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Massachusetts Senate Bill S470

Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S470 Compare Versions

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22 SENATE DOCKET, NO. 1036 FILED ON: 1/15/2025
33 SENATE . . . . . . . . . . . . . . No. 470
44 The Commonwealth of Massachusetts
55 _________________
66 PRESENTED BY:
77 Patricia D. Jehlen
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 :Patricia D. JehlenSecond MiddlesexMichael O. MooreSecond Worcester1/27/2025Paul K. Frost7th Worcester1/28/2025John F. KeenanNorfolk and Plymouth1/29/2025Joanne M. ComerfordHampshire, Franklin and Worcester1/31/2025Rebecca L. RauschNorfolk, Worcester and Middlesex1/31/2025Paul W. MarkBerkshire, Hampden, Franklin and
1616 Hampshire
1717 2/10/2025James B. EldridgeMiddlesex and Worcester2/10/2025Jason M. LewisFifth Middlesex2/12/2025Julian CyrCape and Islands2/13/2025Carmine Lawrence Gentile13th Middlesex2/19/2025Manny Cruz7th Essex2/25/2025Adam J. Scanlon14th Bristol3/3/2025Michael D. BradySecond Plymouth and Norfolk3/3/2025 1 of 13
1818 SENATE DOCKET, NO. 1036 FILED ON: 1/15/2025
1919 SENATE . . . . . . . . . . . . . . No. 470
2020 By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 470) of Patricia D. Jehlen, Michael
2121 O. Moore, Paul K. Frost, John F. Keenan and other members of the General Court for legislation
2222 to improve Massachusetts home care. Elder Affairs.
2323 [SIMILAR MATTER FILED IN PREVIOUS SESSION
2424 SEE SENATE, NO. 380 OF 2023-2024.]
2525 The Commonwealth of Massachusetts
2626 _______________
2727 In the One Hundred and Ninety-Fourth General Court
2828 (2025-2026)
2929 _______________
3030 An Act to improve Massachusetts home care.
3131 Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
3232 of the same, as follows:
3333 1 SECTION 1. Chapter 111 of the General Laws, as appearing in the 2020 Official Edition,
3434 2is hereby amended by inserting after section 51K the following 3 sections:-
3535 3 Section 51L. (a)For the purposes of this section and sections 51M and 51N, the following
3636 4words shall, unless the context clearly requires otherwise, have the following meanings,:-
3737 5 “Home care agency", a business, nonprofit organization or other entity engaged in
3838 6providing home care services to consumers in the consumers’ residence for compensation or any
3939 7entity or individual that represents itself as a home care agency by name, advertising or
4040 8presentments to the public or uses the terms “home care agency” or “home care” in the entity or
4141 9individual’s name; provided however, that ''home care agency'' shall not include any of the 2 of 13
4242 10following: (i) an entity operated by either the federal government or the commonwealth
4343 11providing home care services, (ii) an entity that limits its business to the provision of house
4444 12cleaning services, (iii) an Aging Service Access Points entity as defined in section 4B of chapter
4545 1319A, (v) a hospice program licensed under section 57D or (vi) a home health agency as defined
4646 14in section 51K.
4747 15 “Home care consumers”, an individual receiving home care services or any legal
4848 16representative of such individual.
4949 17 “Home care services", supportive services provided to an individual in their residence to
5050 18enable that individual to remain in their residence safely and comfortably, including, but not
5151 19limited to, assistance with eating, toileting, dressing, bathing, transferring, ambulation and other
5252 20activities of daily living, housekeeping, personal laundry and companionship. Home care
5353 21services shall not include hospice services provided by an entity subject to licensure under
5454 22section 57D or home health services provided by an entity subject to licensure under section
5555 2351K, services provided by a personal care attendant in the commonwealth’s personal care
5656 24attendant program as defined in 130 CMR 422.000 or services provided under the MassHealth
5757 25adult foster care program as defined in 101 CMR 351.00.
5858 26 “Home care worker”, an individual employed by a home care agency who provides home
5959 27care services to a consumer in the consumer’s residence.
6060 28 “Personal care attendant”, an individual who provides consumer-directed personal care
6161 29services to a consumer in the consumer’s residence, including, but not limited to, a person
6262 30providing such services as defined under section 70 of chapter 118E.
