The short answer Massachusetts still has no state licensure for private-pay, non-medical home care agencies as of July 2026 — a licensure bill (H.4706/S.3170, An Act to Improve Massachusetts Home Care) passed the House in November 2025 and the Senate in July 2026 but has not yet been enacted. Only Medicare-certified home health agencies are regulated, under federal rules.
What Massachusetts requires
Massachusetts
No licensure yet; bill pending. The House passed home care agency licensure (H.4706) in November 2025 and the Senate passed a redrafted S.3170 on July 16, 2026; the bill, which directs EOHHS to license agencies with background checks and training standards, was still awaiting final enactment as of late July 2026.
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House bill provisions. H.4706 would require home care agencies to disclose ownership, carry workers' compensation and liability insurance, and provide appropriate levels of employee training, with EOHHS implementing licensure.
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HHAs per federal. Because Massachusetts has no state home health aide training rule, Medicare-certified agencies follow the federal 75-hour training/competency standard and 12-hour annual in-service at 42 CFR 484.80.
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State program contract standards. Agencies serving the state-funded home care program through Aging Services Access Points (ASAPs) must meet Executive Office of Elder Affairs contract training standards for homemakers and personal care homemakers (roughly 60 hours); these apply only to program contractors, not private-pay agencies.
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The federal baseline (applies in every state)
Federal
75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training.
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Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry.
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12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse.
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RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals.
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