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Massachusetts House Bill H789

Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H789 Compare Versions

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22 HOUSE DOCKET, NO. 1449 FILED ON: 1/15/2025
33 HOUSE . . . . . . . . . . . . . . . No. 789
44 The Commonwealth of Massachusetts
55 _________________
66 PRESENTED BY:
77 Thomas M. Stanley
88 _________________
99 To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
1010 Court assembled:
1111 The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
1212 An Act to improve Massachusetts home care.
1313 _______________
1414 PETITION OF:
1515 NAME:DISTRICT/ADDRESS :DATE ADDED:Thomas M. Stanley9th Middlesex1/15/2025Brian W. Murray10th Worcester1/28/2025Lindsay N. Sabadosa1st Hampshire1/28/2025Paul K. Frost7th Worcester1/28/2025Rodney M. Elliott16th Middlesex2/4/2025Rebecca L. RauschNorfolk, Worcester and Middlesex2/4/2025Danillo A. Sena37th Middlesex2/4/2025Paul McMurtry11th Norfolk2/5/2025Samantha Montaño15th Suffolk2/5/2025Erika Uyterhoeven27th Middlesex2/7/2025James B. EldridgeMiddlesex and Worcester2/11/2025James C. Arena-DeRosa8th Middlesex2/12/2025Bruce J. Ayers1st Norfolk2/13/2025Jason M. LewisFifth Middlesex2/13/2025Patricia D. JehlenSecond Middlesex2/14/2025Carmine Lawrence Gentile13th Middlesex2/19/2025Carlos González10th Hampden2/24/2025Natalie M. Higgins4th Worcester2/24/2025 2 of 2
1616 Manny Cruz7th Essex2/28/2025James Arciero2nd Middlesex2/28/2025Adam J. Scanlon14th Bristol2/28/2025Michael D. BradySecond Plymouth and Norfolk3/3/2025Mary S. Keefe15th Worcester3/5/2025Adrianne Pusateri Ramos14th Essex3/12/2025Kevin G. Honan17th Suffolk3/12/2025 1 of 13
1717 HOUSE DOCKET, NO. 1449 FILED ON: 1/15/2025
1818 HOUSE . . . . . . . . . . . . . . . No. 789
1919 By Representative Stanley of Waltham, a petition (accompanied by bill, House, No. 789) of
2020 Thomas M. Stanley and others for legislation to create safe environments for home care workers
2121 and consumers. Elder Affairs.
2222 The Commonwealth of Massachusetts
2323 _______________
2424 In the One Hundred and Ninety-Fourth General Court
2525 (2025-2026)
2626 _______________
2727 An Act to improve Massachusetts home care.
2828 Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
2929 of the same, as follows:
3030 1 SECTION 1. Chapter 111 of the General Laws, as appearing in the 2022 Official Edition,
3131 2is hereby amended by inserting after section 51K the following 3 sections:-
3232 3 Section 51L. (a) For the purposes of this section and sections 51M and 51N, the
3333 4following words shall, unless the context clearly requires otherwise, have the following
3434 5meanings,:-
3535 6 “Home care agency", a business, nonprofit organization or other entity engaged in
3636 7providing home care services to consumers in the consumers’ residence for compensation or any
3737 8entity or individual that represents itself as a home care agency by name, advertising or
3838 9presentments to the public or uses the terms “home care agency” or “home care” in the entity or
3939 10individual’s name; provided however, that ''home care agency'' shall not include any of the
4040 11following: (i) an entity operated by either the federal government or the commonwealth
4141 12providing home care services, (ii) an entity that limits its business to the provision of house 2 of 13
4242 13cleaning services, (iii) an Aging Service Access Points entity as defined in section 4B of chapter
4343 1419A, (v) a hospice program licensed under section 57D or (vi) a home health agency as defined
4444 15in section 51K.
4545 16 “Home care consumers”, an individual receiving home care services or any legal
4646 17representative of such individual.
4747 18 “Home care services", supportive services provided to an individual in their residence to
4848 19enable that individual to remain in their residence safely and comfortably, including, but not
4949 20limited to, assistance with eating, toileting, dressing, bathing, transferring, ambulation and other
5050 21activities of daily living, housekeeping, personal laundry and companionship. Home care
5151 22services shall not include hospice services provided by an entity subject to licensure under
5252 23section 57D or home health services provided by an entity subject to licensure under section
5353 2451K, services provided by a personal care attendant in the commonwealth’s personal care
5454 25attendant program as defined in 130 CMR 422.000 or services provided under the MassHealth
5555 26adult foster care program as defined in 101 CMR 351.00.
