A Guide for Consumers, Homemaking Agencies & HCAs

The Home Care Assistance Program
600 Washington Street, Boston, MA 02111
Telephone/TTY 1-800-223-2559, then dial 3 or (617) 204 3853
Fax 617-727-2809


  • MRC-HCAP Mission Statement: Assist Consumers with addressing homemaking tasks that they are unable to perform independently through a collaborative effort among consumers, HCAP staff and service providers.
  • Homemaking tasks: grocery shopping, medication pick-up, meal preparation, laundry and light house-cleaning.
  • Authorized hours: the amount of time approved by the MRC-HCAP to provide services each week. The MRC-HCAP provides the most minimal assistance to enhance independent living.
  • The MRC-HCAP is not an emergency service and cannot guarantee service without interruption. Some causes for interruption could be illness, vacation, staff shortages, or a non-disabled visitor staying with a consumer for more than 2 weeks.



  • The HCAP Case Manager oversees all aspects of homemaking service, assesses applicants and service recipients for eligibility, initiates service referrals/changes/terminations, provides information and referral, and assists with questions and concerns.
  • The Consumer is the individual receiving homemaking services.
  • The Homemaking Agency is the agency providing homemaking services directly to the consumer.
  • The Homemaker is the person assigned by the homemaking agency to perform homemaking tasks.
  • The Home Care Assistant (HCA) is a person over the age of 18, chosen by the consumer, who contracts with the MRC-HCAP to provide homemaking services. The HCA is not an immediate family member and must undergo a CORI (Criminal Offender Record Information) check. Information about this option is available upon request.



A person is eligible for HCAP services if the individual:

  • Has a disabling condition that prevents him/her from performing one or more homemaking tasks.
  • Requires homemaking assistance to prevent hospitalization or institutionalization.
  • Meets MRC-HCAP financial guidelines.
  • Is living alone, with another adult who is unable to perform homemaking due to disability, or dependent children under 18 years.
  • Is between the ages of 18 and 59, inclusive.
  • Is not legally blind (Mass. Commission for the Blind has a program).



  • Meal Preparation - Advanced and/or partial preparation of light meals. Meal choices and recipes must be offered by the consumer.
  • Grocery Shopping - Closest grocery store, once per week. Consumer offers a detailed list with alternate choices. The homemaker/HCA will pay with consumer's cash, check, or EBT ONLY.
  • Medication Pick-up -Consumer must call prescriptions in first. Performed while the homemaker/HCA grocery shops. For consumer only.
  • Laundry - Washing/drying of consumer's clothing ONLY. The homemaker/HCA does not take clothes to a dry cleaner.
  • Light housekeeping - Light cleaning of primary living areas: bathroom, living room, bedroom (consumer only), kitchen. The consumer provides the cleaning supplies. Tasks performed:
    • Kitchen clean-up - Wipe down counter top, outside of refrigerator, stove, dishwashing (HCAP recommends soaking dishes in hot water 1 hour before homemaker visit).
    • Dusting - Surface dusting only. The homemaker/HCA is not allowed to touch or move fragile/personal items/collectibles. The homemaker/HCA cannot stand on ladder/chairs or polish/wax furniture.
    • Vacuuming/sweeping - Vacuum 1 time per week in primary areas. The homemaker/HCA cannot move furniture or rugs.
    • Change bed - Change bed linens on bed 1 time per week. Please remove any clutter on bed prior to bed linen change.
    • Clean bathroom - Clean toilet, sink, tub/shower 1 time per week.
    • Mop floors - Damp/wet mop primary living areas 1 time per week. The homemaker/HCA cannot wax, buff, or polish floors.
    • Trash - Remove light trash at end of visit. The homemaker/HCA cannot return bottles or throw out large items.


The MRC-HCAP cannot provide the following tasks:

  • Homemaking service for others in the household
  • Banking, miscellaneous errands, post office errands, library visits, drop-offs or pick-ups
  • Personal care such as: bathing, dressing, feeding, transfers, toileting, hair care
  • Companionship
  • Heavy spring cleaning or home organization
  • Dry cleaning, ironing
  • Polishing furniture, waxing floors, moving furniture, moving or packing
  • Climbing on ladders/chairs to clean
  • Window washing or wall washing
  • Hanging pictures or curtains
  • Transportation
  • Pet care
  • Exterior home maintenance such as painting, lawn mowing, raking leaves, or shoveling snow.

* Case Managers will try to assist consumers with finding other resources to meet the above needs.


Based on the assessment of individual needs, the MRC-HCAP Case Manager will inform the consumer of the number of authorized hours and the homemaking tasks a homemaker/HCA will perform according to the consumer's individual service plan. The MRC-HCAP Case Manager will then refer the consumer to a homemaking agency, or approved HCA, that has availability in the consumer's area.

Before the consumer begins homemaking services, the homemaking agency will contact the consumer to arrange a schedule and assign a homemaker. The homemaking agency informs the consumer of the start date, weekly schedule, time of the start and end of services, and the name of the homemaker. The homemaking agency should provide the consumer with their written contact information and grievance procedures.

