COVID-19 Public Health Guidance and Directives

Guidance and directives from the Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health (DPH) 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

DPH guidance for all healthcare workers: Healthcare Personnel: Occupational Exposure & Return to Work Guidance, updated May 7.

Bureau of Health Professions Licensure Licensees

On April 9, Governor Charlie Baker issued two emergency orders to further support the health care workforce and expand its capacity: 

On April 3, the Department of Public Health issued an emergency order expanding the availability of certain health care providers. Guidance: Licensing Changes during State of Emergency.

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:

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.

Information about referrals to regional isolation and recovery sites is available on COVID-19 Isolation and Recovery Sites.

Lab professionals

On April 7, DPH issued guidance to clinical labs which (1) aligns the Massachusetts exempt test with all tests on the current list of CLIA waived tests; and (2) alleviates the need for certain providers to obtain a clinical laboratory license in order to conduct testing on their own patients. Massachusetts Clinical Laboratory Program – Changes to Exempt Test List and ​Definition of Physician

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

    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

    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

    On April 9, Governor Baker issued an emergency order authorizing nursing practice by nursing school graduates and students in their final semester of nursing education programs. Order | Nursing Student Guidance

    Health Care Organizations

    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: 

    Non-Acute Care Hospitals

    DPH Guidance, May 22: Caring for Non-Acute Care Hospital Patients

    Clinics

    DPH guidance, updated May 12: Using Space on Clinic Premises for COVID-19 Testing

    Pharmacies

    April 3 emergency order authorizing licensed pharmacies to create and sell hand sanitizer over the counter:

    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: 

    Substance Addiction Service Providers

    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:

    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

    Guidance for family members of Nursing Facility, Rest Home or Assisted Living residents, April 9: Considerations for Moving a Loved One Home from a Nursing Facility, Rest Home or Assisted Living Residence

    DPH guidance for all healthcare workers, updated May 7: Healthcare Personnel: Occupational Exposure & Return to Work Guidance 

    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 April 14: April 14 Updated Residential and Congregate Care Guidance.

    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 

    Businesses

    DPH Guidance:

    Homeless Shelters

    Guidance and information for homeless shelter providers is available here: Homelessness Support During COVID-19.

    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.

    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

    Guidance was issued on April 6 indicating no DoN dates will be assigned during the state of emergency for any application filed on or after March 10, 2020: Notice Regarding Determination of Need Applications Filed During the COVID-19 Public Health Emergency

     

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