing statute. (6) Practice standards for licensed midwives that shall include, but shall not be limited to: a. Adoption of ethical standards for licensed midwives; b. Maintenance of records of care, including client charts and birth statistics; c. Participation in peer review and continuing education with midwives, physicians and nurses; d. Requirement to have a second attendant certified in neonatal resuscitation at birth; e. Description of the tools and equipment a midwife may and may not use during delivery; and f. Medications and tests the midwife is authorized to obtain and administer in various settings as delineated in regulation. (d) License suspension, revocation, and nonrenewal. — (1) The Council, after appropriate notice and hearing, may recommend to the Board of Medical Licensure and Discipline that the Board revoke, suspend, or refuse to issue a license, or place a licensee on probation, or otherwise discipline a licensee found guilty of unprofessional conduct. Unprofessional conduct includes, but is not limited to, fraud, deceit, incompetence, gross negligence, dishonesty, failure to adhere to the procedures of § 1799JJ of this title below, or other behavior in the licensee’s professional activity which is likely to endanger the public health, safety, or welfare. The Council shall recommend that the Board permanently revoke the license of a person who is convicted of a felony sexual offense. The Council may recommend and Board may take necessary action against a midwife who is unable to practice midwifery with reasonable skill or safety to clients because of physical or mental illness, impairment or incompetence; including illness, impairment, or incompetence caused by or related to substance abuse. Disciplinary action or other action taken against a midwife must be in accordance with the procedures for disciplinary and other actions against licensed health professionals, including appeals as set forth in subchapter IV of this chapter except that a hearing panel for a complaint against a midwife shall be convened as described below. (2) In the event of a formal or informal complaint concerning the activity of a licensee that the Board determines, exercising its reasonable discretion, presents a clear and immediate danger to the public health, safety or welfare, the Board may temporarily suspend the person’s license, pending a hearing, upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Council Chair or the Council Chair’s designee. a. An order temporarily suspending a license to practice may not be issued by the Board, unless the midwife or the midwife’s attorney received at least 24 hours’ written or oral notice prior to the temporary suspension and unless the Secretary of State or the Secretary’s designee, and the Council Chair or the Council Chair’s designee concur. At a minimum, the initial oral or written notice will inform the midwife or the midwife’s attorney of: 1. The essential terms of the suspension; 2. The reason for the suspension; 3. The midwife’s right to a hearing; and 4. The midwife’s right to an expedited hearing. b. Within 48 hours of receiving the initial oral or written notice, a midwife whose license has been temporarily suspended pursuant to this section must be formally notified of the temporary suspension in writing. Formal notification consists of, at minimum: 1. A copy of the complaint; 2. The order of temporary suspension pending a hearing; and 3. A description of the hearing including the midwife’s right to request an expedited hearing, personally served upon the midwife or sent by certified mail, return receipt requested, to the midwife’s last known address. c. A midwife whose license to practice has been temporarily suspended pursuant to this section may request, and has a right to, an expedited hearing. The Board shall schedule the hearing on an expedited basis, provided that the Board receives the request within 5 calendar days from the date on which the person received formal notification of the decision to temporarily suspend the person’s license. d. As soon as possible after the issuance of an order temporarily suspending a midwife’s license to practice pending a hearing, the Council Chair shall appoint a 3-member hearing panel consisting of 3 members; 1 of the 3 shall be an unbiased physician member of the Council or Board; 2 of the 3 shall be unbiased midwife members of the Council; and if possible and no conflict exists, at least 1 of the 2 Council midwife members shall be of the same licensure type as the midwife under complaint. The Chair of the hearing panel shall be 1 of the Council midwife members. After notice to the midwife pursuant this section, the hearing panel shall convene within 60 calendar days of the date of the issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If a midwife requests an expedited hearing, the hearing panel shall convene within 15 calendar days of the receipt by the Council of the request. The 3-member panel shall conduct a hearing in accordance with the procedures set forth in § 1734 of this title and shall render a decision within 15 calendar days of the hearing. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended midwife requests a continuance of the hearing date. If the midwife requests a continuance, the order of temporary suspension will remain in effect until the hearing panel convenes and a decision is rendered by the Board. e. In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board, under § 8735 of Title 29, deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended midwife requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board. (e) The Council shall meet at least quarterly and at such other times as license applications are pending. The Council shall present to the Board the names of individuals qualified to be licensed, shall recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations pursuant to this section. The Council shall keep minutes of its meetings which shall be available to the public upon FOIA request, except that information discussed by the Council concerning a mother or child which is private in nature or which would tend to reveal the identity of a client of a midwife shall be discussed in executive session pursuant to Chapter 100 of Title 29. (f) The Board shall grant limited prescriptive authority upon the issuance of a certified professional midwife license or certified midwife license. The Council shall recommend and the Board shall approve the parameters of the limited prescriptive authority in its regulations.

Del. Code tit. 24, § 1799I Genetic Counselor Advisory Council.

