RALEIGH, N.C. — Wandering residents with tragic or near tragic consequences have made headlines in recent months and raised questions for adult-care facilities.

Taxpayers pay a lot of money to take care of the elderly and mentally ill in North Carolina. Could that money be better spent?

"I would say it's staffing and the training of staff," adult care advocate June Brotherton said.

Brotherton says the issue is not just quality, but quantity of staffers.

The state only requires one care worker for every 20 to 30 residents.

"You have to enter the field knowing that you're the voice of these people," said Donna Ferguson, a former adult care worker.

Ferguson says there are problems at every level.

I think it's a huge accountability issue. No one wants to take accountability," she said.

Lawmakers are pushing for change.

Tuesday, the Study Commission on Aging listed 10 recommendations for the General Assembly to consider in the upcoming short session. They include training, a $5-a-day raise, broader criminal record checks for workers and allowing more Medicaid dollars for home care instead of institutional care.

Even if these recommendations were approved, they would take years to implement.

Advocates feel that the suggestions move the state closer to a system that gives consumers more information about the facilities and about how tax dollars are spent.

"We have close to 80,000 residents in long-term care in North Carolina and about 80 percent are Medicaid patients."

Taxpayers in this state spends a billion dollars every year for long-term care.

"That's why it's so important to make sure we get our money's worth as taxpayers," Brotherton said.

A performance audit on the state's long-term care system was conducted in 1998. The state auditor's office says tracking dollar-to-dollar spending would be "complex".