What the Senate’s Economic Development Bill did for Home Care

July 15, 2016

Late Thursday night, the Senate wrapped up debate on more than 200 amendments to legislation promoting economic and workforce development and the Home Care Alliance was active on several issues.

Senate Bill 2423, “An Act relative to job creation, workforce development and infrastructure investment,” created a a special commission to investigate and report on barriers to meeting labor market demands in the commonwealth. The commission’s report can include a broad range of industries, but according to the legislation, it must consist of cyber-security, high technology and biotechnology, early education and care, home care and home health. Despite this focus, the “labor commission,” as it was labeled, did not have a member that represented the home care industry.

Working together with the Home Care Aide Council, and Senator Patricia D. Jehlen’s office, an amendment was adopted to get a home care agency representative on that commission. If the Senate’s legislation advances and is passed, this commission will be shining a light on home care workforce issues on a level of importance that places it with other industries.

The other amendment, which was of great concern, was an effort that would have created a publicly-available registry with the personal information of home care workers. It was the same provision that showed up in legislation and FY17 budget amendments – all of which were defeated.

In this particular iteration, the result was a redrafted amendment to create a registry of home care workers that does NOT include personal information, but rather certifications and whether that worker has ever committed abuse, mistreatment or neglect of an elderly patient or consumer.

The Alliance thanks the many agencies that weighed in quickly with their state senator by phone and email on both of these matters.

The Senate’s legislation now must pass a conference committee process where differences between S.2423 and the House’s version of the bill must be worked out.

Further updates will be shared when they become available.

Return to www.thinkhome.care.


Unique, Grant-Funded Training Opportunity for Central Mass. Home Care Workers

March 24, 2016

Registration is OPEN NOW for the first Community Health Worker (CHW) Registered Apprenticeship Program established in Massachusetts and one of only a few in the nation.

The Center for Health Impact TM (formerly known as Central MA AHEC) in Worcester, Massachusetts is delighted to report that the Fairlawn Foundation Fund of the Greater Worcester Community Foundation has awarded funds to establish the creation of a Community Health Worker (CHW) Registered Apprenticeship Program in Central Massachusetts.

Apprenticeship is a flexible training system that benefits both employers and workers through its structured on-the-job learning and job-related classroom instruction. (Learn more about Apprenticeship USA at: https://www.doleta.gov/OA/apprenticeship.cfm.)

The 150-hour course, anticipated to start on April 5th, 2016 (pending enrollment/subject to change) will be offered free of charge to qualified applicants in Central Massachusetts by the Center for Health Impact TM Outreach Worker Training Institute (OWTI) in Worcester. Participants will earn a certificate of course completion aligned with the requirements established by the Massachusetts Board of Certification of CHWs.

To qualify, an individual must be employed or about to be employed with an employer who will:

  • Provide them 2200 hours of on-the-job paid apprenticeship learning and supervision in one calendar year
  • Reward the apprentice for skills gained by an increase in pay within one calendar year
  • Authorize the apprentice to attend the 150-Hour course (120 hours of class time; 30 hours of homework).

Benefits for employers:

  • Access to free CHW core competency training for employees
  • Access to incentives as an employer working with the CHW Registered Apprenticeship Program
  • Well trained and job proficient employees who meet employers’ specific needs
  • Enhanced employee retention
  • Improved service delivery

For questions, or to request the registration package for the Community Health Worker (CHW) Registered Apprenticeship 150-Hour Certificate Course, please contact: Tatyana Gorodetsky,  at tatyana@centerforhealthimpact.org or by phone at: 508-556-1332.


Earned Sick Time Final Regulation Summary and Analysis for Home Care Agencies

June 25, 2015

The final regulations on paid Earned Sick Time were released by the Attorney General’s Office (AGO) on Friday, June 19th with a number of substantial changes from the proposed regulations.   (The AG was charged with developing regulations to implement the new law – which was passed via a binding ballot question in 2014.)

The Home Care Alliance is pleased that most of the association’s comments were taken into consideration and the HCA thanks member home care agencies for their questions, concerns and suggestions. It is such involvement that allows the Alliance to better represent agencies and work for better results through our advocacy efforts.

Below is a basic summary of changes that home care agencies inquired about that were made between the proposed and final regulation.

