| 1 | 1 | | 1 of 1 |
|---|
| 2 | 2 | | SENATE DOCKET, NO. 2339 FILED ON: 1/20/2023 |
|---|
| 3 | 3 | | SENATE . . . . . . . . . . . . . . No. 1952 |
|---|
| 4 | 4 | | The Commonwealth of Massachusetts |
|---|
| 5 | 5 | | _________________ |
|---|
| 6 | 6 | | PRESENTED BY: |
|---|
| 7 | 7 | | Bruce E. Tarr |
|---|
| 8 | 8 | | _________________ |
|---|
| 9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
|---|
| 10 | 10 | | Court assembled: |
|---|
| 11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
|---|
| 12 | 12 | | An Act to improve long-term care staffing and dignity for caregivers. |
|---|
| 13 | 13 | | _______________ |
|---|
| 14 | 14 | | PETITION OF: |
|---|
| 15 | 15 | | NAME:DISTRICT/ADDRESS :Bruce E. TarrFirst Essex and MiddlesexJames B. EldridgeMiddlesex and Worcester3/6/2023 1 of 15 |
|---|
| 16 | 16 | | SENATE DOCKET, NO. 2339 FILED ON: 1/20/2023 |
|---|
| 17 | 17 | | SENATE . . . . . . . . . . . . . . No. 1952 |
|---|
| 18 | 18 | | By Mr. Tarr, a petition (accompanied by bill, Senate, No. 1952) of Bruce E. Tarr and James B. |
|---|
| 19 | 19 | | Eldridge for legislation to improve long-term care staffing and dignity for caregivers through |
|---|
| 20 | 20 | | training, tuition reimbursements, tax credits and other programs. Revenue. |
|---|
| 21 | 21 | | The Commonwealth of Massachusetts |
|---|
| 22 | 22 | | _______________ |
|---|
| 23 | 23 | | In the One Hundred and Ninety-Third General Court |
|---|
| 24 | 24 | | (2023-2024) |
|---|
| 25 | 25 | | _______________ |
|---|
| 26 | 26 | | An Act to improve long-term care staffing and dignity for caregivers. |
|---|
| 27 | 27 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
|---|
| 28 | 28 | | of the same, as follows: |
|---|
| 29 | 29 | | 1 SECTION 1. Chapter 23 of the General Laws, as appearing in the 2020 Official Edition, |
|---|
| 30 | 30 | | 2is hereby amended by inserting after section 9U the following 2 sections:- |
|---|
| 31 | 31 | | 3 Section 9V. The executive office of labor and workforce development, through the |
|---|
| 32 | 32 | | 4Commonwealth Corporation, shall establish a grant program for nursing facility supervisory and |
|---|
| 33 | 33 | | 5leadership training. The program shall include, but not be limited to, covering the cost of nursing |
|---|
| 34 | 34 | | 6facility worker participation in evidence-based supervisory training for the express purpose of |
|---|
| 35 | 35 | | 7improving staff satisfaction, retaining staff and reducing turnover. |
|---|
| 36 | 36 | | 8 Section 9W. The Commonwealth Corporation shall, subject to appropriation, establish an |
|---|
| 37 | 37 | | 9extended care career ladder grant program, consistent with section 410 of chapter 159 of the acts |
|---|
| 38 | 38 | | 10of 2000. The Commonwealth Corporation shall make grants available for certified nurses' aides, |
|---|
| 39 | 39 | | 11home health aides, homemakers, personal care attendants, and other entry-level workers in long- |
|---|
| 40 | 40 | | 12term care. The grants may include English language training, training in other languages and 2 of 15 |
|---|
| 41 | 41 | | 13adult basic education programs to improve quality of care and improve direct care worker access |
|---|
| 42 | 42 | | 14to and participation in career ladder training. The length of such grants shall not exceed a period |
|---|
| 43 | 43 | | 15of 3 years. The Commonwealth Corporation shall submit quarterly reports to the house and |
|---|
| 44 | 44 | | 16senate committees on ways and means on said grant program including, but not limited to, the |
|---|
| 45 | 45 | | 17number of grants awarded, the amount of each grant, a description of the career ladder programs, |
|---|
| 46 | 46 | | 18changes in care-giving and workplace practices that have occurred and their impact on quality of |
|---|
| 47 | 47 | | 19care and worker retention and the certificates, degrees or professional status attained by each |
|---|
| 48 | 48 | | 20participating employee. The administrative and program-management costs for the |
|---|
| 49 | 49 | | 21implementation of said grant program shall not exceed 4 per cent of the amount of the grant |
|---|
| 50 | 50 | | 22program, including funding for technical assistance and evaluation. |
|---|
| 51 | 51 | | 23 SECTION 2. Chapter 111 of the General Laws, as so appearing, is hereby amended by |
|---|
| 52 | 52 | | 24inserting after section 4O the following section:- |
|---|
| 53 | 53 | | 25 Section 4P. The department shall, subject to appropriation, establish a tuition |
|---|
