Do you know who is in grandma’s house?

If your beloved senior lives in Massachusetts and is getting home services, the person making granny a nice cup of tea and a sandwich doesn’t even have to be licensed.

As State House News reported, Massachusetts is among a minority of states that does not require non-medical home care agencies or professionals to be licensed. While many submit to industry accreditation instead, experts said the status quo leaves oversight gaps.

Jake Krilovich, executive director of the Home Care Alliance of Massachusetts, said he regularly tells prospective home care agency owners that “in many respects, it’s often easier to open a home care agency than it is a pizza shop in Massachusetts.”

“You simply file with the secretary of state’s office as a business, and then you’re supposed to adhere to one or two (Department of Public Health) regulations when sending workers into an older adult’s home, and then you can operate,” Krilovich told lawmakers at a Joint Committee on Aging and Independence hearing Monday.

“Today, we have no idea how many home care agencies are operating in Massachusetts,” he added. “If you ask any of our provider members, and two of them are here today, any of them can give you an example of an agency operating in the shadows or skirting these best practices, whether it’s by failing to adhere to wage and labor laws, not carrying liability insurance, or not conducting background checks on workers. All of these things are things you would think are required of a provider who is caring for a person in their home.”

Especially a vulnerable senior.

This is frightening news for families putting together a home care plan for elderly family members. We want seniors to be able to age in place as long as they can in familiar surroundings — oversight and safety checks should be a given.

Krilovich and several home care agency operators urged the committee to back legislation (H 789 / S 470) that would require the Executive Office of Health and Human Services to create a new home care licensure process.

These regs would include background checks for workers, service plan standards, training and competency standards for providers , and more, according to a House-produced summary. Officials would also craft fines and a process for suspending or revoking licenses.

How many assumed this was already being done? After all, Massachusetts prides itself on its state-of-the-art hospitals and good geriatric healthcare providers, why wouldn’t home care for seniors also be top notch? Or at the very least, licensed and checked?

A move to require such licensing made the rounds in 2021, but died in the House Ways and Means Committee.

Rep. Thomas Stanley, who chairs the Aging and Independence Committee, said the proposal had been held back by questions about the cost of the state launching a new licensure program.

This is not the place to pinch pennies. As Stanley pointed out, aging in place costs the state a lot less than assisted living or a long-term care facility.

It’s been said that a society is measured by how it treats its elderly. In the case of overseeing home care for seniors, the Bay State has room for improvement.

Editorial cartoon by Gary Varvel (Creators Syndicate)