5656 27 “Home care worker”, an individual employed by a home care agency who provides home
5757 28care services to a consumer in the consumer’s residence.
5858 29 “Personal care attendant”, an individual who provides consumer-directed personal care
5959 30services to a consumer in the consumer’s residence, including, but not limited to, a person
6060 31providing such services as defined under section 70 of chapter 118E.
6161 32 “Secretary”, the secretary of health and human services. 3 of 13
6262 33 (b) Unless otherwise expressly authorized by the secretary, no person shall establish,
6363 34maintain, operate or hold oneself out as a home care agency without a home care agency license
6464 35issued by the secretary and no organization or entity shall provide home care services, use the
6565 36words "home care" to describe its services or establish, maintain, operate or hold itself out as a
6666 37home care agency without a home care agency license issued by the secretary; provided, that
6767 38licensure shall be required for home care agencies that directly employ home care workers or
6868 39directly contract with a company who employs home care workers.
6969 40 (c) The secretary shall issue for a term to be determined, and may renew for like terms, a
7070 41home care agency license to any person or entity of any kind, other than a department, agency or
7171 42institution of the federal government, the commonwealth or any political subdivision thereof,
7272 43that: (i) the secretary deems responsible and suitable to establish or operate a home care agency,
7373 44and (ii) meets the requirements of the executive office of health and human services established
7474 45in accordance with the office’s rules and regulations developed in consultation with the
7575 46executive office of elder affairs and the department of public health as provided in subsection (e).
7676 47 A home care agency license shall be subject to suspension, revocation or refusal to renew
7777 48for cause. License application and renewal fees shall be established pursuant to section 3B of
7878 49chapter 7.
7979 50 The secretary may issue a provisional license for a term not to exceed 120 days to an
8080 51applicant that has not previously operated home care services, or to a home care agency that is
8181 52operating but is temporarily unable to meet applicable standards and requirements. If a
8282 53provisional licensee has made significant progress towards meeting such requirements, the 4 of 13
8383 54secretary may renew the provisional license once for a period not to exceed 120 days from the
8484 55expiration of the initial provisional license.
8585 56 (d) The secretary may impose a fine on a person or entity that advertises, announces,
8686 57establishes, or operates a home care agency without a license granted by the secretary. The
8787 58secretary may impose a fine on a licensed home care agency that violates this section, or any rule
8888 59or regulation promulgated hereunder. Each day during which a violation continues shall
8989 60constitute a separate offense.
9090 61 The secretary, in collaboration with the executive office of elder affairs and the
9191 62department of public health, may conduct surveys and investigations to enforce compliance with
9292 63this section.
9393 64 (e) The secretary shall, in consultation with the executive office of elder affairs and the
9494 65department of public health, promulgate rules and regulations for the licensing and conduct of a
9595 66home care agency. In developing these rules and regulations, the secretary shall review all
9696 67existing licensure, reporting and oversight requirements across the long-term care services and
9797 68support system and other relevant state agencies, including the provider monitoring conducted by
9898 69the Aging Services Access Points, to avoid duplication or conflicting requirements and to ensure
9999 70that home care agency licensure processes align with the current licensure for home health
100100 71agencies and with state oversight process already in place through the Aging Services Access
101101 72Points and the nurse aide registry.
