‘Wildly unprecedented’: Delaware lawmakers question lack of role in Gov. Matt Meyer’s creation of a $270K state surgeon general

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Delaware House and Senate leaders are expected to meet Wednesday to decide whether or not they will sign off on using roughly $270,000 in taxpayer funding for the creation of an Office of Surgeon General, which Gov. Matt Meyer implemented without their knowledge.

Meyer established a state-level surgeon general within the Delaware Department of Health and Social Services through an executive order last month. For the position, he tapped Neil Hockstein, who has been serving patients in Delaware for 20 years as an otolaryngologist, or ear, nose and throat doctor.

Hockstein founded and is the chief medical officer of Parallel ENT & Allergy of Delaware, which has four locations throughout New Castle County.

Hockstein said while he will report to DHSS Secretary Christen Linke Young and supervise the Division of Public Health, he will also report to the governor. Despite the position still pending approval from the state Office of the Controller General, he officially started Monday.

Joint Finance Committee Chairman state Sen. Trey Paradee and other lawmakers said they were stunned to learn of DHSS’ intent to reclassify a nursing supervisor role into the surgeon general position last month.

A spokesperson with the Senate Democratic Majority Caucus said the request was submitted to the Department of Human Resources on July 1, as sleep-deprived lawmakers left Legislative Hall after an all-night final day of session.

Although lawmakers weren’t informed about the new position until July,  Hockstein said he began having conversations about joining DHSS starting around April.

“Unfortunately, the administration announced Dr. Hockstein’s new role before it had any discussions with the legislature and before requesting the job reclassification necessary to create the surgeon general position,” state Senate President Pro Tempore David Sokola said in a statement.

‘Unprecedented’ use of executive authority, lawmaker says

Meyer’s office said Hockstein will serve as the governor’s chief physician advisor, the state’s principal public health communicator and the state’s chief advocate for the health and well-being of Delawareans.

However, some House and Senate Democrats said it’s unclear whether how the office was created and staffed is legal and what the source of current and future funding for the position is. A spokesperson for DHSS said the money is coming from preexisting agency personnel funding.

The proposed pay for the surgeon general salary would cost Delawareans $268,795, the senate caucus spokesperson said. DHSS asked for a base salary of $200,803, but health and retirement benefits increase the cost.

Since the salary and benefits allocated for the original nursing position totaled $119,668, health officials must come up with the remaining $149,127 from somewhere within its budget to fund the surgeon general role.

Hockstein said he did not participate in a competitive process for the position, such as applying to a job ad or submitting a bid for the position. He said discussions about becoming surgeon general happened “organically” through conversations with Meyer and Young.

“It was an evolution, and then the role, in some ways, created itself over the month of, I would imagine, May,” he told WHYY News. “Although, I honestly couldn’t tell you for sure.”

Paradee said he’s concerned that Meyer may have violated state hiring rules.

“The governor just can’t go out and award a six-figure or a $200,000-plus salary to any individual. It just doesn’t work that way,” Paradee said. “You either follow the rules of hiring a new state employee, involving advertising a position and going through that whole process at DHR, or you go the other route and through legislation, create this agency.”

Jonah Anderson, Meyer’s deputy press secretary, said the governor and Young have existing legal authority to create this position as part of their response to the state’s measles outbreak. However, the reclassification request was received by DHR on July 1, and DHSS didn’t announce the state’s first measles case until July 20.

Paradee said creating a statewide office and a new cabinet-level position without lawmakers approving legislation or the Senate confirming a nominee is “wildly unprecedented.”

“It’s just wild to me that the governor thinks he can, just through executive order, create a position that’s going to cost taxpayers $270,000 without giving the general assembly or the public an opportunity to have a conversation,” he said.

Anderson said Hockstein did not require Senate confirmation.

Hockstein could assert significant influence over public policy

Hockstein is designated in the executive order as a deputy cabinet secretary. While he reports to Young, he said he also will partly function as “chief medical officer, reporting to the governor, sitting in on his cabinet meetings, representing the physicians both inside state government and outside state government.”

That could put him in a position to exert significant influence over public health policy with the state’s top leader and a personal friend.

Hockstein and Meyer have been lifelong friends, starting as kids and then drifting apart for many years. He said they reconnected in 2020 during the COVID-19 pandemic, and he has remained a close advisor to Meyer since then. The governor appointed him to head the Delaware Health Care Commission last year.

Divesting of potential conflicts of interest

Hockstein said he is in the process of stepping back from working full-time in his practice and divesting from possible conflicts of interests so he can meet state ethics requirements.

He said he will continue to see patients in the office for a few hours a week to provide continuity of care for some period of time.

“I want to be very respectful and not abandon those patients that I’ve cared for for so long,” he said.

Hockstein said he resigned his surgical privileges and on-call privileges with ChristianaCare Health System effective Aug. 1, and he’s divesting ownership of a surgical center.

He also holds teaching positions at a few colleges, including his alma mater, Thomas Jefferson University in Philadelphia.

Hockstein was on the committee that awarded $78 million for Delaware to partner with Jefferson to create the state’s first medical school. Hockstein said because he was a volunteer faculty member, he was told he did not have a conflict of interest.

House speaker and Senate president have final say

Hockstein said he has been in conversations with state lawmakers since the governor’s surprise announcement of a state-level surgeon general.

The Senate Democratic Majority Caucus spokesperson said the final decision to approve the new position is the Senate president pro tempore and House speaker to make, with the controller general taking direction from them.

Sokola and House Speaker Melissa “Mimi” Minor-Brown both said that they support doing more to address public health issues, including access and affordability. Minor-Brown said in a statement that she is supportive of the idea of a surgeon general.

“But before we get there, I think we owe it to people to be clear about what this role actually involves, how Dr. Hockstein’s position fits within DHSS, and how those responsibilities will be supported without coming at the expense of existing public health priorities,” she said.