(a) The Genetic Counselor Advisory Council (Council) consists of 5 voting members, and 1 ex officio member. The 5 voting members shall consist of 1 physician member of the Board of Medical Licensure and Discipline and 4 Council members licensed and trained as genetic counselors who have been primarily employed in the practice of genetic counseling in this State for at least 3 years immediately prior to appointment. The ex officio member shall be a Delaware physician who has expertise in genetic counseling. The Council may elect officers as necessary. (b) Each Council member is appointed by the Board of Medical Licensure and Discipline for a term of 3 years, and may succeed himself or herself for 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a Council member whose term of office has expired remains eligible to participate in Council proceedings until replaced by the Board. A person who has never served on the Council may be appointed to the Council for 2 consecutive terms, but the person is thereafter ineligible for appointment to the Council except as hereinafter provided. A person who has been twice appointed to the Council or who has served on the Council for 6 years within any 9-year period may not again be appointed to the Council until an interim period of at least 1 year has expired since the person last served. The members of the Council are to be compensated at an appropriate and reasonable level as determined by the Division of Professional Regulation and may be reimbursed for meeting-related travel expenses at the State’s current approved rate. A member serving on the Council may not be an elected officer or a member of the board of directors of any professional association of genetic counselors. (c) The Council shall promulgate rules and regulations governing the practice of genetic counseling, after public hearing and subject to the approval of the Board of Medical Licensure and Discipline. The Board must approve or reject proposed rules or regulations submitted to it by the Council within 60 days. If the Board fails to approve or reject the proposed rules or regulations within 60 days, the proposed rules or regulations are deemed to be approved by the Board. (d) The Council shall meet quarterly, and at such other times as license applications are pending and evaluate the credentials of all persons applying for a license as a licensed genetic counselor in this State, in order to determine whether such persons meet the qualifications for licensing set forth in this chapter. The Council shall present to the Board the names of individuals qualified to be licensed and shall recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations. The Board shall approve or reject these recommendations within a reasonable time period. (e) License suspension, revocation, or nonrenewal. — (1) The Council, after appropriate notice and hearing, may recommend to the Board of Medical Licensure and Discipline that the Board revoke, suspend, or refuse to issue a license, or place the licensee on probation, or otherwise discipline a licensee found guilty of unprofessional conduct. Unprofessional conduct includes, but is not limited to, fraud, deceit, incompetence, negligence, dishonesty, or other behavior in the licensee’s professional activity which is likely to endanger the public health, safety, or welfare. The Council may recommend and Board may take necessary action against a genetic counselor who is unable to render services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness, or the excessive use of drugs including alcohol. Disciplinary action or other action taken against a genetic counselor must be accordance with the procedures for disciplinary and other actions against physicians, including appeals as set forth in subchapter IV of this chapter except that a hearing panel for a complaint against a genetic counselor consists of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Council; and if no conflict exists, 1 of the 2 Council members shall be the Chair of the Council. The Chair of the hearing panel shall be 1 of the Council panel members. (2) a. If the Board or the Council receives a formal or informal complaint concerning the activity of a genetic counselor and the Board or Council members reasonably believe that the activity presents a clear and immediate danger to the public health, the Council may issue an order temporarily suspending the genetic counselor’s license to practice, pending a hearing upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Council Chair or the Chair’s designee. An order temporarily suspending a license to practice may not be issued by the Board, unless the genetic counselor or the genetic counselor’s attorney received at least 24 hours’ written or oral notice prior to the temporary suspension so that the genetic counselor or the genetic counselor’s attorney can be heard in opposition to the proposed suspension. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended genetic counselor requests a continuance of the hearing date. If the genetic counselor requests a continuance, the order of temporary suspension remains in effect until the hearing panel convenes and a decision is rendered. b. A genetic counselor whose license to practice has been temporarily suspended pursuant to this section must be notified of the temporary suspension immediately and in writing. Notification consists of a copy of the complaint and the order of temporary suspension pending a hearing personally served upon the genetic counselor or sent by certified mail, return receipt requested, to the genetic counselor’s last known address. c. A genetic counselor whose license to practice has been temporarily suspended pursuant to this section may request an expedited hearing. The Council shall schedule the hearing on an expedited basis, provided that the Council receives the request within 5 calendar days from the date on which the genetic counselor received notification of the decision of the Board, to temporarily suspend the genetic counselor’s license to practice. d. As soon as possible after the issuance of an order temporarily suspending a genetic counselor’s license to practice pending a hearing, the Council Chair shall appoint a 3-member hearing panel consisting of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Council; and if no conflict exists, 1 of the 2 Council members shall be the Chair of the Council. The Chair of the hearing panel shall be 1 of the Council panel members. After notice to the genetic counselor pursuant to paragraph (e)(2)b. of this section, the hearing panel shall convene within 60 days of the date of issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If a genetic counselor requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Council. The 3-member panel shall proceed to a hearing and shall render a decision within 30 days of the hearing. e. In addition to making findings of fact, the hearing panel shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board deliberates and reaches conclusions of law based upon the findings of fact made by the hearing panel. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered by the hearing panel unless the suspended genetic counselor requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board. (f) The Council shall refer all complaints from practitioners and from the public to the Board. (g) The Genetic Counselor Advisory Council, by the affirmative vote of 3 of its members and with the approval of the Board within 30 days of the vote, may waive the quarterly meeting requirements of this title.

Del. Code tit. 24, § 1799II Licensure.

(a) To be eligible for licensure by the Board as a certified professional midwife, an applicant shall: (1) Possess a valid CPM credential or another valid credential from an accrediting organization as recommended by the Council and approved by the Board; however; applicants who obtain the CPM credential after December 31, 2019, are required to also have obtained an education accredited by the Midwifery Education and Accreditation Council (MEAC), or another midwifery education accreditation organization as recommended by the Council and approved by the Board, and training and education which meet the International Confederation of Midwives (ICM) standards and guidelines as applicable to the scope of midwives licensed under this subchapter; (2) Be at least 21 years of age; (3) Shall not have been assessed any administrative penalties regarding the applicant’s practice of midwifery, including but not limited to fines, formal reprimands, license suspension or revocation — except for license suspension or revocation for nonpayment of license renewal fee or unlicensed practice penalties assessed prior to the establishment of the Council — and/or probationary limitations; (4) Shall not have been convicted of or may not have admitted under oath to having committed a crime substantially related to the practice of midwifery. (5) Be a graduate of a high school or its equivalent; (6) Meet minimum educational requirements as required for attainment of the CPM credential, including prepartum, prenatal, intrapartum, and postpartum care of the mother and baby, and risk assessment for the mother and baby during this period; (7) Notwithstanding the time limitation set forth in § 8735(x)(4) of Title 29, may not have a conviction of a felony sexual offense; and (8) Shall have completed a course in pharmacology and intravenous therapy recommended by the Council and approved by the Board. (b) To be eligible for licensure by the Board as a certified midwife, an applicant shall: (1) Possess a valid CM credential, or another valid credential from an accrediting organization as recommended by the Council and approved by the Board; (2) Be at least 21 years of age; (3) Shall not have been assessed any administrative penalties regarding the applicant’s practice of midwifery, including but not limited to fines, formal reprimands, license suspension or revocation — except for license suspension or revocation for nonpayment of license renewal fee or unlicensed practice penalties assessed prior to the establishment of the Council — and probationary limitations; (4) Not have been convicted of or shall not have admitted under oath to having committed a crime substantially related to the practice of midwifery. (5) Be a graduate of a high school or its equivalent; (6) Meet the minimum educational requirements as required for attainment of the CM credential including successful completion of a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) or meet the education standards approved by the International Confederation of Midwives (ICM); (7) Notwithstanding the time limitation set forth in § 8735(x)(4) of Title 29, may not have a conviction of a felony sexual offense; and (8) Shall have completed a course in pharmacology and intravenous therapy recommended by the Council and approved by the Board. (c) The Council may waive the requirements of paragraphs (a)(3), (a)(4), (b)(3), and (b)(4) of this section if its finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications, and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing midwifery in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a conviction if, after consideration of the factors set forth in § 8735(x)(3) of Title 29, the Council determines that granting a waiver would not create an unreasonable risk to public safety, the Coucil shall grant a waiver. (5) [Repealed.] (d) Any termination, revocation, or suspension of a certification from NARM, AMCB, or other midwifery certifying organization, or discipline from the same must be promptly reported to the Council. (e) Licensure must be renewed every 2 years. (f) An applicant for licensure to practice midwifery shall submit a certified criminal background check pursuant to § 1720(b)(6) of this title. An applicant may not be certified until the applicant’s criminal history reports have been produced. An applicant whose record shows a prior criminal conviction that is substantially related to the practice of midwifery pursuant to paragraphs (a)(4) or (a)(7) of this section or paragraphs (b)(4) or (b)(7) of this section may not be certified by the Board unless a waiver is granted pursuant to subsection (c) of this section. The State Bureau of Identification may release any subsequent criminal history to the Board and Council. (g) Except for unlicensed practice of midwifery established prior to June 30, 2016, the information obtained thereby may be used by the Board and Council to determine the applicant’s eligibility for licensing under this chapter. (h) It shall be unlawful for any person to engage in the practice of midwifery after June 30, 2016, unless such person is licensed under the provisions of this chapter.