| 54 | 54 | | 26reimbursement program for certified nursing assistant training. The department shall reimburse |
|---|
| 55 | 55 | | 27for the costs of certified nursing assistant training or competency, provided that: (i) the costs |
|---|
| 56 | 56 | | 28have been incurred for an approved certified nursing assistant training program; (ii) the costs |
|---|
| 57 | 57 | | 29have been actually paid by the certified nursing assistant from their own personal funds; and (iii) |
|---|
| 58 | 58 | | 30individuals have begun employment as a certified nursing assistant in a licensed nursing facility |
|---|
| 59 | 59 | | 31within 12 months of completing the training program, including passing the competency testing. |
|---|
| 60 | 60 | | 32 SECTION 3.. Section 6 of Chapter 62 of the General Laws, as appearing in the 2020 |
|---|
| 61 | 61 | | 33Official Edition, is hereby amended by inserting after subsection (t) the following new 3 of 15 |
|---|
| 62 | 62 | | 34subsection:- (u)(1) As used in this subsection, the following words shall have the following |
|---|
| 63 | 63 | | 35meanings unless the context clearly requires otherwise: |
|---|
| 64 | 64 | | 36 "Activities of daily living", everyday functions and activities, which individuals usually |
|---|
| 65 | 65 | | 37do without help, including, but not limited to, bathing, continence, dressing, eating, toileting and |
|---|
| 66 | 66 | | 38transferring. |
|---|
| 67 | 67 | | 39 "Eligible family member", an individual who (1) is at least 18 years of age during a |
|---|
| 68 | 68 | | 40taxable year, (2) requires assistance with at least one activity of daily living and (3) qualifies as a |
|---|
| 69 | 69 | | 41dependent, spouse, parent or other relation by blood or marriage, including an in-law, |
|---|
| 70 | 70 | | 42grandparent, grandchild, stepparent, aunt, uncle, niece or nephew of the family caregiver. |
|---|
| 71 | 71 | | 43 “Evaluation year”, the year in which an evaluation of the tax credit is to be complete. The |
|---|
| 72 | 72 | | 44evaluation year shall be every 5 years after the effective date of this subsection. |
|---|
| 73 | 73 | | 45 "Family caregiver", an individual who is a resident taxpayer for the taxable year and had |
|---|
| 74 | 74 | | 46eligible expenditures, as described in paragraph (3) of this subsection, with respect to 1 or more |
|---|
| 75 | 75 | | 47eligible family members during the taxable year. In the case of a joint return, the term includes |
|---|
| 76 | 76 | | 48the individual and the individual's spouse. The family caregiver claiming the credit must have a |
|---|
| 77 | 77 | | 49Massachusetts adjusted gross income of less than $75,000 for an individual and $150,000 for a |
|---|
| 78 | 78 | | 50couple and incur uncompensated expenses directly related to the care of an eligible family |
|---|
| 79 | 79 | | 51member who is an adult. |
|---|
| 80 | 80 | | 52 (2) A taxpayer who is a family caregiver is eligible to receive for a taxable year is equal |
|---|
| 81 | 81 | | 53to a refundable credit against the taxes imposed by this chapter. The credit shall be equal to 100 |
|---|
| 82 | 82 | | 54per cent of the eligible expenditures incurred by the taxpayer during the taxable year, with a |
|---|
| 83 | 83 | | 55maximum allowable credit of $1,500. 4 of 15 |
|---|
| 84 | 84 | | 56 (3) Expenditures eligible to be claimed for the tax credit include the costs associated |
|---|
| 85 | 85 | | 57with: (i) the improvement or alteration to the family caregiver's primary residence to permit the |
|---|
| 86 | 86 | | 58eligible family member to remain mobile, safe, and independent; (ii) the purchase or lease of |
|---|
| 87 | 87 | | 59equipment that is necessary to assist an eligible family member in 2 carrying out one or more |
|---|
| 88 | 88 | | 60activities of daily living; and (iii) other goods, services or supports that assist the family |
|---|
| 89 | 89 | | 61caregiver in providing care to an eligible family member, such as expenditures related to hiring a |
|---|
| 90 | 90 | | 62home care aide or personal care attendant, respite care, adult day health, transportation, legal and |
|---|
| 91 | 91 | | 63financial services and assistive technology. |
|---|
| 92 | 92 | | 64 (4) No taxpayer shall be entitled to claim a tax credit under this subsection for the same |
|---|
| 93 | 93 | | 65eligible expenditures claimed by another taxpayer. The total amount of tax credits claimed by |
|---|
| 94 | 94 | | 66family caregivers shall not exceed $1,500 for the same eligible family member. If two or more |
|---|
| 95 | 95 | | 67family caregivers claim tax credits for the same eligible family member, the total of which |
