House approves home-care licensing, oversight and family caregiver study commission

The Massachusetts House passed House Bill 4706, "an act to improve Massachusetts home care," authorizing a licensing regime and new oversight mechanisms for home-care agencies and adopting an amendment to create a special legislative commission on family caregiving.

Mister Stanley of Waltham, House Chair of the Committee on Aging and Independence, said the bill fills a regulatory gap by bringing private-pay home-care agencies under state licensing standards similar to those in place for nursing homes and assisted-living providers. "There was a saying that people don't know about home care until they need home care," Stanley said, explaining that consumers often seek services during emergencies and lack time to assess agency quality.

The bill directs the Executive Office of Health and Human Services to develop and administer licensing and penalties for noncompliant home-care agencies, and directs coordination with the Executive Office of Aging and Independence and the Department of Public Health for surveys and investigations. The sponsor said the legislation requires suitability reviews for applicants with a 5% or greater ownership interest (the same threshold used for nursing homes and assisted-living under prior law), requires background checks and minimum training for workers, sets standards for service plans and agency contracts (including total cost disclosures), and requires agencies to provide workers with basic equipment and adequate insurance coverage.

To improve implementation and stakeholder oversight, H4706 establishes a Home Care Oversight Advisory Committee and a separate stakeholder advisory group to study and recommend responses to worker abuse and consumer abuse, with protections extending to personal care attendants (PCAs). The bill also contains provisions aimed at transparency regarding private-equity ownership in the sector.

Floor action: Amendment No. 5 (as offered by members including representatives from Fitchburg and others) would create a special legislative commission to conduct a comprehensive study of family caregiving policies. The amendment was adopted on a roll call (the clerk reported 154 in the affirmative, 0 negative). The final recorded vote on the engrossed bill, with the adopted amendment, was reported by the clerk as 153 in the affirmative and 1 in the negative; the House ordered the bill to be engrossed.

Advocates and industry stakeholders were credited in remarks for working with staff to craft requirements that would not unduly burden smaller providers while improving protection for consumers and home-care workers. The sponsor cited demographic trends cited in testimony and on the floor: U.S. Census Bureau estimates that more than 25% of the Commonwealth’s population will be 60 or older by 2030 (a roughly 33% increase since 2012) and said the state must prepare for increased demand.