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Legislators hear home‑care safety concerns and urge oversight of temporary staffing that may drain providers
Summary
Witnesses told the Joint Committee on Public Health that home health clinicians need stronger safety protections and that Department of Public Health authority is needed to regulate temporary nurse staffing contracts that are drawing clinicians away from home‑based care.
Committee members heard two related sets of testimony: safeguards for home care workers (H.2364/S.1632) and a proposal to allow DPH to regulate temporary nurse staffing contracts that affect home health and hospice agencies (H.2408/S.1633).
Gina Ferragamo, a home care registered nurse, described risks that clinicians face when entering patient homes alone — including threats, unwanted sexual advances and encounters with weapons — and urged that agencies be required to conduct pre‑service safety assessments, share relevant patient risk histories with staff, provide de‑escalation training and allow clinicians to leave dangerous situations without pay penalty or discipline. Ferragamo asked the committee for a favorable report on H.2364, which she said would create a blueprint to protect home‑care clinicians in increasingly complex home‑based settings.
Jake Karlovich of the Home Care Alliance of Massachusetts testified on H.2408/S.1633, which would extend an existing regulatory authority (Section 72Y of chapter 111) to cover home health and hospice agencies and allow DPH to adopt rules governing temporary nurse staffing (TNS) contracts. Karlovich told the committee that temporary staffing agencies are increasingly active in home care and sometimes offer higher hourly contracts (witnesses cited TNS contract rates of $90–$100 per hour versus average MassHealth reimbursement of $70–$80), creating a market pressure that can drain providers' workforce and threaten service access.
Karlovich and other witnesses argued TNS agencies are not held to the same training and oversight standards as certified home‑health providers; they said giving DPH explicit authority to regulate the contracting and standards would level the playing field and protect patient access. The bill language under consideration would allow DPH to apply existing contract‑cap rules used in institutional settings to the home‑care context.
No committee vote occurred. Sponsors and witnesses requested that DPH be given authority to craft regulations, including training standards, safety protocols and contract oversight to prevent workforce destabilization and improve staff safety.
