Massachusetts House Passes Home Care Bill

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BOSTON – Friday, November 7, 2025 – The Massachusetts House of Representatives this week passed a bill that establishes a licensure process for home care agencies to ensure that consumers receive quality non-medical services, and to protect home care workers. The bill tasks the Executive Office of Health and Human Services (EOHHS) with implementing the licensure process, and grants the secretariat the authority to approve licenses, survey and investigate home care agencies, and impose fines when appropriate. Under the bill, home care agencies would be required to disclose anyone with a 5 percent ownership interest in the agency, carry workers compensation and liability insurance, and provide appropriate levels of training for their employees. 

The bill also creates two advisory councils: the Home Care Oversight Advisory Council to help guide the development and implementation of the home care licensure process, and the Home Care Worker and Consumer Abuse Stakeholder Advisory Committee to make recommendations on standards and procedures to address the abusive treatment of home care workers, personal care attendants (PCAs), and home care consumers. The bill also grants additional anti-discrimination protections for PCAs. 

“This legislation takes important steps to improve services for seniors, and to ensure a safe work environment for home care workers,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Chairman Stanley for his work on this legislation, as well as all my colleagues in the House for recognizing the importance of these reforms.” 

“Home care workers are a critical part of our healthcare system, allowing our seniors to remain independent and age in place,” said Representative Tackey Chan (D-Quincy). “Increased oversight and training will reinforce the safety of our seniors, while the additional workforce protections and supports will ensure home care workers are protected as they visit private homes.” 

“As Massachusetts faces growing demand for in-home care, this legislation will strengthen workforce training and safety standards, enhance accountability through the Executive Office of Health and Human Services’ new licensure and oversight process, and establish clear quality-of-care benchmarks to ensure that every patient receives safe, consistent, and high-standard services at home,” said Representative Bruce J. Ayers (D-Quincy). 

Oversight: Transparency & Accountability  

  • Grants EOHHS the ability to fine any person or entity that represents themselves as a home care agency without proper licensure, or that violates any other rules and regulations  

  • Grants EOHHS the ability to work with the Executive Office of Aging and Independence (AGE) and the Department of Public Health (DPH) on surveying and investigating home care agencies to ensure compliance  

  • Requires EOHHS to conduct a suitability review for all licensure applicants, including for all individuals with at least a 5 percent ownership interest in the agency, and a review to ensure that all applicants have sufficient financial capacity to provide a minimum standard of care 

  • Requires EOHHS to publish a list of all licensed home care agencies on its website 

  • Establishes standards for consumer-specific service plans and contracts, including a description of services, total cost of care, and agency contact information 

  • Establishes quality metrics and standards for monitoring home care agency performance  

Workforce Protections  

  • Establishes procedures to ensure home care workers have safe working conditions, adequate training, and a process for submitting complaints 

  • Requires licensed home care agencies to have coverage for worker’s compensation and liability insurance, and to provide adequate equipment and supplies to home care workers 

  • Creates the Home Care Worker and Consumer Abuse Stakeholder Advisory Committee to study and make recommendations on standards and procedures for addressing abusive treatment, including physical, verbal, mental abuse, and bullying of home care workers, PCAs, home care consumers, and family members, including: 

  • Reporting abusive treatment and debriefing after incidents of abusive treatment 

  • Tracking and retaining records of abusive treatment 

  • Informing home care workers of potentially unsafe working environments 

  • Training for all employees of home care agencies, including on escalation cycles and effective de-escalation techniques  

  • Grants PCAs anti-discrimination protections to shield them from harassment or discrimination based on sex, race, religion, etc. 

Minimum Standards for Home Care Workers  

  • Requires several background screening checks for all home care workers  

  • Establishes annual training and competency requirements, including:  

  • Confidentiality and privacy rights of home care consumers  

  • Infection control and communicable diseases  

  • Handling of emergencies, including safety and falls prevention  

  • Observing, reporting, and documenting changes in home care consumer needs and environment  

  • Identifying and reporting suspected abuse, neglect, or theft  

  • Understanding Alzheimer’s disease and dementia, including person-centered care, activities of daily living, safety, and dementia-related behaviors and communication  

Having passed the House of Representatives 153-1, the bill now goes to the Senate for consideration.