|---|
| 96 | 96 | | 68exceeds $1,500, the total amount of the credit allowed shall be allocated in amounts |
|---|
| 97 | 97 | | 69proportionate to each eligible taxpayer’s share of the total amount of the eligible expenditures for |
|---|
| 98 | 98 | | 70the eligible family member. |
|---|
| 99 | 99 | | 71 (5) A taxpayer may not claim a tax credit under this section for expenses incurred in |
|---|
| 100 | 100 | | 72carrying out general household maintenance activities, including painting, plumbing, electrical |
|---|
| 101 | 101 | | 73repairs or exterior maintenance, provided, however, that home modifications to accommodate |
|---|
| 102 | 102 | | 74that person receiving care and such expenses must be directly related to assisting the family |
|---|
| 103 | 103 | | 75caregiver in providing care to an eligible family member are allowable. |
|---|
| 104 | 104 | | 76 (6) The commissioner of the department of revenue shall promulgate rules and |
|---|
| 105 | 105 | | 77regulations relative to the administration and enforcement of this subsection. 5 of 15 |
|---|
| 106 | 106 | | 78 (7) The commissioner shall annually, not later than September 1, file a report with the |
|---|
| 107 | 107 | | 79house and senate committees on ways and means, the chairs of the joint committee on revenue |
|---|
| 108 | 108 | | 80and the chairs of the joint committee on elder affairs identifying, by community, the total amount |
|---|
| 109 | 109 | | 81of tax credits claimed and the total number of tax filers who received the tax credit for the |
|---|
| 110 | 110 | | 82preceding fiscal year. |
|---|
| 111 | 111 | | 83 (8) On or before May 31 of the year before the evaluation year, there shall be established |
|---|
| 112 | 112 | | 84a committee entitled the Caregiver Tax Credit Evaluation Committee to conduct a review of the |
|---|
| 113 | 113 | | 85tax credit. The committee shall be comprised of 7 members: 2 of whom shall be appointed by the |
|---|
| 114 | 114 | | 86secretary of the executive office of health and human services; 2 of whom shall be appointed by |
|---|
| 115 | 115 | | 87the secretary of the executive office of elder affairs; 1 of whom shall be appointed by the |
|---|
| 116 | 116 | | 88secretary of the executive office for administration and finance; 1 of whom shall be appointed by |
|---|
| 117 | 117 | | 89the president of the senate; and 1 of whom shall be appointed by the speaker of the house of |
|---|
| 118 | 118 | | 90representatives. |
|---|
| 119 | 119 | | 91 The committee shall:: |
|---|
| 120 | 120 | | 92 (1) examine the purpose for which the tax credit was established; |
|---|
| 121 | 121 | | 93 (2) determine whether the original intent of the tax credit is still appropriate; |
|---|
| 122 | 122 | | 94 (3) examine whether the tax credit is meeting its objectives; |
|---|
| 123 | 123 | | 95 (4) examine whether the purposes of the tax credit could be more efficiently and |
|---|
| 124 | 124 | | 96effectively carried out through alternative methods; and |
|---|
| 125 | 125 | | 97 (5) calculate the costs of providing the tax credit, including the administrative cost and |
|---|
| 126 | 126 | | 98lost revenues to the commonwealth as well as any estimated saving to the Commonwealth by 6 of 15 |
|---|
| 127 | 127 | | 99helping the person to avoid nursing home care. The committee shall file a report of its findings |
|---|
| 128 | 128 | | 100with the senate and house clerks and with the governor, which shall include a recommendation as |
|---|
| 129 | 129 | | 101to whether the tax credit should be continued, with or without changes, or be terminated. The |
|---|
| 130 | 130 | | 102report shall be accompanied by any legislation that is needed to accomplish the |
|---|
| 131 | 131 | | 103recommendations of the report. The report shall be filed no later than 3 December 31 of the |
|---|
| 132 | 132 | | 104evaluation year. |
|---|
| 133 | 133 | | 105 SECTION 4. Section 9 of chapter 118E of the General Laws, as appearing in the 2018 |
|---|
| 134 | 134 | | 106Official Edition, is hereby amended by inserting in line 16, after the words "requirements of Title |
|---|
| 135 | 135 | | 107XIX;", the following words:- provided further, that spouses shall be permitted to serve as |
|---|
| 136 | 136 | | 108caregivers in the adult foster care and personal care attendant programs. |
|---|
| 137 | 137 | | 109 SECTION 5. Notwithstanding any general or special law to the contrary, the executive |
|---|
| 138 | 138 | | 110office of health and human services, in consultation with the department of elder affairs and the |