Del. Code tit. 24, § 1799J Licensure.

(a) An applicant who is applying for licensure under this subchapter shall: (1) Provide satisfactory evidence of having certification as a: a. Genetic counselor by the ABGC or ABMGG; or b. Medical geneticist by the ABMGG. (2) Submit an application prescribed by the Council. (3) Submit a certified criminal background check pursuant to § 1720(b)(6) of this title. (4) The applicant may not have an impairment related to the current use of drugs or alcohol which substantially impairs the practice of genetic counseling with reasonable skill and safety. (b) The Board may refuse or reject an applicant, if after hearing, the Board finds that: (1) The applicant has engaged in activities that are grounds for discipline under § 1799P of this title. (2) The applicant has been convicted of a crime substantially related to the practice of genetic counseling as determined by the Board of Medical Licensure and Discipline in its rules and regulations. (3) The applicant has been the recipient of any administrative penalties from any other jurisdiction or jurisdictions regarding the applicant’s practice of genetic counseling, including but not limited to fines, formal reprimands, license suspensions or revocation (except for license revocations for nonpayment of license renewal fees), probationary limitations, and/or has entered into any “consent agreements” which contain conditions placed by a Board on the applicant’s professional conduct and practice, including any voluntary surrender of a license in lieu of discipline. (c) Waiver of requirements. — The Council, by the affirmative vote of 3 of its members and with the approval of the Board within a reasonable period of time from the vote, may waive any of the requirements of subsection (b) of this section if it finds all of the following by clear and convincing evidence: (1) The applicant’s education, training, qualifications and conduct have been sufficient to overcome the deficiency or deficiencies in meeting the requirements of this section; (2) The applicant is capable of practicing as a genetic counselor in a competent and professional manner; (3) The granting of the waiver will not endanger the public health, safety, or welfare; and (4) For waiver of a conviction, if, after consideration of the factors set forth in § 8735(x)(3) of Title 29, the Council determines that granting a waiver would not create an unreasonable risk to public safety, the Council shall waive paragraph (b)(2) of this section. (5) [Repealed.] (d) Where the application of a person has been refused or rejected and such applicant feels that the Board has acted without justification, and imposed higher or different standards for the person than for other applicants or licensees, or has in some other manner contributed to or caused the failure of such application, the applicant may appeal to the Superior Court.

Del. Code tit. 24, § 1799JJ Client screening for homebirth delivery services.

