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225 <br /> REQUESTING ACTION ON CRITICAL <br /> DOMICILIARY CARE ISSUES <br /> WHEREAS, North Carolina has the second highest domiciliary bed to older , <br /> adult population ratio in the nation; and North Carolina has the <br /> fourth highest domiciliary reimbursement rate in the nation; and <br /> has never conducted an independent fiscal audit with which to <br /> establish an actual reimbursement rate; and <br /> WHEREAS, it is estimated that 66% of domiciliary residents have physical <br /> disabilities; over 50% have mental disabilities; and less than 7% <br /> of the resident population have no physical or mental disability; <br /> and <br /> WHEREAS, N.C. domiciliary care regulations require only an annual review <br /> with no ongoing medical status review, resulting in only an <br /> occasional and incidental medical care review for each resident; <br /> and <br /> WHEREAS, there currently are no specific formal training requirements for <br /> domiciliary home personal care staff in North Carolina's <br /> regulations and standards; and <br /> WHEREAS, most domiciliary residents have multiple prescription/medical needs <br /> and they do not manage their own medications or self medicate; and <br /> WHEREAS, there are no requirements for ,formal training in drug management <br /> practice for domiciliary staff, and medications are given to <br /> residents by untrained staff; and <br /> WHEREAS, domiciliary homes remain exempt from registration under the N.C. <br /> Controlled Substances Act; and <br /> WHEREAS, N.C. domiciliary homes vary in size from small family care home <br /> with under seven residents to large institutional facilities wit, <br /> 200 residents or more; <br /> NOW, THEREFORE BE IT RESOLVED THAT: <br /> 1. A formal resident assessment procedure, including an ongoing <br /> level of care review, be established for all N.C. domiciliary <br /> residents. <br /> 2. Regulations governing the procedures for procuring, storage, <br /> handling, and administration of prescription and over-the- <br /> counter medicines (drugs) be reviewed and strengthened as <br /> needed. <br /> 3. Regulations be developed to identify the level of specialized <br /> training requirements for the staff responsible for handling <br /> and administering all medicines. <br /> 4. Domiciliary homes should be included under the North Carolina <br /> Controlled Substances Act. <br /> 5. Laws and regulations establishing a consistent state certified <br /> training program for all personal care staff in North <br /> Carolina's domiciliary homes be enacted and enforced. <br /> 6. North Carolina conduct in independent fiscal audit to establish <br /> a basis for setting sound domiciliary reimbursement rates. <br /> 7. The adequacy and use of personal allowance funds received by <br /> residents on state/county assistance program needs be reviewed <br /> and revised. <br /> 8. Future fiscal increases from public funds for the State/Count", <br /> Special Assistance Program be directly allocated for certifie <br /> staff training and specifically identified personal care <br /> services to be provided. <br />