|---|
| 139 | 139 | | 111office of Medicaid, shall develop metrics, standards, and procedures that trigger emergency long- |
|---|
| 140 | 140 | | 112term care provider rates of payment that include hazard pay wage add-ons for employees of |
|---|
| 141 | 141 | | 113home health agencies, personal care agencies, and home care agencies that shall be implemented |
|---|
| 142 | 142 | | 114in response to any COVID19 resurgence, statewide public health emergency, severe statewide |
|---|
| 143 | 143 | | 115weather emergency, or other statewide emergency incident. The executive office of health and |
|---|
| 144 | 144 | | 116human services shall also develop standard, comprehensive, timely and publicly accessible |
|---|
| 145 | 145 | | 117processes for provider reporting and state audits of the use of emergency rate increases for wage |
|---|
| 146 | 146 | | 118increases. |
|---|
| 147 | 147 | | 119 SECTION 6. Notwithstanding any general or special law to the contrary, the executive |
|---|
| 148 | 148 | | 120office of health and human services, in consultation with all appropriate state agencies and all 7 of 15 |
|---|
| 149 | 149 | | 121relevant public stakeholders, shall develop and implement a mandatory infection control and |
|---|
| 150 | 150 | | 122public health training program that all new and incumbent direct care employees of home health |
|---|
| 151 | 151 | | 123agencies and home care agencies shall complete as a condition of employment. The executive |
|---|
| 152 | 152 | | 124office shall establish contracts with labor-management training funds, community colleges, and |
|---|
| 153 | 153 | | 125other entities capable of conducting the training program and shall ensure the training program is |
|---|
| 154 | 154 | | 126implemented in a manner that is coordinated with the work of other state agencies and public and |
|---|
| 155 | 155 | | 127private entities involved in health care workforce training, recruitment, and retention. |
|---|
| 156 | 156 | | 128 SECTION 7. Notwithstanding any general or special law to the contrary, the executive |
|---|
| 157 | 157 | | 129office of health and human services shall establish an online personal protective equipment |
|---|
| 158 | 158 | | 130exchange for the purpose of identifying, aggregating, and making available for private purchase |
|---|
| 159 | 159 | | 131and procurement necessary personal protective equipment to be utilized by long-term care |
|---|
| 160 | 160 | | 132workers, including, but not limited to, personal care attendants and all employees of nursing |
|---|
| 161 | 161 | | 133facilities, resident care facilities, assisted living residences, adult day programs, home health |
|---|
| 162 | 162 | | 134agencies, and home care agencies in the Commonwealth. The executive office shall: (i) identify |
|---|
| 163 | 163 | | 135and offer qualified private wholesalers, manufacturers, and suppliers the opportunity to |
|---|
| 164 | 164 | | 136participate on the exchange; (ii) ensure that the personal protective equipment offered on the |
|---|
| 165 | 165 | | 137exchange complies with all federal and state requirements and specifications; and (iii) establish |
|---|
| 166 | 166 | | 138and implement a 2 comprehensive process to receive, negotiate, and finalize competitive pricing |
|---|
| 167 | 167 | | 139to be offered for the personal protective equipment placed on the exchange. 2 All sales of the |
|---|
| 168 | 168 | | 140personal protective equipment from the exchange shall be private transactions by and between |
|---|
| 169 | 169 | | 141the private purchaser and private seller. The executive office shall operate the exchange and |
|---|
| 170 | 170 | | 142therefore facilitate such transactions but shall have no legal responsibility to offer payment for or |
|---|
| 171 | 171 | | 143the delivery of the personal protective equipment. The executive office may establish processes 8 of 15 |
|---|
| 172 | 172 | | 144to subsidize or to discount the cost of personal protective equipment that is purchased through |
|---|
| 173 | 173 | | 145the exchange for certain purchasers. In developing the exchange, the executive office shall |
|---|
| 174 | 174 | | 146establish a stakeholder group, which shall be comprised of representatives from 1199SEIU, the |
|---|
| 175 | 175 | | 147Massachusetts Senior Care Association, the Massachusetts Assisted Living Association, Leading |
|---|
| 176 | 176 | | 148Age of Massachusetts, the Hospice Federation of Massachusetts, the Home Care Alliance of |
|---|