Additionally, the Boston law firm Donahue, Barrett & Singal posted an analysis available to the public that is an excellent guide to the Earned Sick Time regulations. The Alliance has also partnered with Kurker Paget, LLC on a webinar for HCA members and further details and interpretation may become available.

Summary of Regulation Changes:

Section 33.01: Purpose, Scope and Other General Provisions

  • AGO added that “employees may choose to use, or employers may require employees to use, concurrent earned paid sick time…to receive pay when taking other statutorily-authorized leave that would otherwise be unpaid.”

Section 33.02: Definitions

  • AGO explained that “benefit year” is used interchangeably with “calendar year.”
  • The term “Calendar Year” was simplified to stand for any consecutive 12-month period as determined by the employer.
  • The term “Date of hire” was simplified to mean the employees “first date of actual work.”
  • Much more detail of employees and employers exempt from the law. Clarification that PCA’s are covered.
  • Regular hourly rate is newly defined as “the amount that an employee is regularly paid for each hour of work.”
  • “Same hourly rate” is clarified to mean employees regular hourly rate or, for employees earning varying rates from the same employer, either
    • The wages the employee would have been paid for the hours absent during the use of earned sick time if the employee had worked, or
    • A blended, weighted average of all regular rates over the previous pay period.
    • A clarification made in response to HCA’s comments for employees paid “fee-for-service,” the same hourly rate means a reasonable calculation of the wages or fees the employee would have received for the piece work, service or part thereof, if the employee had worked.
  • A clarification relative to “overtime, holiday pay, or other premium rates” that states “where an employee’s hourly regular hourly rate is a ‘differential rate,’ meaning  a different wage rate paid for the same work performed under differing conditions (e.g. a night shift), the ‘differential rate’ is not a premium.

 Section 33.03: Accrual and Use of Earned Sick Time

  • The AGO clarified that 40 hours per benefit year is the cap under the law. Employees  cannot accrue more unless the employer’s policy allows.
  • Employees accrue sick time only on hours worked, not while on PTO.
  • AGO added “Earned sick time may not be invoked as an excuse to be late for work without an authorized purpose under the regulations.”
  • AGO added “An employee may not accept a specific shift assignment with the intention of calling out sick for all or part of that shift.”
  • AGO added “Employers and their fee-for-service employees may arrange to make up hours during the same or next pay period.
  • AGO clarified “If an employee is exhibiting a clear pattern of taking leave on days just before or after a weekend, vacation, or holiday, an employer may discipline the employee for misuse of earned sick time, unless the employee provides verification of authorized use” under the regulation.

Break in Service

  • Regarding “Break in Service,” the AGO heard the Home Care Alliance’s concerns and shortened the timeline an employee has a right to use any unused sick time following “a break in service of up to four months.” However, following a break in service of between four months and one year, “an employee shall maintain the right to use earned sick time accrued before the break in service” if the unused time equals or exceeds 10 hours.

Transition Year/Safe Harbor

  • AGO clarified the “Transition Year/Safe Harbor” provision for employers with part time staff and per diem staff.
    • These employees must either accrue paid time off at the same rate as covered full time employees or receive prorated “lump sums” of paid time off.
    • If an employee is compensated other than on an hourly or salaried basis, the employee must accrue or receive lump sum allocations based on “a reasonable approximation of hours worked.”

 Section 33.06: Documentation of Use of Earned Sick Time

  • AGO clarified that an employer may require written documentation for an employee’s use of earned sick time that:
    • Exceeds 24 consecutive scheduled work hours;
    • Exceeds 3 consecutive days on which the employee was scheduled to work;
    • Occurs within 2 weeks prior to an employee’s final scheduled day of work before termination of employment, except in the case of temporary employees;
    • Occurs after 4 unforeseeable and undocumented absences within a three-month period.
  • AGO clarified that “health care providers may require employees making any use of earned sick time during local, state or federally declared emergencies to provide written documentation from a medical provider substantiating its use and to follow additional notification procedures set forth by the employer.” The employer may discipline the worker if they fail in this regard.

Fitness for Duty

  • AGO clarified that “an employer may require an employee to provide a ‘fitness-for-duty’ certification, a work release, or other documentation from a medical provider before an employee returns to work after an absence during which earned sick time was used if such certification is customarily required and consistent with industry practice or state and federal safety requirements and reasonable safety concerns exist regarding the employee’s ability to perform duties.”
    • “Reasonable safety concerns” means a reasonable belief of significant risk of harm to the employee or others.

