A series of recent Boston Globe Letters to the Editor reveals a notable shift in public sentiment around home care licensure in Massachusetts. Writers from across the care continuum highlight shared concerns: the risks of an unregulated market, the need for workforce protections, and the importance of implementation—not just legislation.

Licensure must protect both clients and workers

“Many private home care workers currently operate without required training or oversight despite assisting older adults and people with disabilities with deeply personal daily tasks. This lack of standards places both clients and workers at risk.”

— Liz Friedman, Cofounder & CEO, GPS Group Peer Support (MASStrong), Northampton

“Regulation must be paired with real investment: fair pay, benefits, safe working conditions, mental health and peer support, and ongoing education.”

— Liz Friedman

Higher-acuity and behavioral health patients raise the stakes

“Safeguards are especially critical for behavioral health patients living with severe mental illness and complex medical conditions.”

— Joseph McDonough, Founder & CEO, Innovive Health, Medford

“Undertrained caregivers are more likely to have patients who end up back in the emergency department… Without well-trained and certified clinicians, these individuals are at heightened risk of preventable hospitalizations and poor outcomes.”

— Joseph McDonough

Passing a bill is not enough

“Passing a law is only half the job. The real failure comes when the state never writes the regulations needed to make the law real.”

— James A. Lomastro, Conway
Former health care administrator and member of Dignity Alliance Massachusetts

“When state agencies do nothing, two groups suffer: vulnerable elders and people with disabilities, and caregivers who are thrown into complex situations without training, support, or protection.”

— James A. Lomastro

Together, these letters make clear that public support for licensure is strong—but conditional. Massachusetts residents expect the Commonwealth to follow through with enforceable standards and real investment in the home care workforce.