| 177 | 177 | | 149Massachusetts, manufacturers and suppliers of personal protective equipment, and other |
|---|
| 178 | 178 | | 150stakeholders that the executive office deem necessary to organize and establish the exchange. |
|---|
| 179 | 179 | | 151 SECTION 8. Notwithstanding any general or special law to the contrary, the executive |
|---|
| 180 | 180 | | 152office of health and human services, in consultation with the department of elder affairs and the |
|---|
| 181 | 181 | | 153office of Medicaid, shall develop and implement new standards and practices that use the worker |
|---|
| 182 | 182 | | 154contact information included in the Massachusetts Home Care Worker Registry established in |
|---|
| 183 | 183 | | 155Chapter 139 of the Acts of 2017 to ensure robust communication with the home care agency |
|---|
| 184 | 184 | | 156workforce during a state public health emergency or other state emergencies. Such |
|---|
| 185 | 185 | | 157communication shall include, but not be limited to, informing the home care agency workforce |
|---|
| 186 | 186 | | 158about any new provider rates designated for hazard pay, the availability of and standards for |
|---|
| 187 | 187 | | 159mandatory infection control trainings, and procedures for accessing personal protective |
|---|
| 188 | 188 | | 160equipment from any state-run online exchange. |
|---|
| 189 | 189 | | 161 SECTION 9. The personal protective equipment exchange established in Section 3 shall |
|---|
| 190 | 190 | | 162be implemented not later than 90 days after the effective date of this act |
|---|
| 191 | 191 | | 163 SECTION 10... Chapter 111 of the Massachusetts General Laws, as so appearing, is |
|---|
| 192 | 192 | | 164hereby amended by adding the following new section:- For the purposes of this section the 9 of 15 |
|---|
| 193 | 193 | | 165following words shall, unless the context clearly requires otherwise, have the following |
|---|
| 194 | 194 | | 166meanings: |
|---|
| 195 | 195 | | 167 "Health Care Workforce", personnel employed by or contracted to work at a skilled |
|---|
| 196 | 196 | | 168nursing facility that influence the delivery of quality care to residents, including but not limited |
|---|
| 197 | 197 | | 169to registered nurses, licensed practical nurses, certified nursing assistants, unlicensed assistive |
|---|
| 198 | 198 | | 170personnel, service, maintenance, clerical, and all other health care workers. |
|---|
| 199 | 199 | | 171 "Skilled Nursing Facility" shall mean a Level 1, Level 2, or Level 3 long term care |
|---|
| 200 | 200 | | 172facility as defined in Massachusetts standard operations of long-term care facility regulations |
|---|
| 201 | 201 | | 173(105 CMR 150). (a) Notwithstanding any special or general law to the contrary, each skilled |
|---|
| 202 | 202 | | 174nursing facility shall establish and develop a health care workforce care planning committee |
|---|
| 203 | 203 | | 175within 90 days of the effective date of this act. The membership of the planning committee shall |
|---|
| 204 | 204 | | 176include at least one nurse, one certified nurse assistant, and one representative for each labor |
|---|
| 205 | 205 | | 177organization representing bargaining units at the facility. The membership of the planning |
|---|
| 206 | 206 | | 178committee shall include no more than the same number of management representatives relative |
|---|
| 207 | 207 | | 179to the number of appointed members of the health care workforce. (b) The committee shall |
|---|
| 208 | 208 | | 180participate in at least one meeting of labor management committee training. Such training shall |
|---|
| 209 | 209 | | 181be provided by an outside training vendor with demonstrated experience in labormanagement |
|---|
| 210 | 210 | | 182training. The training vendor shall be selected by majority vote of the planning committee and |
|---|
| 211 | 211 | | 183the facility shall pay for costs of this training. 2 (c) Each facility’s health care workforce |
|---|
| 212 | 212 | | 184planning committee shall develop, implement, monitor and regularly adjust a comprehensive |
|---|
| 213 | 213 | | 185care team plan that accounts for each unit or other skilled nursing facility division in which direct |
|---|
| 214 | 214 | | 186patient care is provided. The care team plan shall be developed to ensure that the assigned health |
|---|
| 215 | 215 | | 187care workforce members are sufficient to ensure a safe working environment and to provide 10 of 15 |
|---|
| 216 | 216 | | 188quality care to the facility’s residents. Further, the care team plan shall account for all anticipated |