6363 31 “Secretary”, the secretary of health and human services. 3 of 13
6464 32 (b) Unless otherwise expressly authorized by the secretary, no person shall establish,
6565 33maintain, operate or hold oneself out as a home care agency without a home care agency license
6666 34issued by the secretary and no organization or entity shall provide home care services, use the
6767 35words "home care" to describe its services or establish, maintain, operate or hold itself out as a
6868 36home care agency without a home care agency license issued by the secretary; provided, that
6969 37licensure shall be required for home care agencies that directly employ home care workers or
7070 38directly contract with a company who employs home care workers.
7171 39 (c) The secretary shall issue for a term to be determined, and may renew for like terms, a
7272 40home care agency license to any person or entity of any kind, other than a department, agency or
7373 41institution of the federal government, the commonwealth or any political subdivision thereof,
7474 42that: (i) the secretary deems responsible and suitable to establish or operate a home care agency,
7575 43and (ii) meets the requirements of the executive office of health and human services established
7676 44in accordance with the office’s rules and regulations developed in consultation with the
7777 45executive office of elder affairs and the department of public health as provided in subsection (e).
7878 46 A home care agency license shall be subject to suspension, revocation or refusal to renew
7979 47for cause. License application and renewal fees shall be established pursuant to section 3B of
8080 48chapter 7.
8181 49 The secretary may issue a provisional license for a term not to exceed 120 days to an
8282 50applicant that has not previously operated home care services, or to a home care agency that is
8383 51operating but is temporarily unable to meet applicable standards and requirements. If a
8484 52provisional licensee has made significant progress towards meeting such requirements, the 4 of 13
8585 53secretary may renew the provisional license once for a period not to exceed 120 days from the
8686 54expiration of the initial provisional license.
8787 55 (d) The secretary may impose a fine on a person or entity that advertises, announces,
8888 56establishes, or operates a home care agency without a license granted by the secretary. The
8989 57secretary may impose a fine on a licensed home care agency that violates this section, or any rule
9090 58or regulation promulgated hereunder. Each day during which a violation continues shall
9191 59constitute a separate offense.
9292 60 The secretary, in collaboration with the executive office of elder affairs and the
9393 61department of public health, may conduct surveys and investigations to enforce compliance with
9494 62this section.
9595 63 (e) The secretary shall, in consultation with the executive office of elder affairs and the
9696 64department of public health, promulgate rules and regulations for the licensing and conduct of a
9797 65home care agency. In developing these rules and regulations, the secretary shall review all
9898 66existing licensure, reporting and oversight requirements across the long-term care services and
9999 67support system and other relevant state agencies, including the provider monitoring conducted by
100100 68the Aging Services Access Points, to avoid duplication or conflicting requirements and to ensure
101101 69that home care agency licensure processes align with the current licensure for home health
102102 70agencies and with state oversight process already in place through the Aging Services Access
103103 71Points and the nurse aide registry.
104104 72 The regulations shall include, but shall not be limited to:
105105 73 (i) background screening check requirements for all home care workers which may
106106 74include: (1) Massachusetts criminal background checks, (2) state or county criminal history 5 of 13
107107 75screenings for each location outside of the commonwealth in which the home care professional is
108108 76known to have lived or worked during the previous 5 years, (3) review of the federal Office of
109109 77Inspector General List of Excluded Individuals/Entities, (4) review of the nurse aide registry, (5)
110110 78applicable professional licensing board check and (6) for all home care professionals who will
111111 79transport consumers, verification of auto insurance and driving records for a minimum of the
112112 80previous 5 years;
113113 81 (ii) minimum standards for consumer-specific service plans and contracts; provided, that
114114 82the plans shall include: (1) a detailed description of services, including services the primary
115115 83agency is subcontracting to another agency or provider, (2) a written unit rate and total cost of
116116 84services, inclusive of any additional fees or deposits, and (3) contact information for consumer
117117 85questions;
118118 86 (iii) minimum coverage requirements for workers’ compensation insurance and liability
119119 87insurance;
120120 88 (iv) maintenance of a payroll process that follows all state and federal labor and wage
121121 89laws;
122122 90 (v) annual and ongoing training and competency requirements for home care agency staff
123123 91that are in direct contact with home care consumers; provided, that minimum training
124124 92requirements shall include (1) confidentiality and privacy of home care consumer’s rights, (2)