The provisions of this section shall apply only to a midwife while providing home birth delivery services. For the purposes of obtaining informed consent as governed by this section, the mother that is part of the client shall give informed consent on behalf of herself and the newborn. (1) When accepting a client for care, a midwife shall obtain the client’s informed consent, which shall be evidenced by a written statement signed by both the midwife and the client which shall contain the following elements, in a form drafted by the Council and adopted by the Board, if the midwife offers home birth services: a. An acknowledgement that home birth can include increased risk of death and disability for mother and child; b. A clear statement that the risks have been explained and understood by the client; c. A clear statement that the client is aware that the midwife is not a licensed physician or nurse, nor are they seeking the services of one for their home birth; d. A newborn checklist describing the services and care of the newborn; and e. Information regarding procedures in the event a transfer becomes necessary and that a transfer may be required to protect the safety of the client if signs or symptoms are observed by the midwife that necessitate such transfer that includes: 1. Estimated distance between the planned birth site and the receiving facility; and 2. Information regarding concurrent care policies at the receiving facility. The statement on concurrent care will be repeated orally to the client or, if the client is incapacitated, the client’s designated agent, in the event of a transfer. (2) When accepting a client for care, a midwife shall obtain in addition to the client’s informed consent, a written statement in a form proposed by the Council and adopted by the Board, and signed by both the midwife and the client. The form shall certify that full disclosure has been made and acknowledged by the client as to each of the following items, with the client’s acknowledgement evidenced by a separate signature adjacent to each item in addition to the client’s signature and the date at the end of the form: a. The name, address, telephone number, and license number of the licensed midwife; b. A description of the midwife’s education, training, and experience in midwifery in relation to both the mother and the newborn; c. The nature and scope of the care to be given, including a description of the ante partum, intrapartum, and postpartum conditions requiring consultation, transfer of care, or transport to a hospital; d. A copy of the written plan described in paragraph (3) of this section below which is particular to each client; e. An explanation that in the event of an emergency or voluntary transfer that no liability from the actions of the midwife are assignable to the receiving facility or medical professional; f. An explanation of the right of the client to file a complaint with the Council and instructions on how to file a complaint with the Council; g. A statement indicating that the client’s records and any transaction with the midwife are confidential pursuant to the federal Health Insurance Portability and Accountability Act [P.L. 104-191]; h. A disclosure of whether the midwife carries malpractice or liability insurance; and i. Any further information as required by the Council. (3) A midwife shall prepare, in a form proposed by the Council and adopted by the Board, a written plan for the appropriate delivery of emergency care and provide the client with a copy of the plan as provided in paragraph (2) of this section. The plan shall address the following: a. Consultation with other health-care providers; b. Emergency transfer; c. Access to neonatal intensive care units and obstetrical units or other patient care areas; (4) A midwife shall provide an initial screening to ensure that each client receives safe and appropriate care and to determine whether any contraindications are present. A midwife will also perform ongoing screening and maintain, beginning at the time of the initial screening, a detailed health history in a form prescribed by the Council and adopted by the Board. (5) Upon transfer of a client, emergency or otherwise, a midwife shall provide all records described in this section to the receiving care provider or facility and remain available to speak with the receiving health-care provider at the point of transfer about the course of care provided to the client. (6) A midwife offering home birth services shall only accept and provide care to those women who are classified as eligible for a home birth or midwife-assisted birth in accordance with evidence based standards proposed by the Council and adopted by the Board as being low risk pregnancy, labor, and delivery, which includes but is not limited to: a. There is no preexisting maternal disease or condition likely to affect the pregnancy, such as uterine surgeries including Caesarean procedures and others, as recommended by the Council and approved by the Board; b. There is no significant disease arising from the pregnancy; c. There is a singleton fetus; d. There appears to be a cephalic presentation prior to delivery; e. The onset of labor occurs when the fetus has a gestational age greater than 37 weeks and less than 42 weeks, which period can be expanded or contracted if the Council and Board determine that it would be in the best interests of clients to do so; and f. Labor is most likely to be spontaneous. (7) The midwife must be able at all times to recognize the warning signs of conditions that render the woman ineligible for a midwife-assisted home birth. If a midwife determines at any time during the course of the pregnancy that a woman’s condition may preclude attendance by the midwife, the client shall be informed that she should transfer to an appropriate, licensed, health-care provider. A midwife may and shall, at any time, terminate a relationship with a client if that midwife deems the woman is or has become ineligible for a midwife-assisted birth or home birth. The cause for termination must be documented and included in the health history described in paragraph (4) of this section. Such midwife shall inform the client of such termination in writing and recommend transfer to an appropriate licensed health-care provider. (8) If a midwife identifies that the client demonstrates a high risk condition as defined by the Council and approved by the Board, the midwife shall refer the client to a physician with obstetrical hospital privileges for client assessment and/or screening, at the time the condition is noted by the midwife. In the event of an emergency, if the midwife determines that immediate termination of the relationship pursuant to paragraph (7) of this section would increase or create risk of death or injury to the mother or her infant, the midwife will immediately engage emergency medical services, and may continue to assist in the emergency.

Del. Code tit. 24, § 1799K Provisional license.

(a) The Board may issue a provisional license to practice genetic counseling to a candidate for licensure who has been granted active candidate status by the ABGC, provided the candidate meets the other qualifications for licensure listed in § 1799J of this title. (b) The provisional license shall be valid for up to 1 year from the date it was issued, and may be renewed for 1 additional year if the applicant fails the certification examination. The provisional license automatically expires: (1) When the applicant is issued a license; or (2) On the expiration date printed on the provisional license; or (3) Upon notice of the second failure of the certification examination. (c) An application for extension of a provisional license must be signed by the applicant’s supervisor. A genetic counselor working under a provisional license must be under the general supervision of a licensed genetic counselor or a licensed physician. If a candidate fails to pass the exam 2 times within this provision, they may reapply for provisional licensure after regaining active candidate status by the ABGC or another organization acceptable to the Board. The Board may establish in its rules additional requirements relating to provisional licensure.

Del. Code tit. 24, § 1799KK Physician-midwife relationship.

(a) No health-care provider or facility shall be vicariously liable for an injury resulting from an act or omission by a midwife unless an employment and/or agency relationship has been established between the midwife and the health-care provider or facility. (b) Upon the successful transfer of care of a client from a midwife to a licensed physician in accordance with § 1799JJ(1) of this title, if authorized by the client, physician, and facility the licensed midwife may provide concurrent care with a physician and surgeon and, be present during the labor and childbirth, and resume postpartum care, if appropriate.

Del. Code tit. 24, § 1799L Reciprocity.

An applicant for licensure by reciprocity must possess a current license in a state which has licensing requirements equal to or exceeding the requirements of this subchapter, and there may not be any outstanding or unresolved complaints against the applicant.

Del. Code tit. 24, § 1799LL Treatment or examination of minors.

(a) A parent, guardian or other caregiver, or an adult staff member, shall be present when a person licensed to practice midwifery under this chapter provides outpatient treatment to a minor client who is disrobed or partially disrobed or during an outpatient physical examination involving the breasts, genitalia or rectum, regardless of sex of the licensed person and client, except when rendering care during an emergency. When using an adult staff member to observe the treatment or examination, the adult staff member shall be of the same gender as the client when practicable. The minor client may decline the presence of a third person only with consent of a parent, guardian or other caregiver. The minor client may request private consultation with the person licensed to practice midwifery without the presence of a third person after the physical examination. Every hospital and nursing facility and similar facility that provides treatment to minors shall develop and implement policies regarding the treatment of minor clients that are consistent with the purposes of this section and will submit those policies for approval by the Department of Health and Social Services. Violations of approved policies will be treated as a violation of this section. (b) When a minor client is to be disrobed, partially disrobed or will undergo a physical examination involving the breasts, genitalia or rectum, a person licensed to practice midwifery under this chapter shall provide notice to the person providing consent to treatment of the rights under this section. The notice shall be provided in written form or be conspicuously posted in a manner in which a minor client and the minor client’s parent, guardian or other caregiver are made aware of the notice. In circumstances in which the posting or the provision to the client of the written notice would not convey the right to have a chaperone present, the person licensed to practice midwifery shall use another means to ensure that the client or person understands the right under this section. (c) For the purposes of this section, “minor” is defined as a person 15 years of age or younger, “adult staff member” is defined as a person 18 years of age or older who acting under the direction of the licensed person or the employer of the licensed person or who is otherwise licensed under this chapter, “hospital” has the meaning prescribed by Chapter 10 of Title 16, and “nursing facility and similar facility” has the meaning prescribed by Chapter 11 of Title 16. (d) The person licensed under this chapter that provides outpatient treatment to a minor pursuant to this section shall, contemporaneously with such treatment, note in the child’s medical record the name of each person present when such treatment is being provided.