|---|
| 217 | 217 | | 189variables that can influence a facility’s delivery of quality patient care. The care team plan shall |
|---|
| 218 | 218 | | 190include account for (i) the numbers and skill mix of needed health care workforce members to be |
|---|
| 219 | 219 | | 191assigned to residents, (ii) anticipated resident census, (iii) the time needed 2 to complete |
|---|
| 220 | 220 | | 192expected care tasks, (iv) the need for specialized equipment and technology, (v) the physical |
|---|
| 221 | 221 | | 193environment of the facility; and (vi) the necessity of ensuring a safe working environment. (d) As |
|---|
| 222 | 222 | | 194a condition of licensure, each skilled nursing facility shall submit the care team plan developed |
|---|
| 223 | 223 | | 195under subsection (b) and (c) to the department of public health on at least an annual basis. Such |
|---|
| 224 | 224 | | 196submission shall include a certification from each member of the health care workforce planning |
|---|
| 225 | 225 | | 197committee that the care team plan submitted accurately represents the consensus decisions of the |
|---|
| 226 | 226 | | 198facility’s planning committee. (e) The department of public health shall develop rules and |
|---|
| 227 | 227 | | 199regulations as needed to implement this section. |
|---|
| 228 | 228 | | 200 SECTION 11.: Notwithstanding any general or special law, rule or regulation to the |
|---|
| 229 | 229 | | 201contrary, the Department of Public Health shall amend the regulations governing “Nursing |
|---|
| 230 | 230 | | 202Services” and the standard operations of long-term care facilities (105 CMR 150.007). Such |
|---|
| 231 | 231 | | 203amendments shall establish enhanced operational standards for Level 1, 2, and 3 facilities |
|---|
| 232 | 232 | | 204mandating that, on and after October 1, 2022, compliance with sufficient staffing standards must |
|---|
| 233 | 233 | | 205include the provision of a minimum number of hours of care per resident per day (PPD) of 4.0 |
|---|
| 234 | 234 | | 206hours, of which at least 3.5 hours must be care provided to the resident by a certified nursing |
|---|
| 235 | 235 | | 207assistant. |
|---|
| 236 | 236 | | 208 SECTION 12. SECTION 1. (a) The following terms, as used in this section, shall, unless |
|---|
| 237 | 237 | | 209the context requires otherwise, have the following meanings:- 11 of 15 |
|---|
| 238 | 238 | | 210 “Consumer”, means a person receiving home care services from a home care worker |
|---|
| 239 | 239 | | 211employed by a home care agency or from a personal care attendant. |
|---|
| 240 | 240 | | 212 “Home care agency”, an entity or organization, however organized and whether |
|---|
| 241 | 241 | | 213conducted for profit or not for profit, that is owned, operated, maintained or advertised for the |
|---|
| 242 | 242 | | 214purpose of providing home care services in residential settings for compensation, provided, |
|---|
| 243 | 243 | | 215however, that home care agency shall not include an entity operated by either the federal |
|---|
| 244 | 244 | | 216government or the commonwealth providing home care services; an entity that limits its business |
|---|
| 245 | 245 | | 217exclusively to the provision of house cleaning services; an aging service access points or ASAP |
|---|
| 246 | 246 | | 218entity as defined in section 4B of chapter 19A; a hospice program licensed under section 57D of |
|---|
| 247 | 247 | | 219chapter 111; or an adult foster care program regulated under 130 CMR 408. |
|---|
| 248 | 248 | | 220 “Home care services”, supportive services provided to an individual in his or her |
|---|
| 249 | 249 | | 221residence to enable that individual to remain in his or her residence safely and comfortably, |
|---|
| 250 | 250 | | 222including, but not limited to, assistance with activities of daily living, homemaker services, |
|---|
| 251 | 251 | | 223housekeeping, personal laundry, personal care and companionship, provided, however, that |
|---|
| 252 | 252 | | 224home care services shall not include hospice services provided by an entity subject to licensure |
|---|
| 253 | 253 | | 225under section 57D of chapter 111, the home health services provided by an entity subject to |
|---|
| 254 | 254 | | 226licensure under section 51K of chapter 111, services provided by a personal care attendant in the |
|---|
| 255 | 255 | | 227commonwealth’s personal care attendant program as defined in 130 CMR 422.000, or services |
|---|