102102 73 The regulations shall include, but shall not be limited to:
103103 74 (i) background screening check requirements for all home care workers which may
104104 75include: (1) Massachusetts criminal background checks, (2) state or county criminal history 5 of 13
105105 76screenings for each location outside of the commonwealth in which the home care professional is
106106 77known to have lived or worked during the previous 5 years, (3) review of the federal Office of
107107 78Inspector General List of Excluded Individuals/Entities, (4) review of the nurse aide registry, (5)
108108 79applicable professional licensing board check and (6) for all home care professionals who will
109109 80transport consumers, verification of auto insurance and driving records for a minimum of the
110110 81previous 5 years;
111111 82 (ii) minimum standards for consumer-specific service plans and contracts; provided, that
112112 83the plans shall include: (1) a detailed description of services, including services the primary
113113 84agency is subcontracting to another agency or provider, (2) a written unit rate and total cost of
114114 85services, inclusive of any additional fees or deposits, and (3) contact information for consumer
115115 86questions;
116116 87 (iii) minimum coverage requirements for workers’ compensation insurance and liability
117117 88insurance;
118118 89 (iv) maintenance of a payroll process that follows all state and federal labor and wage
119119 90laws;
120120 91 (v) annual and ongoing training and competency requirements for home care agency staff
121121 92that are in direct contact with home care consumers; provided, that minimum training
122122 93requirements shall include (1) confidentiality and privacy of home care consumer’s rights, (2)
123123 94infection control and communicable diseases, (3) handling of emergencies, including safety and
124124 95falls prevention, (4) observation, reporting and documenting changes in consumer needs and
125125 96environment, (5) identifying and reporting suspected abuse, neglect or theft, (6) understanding
126126 97Alzheimer’s disease and dementia, including person centered care, activities of daily living, 6 of 13
127127 98safety and dementia-related behaviors and communication and (7) wage theft. The trainings shall
128128 99be culturally and linguistically competent for the trainee;
129129 100 (vi) policies and procedures to ensure home care workers have safe working conditions,
130130 101adequate training and a process for submitting complaints;
131131 102 (vii) maintenance of an emergency preparedness plan;
132132 103 (viii) meeting of quality metrics and standards to be set forth in the licensing regulations;
133133 104 (ix) requirements and written processes for the timely reporting of home care consumer
134134 105complaints;
135135 106 (x) a suitability determination process; provided, that the process shall include, but not be
136136 107limited to, requiring all applicants to attest to having sufficient financial capacity to provide
137137 108ongoing care and services in compliance with state law and regulation; and
138138 109 (xi) providing adequate equipment and supplies for home care workers.
139139 110 (f)The secretary shall be responsible for licensing home care agencies. To accomplish the
140140 111objectives set forth in this section, the secretary may coordinate and consult with the offices and
141141 112agencies that are interested in matters pertaining to the delivery of home care services, including
142142 113but not limited to: (1) the department of public health, (2) the executive office of elder affairs, (3)
143143 114the department of consumer affairs and business regulation and (4) the department of public
144144 115health. The responsibilities of the regulating agency shall include:
145145 116 (i) reviewing and processing licensure applications, including a suitability review that
146146 117ensures the applicant can meet the obligations and conditions of licensure, including: 7 of 13
147147 118 (A) a review of the state disbarment list and federal Office of Inspector General List of
148148 119Excluded Individuals/Entities; and
149149 120 (B) a competency review where all individuals with at least a 5 per cent ownership stake
150150 121in the home care agency shall submit the individuals’ names, contact information, companies
151151 122where they have at least a 5 per cent ownership, any civil or criminal findings against said
152152 123individual, and a completed background check;
153153 124 (ii) establishing a process for a change of ownership that includes advanced notice to
154154 125home care consumers and home care workers and a review by the regulating state agency to
155155 126determine if the new licensee can meet the obligations and conditions of licensure, including a
156156 127suitability review; provided, that home care agency licenses shall not be transferable;
157157 128 (iii) working with other regulators to investigate and resolve complaints;
158158 129 (iv) imposing fines on the licensee when determined to be appropriate;
159159 130 (v) suspending or revoking licenses when determined to be appropriate;
160160 131 (vi) posting a listing of licensed home care agencies on a publicly available webpage;
161161 132 (vii) allowing for “deemed status” for licensure of home care agencies if an Aging
162162 133Service Access Points or MassHealth provider contract is in place;
163163 134 (viii) establishing of quality metrics and standards for monitoring the licensed home care
164164 135agency performance, including reporting mechanisms for tracking performance; and
165165 136 (ix) annual reporting by home care agencies, which may include reporting on quality
166166 137metrics and significant changes related to home care agency finances. 8 of 13
167167 138 Section 51M. (a) The secretary, in consultation with the home care worker and consumer
168168 139abuse stakeholder advisory committee establishing in subsection (b), MassHealth, the department
169169 140of elder affairs, the department of public health and the PCA quality home care workforce
170170 141council established pursuant to section 71 of chapter 118E, shall adopt minimum standards and
171171 142procedures for addressing abusive treatment and bullying of Massachusetts home care workers,
172172 143personal care attendants and home care consumers. The standards and procedures shall address
173173 144physical, verbal and mental abuse either of or from individual home care consumers as well as
174174 145any abusive treatment or bullying from home care consumer surrogates, family members, other
175175 146caregivers and any others present in the home care consumers’ household when the home care
176176 147worker is providing home care services. The standards and procedures shall promote appropriate
177177 148home care worker and home care consumer training and support and a safe and healthy work
178178 149environment for home care workers, while recognizing the privacy rights of home care
179179 150consumers, the role of personal care attendant consumer employers and that home care
180180 151consumers may have a disruptive behavioral disorder underlying abuse behavior.