125125 93infection control and communicable diseases, (3) handling of emergencies, including safety and
126126 94falls prevention, (4) observation, reporting and documenting changes in consumer needs and
127127 95environment, (5) identifying and reporting suspected abuse, neglect or theft, (6) understanding
128128 96Alzheimer’s disease and dementia, including person centered care, activities of daily living, 6 of 13
129129 97safety and dementia-related behaviors and communication and (7) wage theft. The trainings shall
130130 98be culturally and linguistically competent for the trainee;
131131 99 (vi) policies and procedures to ensure home care workers have safe working conditions,
132132 100adequate training and a process for submitting complaints;
133133 101 (vii) maintenance of an emergency preparedness plan;
134134 102 (viii) meeting of quality metrics and standards to be set forth in the licensing regulations;
135135 103 (ix) requirements and written processes for the timely reporting of home care consumer
136136 104complaints;
137137 105 (x) a suitability determination process; provided, that the process shall include, but not be
138138 106limited to, requiring all applicants to attest to having sufficient financial capacity to provide
139139 107ongoing care and services in compliance with state law and regulation; and
140140 108 (xi) providing adequate equipment and supplies for home care workers.
141141 109 (f) The secretary shall be responsible for licensing home care agencies. To accomplish
142142 110the objectives set forth in this section, the secretary may coordinate and consult with the offices
143143 111and agencies that are interested in matters pertaining to the delivery of home care services,
144144 112including but not limited to: (1) the department of public health, (2) the executive office of elder
145145 113affairs, (3) the department of consumer affairs and business regulation and (4) the department of
146146 114public health. The responsibilities of the regulating agency shall include:
147147 115 (i) reviewing and processing licensure applications, including a suitability review that
148148 116ensures the applicant can meet the obligations and conditions of licensure, including: 7 of 13
149149 117 (A) a review of the state disbarment list and federal Office of Inspector General List of
150150 118Excluded Individuals/Entities; and
151151 119 (B) a competency review where all individuals with at least a 5 per cent ownership stake
152152 120in the home care agency shall submit the individuals’ names, contact information, companies
153153 121where they have at least a 5 per cent ownership, any civil or criminal findings against said
154154 122individual, and a completed background check;
155155 123 (ii) establishing a process for a change of ownership that includes advanced notice to
156156 124home care consumers and home care workers and a review by the regulating state agency to
157157 125determine if the new licensee can meet the obligations and conditions of licensure, including a
158158 126suitability review; provided, that home care agency licenses shall not be transferable;
159159 127 (iii) working with other regulators to investigate and resolve complaints;
160160 128 (iv) imposing fines on the licensee when determined to be appropriate;
161161 129 (v) suspending or revoking licenses when determined to be appropriate;
162162 130 (vi) posting a listing of licensed home care agencies on a publicly available webpage;
163163 131 (vii) allowing for “deemed status” for licensure of home care agencies if an Aging
164164 132Service Access Points or MassHealth provider contract is in place;
165165 133 (viii) establishing of quality metrics and standards for monitoring the licensed home care
166166 134agency performance, including reporting mechanisms for tracking performance; and
167167 135 (ix) annual reporting by home care agencies, which may include reporting on quality
168168 136metrics and significant changes related to home care agency finances. 8 of 13
169169 137 Section 51M. (a) The secretary, in consultation with the home care worker and consumer
170170 138abuse stakeholder advisory committee establishing in subsection (b), MassHealth, the department
171171 139of elder affairs, the department of public health and the PCA quality home care workforce
172172 140council established pursuant to section 71 of chapter 118E, shall adopt minimum standards and
173173 141procedures for addressing abusive treatment and bullying of Massachusetts home care workers,
174174 142personal care attendants and home care consumers. The standards and procedures shall address
175175 143physical, verbal and mental abuse either of or from individual home care consumers as well as
176176 144any abusive treatment or bullying from home care consumer surrogates, family members, other
177177 145caregivers and any others present in the home care consumers’ household when the home care
178178 146worker is providing home care services. The standards and procedures shall promote appropriate
179179 147home care worker and home care consumer training and support and a safe and healthy work
180180 148environment for home care workers, while recognizing the privacy rights of home care
181181 149consumers, the role of personal care attendant consumer employers and that home care
182182 150consumers may have a disruptive behavioral disorder underlying abuse behavior.