| 256 | 256 | | 228provided under the MassHealth adult foster care program as defined in 101 CMR 351.00. |
|---|
| 257 | 257 | | 229 “Home care worker”, means an individual employed by a home care agency who |
|---|
| 258 | 258 | | 230provides home care services to a consumer in the consumer’s residence. 12 of 15 |
|---|
| 259 | 259 | | 231 “Personal Care Attendant”, means an individual who provides consumer-directed |
|---|
| 260 | 260 | | 232personal care services to a consumer in the consumer’s residence, including, but not limited to, a |
|---|
| 261 | 261 | | 233person providing such services as defined under section 70 of chapter 118E. |
|---|
| 262 | 262 | | 234 (b) The executive office of health and human services, in consultation with the home care |
|---|
| 263 | 263 | | 235worker and consumer abuse stakeholder advisory committee, mass health, the department of |
|---|
| 264 | 264 | | 236elder affairs, the department of public health, and the personal care attendant workforce council, |
|---|
| 265 | 265 | | 237shall adopt minimum standards and procedures for addressing abusive treatment and bullying of |
|---|
| 266 | 266 | | 238Massachusetts home care workers, personal care attendants and consumers. Such standards and |
|---|
| 267 | 267 | | 239procedures shall address physical, verbal and mental abuse either of or from individual clients or |
|---|
| 268 | 268 | | 240consumers as well as any abusive treatment or bullying from consumer surrogates, family |
|---|
| 269 | 269 | | 241members, other caregivers and any others present in the consumers’ household when the home |
|---|
| 270 | 270 | | 242care worker is providing care services. Such standards and procedures shall promote appropriate |
|---|
| 271 | 271 | | 243worker and consumer training and supports, and a safe and healthy work environment for home |
|---|
| 272 | 272 | | 244care workers, while recognizing the privacy rights of home care clients and consumers, the role |
|---|
| 273 | 273 | | 245of PCA consumer employers and that home care consumers/clients may have a disruptive |
|---|
| 274 | 274 | | 246behavioral disorder underlying abuse behavior. |
|---|
| 275 | 275 | | 247 (c) There shall be a Home Care Worker and Consumer Abuse Stakeholder Advisory |
|---|
| 276 | 276 | | 248Committee that shall meet, study, and make recommendations to the Executive Office of Health |
|---|
| 277 | 277 | | 249and Human Services relative to standards and procedures for addressing abusive treatment and |
|---|
| 278 | 278 | | 250bullying of home care workers, personal care attendants and consumers. |
|---|
| 279 | 279 | | 251 The advisory committee shall consist of the following 15 members: the secretary of |
|---|
| 280 | 280 | | 252health and human services or a designee who shall serve as chair; the assistant secretary for 13 of 15 |
|---|
| 281 | 281 | | 253MassHealth or a designee; the secretary of elder affairs or a designee; the commissioner of |
|---|
| 282 | 282 | | 254public health or a designee; the chairs of the joint committee on elder affairs or their designees; |
|---|
| 283 | 283 | | 255the chairs of the joint committee on children, families, and disabilities, and 9 persons to be |
|---|
| 284 | 284 | | 256appointed by the governor, 1 of whom shall be a personal care attendant, 1 of whom shall be a |
|---|
| 285 | 285 | | 257home care agency direct care worker, 1 of whom shall be a consumer of pca services who shall |
|---|
| 286 | 286 | | 258be a member of the pca workforce council, 1 of whom shall be a consumer of home care agency |
|---|
| 287 | 287 | | 259services, 1 of whom shall be a representative of the Massachusetts statewide independent living |
|---|
| 288 | 288 | | 260council, 1 of whom shall be a representative of the disability Law center, 1 of whom shall be a |
|---|
| 289 | 289 | | 261representative of the Massachusetts home care, 1 of whom shall be a representative of the |
|---|
| 290 | 290 | | 262Massachusetts home care aide council and 1 of whom shall be a representative of the |
|---|
| 291 | 291 | | 263Massachusetts division of 1199SEIU-UHE. The members of the advisory committee shall serve |
|---|
| 292 | 292 | | 264without compensation. |
|---|
| 293 | 293 | | 265 The advisory committee shall meet at least monthly in the first six months after passage |
|---|
| 294 | 294 | | 266of this Act to develop initial findings and recommendations. The advisory committee shall |
|---|
| 295 | 295 | | 267submit a report containing initial findings and recommendations, including drafts of proposed |
|---|