Del. Code tit. 24, § 1799M Continuing education.

The Council, with the approval of the Board, is authorized to adopt regulations specifying continuing education requirements which must be met by a licensee before a licensee will be eligible for renewal of their license.

Del. Code tit. 24, § 1799MM Recordkeeping.

(a) A person licensed under this chapter who is discontinuing practice in this State or who is leaving this State and who is not transferring client records to another person licensed to practice midwifery or medicine shall notify that person’s clients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the person practices. The notice must be published at least 1 time per month over a 3-month period in advance of discontinuing the business or leaving the State and must explain how a client can procure that client’s records. All clients of record who have not requested their records 30 days before the person discontinues the practice or leaves the State must be notified by first-class mail by the person to permit that person’s clients to procure their records. Any client records that have not been procured within 7 years after the person discontinues practice or leaves the State may be permanently disposed of in a manner that ensures confidentiality of the records. (b) If a person licensed under this chapter dies and has not transferred client records to another person licensed to practice midwifery or medicine and has not made provisions for a transfer of client records to occur upon the person’s death, a personal representative of the person’s estate shall notify the person’s clients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the person practiced. The notice must be published at least 1 time per month over a 3-month period after the person’s death and must explain how a former client can procure the client’s records. All former clients who have not requested their records 30 days after such publication must be notified by first class mail by the personal representative of the estate to permit the clients to procure their records. Any client records that have not been procured within 7 years after the death of the person may be permanently disposed of in a manner that ensures confidentiality of the records. (c) If a client changes from the care of 1 person licensed to practice midwifery or medicine to another person certified to practice midwifery or medicine, the former person shall transfer a copy of the records of the client to the current person upon the request of either the current person or the client. The former person may charge for the reasonable expenses of copying the client’s records, according to a payment schedule established by the Board of Medical Licensure and Discipline. The actual cost of postage or shipping may also be charged if the records are mailed. Alternatively, if the client and current person agree, the former person may forward to the current person a summary of the client’s record, in lieu of transferring the entire record, at no charge to the client. If a client changes care from 1 person certified to practice midwifery or medicine to another and fails to notify the former person, or leaves the care of the former person for a period of 7 years from the last entry date on the client’s record and fails to notify the former person, or fails to request the transfer of records to the current person, then the former person shall maintain the client’s records for a period of 7 years from the last entry date in the client’s medical record, after which time the records may be permanently disposed of in a manner that insures confidentiality of the records. (d) Clients, on their own behalf, shall have the right to obtain a copy of their records from any person certified to practice midwifery or medicine according to a payment schedule established by the Board of Medical Licensure and Discipline. The actual cost of postage or shipping may also be charged if the records are mailed.

Del. Code tit. 24, § 1799N Issuance and renewal of licenses; fees.

(a) The Division of Professional Regulation shall establish reasonable fees for licensing genetic counselors and for biennial license renewal. (b) The Board shall issue a license to each applicant who meets the requirements of this chapter for licensure as a genetic counselor and who pays the established fees. (c) Each license shall be renewed biennially, in such manner as is determined by the Division and upon payment of the appropriate fee and submission of a renewal form provided by the Division, and proof that the licensee has met the continuing education requirements established by § 1799M of this title. (d) The Council, in its rules and regulation, shall determine the period of time within which a licensee may still renew the licensee’s license and determine late fees associated with the license renewal, notwithstanding the fact that such licensee has failed to renew on or before the renewal date, provided, however that such period shall not exceed 1 year. (e) A licensee, upon written request, may be placed in an inactive status for no more than 5 years. Such person, who desires to reactivate that person’s license, shall complete a Board-approved application form, obtain an updated certified criminal background check, submit a renewal fee, and proof of fulfillment of continuing education requirements in accordance with the rules and regulation of the Council.

Del. Code tit. 24, § 1799NN Duty to report conduct that constitutes grounds for discipline or inability to practice.

(a) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other health-care provider has engaged in or is engaging in conduct that would constitute grounds for disciplinary action under this chapter or the other health-care provider’s licensing statute. (b) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation in writing information that the licensee reasonably believes indicates that any other practitioner licensed under this chapter or any other health-care provider may be unable to practice with reasonable skill and safety to the public by reason of: mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive abuse of drugs, including alcohol. (c) Every person to whom a license to practice has been issued under this subchapter has a duty to report to the Division of Professional Regulation any information that the reporting person reasonably believes indicates that a person certified and registered to practice medicine in this State is or may be guilty of unprofessional conduct or may be unable to practice medicine with reasonable skill or safety to clients by reason of: mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive use or abuse of drugs, including alcohol. (d) All reports required under subsections (a), (b) and (c) of this section must be filed within 30 days of becoming aware of such information. A person reporting or testifying in any proceeding as a result of making a report pursuant to this section is immune from claim, suit, liability, damages, or any other recourse, civil or criminal, so long as the person acted in good faith and without gross or wanton negligence; good faith being presumed until proven otherwise, and gross or wanton negligence required to be shown by the complainant.

Del. Code tit. 24, § 1799O Licensure required.

(a) No person shall represent oneself or engage in the practice of genetic counseling as a licensed genetic counselor in this State or use the title “genetic counselor”, “licensed genetic counselor”, “L.G.C.”, “gene counselor”, “genetic consultant”, “genetic associate” or any combination of above terms and/or abbreviations unless such a person is licensed under this subchapter. (b) This subchapter does not prohibit or restrict: (1) Any person licensed in this State under any chapter of this title who are physicians or other healthcare professionals from engaging in the practice for which that person is licensed. (2) The practice of genetic counseling by a person who is employed by the United States or state government or any of its bureaus, divisions, or agencies while in the discharge of the employee’s official duties. (3) The supervised practice of genetic counseling of a person pursuing a course of study leading to a degree in genetic counseling or an equivalent major, as authorized by the Board, from a ABGC accredited school or program, if the activities and services constitute a part of a supervised course of study and if the person is designated by a title that clearly indicates the person’s status as a student. This period is not to exceed 2 years unless written approval is provided by the Board. The individual will be supervised by an individual licensed under this subchapter or a physician.