181181 152 (b) There shall be a home care worker and consumer abuse stakeholder advisory
182182 153committee that shall meet, study and make recommendations to the secretary relative to
183183 154standards and procedures for addressing abusive treatment and bullying of home care workers,
184184 155personal care attendants and home care consumers.
185185 156 The advisory committee shall consist of the following 16 members: the secretary or a
186186 157designee, who shall serve as chair; the assistant secretary for MassHealth or a designee; the
187187 158secretary of elder affairs or a designee; the commissioner of public health or a designee; the
188188 159chairs of the joint committee on elder affairs or their designees; and 10 persons to be appointed
189189 160by the governor, 1 of whom shall be a personal care attendant, 1 of whom shall be a home care 9 of 13
190190 161agency direct care worker, 1 of whom shall be a consumer of personal care attendant services
191191 162who shall be a member of the PCA workforce council, 1 of whom shall be a consumer of home
192192 163care agency services, 1 of whom shall be a representative of the statewide independent living
193193 164council, 1 of whom shall be a representative of the Disability Law Center, Inc., 1 of whom shall
194194 165be a representative of the Massachusetts Home Care, Inc., 1 of whom shall be a representative of
195195 166the Home Care Aide Council, 1 of whom shall be a representative of the Home Care Alliance of
196196 167Massachusetts, Inc., and 1 of whom shall be a representative of the Massachusetts division of
197197 1681199SEIU. The members of the advisory committee shall serve without compensation.
198198 169 The advisory committee shall submit a report containing initial findings and
199199 170recommendations, including drafts of proposed legislation or regulatory changes to carry out its
200200 171recommendations, by filing the same with the clerks of the senate and house of representatives,
201201 172the joint committee on elder affairs and the joint committee on public health. The advisory
202202 173committee shall continue to meet quarterly following submission of the report and until the
203203 174advisory committee votes to dissolve itself.
204204 175 (c) The home care worker and consumer abuse stakeholder advisory committee shall
205205 176study and make findings and recommendations relative to the development and implementation
206206 177of minimum standards and procedures for addressing abusive treatment and bullying of
207207 178Massachusetts home care workers, personal care attendants and home care consumers. The
208208 179advisory committee’s study, findings and recommendations shall include, but not be limited to:
209209 180 (1) Reporting and debriefing, including best practices for standards and procedures for
210210 181home care workers and their home care consumers experiencing abusive treatment, bullying or
211211 182neglect to report abuse to the home care workers’ employers or appropriate state entities, 10 of 13
212212 183including the PCA workforce council or MassHealth for personal care assistants, without
213213 184retaliation and while retaining the right to report any criminal activity to law enforcement. The
214214 185standards shall include, but not be limited to, best practices for a debriefing process for affected
215215 186home care workers and home care consumers following violent acts.
216216 187 (2) Tracking and record retention, including best practices for standards and procedures
217217 188for the secretary to track and monitor reports of both home care worker abuse and reports of
218218 189home care consumer abuse or neglect.
219219 190 (3) Informing workers, including best practices for standards and procedures that would
220220 191require employers of home care workers or other appropriate state entities, including the PCA
221221 192workforce council or MassHealth for personal care assistants, to regularly inform home care
222222 193workers of patterns of consumer or worker abuse or bullying that indicates a potentially unsafe
223223 194working environment. The standards and procedures shall respect home care consumer privacy
224224 195while prioritizing home care worker safety and while ensuring continuity of care.