| 296 | 296 | | 268legislation or regulatory changes to carry out its recommendations, by filing the same with the |
|---|
| 297 | 297 | | 269clerks of the senate and house of representatives, the joint committee on elder affairs and the |
|---|
| 298 | 298 | | 270joint committee on public health not later than six months following the passage of this Act. The |
|---|
| 299 | 299 | | 271advisory committee shall continue to meet quarterly thereafter and until the advisory committee |
|---|
| 300 | 300 | | 272votes to dissolve itself. |
|---|
| 301 | 301 | | 273 (d) The home care worker and consumer abuse stakeholder advisory committee shall |
|---|
| 302 | 302 | | 274study and make findings and recommendations relative to the development and implementation |
|---|
| 303 | 303 | | 275of minimum standards and procedures for addressing abusive treatment and bullying of 14 of 15 |
|---|
| 304 | 304 | | 276Massachusetts home care workers, personal care attendants and consumers. The advisory |
|---|
| 305 | 305 | | 277committee’s study, findings and recommendations shall include, but not be limited to, each of |
|---|
| 306 | 306 | | 278the following matters: |
|---|
| 307 | 307 | | 279 1) Reporting and debriefing: best practices for standards and procedures for home care |
|---|
| 308 | 308 | | 280workers and their consumers/clients experiencing abusive treatment, bullying or neglect to report |
|---|
| 309 | 309 | | 281such abuse to their employers and/or appropriate state entities, including the Personal Care |
|---|
| 310 | 310 | | 282Attendant Workforce Council and/or MassHealth for PCAs, without retaliation and while |
|---|
| 311 | 311 | | 283retaining the right to report any criminal activity to law enforcement. Such standards shall |
|---|
| 312 | 312 | | 284include, but not be limited to, best practices for a debriefing process for affected workers and |
|---|
| 313 | 313 | | 285consumers following violent acts. |
|---|
| 314 | 314 | | 286 2) Tracking and record retention: Best practices for standards and procedures for the |
|---|
| 315 | 315 | | 287Executive Office of Health and Human Services to track and monitor reports of both worker |
|---|
| 316 | 316 | | 288abuse and reports of consumer abuse or neglect. |
|---|
| 317 | 317 | | 289 3) Informing workers: Best practices for standards and procedures that would require |
|---|
| 318 | 318 | | 290employers of home care workers or other appropriate state entities, including the Personal Care |
|---|
| 319 | 319 | | 291Attendant Workforce Council and/or MassHealth for PCAs, to regularly inform home care |
|---|
| 320 | 320 | | 292workers of patterns of consumer/client worker abuse or bullying that indicates a potentially |
|---|
| 321 | 321 | | 293unsafe working environment. Such standards and procedures shall respect home care |
|---|
| 322 | 322 | | 294client/consumer privacy while prioritizing worker safety and while ensuring continuity of care. |
|---|
| 323 | 323 | | 295 4) Training and employer policies: Best practices for standards and procedures for the |
|---|
| 324 | 324 | | 296Executive Office of Health and Human Services, in consultation with home care employers and |
|---|
| 325 | 325 | | 297other stakeholders, to develop and implement home care worker and consumer orientations and 15 of 15 |
|---|
| 326 | 326 | | 298other trainings on worker abuse and bullying, escalation cycles and effective de-escalation |
|---|
| 327 | 327 | | 299techniques, culturally competent and peer-to-peer trainings and strategies to prevent physical |
|---|
| 328 | 328 | | 300harm with hands-on practice or role play. Best practices for home care employers to implement |
|---|
| 329 | 329 | | 301additional internal plans and procedures to reduce workplace violence and abuse, offer resources |
|---|
| 330 | 330 | | 302to employees for coping with the effects of violence and develop labor-management workplace |
|---|
| 331 | 331 | | 303safety committees. |
|---|
| 332 | 332 | | 304 SECTION 13. Section 1 of chapter 151B of the General Laws is hereby amended in line |
|---|
| 333 | 333 | | 30521 by inserting after the word “thereof” the following words:- |
|---|
| 334 | 334 | | 306 and shall also include an employer of a personal care attendant as defined under section |
|---|
| 335 | 335 | | 30770 of chapter 118e of the General Laws including individual consumers of a personal care |
|---|
| 336 | 336 | | 308attendant |
|---|
| 337 | 337 | | 309 SECTION 14. Section 3 of this act shall apply to taxable years beginning on or after |
|---|
| 338 | 338 | | 310January 1 next following the date of enactment. |
|---|