183183 151 (b) There shall be a home care worker and consumer abuse stakeholder advisory
184184 152committee that shall meet, study and make recommendations to the secretary relative to
185185 153standards and procedures for addressing abusive treatment and bullying of home care workers,
186186 154personal care attendants and home care consumers.
187187 155 The advisory committee shall consist of the following 16 members: the secretary or a
188188 156designee, who shall serve as chair; the assistant secretary for MassHealth or a designee; the
189189 157secretary of elder affairs or a designee; the commissioner of public health or a designee; the
190190 158chairs of the joint committee on elder affairs or their designees; and 10 persons to be appointed
191191 159by the governor, 1 of whom shall be a personal care attendant, 1 of whom shall be a home care 9 of 13
192192 160agency direct care worker, 1 of whom shall be a consumer of personal care attendant services
193193 161who shall be a member of the PCA workforce council, 1 of whom shall be a consumer of home
194194 162care agency services, 1 of whom shall be a representative of the statewide independent living
195195 163council, 1 of whom shall be a representative of the Disability Law Center, Inc., 1 of whom shall
196196 164be a representative of the Massachusetts Home Care, Inc., 1 of whom shall be a representative of
197197 165the Home Care Aide Council, 1 of whom shall be a representative of the Home Care Alliance of
198198 166Massachusetts, Inc., and 1 of whom shall be a representative of the Massachusetts division of
199199 1671199SEIU. The members of the advisory committee shall serve without compensation.
200200 168 The advisory committee shall submit a report containing initial findings and
201201 169recommendations, including drafts of proposed legislation or regulatory changes to carry out its
202202 170recommendations, by filing the same with the clerks of the senate and house of representatives,
203203 171the joint committee on elder affairs and the joint committee on public health. The advisory
204204 172committee shall continue to meet quarterly following submission of the report and until the
205205 173advisory committee votes to dissolve itself.
206206 174 (c) The home care worker and consumer abuse stakeholder advisory committee shall
207207 175study and make findings and recommendations relative to the development and implementation
208208 176of minimum standards and procedures for addressing abusive treatment and bullying of
209209 177Massachusetts home care workers, personal care attendants and home care consumers. The
210210 178advisory committee’s study, findings and recommendations shall include, but not be limited to:
211211 179 (1) Reporting and debriefing, including best practices for standards and procedures for
212212 180home care workers and their home care consumers experiencing abusive treatment, bullying or
213213 181neglect to report abuse to the home care workers’ employers or appropriate state entities, 10 of 13
214214 182including the PCA workforce council or MassHealth for personal care assistants, without
215215 183retaliation and while retaining the right to report any criminal activity to law enforcement. The
216216 184standards shall include, but not be limited to, best practices for a debriefing process for affected
217217 185home care workers and home care consumers following violent acts.
218218 186 (2) Tracking and record retention, including best practices for standards and procedures
219219 187for the secretary to track and monitor reports of both home care worker abuse and reports of
220220 188home care consumer abuse or neglect.
221221 189 (3) Informing workers, including best practices for standards and procedures that would
222222 190require employers of home care workers or other appropriate state entities, including the PCA
223223 191workforce council or MassHealth for personal care assistants, to regularly inform home care
224224 192workers of patterns of consumer or worker abuse or bullying that indicates a potentially unsafe
225225 193working environment. The standards and procedures shall respect home care consumer privacy
226226 194while prioritizing home care worker safety and while ensuring continuity of care.
227227 195 (4) Training and employer policies, including best practices for standards and procedures
228228 196for the secretary, in consultation with home care employers and other stakeholders, to develop
229229 197and implement home care worker and home care consumer orientations and other trainings on:
230230 198(i) worker abuse and bullying, (ii) escalation cycles and effective de-escalation techniques and
231231 199(iii) culturally competent and peer-to-peer trainings and strategies to prevent physical harm with
232232 200hands-on practice or role play. The training and employer policies shall also include best
233233 201practices for home care employers to implement additional internal plans and procedures to: (A)
234234 202reduce workplace violence and abuse, (B) offer resources to employees for coping with the
235235 203effects of violence and (C) develop labor-management workplace safety committees. The 11 of 13
236236 204training and employer policies shall consider and avoid duplication of existing requirements and
237237 205trainings in place through Aging Service Access Points.