Section 33.07: Allowable Substitution of Employers’ Paid Time Off

  • AGO clarified that “an employer’s own paid time off, vacation, sick leave, or other policy may be substituted for earned sick time so long as 40 hours of time off is provided under the policy, or such lesser amount as each employee might earn if the employer were not using the substitute policy” and the employees can use PTO for the same purposes under the same conditions as outlined in the regulation.

Return to www.thinkhomecare.org.


MA Attorney General Announces Earned Sick Time ‘Transition Year’

May 18, 2015

At the first of a string of public hearings to provide input on proposed regulations on the forthcoming earned sick time law, Attorney General Maura Healey announced a “transition year” for employers already offering paid time-off.

The Attorney General explained that for the period of July 1 when the law goes into effect until December 31, 2015, “any employer with a paid time off policy in existence as of May 1, 2015, providing to employees the right to use at least 30 hours of paid time off during the calendar year 2015 shall be in compliance with the law with respect to those employees and to any other employees to whom the use of at least 30 hours of paid time off under the same conditions are extended.”

Further details are available on a bulletin released on the AG’s earned sick time webpage.

The AG also revealed the intent of her office to avoid a six-month delay in implementing the law, as has been requested by some business advocacy groups. With Healey holding firm on not delaying the law’s implementation, and with some major business groups endorsing the “transition year” move, it was very likely a compromise to grant some leniency to employers.

For more information on the earned sick time law as well as how you can submit comments and help the HCA comment, see this previous blog post.

Return to www.thinkhomecare.org.


Advocacy Alert: Email your Senator to Support Home Care in the Senate Budget

May 15, 2015

The Alliance has worked with home care champions in the Senate to file amendments to the Ways & Means budget to improve home health care services. The HCA now needs home care agencies and advocates to send a message to gain support these proposals TODAY by clicking here!

Below is a list of the items the Alliance will be leading on and supporting in the FY16 Senate budget process.

Restoring Home Nursing Rates: Senator Jennifer Flanagan

•    Purpose: This budget language seeks to restore the MassHealth rate for home health nursing visits past 60 calendar days of care to the payment level prior to the rate cut of December 1, 2008. This amendment creates a consistent rate for as long as an individual on MassHealth requires home health care.

Improved MassHealth Rates for Home Health Aide Services: Senator Barbara L’Italien

•    Purpose: Since 2007, home health aide rates to agencies from MassHealth have remained at $24.40 per hour, which is meant to cover aide salary, benefits, travel, supervision and administrative costs for the employing home health agency. This amendment seeks to raise the rate MassHealth reimburses home health agencies for home health aide services by 12% at a cost to MassHealth of $1.75 million.

Study of MassHealth Third Party Liability: Senator Anne Gobi

•    Purpose: A study is necessary because correct reimbursement coverage determinations for Medicare/Medicaid dual eligibles are far more complex in home health care than in other medical services as the services and program coverage rules are very similar. The process of submitting all or most MassHealth home health claims for review and re-review to Medicare is highly costly to both agencies and the state. The rate of Medicare coverage has also been steadily declining.

Homemaker Salary Reserve: Senator Michael Barrett

•    Purpose: Appropriate $3 million from the Community First Trust Fund for a FY16 Homemaker Salary Reserve.  This request will continue a campaign to support essential workers by providing an annualized wage and benefit increase of approximately 32 cents an hour to over 26,000 homemakers and personal care homemakers.

Community-Based Safety Net Adjustment: Senator Kathleen O’Connor Ives

•    Purpose: Treat non-profit home health agencies that provide a significant number of home health visits to MassHealth patients as safety-net providers eligible for upward rate adjustments.

FMAP Trust Fund: Senator Michael Rodrigues

•    Purpose: On January 1, 2014, Massachusetts began receiving an enhanced Federal Medical Assistance Percentage (FMAP) for certain Medicaid expansion populations through the ACA.  This amendment creates a trust fund to house this funding and dedicate it to Medicaid and low-income health programs.

Expand Elder Service Home Care Income Eligibility: Senator Barbara L’Italien

•    Purpose: Raise the income eligibility standard for State Home Care Program services funded by Elder Affairs to those below 300% of the Federal Poverty Level.

