COVID-19 Guidance and Directives

Guidance and directives from the Centers for Disease Control and Prevention (CDC), Massachusetts Department of Public Health (DPH), and other state agencies related to COVID-19.

Table of Contents

Guidance on Prioritization of PPE in MA

Visit Guidance for Requesting Personal Protective Equipment (PPE) for information about PPE requests and prioritizing and optimizing use of PPE in Massachusetts during the COVID-19 response.

Health Care Professionals & Organizations

Clinicians

Clinicians who see patients with recent travel to areas with community transmission of COVID-19  who have a fever, lower respiratory tract symptoms (such as shortness of breath and cough), and/or contact with a known COVID-19 patient, should contact the Massachusetts Department of Public Health (MDPH) 24/7 at (617) 983-6800 for assistance. Further clinical guidance can be found in these advisories:

In the event of an outbreak, all hospitals should be prepared for the possible arrival of patients with COVID-19. The CDC Hospital Preparedness Checklist outlines a number of important practices.

Lab professionals

On March 13, DPH issued a guidance letter for testing of persons with suspect COVID-19 through the Massachusetts State Public Health Laboratory: COVID-19 PUI Criteria PDF | Doc

DPH has outlined guidance for clinical laboratories regarding clinical and epidemiologic criteria for COVID-19, specimen collection, testing, and submission to the Massachusetts State Public Health Laboratory: COVID-19 Guidance: Massachusetts State Public Health Laboratory FAQ PDF | Doc

Hospitals

DPH asks hospitals carefully review guidance from the CDC with all healthcare personnel and continue to prepare to care for patients with suspected or confirmed COVID-19. In addition to sharing important CDC guidance, DPH has also issued guidance to acute and non-acute care hospitals, including: 

Pharmacies

March 24 emergency order regarding modifications to pharmacy practice:

March 18 emergency order regarding the administration of certain medications for the treatment of opioid misuse disorder: 

March 15 emergency order authorizing licensed pharmacies to create and sell hand sanitizer over the counter:

Dentists

Guidance from the Massachusetts Department of Public Health (DPH) and the Board of Registration in Dentistry (BORID) in response to the Massachusetts COVID-19 State of Emergency. Download: Board of Registration in Dentistry COVID-19 Guidance

Sexual and Domestic Violence (SDV) service providers

DPH Guidance, March 23: 

Physician Assistants

On March 18, the Department of Public Health issued an order regarding the flexible reassignment of Physicians Assistants: Guidance: Flexible Reassignment of Physician Assistants

Advanced practice registered nurses (APRN)

On March 26, the Department of Public Health issued an emergency order addressing independent prescriptive practice for advanced practice registered nurses: Guidance: Independent Practice of Advanced Practice Registered Nurses

Substance Addiction Service Providers

DPH guidance:

Education

Elementary and Secondary Schools

Suspend educational operations from March 17 until May 4

Governor Charlie Baker issued an emergency order extending the closure of all public and private schools, until May 4 in an effort to prevent the further spread of COVID-19 in the Commonwealth. 

  • This order expands on a previous order issued on March 15 suspending normal educational operations at schools until April 6
  • This closure extends one week beyond scheduled spring vacation week on most school district calendars.
  • The order does not apply to residential special education schools.
  • This extension will allow school administrators and educators added planning time to ensure students can complete course requirements, as well as provide teachers with time to expand remote learning opportunities.

Early Education and Care

Governor Charlie Baker issued an emergency order extending the closure of all and all non-emergency childcare programs until May 4 in an effort to prevent the further spread of COVID-19 in the Commonwealth. 

This order expands on a previous order issued on March 18 suspending non-emergency child care programs until April 6.

Exempt Emergency Child Care Programs will continue to be the only child care programs that are allowed to operate during the COVID-19 State of Emergency.

Click here to view the list of Exempt Emergency Child Care Programs

Providers who have subsidized children and remain closed will continue to receive child care subsidy payments from the state; the Commonwealth will also temporarily cover the cost of parent fees for our subsidized enrollment. This attempts to ensure that programs will be able to re-open once the crisis is over. Parents who receive subsidies will not lose their vouchers. This closure does not apply to residential and placement schools.

