Privacy concerns still swirling as home care bill heads back to Baker

BOSTON (SHNS) – Lawmakers this week again sent Gov. Charlie Baker legislation establishing a registry for home care aides, setting aside privacy and safety concerns voiced by the governor and groups representing the workers.
A trio of home care aide organizations also warned the bill could end up increasing costs and exacerbating a workforce shortage.
The House and Senate on Wednesday shipped Baker a bill (H 3821) calling on the Department of Elder Affairs to set up a registry of all workers employed by home care agencies, containing the workers’ names, addresses and training information.
It’s the second time the proposal has come before Baker, who in July returned it to lawmakers with an amendment, citing privacy concerns.
“Under the legislation, employee organizations are granted full access to the personal information of these workers, without providing the workers with a process to object to the disclosure of such information, Baker wrote, suggesting language that would allow the workers to opt out of inclusion in the registry.
Both the House and Senate had included home care worker registry in their versions of this year’ budget. Lawmakers described it as a way to ensure workers are properly trained and better assess workforce needs.
The health care workers union 1199 SEIU cautioned against agreeing to Baker’s amendment, arguing at a July hearing that it would “significantly and unnecessarily weaken the planned home care registry.”
“These amendments would make the registry voluntary and therefore significantly less robust — rendering it inconsistent with the growing need to professionalize a rapidly flourishing industry. Additionally, employers would have unchecked authority to remove worker participation from the registry,” the union’s testimony said.
It said enabling an opt-out process without explicit standards “would create inconsistency among the home care agencies that we seek to better regulate,” and the legislation as written includes a mechanism for exemptions, rather than an opt-out option.
The House rejected Baker’s amendment in September on a 35-117 party line vote. The Senate followed suit Nov. 2, with Democrat Sens. Michael Barrett and Patricia Jehlen joining the chamber’s six Republicans in favor of the amendment.
The bill re-enacted Wednesday calls for the state to collect a worker’s full name, gender, home and mailing address, employing agency, list of completed home care trainings or certifications, and “assigned unique identification number,” with the information “submitted and regularly updated” by agencies. 
Name, identification number, and agency training information could be disclosed to the public upon request, except in cases of exemptions, and labor unions or other employee organizations, home care agencies and aging services access points could access all reported information upon request. The elder affairs department would be charged with developing regulations governing any exemptions from reporting.
Opponents of the bill argue that allowing the information to be released to third parties would leave personal details unprotected and subject to additional dissemination.
Before passing the bill a second time, the House tacked on an amendment from Ways and Means Chairman Jeffrey Sánchez, stipulating that registry regulations must include exemptions for victims of domestic violence, rape, sexual assault or stalking.
When the bill returned to the Senate, Minority Leader Bruce Tarr read a letter from Jane Doe Inc., a coalition against sexual assault and domestic violence, saying the Sánchez amendment could create a “highly concerning” situation where employers would be asking workers about their status as a victim and potentially requesting documentation.
“By virtue of this exemption existing, any worker that is not listed on the registry is de facto publicly identified as a victim of domestic violence, rape, sexual assault or stalking,” said the letter from Jane Doe executive director Debra Robbin to Senate President Stanley Rosenberg.
Robbin said separate legislation creating a home care registry (S 343, H 2068), filed by Jehlen and Rep. Christine Barber, has protections for workers’ private information and would “more appropriately” address the issue.
The Senate rejected a Tarr amendment offering new language that did not make registry information available to employee organizations, and that charged the state with establishing “appropriate security mechanisms to safeguard” personally identifiable information.
“There is no reason to take a chance on the safety of individuals who do incredibly important and sensitive work in the homes of some of the most vulnerable citizens of the commonwealth, no reason at all, Mr. President, to do that,” Tarr said on the floor Tuesday. “And we have a proud record of standing up for victims, of trying to protect privacy, of trying to pursue appropriate transparency. Why would we compromise that now?”
In a joint statement, the Home Care Aide Council, Home Care Alliance of Massachusetts and Massachusetts chapter of the Home Care Association of America thanked Tarr for offering his amendment and called it “unfortunate” that home care aides “were silenced and denied a voice in the process.”
“We are concerned that this legislation will force home care aides to leave the field for jobs that do not jeopardize their privacy and due process rights as a condition of employment and will create a disincentive for home care agencies to serve publicly subsidized consumers,” the groups wrote. “At a time when the state is already facing an extreme shortage of qualified and dedicated home care aides to support consumers in the community, the last thing the Commonwealth should be doing is spending limited state dollars to set up a Home Care Aide Registry targeted to only one segment of this critical workforce. This bill will further exacerbate the existing workforce crisis and could lead to significant waitlists and increased costs for services to publicly funded home care clients.”