Del. Code tit. 24, § 1799P Grounds for discipline, sanctions, or penalties.

(a) The following conditions and actions of an L.G.C. may result in disciplinary action as set forth in subsection (b) of this section if, after a hearing, the Board finds that an applicant or L.G.C: (1) Has employed or knowingly cooperated in fraud or material deception in order to be licensed: or (2) Has engaged in illegal, incompetent or negligent conduct in the provision of genetic counseling; or (3) Has, in the practice of the profession, knowingly engaged in an act of consumer fraud or deception; or (4) Has violated the code of ethics as established by the NSGC; or (5) Has violated a lawful provision of this subchapter or any lawful rule or regulation established hereunder; or (6) Has been convicted of a crime substantially related to the practice of genetic counseling as determined by the Board of Medical Licensure and Discipline in its rules and regulations. (b) Persons licensed under this subchapter who have been determined to be in violation of this subchapter shall be subject to the following disciplinary actions: (1) Issuance of a letter of reprimand. (2) Censure. (3) Placement on probationary status. (4) Denial of license. (5) Suspension of license. (6) Revocation of license. (7) Impose a monetary penalty not to exceed $500 for each violation. (c) As a condition of reinstatement of a suspended license or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized under this subchapter.

Del. Code tit. 24, § 1799Q Unauthorized practice of genetic counseling.

Whoever engages in the practice of genetic counseling or attempts to engage in the practice of genetic counseling contrary to the provisions of this subchapter shall be guilty of a Class G felony and shall be fined not less than $500 and not more than $1,500, or imprisoned not more than 2 years, or both.

Del. Code tit. 24, § 1799R Administrative procedures.

All procedures under this chapter shall be governed by the Delaware Administrative Procedures Act, Chapter 101 of Title 29.

Del. Code tit. 24, § 1799S Procedure or action not described.

This subchapter governs the practice of genetic counseling practitioners. If a procedure or action is not specifically prescribed in the subchapter, but is prescribed in the subchapters relating to the practice of medicine, and the procedure or action would be useful or necessary for the regulation of genetics counseling practitioners, the Board may, in its discretion, proceed in a manner prescribed for physicians in the practice of medicine.

Del. Code tit. 24, § 1799T Statement of purpose.

The intent of the General Assembly in enacting this subchapter is to establish minimum standards of education, experience and examination for professional polysomnographers so that the public can readily identify those who meet these minimum standards. In enacting this subchapter the General Assembly intends to provide a licensure process for professional polysomnographers, a scope of practice for polysomnographer services, and to establish “licensed polysomnographer” as the state-recognized legal title for professional polysomnographers. It is also the intent of the General Assembly in enacting this subchapter to assure consumers the right to choose from whom they receive information and advice. Recognition of these goals will protect the health of the public by broadening access to appropriate polysomnography services.

Del. Code tit. 24, § 1799U Definitions.

As used in this subchapter: (1) “AASM” shall mean the American Academy of Sleep Medicine or an organization that is recognized as equivalent. (2) “Board” shall mean the Board of Medical Licensure and Discipline. (3) “BRPT” shall mean the Board of Registered Polysomnographic Technologists or its successor organization. (4) “Council” means the Polysomnography Advisory Council. (5) “Direct supervision” means that the licensed polysomnographer providing supervision must be present in the area where the polysomnographic procedure is being performed and immediately available to furnish assistance and direction throughout the performance of the procedure. (6) “General supervision” means that the licensed polysomnographer works under the supervision of a person licensed to practice medicine, whether by direct observation and monitoring, by protocols approved by a person licensed to practice medicine, or by orders written or verbally given by a person licensed to practice medicine. A licensed polysomnographer may evaluate patients and make decisions within parameters defined by a person certified to practice medicine and by the Board. The licensed polysomnographer works under a physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure. (7) “License” shall mean any document which indicates that a person is currently licensed by the Board to practice polysomnography. (8) “LPSGT” shall be the abbreviation for the title “licensed polysomnographer”. (9) “NBRC SDS exam” means the National Board for Respiratory Care Sleep Disorders and Therapeutic Intervention Respiratory Care Specialist exam. (10) “Polysomnographer” means an allied health professional, practicing polysomnography under the direction of a person licensed to practice medicine, who is responsible for direct and indirect services in the treatment, management, diagnostic testing, control, and care of patients with deficiencies and abnormalities associated with the human sleep wake cycle. (11) “Polysomnographic student” means a person who is enrolled in an accredited educational program described in § 1799V of this title and who may provide sleep-related services under the direct supervision of a licensed polysomnographer as a part of the person’s educational program and is therefore, exempt from the licensure requirement. (12) “Polysomnographic trainee” means a person who has completed an accredited educational program described in § 1799V of this title and who may provide sleep-related services under the direct supervision of a licensed polysomnographer as part of the person’s clinical program and is therefore exempt from the licensure requirement. (13) “Practice of polysomnography” means the performance of any of the following tasks as directly related to the diagnosis and treatment of sleep-related disorders, under the general supervision of a licensed physician: a. Monitoring and recording physiologic data during the evaluation of sleep-related disorders, including sleep-related respiratory disturbances, by applying the following techniques, equipment, and procedures: 1. Titration using approved airway pressure devices and/or other technologies on spontaneously breathing patients using a mask or oral appliance, provided the mask or oral appliance does not extend into the trachea or attach to an artificial airway; 2. Supplemental low flow oxygen therapy (less than or equal to 6 liters per minute) during a polysomnogram utilizing a nasal cannula or approved airway pressure devices and technologies on spontaneously breathing patients, provided the devices or technologies do not extend into the trachea or attach to an artificial airway; 3. Capnography during a polysomnogram; 4. Cardiopulmonary resuscitation; 5. Pulse oximetry; 6. Gastroesophageal pH monitoring; 7. Esophageal pressure monitoring; 8. Sleep staging (including surface electroencephalography, surface electrooculography, and surface submental electromyography); 9. Surface electromyography; 10. Electrocardiography; 11. Respiratory effort monitoring, including thoracic and abdominal movement; 12. Plethysmography blood flow monitoring; 13. Snore monitoring; 14. Audio and video monitoring; 15. Body movement and body position monitoring; 16. Nocturnal penile tumescence monitoring; 17. Nasal and oral airflow monitoring; 18. Body temperature monitoring; 19. Monitoring the effects that a mask or oral appliance used to treat sleep disorders has on sleep patterns; provided, however, the mask or oral appliance shall not extend into the trachea or attach to an artificial airway; 20. Actigraphy; b. Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and recommending whether initiation, modification, or discontinuation of a treatment regimen is warranted; c. Analyzing and scoring data collected during the monitoring described in paragraphs (13)a.1. and 2. of this section for the purpose of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders; d. Implementation of a written or verbal order from a licensed physician which requires the practice of polysomnography; e. Education of a patient regarding sleep disorders and the treatment regimen which assists that patient in improving the patient’s sleep.