Higher Education

Continue to move towards remote learning

With regard to higher education, the Department of Higher Education and DPH strongly recommend that colleges and universities, both public and private, continue to pursue strategies to reduce the need for students to be on campus, including suspending in-person classes and implementing institution-wide programs to shift to remote learning, technology enabled solutions, and other tools to allow students to successfully complete course and degree requirements. Institutions should also pursue strategies to reduce the need for faculty and staff to be on campus by maximizing remote work opportunities, while maintaining essential on-campus services, especially for residential students who cannot safely return home.  Existing guidance is posted here and additional guidance will be forthcoming.

Businesses & Employment

Unemployment Resources

The Executive Office of Labor and Workforce Development (EOLWD) and the Department of Unemployment Assistance (DUA), in coordination with the US Department of Labor (USDOL), are taking a series of actions to assist workers and employers.

For current unemployment claims:

  • All requirements regarding attending seminars at the MassHire career centers have been suspended.
  • Missing deadlines due to effects of COVID-19 will be considered good cause, and lateness will be excused.
  • All appeal hearings will be held by telephone only.

The Department of Labor issued guidance to the states instructing state agencies to apply existing law flexibly. Under the DOL guidance, DUA may now pay unemployment benefits if a worker is quarantined due to an order by a civil authority or medical professional or leaves employment due to reasonable risk of exposure or infection or to care for a family member and does not intend to or is not allowed to return to work. The worker need not provide medical documentation and need only be available for work when and as able.

To assist individuals who cannot work due to the impact of COVID-19, the Administration is filing emergency legislation that will allow new claims to be paid more quickly by waiving the one week waiting period for unemployment benefits. Read the legislation here

EOLWD and DUA are also filing emergency regulations that will allow people impacted by COVID-19 to collect unemployment in the following circumstances:

  • The workplace is shut down and expects to reopen in four or fewer weeks. Workers must remain in contact with their employer and be available for any work their employer may have for them that they are able to do, but do not otherwise need to be looking for work.
  • An employer may extend the period of the shut-down to eight weeks, and the employees will remain eligible for the longer period under the same conditions described above.
  • If necessary, DUA may extend these time periods.

Employers who are impacted by COVID-19 may request up to a 60-day grace period to file quarterly reports and pay contributions.

The pending federal legislation proposes further relief including additional money for unemployment benefits, and relief to employers for charges related to unemployment benefits paid due to COVID-19.

Resources for Businesses

Executive Office of Housing and Economic Development: EOHED COVID-19 Resources and Guidance for Businesses

CDC: Interim Guidance for Businesses and Employers to Plan and Respond to COVID-19

Construction

Guidance related to construction and public works: March 25, 2020 Construction Guidance

Nurseries, Greenhouses, Garden Centers, and Agricultural Supply Stores

Guidance related to the operation of nurseries, greenhouses, garden centers and agricultural supply stores: April 4, 2020 Guidance

Small Business Relief 

The U.S. Small Business Administration’s Economic Injury Disaster Loan (EIDL) program is accepting applications from Massachusetts businesses.

We encourage impacted Massachusetts companies to apply: disasterloan.sba.gov/ela

If you applied to Mass Growth Capital Corporation’s Small Business Recovery Loan Fund, we encourage you to apply for additional EIDL support.

Due to the availability of EIDL funds, we are no longer accepting applications to the Small Business Recovery Loan Fund at MGCC as of 12:30PM on March 19th, 2020.

Small Business Tax Relief

Department of Revenue: Late-File and Late- Pay Penalty Relief for Certain Business Taxpayers Affected by the COVID-19 State of Emergency

Gatherings Over 10 People, Bars & Restaurants 

Governor Baker issued an emergency order limiting gatherings to 10 individuals and prohibiting on-premises consumption of food or drink at bars and restaurants, beginning on March 24. ORDER  | GUIDANCE

State and Local Government

Frequently Asked Questions

FAQs for municipal government

Local Boards of Health

DPH COVID-19 Information for Local Boards of Health includes updates on emergency orders, materials for communicating with the public, and shareable preparedness resources.

Cities and Towns

The Baker-Polito Administration has announced an emergency order temporarily modifying the state’s open meeting law in order to allow state, quasi and local governments to continue to carry out essential functions and operations during the ongoing COVID-19 outbreak.