For more information on what was included in the Senate Ways & Means budget, visit this previous blog post.

Return to www.thinkhomecare.org.


Paid Sick Time Proposed Regs Need Comments from Home Care Agencies

April 27, 2015

The Attorney General’s office released proposed regulations for the paid sick time law passed via ballot question and due to be effective on July 1, 2015.

The law essentially states that workers employed by companies with eleven or more employees can earn and use up to 40 hours of paid sick time per calendar year, while employees working for smaller employers can earn and use up to 40 hours of unpaid sick time per calendar year.

A full summary of the law, along with the proposed regulations and a list of public hearing dates are available on a special “Earned Sick Time” webpage on the Attorney General’s website. Associated Industries of Massachusetts (AIM) conducted a quick analysis of the draft regulations posted on their blog.

The Alliance will be testifying on these regulations at the Boston hearing on May 18th so the Alliance strongly encourages home care agencies to review the draft regulation and send comments to James Fuccione so the HCA can formulate testimony. We further encourage agencies to attend and comment at the other hearings and listening sessions to be held across the state and to notify HCA if you’re planning to do so in order for the comments to be consistent.

A full list of the hearing dates and locations are below:

Friday, May 8, 2015
Brockton Listening Session
Location: Brockton Public Library
(304 Main Street, Brockton, MA 02301)
Time: 10:00 am – 1:00 pm

Monday, May 11, 2015
Salem Listening Session
Location: City Hall Annex Building, 3rd Floor Conference room
(120 Washington Street, Salem, MA)
Time: 10:00 am – 1:00 pm

Friday, May 15, 2015
Lowell Listening Session
Location:  Lowell  Lowell Federal Building
(50 Kearney Square, Lowell, MA)
Time: 10:00 am – 1:00 pm

Monday, May 18, 2015
Boston Public Hearing
Location: Saltonstall Building, 2nd floor Conference Rooms C & D
(100 Cambridge Street,  Boston, MA)
Time- 10:30 am – 1:30 pm

Friday, May 22, 2015
Framingham Public Hearing
Location: Framingham Town Hall, Memorial Building, Ablondi Room
(150 Concord Street,  Framingham, MA 01702)
Time: 10:00 am – 1:00 pm

Friday, May 29, 2015
Springfield Public Hearing
Location: 1350 Main Street – 3rd Floor Community Room
Time: 10:30 am to 1:30 pm

Friday, May 29, 2015
Pittsfield Public Hearing
Location: Pittsfield City Hall – Council Chambers
(70 Allen Street, Pittsfield, MA)
Time: 10:00 am – 1:00 pm

Monday, June 1, 2015
Fall River Public Hearing
Location: City Hall: 1 Government Center – The Hearing Room
(1 Government Center, Fall River, MA 02722)
Time: 1:30 pm – 4:30 pm

Friday, June 5, 2015
Worcester Public Hearing
Location: Main Library- Saxe Room
(3 Salem Square, Worcester, MA 01608)
Time: 10:00 am – 1:00 pm

Return to www.thinkhomecare.org


CDC, Mass DPH Release Updated Ebola Guidance for Healthcare Workers

October 21, 2014

On October 20th, the federal Centers for Disease Control and Prevention (CDC) released stricter guidance on Personal Protective Equipment (PPE) recommended for healthcare workers treating patients with the Ebola virus.

The new enhanced guidance from CDC is centered on three principles:

  • All healthcare workers undergo rigorous training and are practiced and competent with PPE, including putting it on and taking it off in a systemic manner
  • No skin exposure when PPE is worn
  • All workers are supervised by a trained monitor who watches each worker putting PPE on and taking it off.

These principles and other guidance listed on the new advisory appear to be geared towards healthcare facilities and are based on lessons learned from those hospitals and clinics that have treated Ebola cases in the US thus far, including Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center.

Also on October 20th, the Massachusetts Department of Public Health (DPH) and Boston Public Health Commission released updated clinical guidance on sending in patient specimens for laboratory testing for suspected Ebola cases. According to DPH, prior to sending a sample, the facility should consult the MDPH Hinton State Laboratory Institute for specimen collection, handling, packaging and transport advice via the 24/7 lab number (617-590-6390).

More information will be shared as it becomes available.

Return to www.thinkhomecare.org.


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