Home Health Aide Requirements in Massachusetts

Massachusetts needs home health aides. There are many organizations and individuals in the state working to ensure that the elderly and other vulnerable people have good care — and that direct care workers have the support they need to make it happen. They want to draw people into the profession, and they want to give them incentives and opportunities to stay in healthcare.

To this end, Massachusetts has created a career ladder that includes homemaker, personal care homemaker, home health aide, and supportive home health aide. Adept workers may go even higher.

Select a Massachusetts Home Health Aide Topic:

Home Care Worker Duties

Home health can be thought of as part of the home care continuum. A worker at the most basic level can carry out household tasks to help a sick or disabled person maintain a living environment that is clean, safe, and habitable. At the next level, he or she can provide personal care, for example, assistance with bathing, getting dressed, and moving about. Home health aide is a rung above. A home health aide may provide some additional services like help with physical exercises; the HHA may, in some sense, serve as an extra pair of hands for therapist or nurse. A supportive home health aide also supports socialization needs. There are two tracks: Alzheimer’s and mental health. Supportive home health aide can be a desirable credential from an employer standpoint; this has to do with reimbursement.

The role of a home health aide is also closely related to that of a nursing assistant. Both can carry out basic nursing-related tasks under delegation. A person who carries out basic health tasks for a Medicare-certified home health agency must meet federal standards for HHA. A person who works at a nursing home must meet standards for CNA. Direct care classifications are distinguished in part by setting. According to a report published by the Massachusetts Nursing and Allied Health Initiative, there are overlapping duties (and blurry lines) between different types of direct care role, including medical assistant.

Home Health Training Options

There are multiple program options in Massachusetts. A person can begin by learning to provide basic home care services, then progress to the level of HHA. It is also an option to enroll in a combined CNA/ HHA program.

The minimum standard for a home health program is 75 hours. A student who enrolls in a combined HHA/ CNA program will likely receive more than 100 hours of training. It’s still a short path into the healthcare industry.

Some people receive training through an employer. Others enroll in school to make themselves employment-ready. Students who are considering proprietary schools may want to visit the website of the Department of Elementary and Secondary Education, Office of Proprietary Schools. There are some unique opportunities in Massachusetts; one can even enroll in a bilingual training program.

Career Outlook and Salary: Opportunities and Challenges

The average wage for a Massachusetts home health aide was $14.04 an hour in 2016.

Massachusetts home health employment levels have been projected to increase by 38% between 2014 and 2024.

The Nursing and Allied Health Initiative has, in recent years published several reports addressing the need to attract and retain more direct care workers (http://www.mass.edu/nahi/resources/alliedreports.asp). A 2017 report summarizes findings of employer focus groups.

Among the issues noted: that employers were competing for the same limited pool of applicants and that people sometimes left for hiring bonuses or slightly higher wages, that it could be important to train managers to be managers, that employees liked a lot of ‘thank you’s’ and responded to tangibles like awards, free lunches, and pizza days. Money was of course a concern. Another retention challenge stemmed from the difficulty of separating applicants who thought they wanted to be in this line of work (without necessarily understanding what it entailed) from those who really did want to.

By and large, employers felt that direct care workers coming from community colleges were well-prepared. Some would like to see more training in various areas from housekeeping and food preparation to dementia. Some noted that it would be desirable to have a more tech-savvy workforce. Technology is transforming some aspects of the job, and many employees lacked adequate tech skills and/ or interest in this area of the job.

According to a 2014 workforce plan, Massachusetts’ direct care workforce is more diverse than the healthcare workforce as a whole, and supporting workers in moving up the career ladder is one way to increase healthcare diversity and make it more reflective of the population as a whole.

There are many immigrants in Massachusetts who are not only literate in their own language but have healthcare skills.

Exemplary Massachusetts Home Care Employers Rankings

Massachusetts has both Medicare-certified and private payer home care organizations.

The Medicare Compare website includes rankings of certified home health agencies. The following are among Massachusetts’ highest ranked home health agencies:

  • Walpole area VNA
  • Stoughton Public Health Association
  • Community Nurse Home Care in Fairhaven
  • Kindred at Home in Fall River

Some home care agencies work with Home Care Pulse to manage quality and customer satisfaction. The following Massachusetts agencies were awarded ‘Employer of Choice’ in 2017:

  • BrightStar Care in Norwood
  • FistLight Home Care in Salem
  • Home Helpers in Norwood
  • Right at Home in Westborough
  • Visiting Angels in Newport and Newton/Canton

PHInternational has recognized several long-term care facilities that are Massachusetts-based or offer services within Massachusetts. The Leonard Florence Center for Living has sought to provide greater autonomy to direct care workers as well as dignity to the community’s elders. Direct care workers, or Shahbazim, make some decisions that might traditionally be made at the administrative level – this can save money and increase job satisfaction. The Leonard Florence Center for Living is a skilled nursing facility and as such employs CNAs to carry out basic nursing duties. The organization, though, has multiple programs and facilities and employs some HHAs.

Advancement Opportunities

Some Massachusetts home care workers receive enhanced training through the Massachusetts Workforce Training Fund Direct Access Program – training runs the gamut from Alzheimer’s to care of LGBT elders (http://hcacouncil.org/page/WorkForceTraining). The program can provide training in the supportive home health aide role.

Some HHAs will want to further their education and move into more advanced healthcare roles. Direct care workers in some facilities (including assisted living residences that are members of the Massachusetts Senior Care Association) can apply for the Massachusetts Senior Care Foundation Scholarship Program. The Massachusetts Senior Care Association has provided information about additional scholarship programs (http://www.maseniorcarefoundation.org/Education/Scholarship_Program.aspx).