Details of Theresa's Law - Substitute Bill
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Ensuring the safety of residents in Adult Foster Care (AFC), one form of assisted living in Michigan, is a priority. It is critical to have strong and effective regulations as well as training and competency requirements for those who are a part of the medication administration process.
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Theresa's Law is in response to the failure to modernize regulations to meet the needs and safety of residents with increased acuity levels that AFCs are voluntarily accepting.
THE PROBLEM
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Administration of medication by unlicensed staff with MINIMAL training and competency testing.
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Most training is done on-the-job by those who have no medical training.
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Most residents not capable of self-administering their own medications; confirmed by industry lobbyists and LARA the state's regulatory authority.
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Everyone in the chain of risk management has no required medical credentials, including AFC consultants, inspectors of violations.
WHY IS ADDRESSING THE PROBLEM URGENT?
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Medication Errors - #1 category of substantiated violations for past 4 years*
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Medication errors cause harm to residents, undue stress & turnover for DCWs, and harm to facility reputation - LARA, Reducing Medication Errors & the Six Rights of Medication Administration.
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73% of other states DO NOT allow passing of medications by unlicensed staff.
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*Years 1-3 = 10/28/2019 – 10/29/2022 Year 4 = 10/30/2022 – 10/30/2023
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BUT ISN'T THERE A STAFFING CRISIS?
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The long term care industry has had chronic issues with staff turnover for decades. There are many reasons for this. This legislation focuses on safety issues, that is, training the current staff to do their job with competency. It does NOT call for extra staff.
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- Just because there is a staff shortage doesn't mean you don't train the staff you have. If there's a shortage of firefighters, would you not train the ones you do have to do their job with safety precautions? Same is true for police or other roles where people's lives are at risk. It's imperative to train & educate current staff to be prepared and able. TRAINING IS AN INVESTMENT, NOT A COST.
HOW THE PROBLEM BE IMPROVED
A long-term and short-term approach are needed. Each will enhance standards to improve care and increase resident safety.
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Solutions addressed in the Substitute Bill:
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​Increased Transparency - breadth and depth of training and certification of staff administering medications BEFORE signing a contract.
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​Additional Training to equip DCW for current job and support for existing responsibilities. Training related to: Diabetes, PRNs, Meds. w/Parameters, Controlled Substances, Ethics.
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Solutions targeted for next session:
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​Quarterly Audits - review of Medication Administration Record (MAR) by licensed staff (monthly audits required in nursing homes of licensed staff).
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​Certified Medication Aide (CMA) Role specific to Assisted Living
WHAT ARE SOME POSITIVE OUTCOMES?
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For Residents:
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​Better care and healthier outcomes​
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Reduced hospitalizations, ER visits due to medication errors
For Direct Care Workers:
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​Better equipped for current job​
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Reduced stress, burnout, and turnover*
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Building blocks for a career path - incentive to stay in profession
For AFC Homes:
- Less staff turnover
- IMPART ALLIANCE, PHI, LARA, and industry experts state top reasons for DCW shortage & turnover: Low Pay, Poor Benefits, Lack of training and credentials, and lack of career path
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Increased Return on Investment
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Costs of staff turnover: $2,600 yearly per DCW (IMPART ALLIANCE); Michigan Health Endowment Fund estimates costs to be between $6-7K per DCW
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Improved AFC reputation
* Research shows how lack of training has a direct connection to current staffing shortages in health care.
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