Governor Baker has also filed two bills to help address challenges to municipal governance resulting from the ongoing COVID-19 outbreak:

March 15 Legislation: LEGISLATION | PRESS RELEASE

March 24 Legislation: LEGISLATION | PRESS RELEASE

Housing Authorities

The Department of Housing and Community Development has posted guidance for local housing authorities with regards to COVID-19, including guidance on cleaning, communications, and planning: DHCD Guidance for Local Housing Authorities.

    State Government Buyers & Vendors

    Executive Branch Employees

    On March 17, the Baker-Polito Administration issued new guidelines to Executive Branch employees to ensure core state government functions are able to continue and key services are able to be provided to residents during the COVID-19 outbreak, while protecting the health and safety of the Executive Branch workforce and the public. The new protocols are effective March 18, 2020 and will remain in effect until April 3, 2020, at which time this will be revisited.

    Click here to view the status of in-person state office locations for Executive Branch agencies.

    Court Employees & Users

    From the Massachusetts Court System: Court system response to COVID-19

    Emergency Responders & Law Enforcement

    DPH has shared important CDC guidance and has issued new advisories, emergency waivers and Statewide Treatment Protocols, and updates to administrative requirements for emergency medical services, including:

    Insurance

    Insurers

    The Division of Insurance has issued a bulletin to commercial health insurers and other organizations outlining the Division’s expectations regarding appropriate coverage of testing and treatment for COVID-19. Division of Insurance Bulletin: Addressing COVID-19 Testing and Treatment.

    Division of Insurance Telehealth Bulletin, March 16: Emergency Measures to Address and Stop the Spread of COVID-19

    The Department of Public Health has issued the following guidance:

    • All commercial insurers and the Group Insurance Commission are required to cover medically necessary telehealth services in the same manner they cover in-person services. The full order is available here.
    • Insurers must cover COVID-19 related treatment and testing without requiring cost-sharing of any kind – such as co-pays and coinsurance – for testing and treatment.
    • Additionally, insurers cannot require prior authorization for these services.

    Group Insurance Commission

    The Group Insurance Commission is providing several resources to help members cope with COVID-19: GIC Resources.

    MassHealth

    From MassHealth: Find resources and information related to the coronavirus for MassHealth applicants, members, and providers.

      Caregivers

      On March 27, the Baker-Polito administration established dedicated skilled nursing facilities to care for people with COVID-19. Beaumont Rehabilitation and Skilled Nursing Center in Worcester will be the first of these designated sites. Read the COVID-19 Dedicated Nursing Facility Letter

      For long term care facilities

      DPH asks long term care facilities, including nursing homes and rest homes, to carefully review the current guidance from DPH and the CDC with all healthcare personnel and continue to prepare to care for residents with suspected or confirmed COVID-19 by implementing the following measures:

      • Clinicians caring for patients with suspected or confirmed COVID-19 should immediately contact the Massachusetts Department of Public Health 24/7 at (617) 983-6800 to review the risk assessment and discuss laboratory testing and control measures. 
      • Review your facility's current policies and procedures to minimize exposures to respiratory pathogens such as COVID-19 and influenza.
      • Adhere to current CDC guidelines for healthcare personnel involved in treatment of confirmed or suspected cases of COVID-19 including standard, contact and airborne precautions, including the use of eye protection. Re-educate healthcare personnel on proper use of personal protective equipment (PPE).

      Beginning Monday March 16, nursing homes and rest homes should implement the following provisions to protect the health and safety of residents and staff:

      • Restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation.
      • Carefully screen individuals who are permitted to enter in compassionate care situations for fever or respiratory infection and require that they perform hand hygiene. Individuals with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the long term care facility at any time.
      • Follow CDC guidelines for restricting access to health care workers and confirm that the health care worker does not have a fever by taking each healthcare worker’s temperature upon arrival.
      • Suspend communal dining as well as internal and external group activities.
      • Provide care to patients with known or suspected COVID-19 in a single-person room.

      Please review the complete guidance which was issued on March 16 and replaces previously issued guidance on March 11: Policies and Procedures for Restricting Resident Visitors in Nursing Homes and Rest Homes and Personal Protective Equipment Recommendation Updates during the COVID-19 Outbreak.

      Additionally, DPH has issued guidance to long term care facilities and has shared important guidance from the CDC, including: 

      For congregate care programs

      Executive Office of Health and Human Services (EOHHS) issued guidance for organizations that operate congregate care programs and updated this guidance on March 25: Congregate Care Guidance, Updated 3/25.