238238 206 Section 51N. (a) There is hereby established a home care oversight advisory council
239239 207within the executive office of health and human services.
240240 208 The advisory council shall advise the secretary relating to the regulations described in
241241 209subsection (e) of section 51L. The executive office of health and human services shall consult
242242 210with the advisory council on implementation of the home care agency licensure process outlined
243243 211in section 51L. The advisory council may also conduct a review concurrently with the
244244 212development of the home care agency licensure process to include, but not be limited to:
245245 213 (i) the process of implementing the new home care agency licensure process in the
246246 214commonwealth, including the creation of a provisional license to address identified gaps in home
247247 215care services;
248248 216 (ii) existing licensure, reporting and oversight requirements across the long-term care
249249 217services and support systems and other relevant state agencies, including the provider monitoring
250250 218conducted by the Aging Services Access Points, to avoid duplication and conflicting
251251 219requirements;
252252 220 (iii) home care agency licensure requirements in other states;
253253 221 (iv) processes to ensure that the home care agency licensure process will align with
254254 222licensure for home health agencies and with state oversight process already in place through the
255255 223Aging Services Access Points, the home care worker registry established in section 4D of
256256 224chapter 19A and the nurse aide registry established in section 72J; 12 of 13
257257 225 (v) the development of a process for state government to conduct a statewide home care
258258 226market analysis and report on current available home care services in all regions that may inform
259259 227the regulating agency and the issuance of new home care agency licenses; and
260260 228 (vi) any additional subjects that the home care oversight advisory council and the
261261 229secretary deem necessary and appropriate.
262262 230 (b) The advisory council shall be composed of the secretary or their designee, who shall
263263 231serve as chair; the chairs of the joint committee on elder affairs or their designees; the secretary
264264 232of elder affairs or their designee; the commissioner of public health or their designee; the
265265 233assistant secretary for MassHealth or their designee; 1 person to be appointed by the minority
266266 234leader of the house of representatives; 1 person to be appointed by the minority leader of the
267267 235senate; and 4 persons to be appointed by the governor, 1 of whom shall be a representative of the
268268 236Home Care Aide Council, 1 of whom shall be a representative of the Home Care Alliance of
269269 237Massachusetts, Inc., 1 of whom shall be a representative of Massachusetts Home Care, Inc. and 1
270270 238of whom shall be a representative of the Massachusetts division of 1199SEIU.
271271 239 (c) The council shall meet quarterly. Upon the promulgation of regulations for home care
272272 240agency licensure pursuant to subsection (e) of section 51L, the council may introduce a motion to
273273 241dissolve by a majority vote of its members.
274274 242 SECTION 2. Section 1 of chapter 151B of the General Laws, as so appearing, is hereby
275275 243amended by inserting after the word “thereof”, in line 21, the following words:- and an employer
276276 244of a personal care attendant as defined in section 70 of chapter 118E, including individual
277277 245consumers of a personal care attendant. 13 of 13
278278 246 SECTION 3. The secretary of health and human services shall, in consultation with the
279279 247executive office of elder affairs and the department of public health, promulgate rules and
280280 248regulations for the licensing and conduct of a home care agency, as provided in subsection (e) of
281281 249section 51L of chapter 111 of the General Laws, within 1 year of the effective date of this act.
282282 250 SECTION 4. The home care worker and consumer abuse stakeholder advisory committee
283283 251established in subsection (b) of section 51M of said chapter 111 shall meet at least monthly in
284284 252the first 6 months after the effective date of this act to develop initial findings and
285285 253recommendations. The advisory committee shall submit the report described in said subsection
286286 254(b) of said section 51M of said chapter 111 not later than 6 months after the effective date of this
287287 255act.
288288 256 SECTION 5. Members of the home care oversight advisory council established in section
289289 25751N of said chapter 111 shall be named and the council shall commence its work within 60 days
290290 258of the effective date of this act.