House passes bill setting state standards for level-4 neonatal intensive-care units

The Delaware House passed House Bill 3-27 on April 23, 2026, codifying state standards for levels of neonatal intensive care and adding explicit requirements for level‑4 NICU designation.

Sponsor Representative Ross Levin said the bill aligns levels 1 through 3 with American Academy of Pediatrics standards while establishing Delaware-specific minimums for level 4—such as immediate access to pediatric subspecialists and lifesaving services like ECMO—so families will know that a level‑4 designation signifies the highest available care. "Our most medically fragile newborns deserve to receive the right care at the right place at the right time," Ross Levin said.

During floor discussion Representative Jones Giltner questioned whether the standards were better set by regulation rather than statute; Levin and witnesses said codifying minimum level‑4 requirements provides accountability that some clinicians prefer. Nemours neonatologist Dr. Megan Walls testified from the podium that clinicians and hospitals involved in drafting the bill view certain resources—ECMO capability, on‑site specialized surgical support and continuous access to key personnel—as minimums that should not be treated as flexible policy. "We don't want a level 4 program without these things," Walls said.

The House conducted a roll call and recorded the required constitutional majority; the bill passed (33 yes, 3 no, 5 absent). Sponsors said implementation will involve regulatory and clinical coordination between hospitals and the Department of Health and Social Services to educate referring physicians and operationalize level designations.

Next steps include administrative rulemaking and coordination among clinical partners to publish guidance and referrals protocols so that clinicians and families understand where to seek the appropriate level of neonatal care.