When using an HCA, the consumer and HCA will develop a schedule together.

Once a schedule is confirmed by a homemaking agency/HCA, the MRC-HCAP Case Manager will send a letter of eligibility determination with a service plan to the consumer and the assigned homemaking agency/HCA.


The consumer and the homemaking agency/HCA both have responsibilities as follows to ensure successful maintenance of services:


The consumer is expected to:

  • Be at home for the scheduled appointment.
  • Cancel/reschedule appointments as soon as possible if the consumer has a schedule conflict or is in the hospital.
  • Call the homemaking agency/HCA if the homemaker/HCA is more than 15 minutes late.
  • Sign a time sheet at the end of the visit that is completed by the homemaker showing the accurate service hours performed.* Do not sign time sheets before completion of services or sign blank time sheets.

* A consumer's signature verifies the time sheet is accurate and the homemaker/HCA performed all homemaking tasks in full as determined by the consumer's individualized service plan.

  • Allow the homemaker/HCA to leave if all homemaking tasks are completed before the time allotted is up. The consumer should not ask the homemaker/HCA to perform any task outside the scope of services in order to fill up any remaining time. The time sheet should reflect any early departure of the homemaker/HCA.

To orient your homemaker/HCA to your home and your individual service plan, the MRC-HCAP suggests the following:

  • Show the homemaker/HCA where you keep your cleaning supplies or what cleaning supplies you would like the homemaker/HCA to use.
  • Inform the homemaker/HCA where the laundry room is located.
  • Explain the homemaking priorities for the day.

The consumer should be prepared for homemaking service. Consumers should have the following ready before the homemaker/HCA visit:

  • Money or check ready for grocery shopping and laundry.
  • Grocery shopping list ready for homemaker/HCA.
  • Cleaning equipment/supplies and laundry detergent on the premises.
  • Laundry pre-sorted in baskets or bags.

Also, for preventive measures ensuring your protection, NEVER share your:

  • PIN (Personal Identification Number)
  • bank account/credit card information
  • social-security number


The Homemaking Agency is expected to:

  • Conduct reference and background checks, including Criminal Offender Record Information (CORI) and Department of Public Health Abuse Registry checks, before hiring homemakers.
  • Train and supervise homemaker staff.
  • Equip the homemaker with gloves to maintain universal precautions.
  • Instruct the homemaker to complete time sheets accurately so they reflect service hours worked. Make sure the homemakers are completing the time sheets before a consumer signs it.
  • Contact the consumer as soon as possible to cancel/reschedule service if homemaker is not available on the scheduled service day.
  • Contact the consumer if homemaker is known to be more than 15 minutes late.
  • Provide homemakers with Homemaking Agency photo I.D.


  • If the consumer is not answering the door for the homemaker, the homemaker or coordinator will call the consumer to see if he/she is home.
  • If the consumer does not answer the telephone, the coordinator will inform the MRC-HCAP Case Manager and the consumer's emergency contact person that he/she cannot locate the consumer.
  • If the emergency contact person cannot be reached or the emergency contact person cannot verify the consumer's location, the MRC-HCAP Case Manager may contact the police and request a "well-being check".


If problems occur, the consumer and the homemaking agency should follow a 3-step problem solving process as follows:

  • Discuss the problem with the homemaker/consumer and try to resolve the issue.
  • Discuss the problem with the homemaking agency coordinator who will then try to resolve the issue.
  • Discuss the problem with the MRC-HCAP Case Manager who will work with all parties to help resolve the issue.
  • If a problem is still not resolved, the MRC-HCAP Case Manager will inform the consumer of the program's internal grievance procedures.

Sometimes a problem is not easily resolved and services may need to be interrupted or terminated in instances of non-use, misuse of services or any form of abuse. H CA responsibilities are provided in the HCA brochure.



The consumer's eligibility for services is reviewed every 1-1.5 years or on an as needed basis. The purpose of the review is to:

  • Update consumer information
  • Conduct a quality assurance interview
  • Re-assess homemaking hours and continued eligibility
  • Inform consumers of community resources as needed


The MRC-HCAP provides homemaking services to eligible consumers up to the age of 60. The consumer will be contacted one month prior to his/her 60th birthday to report case closure and make a referral (if needed) to the local Aging Service Access Point (ASAP) in the area. The ASAP will conduct its own eligibility assessment. The MRC-HCAP cannot guarantee a consumer's eligibility or amount of service hours for the ASAP services.


There are three divisions of the Massachusetts Rehabilitation Commission:

  • Vocational Rehabilitation Services: Assists consumers with disabilities whose impairments present barriers to employment and who may benefit from vocational rehabilitation.
  • Community Living Services: Assists consumers with severe disabilities to live independently in the community through service coordination and information and referral.
  • Disability Determination Services: Determines eligibility for Social Security Disability Income and Supplemental Security Income for individuals who have medically determined impairments which preclude them from working for 12 months or more.

Please refer to the MRC website for a detailed description with phone numbers of the services offered by the Massachusetts Rehabilitation Commission. Contact your MRC-HCAP Case Manager if you have any questions.


This information is provided by the Massachusetts Rehabilitation Commission.