Del. Code tit. 24, § 1799V Education.

The following qualify as approved educational programs: (1) A polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; (2) A respiratory care educational program that is accredited by the Commission on Accreditation for Respiratory Care and completion of the curriculum for a polysomnography certificate established and accredited by the Commission on Accreditation for Respiratory Care; (3) An electroneurodiagnostic technologist educational program with a polysomnographic technology track that is accredited by the Commission on Accreditation of Allied Health Education Programs; (4) An Accredited Sleep Technologist Educational Program (A-STEP) that is accredited by the American Academy of Sleep Medicine; or (5) Any other educational program incorporating both formal instruction and supervised clinical practice as recommended by the Council and approved by the Board.

Del. Code tit. 24, § 1799W Polysomnography Advisory Council.

(a) The Council consists of 5 voting members. The 5 voting members shall consist of 1 physician member certified in the field of sleep medicine and 4 council members who are credentialed registered polysomnographic technologists and have been primarily employed in the practice of polysomnography in this State for at least 3 years immediately prior to appointment. The 4 polysomnography practicing members shall be licensed pursuant to this subchapter no later than July 1, 2014, and all polysomnography practicing members thereafter shall be licensed pursuant to this subchapter. The Council may elect officers as necessary. (b) Each council member is appointed by the Board for a term of 3 years, and may succeed himself or herself for 1 additional 3-year term. A person appointed to fill a vacancy on the Council is entitled to hold office for the remainder of the unexpired term of the former member. Each term of office expires on the date specified in the appointment; however, a council member whose term of office has expired remains eligible to participate in council proceedings until replaced by the Board. A person who has never served on the Council may be appointed to the Council for 2 consecutive terms, but the person is thereafter ineligible for appointment to the Council except as hereinafter provided. A person who has been twice appointed to the Council or who has served on the Council for 6 years within any 9-year period may not again be appointed to the Council until an interim period of at least 1 year has expired since the person last served. The members of the Council are to be compensated at an appropriate and reasonable level as determined by the Division of Professional Regulation and may be reimbursed for meeting-related travel expenses at the State’s current approved rate. A member serving on the Council may not be an elected officer or a member of the board of directors of any professional association of polysomnographers. (c) The Council shall promulgate rules and regulations governing the practice of polysomnography, after public hearing and subject to the approval of the Board. The Board must approve or reject proposed rules or regulations submitted to it by the Council within 60 days. If the Board fails to approve or reject the proposed rules or regulations within 60 days, the proposed rules or regulations are deemed to be approved by the Board. (d) The Council shall meet quarterly, and at such other times as license applications are pending and evaluate the credentials of all persons applying for a license as a licensed polysomnographer in this State, in order to determine whether such persons meet the qualifications for licensing set forth in this chapter. The Council shall present to the Board the names of individuals qualified to be licensed and shall recommend disciplinary action against licensees as necessary, and shall suggest changes in operations or regulations. The Board shall approve or reject these recommendations within a reasonable time period. (e) License suspension, revocation, or nonrenewal. — (1) The Council, after appropriate notice and hearing, may recommend to the Board that the Board revoke, suspend, or refuse to issue a license, or place the licensee on probation, or otherwise discipline a licensee found guilty of unprofessional conduct. Unprofessional conduct includes, but is not limited to, fraud, deceit, incompetence, negligence, dishonesty, or other behavior in the licensee’s professional activity which is likely to endanger the public health, safety, or welfare. The Council may recommend and the Board may take necessary action against a licensed polysomnographer, who is unable to render services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness, or the excessive use of drugs including alcohol. Disciplinary action or other action taken against a licensed polysomnographer must be accordance with the procedures for disciplinary and other actions against physicians, including appeals as set forth in subchapter IV of this chapter except that a hearing panel for a complaint against a licensed polysomnographer consists of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Council; and if no conflict exists, 1 of the 2 council members shall be the Chair of the Council. The Chair of the hearing panel shall be 1 of the council panel members. (2) a. In the event of a formal or informal complaint concerning the activity of a licensee that presents a clear and immediate danger to the public health, the Council may temporarily suspend the person’s license, pending a hearing, upon the written order of the Secretary of State or the Secretary’s designee, with the concurrence of the Council Chair or the Chair’s designee. An order temporarily suspending a license may not be issued unless the person or the person’s attorney received at least 24 hours’ written or oral notice before the temporary suspension so that the person or the person’s attorney may file a written response to the proposed suspension. The decision as to whether to issue the temporary order of suspension will be decided on the written submissions. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporary suspended person requests a continuance of the hearing date. If the temporary suspended person requests a continuance, the order of temporary suspension remains in effect until the hearing is convened and a decision is rendered by the Board. A person whose license has been temporarily suspended pursuant to this section may request an expedited hearing. The Board shall schedule the hearing on an expedited basis, provided that the Board receives the request within 5 calendar days from the date on which the person received notification of the decision to temporarily suspend the person’s license. b. As soon as possible after the issuance of an order temporarily suspending a polysomnographer’s license to practice pending a hearing, the Council Chair shall appoint a 3-member hearing panel consisting of 3 members; 1 of the 3 shall be a physician member of the Board; 2 of the 3 shall be unbiased members of the Council; and if no conflict exists, 1 of the 2 Council members shall be the Chair of the Council. The Chair of the hearing panel shall be 1 of the Council panel members; or the complaint may be scheduled before a hearing officer pursuant to § 8735(v)(1)d. of Title 29. The hearing shall be convened within 60 days of the date of issuance of the order of temporary suspension to consider the evidence regarding the matters alleged in the complaint. If a polysomnographer requests in a timely manner an expedited hearing, the hearing panel shall convene within 15 days of the receipt of the request by the Council. A decision shall be rendered within 30 days of the hearing. c. In addition to making findings of fact, the hearing panel or hearing officer shall also determine whether the facts found by it constitute a clear and immediate danger to public health. If the hearing panel or hearing officer determines that the facts found constitute a clear and immediate danger to public health, the order of temporary suspension must remain in effect until the Board deliberates and reaches conclusions of law based upon the findings of fact. An order of temporary suspension may not remain in effect for longer than 60 days from the date of the decision rendered unless the suspended polysomnographer requests an extension of the order pending a final decision of the Board. Upon the final decision of the Board, an order of temporary suspension is vacated as a matter of law and is replaced by the disciplinary action, if any, ordered by the Board.