      This audience includes group homes and residential treatment programs funded, operated, licensed, and/or regulated by:

      • The Department of Early Education and Care (DEEC),
      • Department of Children and Families (DCF),
      • Department of Transitional Assistance (DTA),
      • Department of Youth Services (DYS),
      • Department of Mental Health (DMH),
      • Department of Public Health (DPH),
      • Department of Developmental Services (DDS),
      • Massachusetts Commission for the Blind (MCB), or
      • Massachusetts Rehabilitation Commission (MRC).

      For assisted living residences

      DPH order on Assisted Living Residents' visitor restrictions, March 15: Assisted Living Visitor Restrictions Order

      Executive Office of Elder Affairs (EOEA) issued guidance for Assisted Living Residences (ALRs): Assisted Living Residence Operators Guidance and Policies and Procedures to Protect Residents, Facilities, and Services during the COVID-19 Outbreak

      For Early Intervention Providers

      Guidance for Massachusetts Early Intervention vendor agencies:

      MA EI Telehealth Policy for Specialty Providers:

      For in-home caregivers

      Guidance for agency based in-home caregivers & workers (e.g. Home Health Agencies, Personal Care Management Agencies, Home Care Agencies, Adult Foster Care, etc.): 

      Guidance for agencies working with the DPH Bureau of Family Health and Nutrition:

      Guidance for non-agency based in-home caregivers (e.g. PCAs, Independent Nurses, etc.): 

      For community day programs

      Guidance for community day program settings (e.g. Adult Day Health, Day Habilitation, Clubhouses, Councils on Aging, etc.): Community Day Program COVID-19 Guidance 

      Transportation

      Registry of Motor Vehicles

      RMV - COVID-19 Information

      The Registry of Motor Vehicles (RMV) will extend the renewal timeline of certain credentials to reduce the need for customers to physically visit an RMV service center for in-person transactions. The full order is available here.

      MBTA

      Visit www.mbta.com/covid19 for ongoing MBTA updates on COVID-19.

      March 16: MBTA Announces Schedule Revisions to Take Effect Tuesday, March 17

      March 4: MBTA Announces Additional Increased Sanitation Schedule as Part of State's Preparedness Planning for Coronavirus

      Other Guidance

      Taxpayers

      Massachusetts has announced that the individual income tax deadline will be extended until July 15, to match the federal government's adjustment. Read more: Massachusetts Announces State Income Tax Filing Deadline Being Extended to July 15

      Department of Revenue: Important COVID-19 Coronavirus Response Update from DOR

      Pregnant women and children

      CDC-issued guidance for Pregnant Women and Children, including Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation For COVID-19.

      Financial Institutions

      Division of Banks: Statement on Financial Institutions Working with Customers Affected by the Coronavirus and Regulatory Assistance

      Utilities

      The Department of Environmental Protection has coordinated with both the Massachusetts Water Works Association (MWWA) and the New England Water Works Association (NEWWA) to share guidance for utilities as well as additional resources to assist in preparing for potential impacts: MassDEP Coronavirus (COVID-19) Tips for Water Utilities.

      The Department of Public Utilities has communicated with utility companies to prevent them from shutting off residents’ power during the governor’s state of emergency: DPU Letter

      Agricultural Community

      Massachusetts Department of Agricultural Resources:

      Department of Environmental Protection

      MassDEP: Massachusetts to Temporarily Suspend Bottle Redemption Enforcement

      Cannabis Control Commission

      A Message from the Cannabis Control Commission Regarding COVID-19 (Coronavirus)

      Solid Waste Management

      The Massachusetts Department of Environmental Protection has identified the following resources related to the management of solid waste during the evolving Coronavirus Disease (COVID-19) outbreak. The resources are directed towards the companies and employees who collect, transport and dispose of solid waste from households and commercial entities. As information on COVID-19 evolves, the Department will continue to engage with the solid waste industry and provide additional guidance and resources as they become available.  

      Determination of Need (DON) 

      On March 24, the Department of Public Health issued an emergency order exempting certain activities from determination of need approval, that are necessary to address COVID-19. Guidance: Requesting Determination of Need (DoN) Approval for projects related to COVID-19 during the State of Emergency

      Homeless Shelters

      DPH Guidance, April 3, 2020:

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