The House budget proposal is filled with law changes that don’t have anything to do with spending tax money. One of the special provisions is about actions adult care homes should take to prevent the spread of contagious diseases.
The state adopted temporary rules last year on infection control in adult care homes intended to curb the spread of COVID-19. The state Department of Health and Human Services wanted to make the temporary rule permanent, but the NC Senior Living Association didn’t like it. The association had its preferred version implanted in the House budget.
“We had concerns about some rules the state was getting ready to pass,” said Jeff Horton, association executive director. “We felt like we would put what we wanted in statutes.”
Friends of Residents in Long-Term Care in a legislative alert called the House budget provision “ambiguous at best and potentially harmful.”
The rule on infection prevention expands on a law passed about 10 years ago that focuses on curbing the spread of bloodborne diseases. A fatal hepatitis outbreak at a Mt. Olive assisted living center in 2010 that was traced to staff members using one device to draw blood from multiple diabetic residents spurred the original law.
The rewritten would cover all infectious diseases, including respiratory diseases.
The rule DHHS proposed would require adult care homes use CDC guidelines as a basis for writing and implementing infection control measures.
The budget version says adult care home plans should meet “accepted national standards” for infection control.
The reference to accepted national standards is far too vague, said Bill Lamb, board chairman for Friends of Residents.
“That ambiguity and what would become the standard in place of the CDC guidelines gives us pause,” Lamb said in an interview.
In a May letter objecting to the proposed rule, Horton wrote that information on the CDC website changes, and the CDC links to other websites with changing information. It would be unreasonable for adult care homes to keep track of the CDC information, update their own polices to match, and train staff in new procedures, he wrote.
In an interview, Horton said the association wants DHHS to develop the training program rather than have each facility do its own thing.
In response to questions, DHHS said in an email last month that the department looked forward to working with policymakers on the guidelines.
“Providing clear and enforceable guidance to facilities like adult and family care homes regarding basic health protocols like infection prevention is important, especially in the context of the COVID-19 pandemic,” the email said. “There are aspects of this provision that could be amended to better protect North Carolinians living in these settings by adding specificity and clarity to the standards these facilities should meet, transparency for the public, and consistency with existing public health regulations.”