Del. Code tit. 24, § 1799X Licensure.

(a) On and after July 1, 2014, any person who is engaged in the practice of polysomnography must be licensed as provided in this chapter. It shall be unlawful for any person to engage in the practice of polysomnography on or after July 1, 2014, unless such person is practicing polysomnography under the provisions of this chapter. (b) Polysomnographic license. — (1) A licensed polysomnographer may provide sleep-related services under the general supervision of a licensed physician; (2) A person seeking licensure as a licensed polysomnographer must present proof that the person meets the following requirements: a. Must be at least 18 years of age, and must pay the fees established by the Division of Professional Regulation; b. The licensed polysomnographer applicant must have successfully completed 1 of the educational requirements in § 1799V of this title and passed an exam which is accredited by an independent outside agency and recommended by the Council and approved by the Board unless otherwise exempt pursuant to paragraph (b)(3) of this section; c. The licensed polysomnographer applicant must meet any additional educational or clinical requirements established by the Board. (3) Any individual who is engaged in the practice of polysomnography as of July 1, 2011, shall be eligible for licensure under this chapter without meeting the educational requirement in § 1799V of this title, if the individual has: a. Passed the national certifying examination given by the BRPT; b. Been credentialed by the BRPT; and c. Met any additional educational or clinical requirements established by the Council and approved by the Board. (4) Before practicing polysomnography, an individual must obtain a polysomnographic license from the Board. (5) To be eligible for renewal of a license to engage in the practice of polysomnography, a licensed polysomnographer must continue to be credentialed by BRPT, or other organization approved by the Council. (6) Licensure. — a. No person shall represent oneself or engage in the practice of polysomnography as a licensed polysomnographer in this State or use the title “polysomnographer,” “licensed polysomnographer,” “LPSGT,” or any combination of above terms and/or abbreviations unless such a person is licensed under this subchapter. b. This subchapter does not prohibit or restrict: 1. Any person licensed in this State under any chapter of this title who are physicians or other healthcare professionals from engaging in the practice for which that person is licensed; 2. The practice of polysomnography by a person who is employed by the United States or state government or any of its bureaus, divisions, or agencies while in the discharge of the employee’s official duties; 3. The supervised practice of polysomnography of a person pursuing a course of study leading to a certificate or degree in polysomnography or an equivalent major, as authorized by the Board, from an accredited school or program approved by the Council, if the activities and services constitute a part of a supervised course of study and if the person is designated by a title that clearly indicates the person’s status as a student. This period is not to exceed 2 years unless written approval is provided by the Board. The individual will be supervised by an individual licensed under this subchapter or a physician; or 4. The provision of diagnostic electroencephalograms conducted in accordance with the guidelines of the American Clinical Neurophysiology Society. c. The provisions of this subchapter shall not apply to licensed respiratory care practitioners. (c) Waiver of requirements. — The Polysomnography Advisory Council, by the affirmative vote of 5 of its members and with the approval of the Board within 30 days of the vote, may waive the quarterly meeting requirements of § 1799W(d) of this title. (d) License denial. — If it appears to the Board that an applicant has been intentionally fraudulent or that an applicant has intentionally submitted, or intentionally caused to be submitted, false information as part of the application process, the Board may not issue a license to the applicant and must report the incident of fraud or submitting false information to the Office of the Attorney General for further action. (e) An applicant who is applying for licensure under this subchapter shall: (1) Submit an application prescribed by the Council. (2) Submit a certified criminal background check pursuant to § 1720(b)(6) of this title. (3) The applicant may not have an impairment related to the current use of drugs or alcohol which substantially impairs the practice of polysomnography with reasonable skill and safety. (f) The Board may refuse or reject an applicant, if after hearing, the Board finds that: (1) The applicant has engaged in activities that are grounds for discipline under § 1799BB of this title. (2) The applicant has been convicted of a crime substantially related to the practice of polysomnography as determined by the Board in its rules and regulations. (3) The applicant has been the recipient of any administrative penalties from any other jurisdiction or jurisdictions regarding the applicant’s practice of polysomnography, including but not limited to fines, formal reprimands, license suspensions or revocation (except for license revocations for nonpayment of license renewal fees), probationary limitations, and/or has entered into any “consent agreements” which contain conditions placed by a Board on the applicant’s professional conduct and practice, including any voluntary surrender of a license in lieu of discipline. (g) Waiver of requirements. — The Council, by the affirmative vote of 3 of its members and with the approval of the Board within a reasonable period of time from the vote, shall waive the requirements of paragraph (f)(2) of this section if it finds, after consideration of the factors set forth in § 8735(x)(3) of Title 29, that a waiver would not create an unreasonable risk to public safety. (1)-(5) [Repealed.] (h) Where the application of a person has been refused or rejected and such applicant feels that the Board has acted without justification, and imposed higher or different standards for the person than for other applicants or licensees, or has in some other manner contributed to or caused the failure of such application, the applicant may appeal to the Superior Court.

Del. Code tit. 24, § 1799Y Endorsement.

An applicant for licensure by endorsement must possess a current license in a state which has licensing requirements substantially similar to or exceeding the requirements of this subchapter, and there may not be any outstanding or unresolved complaints against the applicant.

Del. Code tit. 24, § 1799Z Continuing education.

The Council, with the approval of the Board, is authorized to adopt regulations specifying continuing education requirements which must be met by a licensee before a licensee will be eligible for renewal of his or her license.
Source: DE Code (Official Site)URL: https://delcode.delaware.gov/title24/c017/sc01/index.htmlFetched: 10/4/2026