225225 196 (4) Training and employer policies, including best practices for standards and procedures
226226 197for the secretary, in consultation with home care employers and other stakeholders, to develop
227227 198and implement home care worker and home care consumer orientations and other trainings on:
228228 199(i) worker abuse and bullying, (ii) escalation cycles and effective de-escalation techniques and
229229 200(iii) culturally competent and peer-to-peer trainings and strategies to prevent physical harm with
230230 201hands-on practice or role play. The training and employer policies shall also include best
231231 202practices for home care employers to implement additional internal plans and procedures to: (A)
232232 203reduce workplace violence and abuse, (B) offer resources to employees for coping with the
233233 204effects of violence and (C) develop labor-management workplace safety committees. The 11 of 13
234234 205training and employer policies shall consider and avoid duplication of existing requirements and
235235 206trainings in place through Aging Service Access Points.
236236 207 Section 51N. (a) There is hereby established a home care oversight advisory council
237237 208within the executive office of health and human services.
238238 209 The advisory council shall advise the secretary relating to the regulations described in
239239 210subsection (e) of section 51L. The executive office of health and human services shall consult
240240 211with the advisory council on implementation of the home care agency licensure process outlined
241241 212in section 51L. The advisory council may also conduct a review concurrently with the
242242 213development of the home care agency licensure process to include, but not be limited to:
243243 214 (i) the process of implementing the new home care agency licensure process in the
244244 215commonwealth, including the creation of a provisional license to address identified gaps in home
245245 216care services;
246246 217 (ii) existing licensure, reporting and oversight requirements across the long-term care
247247 218services and support systems and other relevant state agencies, including the provider monitoring
248248 219conducted by the Aging Services Access Points, to avoid duplication and conflicting
249249 220requirements;
250250 221 (iii) home care agency licensure requirements in other states;
251251 222 (iv) processes to ensure that the home care agency licensure process will align with
252252 223licensure for home health agencies and with state oversight process already in place through the
253253 224Aging Services Access Points, the home care worker registry established in section 4D of
254254 225chapter 19A and the nurse aide registry established in section 72J; 12 of 13
255255 226 (v) the development of a process for state government to conduct a statewide home care
256256 227market analysis and report on current available home care services in all regions that may inform
257257 228the regulating agency and the issuance of new home care agency licenses; and
258258 229 (vi) any additional subjects that the home care oversight advisory council and the
259259 230secretary deem necessary and appropriate.
260260 231 (b) The advisory council shall be composed of the secretary or their designee, who shall
261261 232serve as chair; the chairs of the joint committee on elder affairs or their designees; the secretary
262262 233of elder affairs or their designee; the commissioner of public health or their designee; the
263263 234assistant secretary for MassHealth or their designee; 1 person to be appointed by the minority
264264 235leader of the house of representatives; 1 person to be appointed by the minority leader of the
265265 236senate; and 4 persons to be appointed by the governor, 1 of whom shall be a representative of the
266266 237Home Care Aide Council, 1 of whom shall be a representative of the Home Care Alliance of
267267 238Massachusetts, Inc., 1 of whom shall be a representative of Massachusetts Home Care, Inc. and 1
268268 239of whom shall be a representative of the Massachusetts division of 1199SEIU.
269269 240 (c) The council shall meet quarterly. Upon the promulgation of regulations for home care
270270 241agency licensure pursuant to subsection (e) of section 51L, the council may introduce a motion to
271271 242dissolve by a majority vote of its members.
272272 243 SECTION 2. Section 1 of chapter 151B of the General Laws, as so appearing, is hereby
273273 244amended by inserting after the word “thereof”, in line 21, the following words:- and an employer
274274 245of a personal care attendant as defined in section 70 of chapter 118E, including individual
275275 246consumers of a personal care attendant. 13 of 13
276276 247 SECTION 3. The secretary of health and human services shall, in consultation with the
277277 248executive office of elder affairs and the department of public health, promulgate rules and
278278 249regulations for the licensing and conduct of a home care agency, as provided in subsection (e) of
279279 250section 51L of chapter 111 of the General Laws, within 1 year of the effective date of this act.
280280 251 SECTION 4. The home care worker and consumer abuse stakeholder advisory committee
281281 252established in subsection (b) of section 51M of said chapter 111 shall meet at least monthly in
282282 253the first 6 months after the effective date of this act to develop initial findings and
283283 254recommendations. The advisory committee shall submit the report described in said subsection
284284 255(b) of said section 51M of said chapter 111 not later than 6 months after the effective date of this
285285 256act.
286286 257 SECTION 5. Members of the home care oversight advisory council established in section
287287 25851N of said chapter 111 shall be named and the council shall commence its work within 60 days
288288 259of the effective date of this act.