COVID-19 Public Health Guidance and Directives

EOHHS Congregate Care

Updated congregate care surveillance testing guidance will go into effect on October 3, 2022.

Effective October 3, 2022:

• EOHHS will transition to offer only over the counter (OTC) rapid antigen tests to all congregate care settings. Providers may use OTC rapid tests for surveillance, outbreak, or symptomatic/exposure testing. Lab-based molecular tests will no longer be available.

Effective January 1, 2023:

• EOHHS will discontinue the distribution of testing supplies to provider-operated congregate care
• Provider operated settings will be able to purchase their own testing supplies through the statewide rapid test contract and EOHHS encourages providers to coordinate bulk purchasing of testing supplies at a discounted rate
  • In preparation for this transition, EOHHS will distribute a 3-month supply of OTC rapid tests in December 2022 to all interested provider-operated settings

Guidance for Congregate Care Programs

• Effective October 3, 2022: EOHHS COVID-19 guidance for organizations that operate congregate care programs
  • This guidance replaces congregate care guidance dated July 1, 2022, January 3, 2022, November 19, 2021, August 4, 2021, July 9, 2021, June 14, 2021, and March 22, 2021.

Congregate Care Surveillance Testing Guidance

Effective October 3, 2022, revised surveillance testing guidance for organizations that operate residential congregate care programs, veteran’s shelters, and residential schools will go into effect. 

• Effective October 3, 2022: EOHHS Congregate Care Surveillance Testing Guidance
  • COVID-19 Self-Test at Home Instructions Graphic | Mass.gov

Guidance on Medication Administration in Congregate Care Facilities

• DPH Guidance, December 30, 2022: Prepackaged Medication Administration by Non-MAP Certified staff in Registered Community Programs
• DPH Advisory, January 21, 2022: Medication Administration in HOCs and DOC Facilities during Public Health Emergency

PLEASE NOTE: As of August 15, 2022, all non-health care congregate care settings/residential programs and shelters should adhere to the Isolation and Exposure Guidance for the General Public.

Congregate Care Infection Control Resources

Click here for infection control resources for Congregate Care Settings, developed through a partnership with Commonwealth Medicine, in coordination with the Executive Office of Health and Human Services (EOHHS), the Department of Public Health (DPH) and state agencies.

Testing Guidance

View all COVID-19 Testing Guidance

Health Care Professionals

• DPH Guidance, issued October 13, 2022: Guidance for Health Care Personnel with SARS/CoV2 Infection or Exposure
  • This guidance replaces guidance issued by the Department on December 29, 2021: Isolation and Quarantine for Health Care Personnel
• DPH Guidance to implement the DPH Order authorizing additional individuals to vaccinate, June 14, 2021
• Considerations for Health Care Personnel After COVID-19 Vaccination, December 16, 2020

Clinicians

• Guidance implementing Order of the Commissioner of Public Health (COVID-19 Public Health Emergency Order No. 2022-02) regarding unsupervised practice by physician assistants (issued January 13, 2022)
• Information for providers about therapeutic treatments for COVID-19, including guidance, provider referral form, and the Monoclonal Antibody Therapy Locator
• COVID-19 Vaccine Breakthrough Hospitalization and Death Report Form
  • Memorandum: Reporting of Vaccine Breakthrough COVID-19 Cases Resulting in Hospitalization or Death
• Guidance for clinicians caring for patients with COVID-19
• Updated infection prevention and control guidance specific to COVID-19

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

• DPH Guidance, August 30, 2021: COVID-19 Variant Reporting and Specimen Requests Memo
• DPH Guidance, June 14, 2021: Temporary Laboratory License for CLIA-waived COVID-19 Testing and Clinical Laboratory Alternate Sites
  • Application Form for Temporary Laboratory License for CLIA-waived COVID-19 Testing
• On April 7, 2020, 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

Sexual and Domestic Violence (SDV) service providers

• COVID-19 Guidance for SDV Programs, updated April 23, 2020

School health professionals

DPH guidance for school nurses and other school personnel:

• Information for School Health Offices, updated June 21, 2022
• Handwashing/Sanitizer Guidance and Limited Waiver of 105 CMR 210.000 Related to Sanitizer, June 10, 2021

Temporary Nursing Agencies

DPH guidance for registered temporary nursing agencies in Massachusetts:

• Temporary Nursing Agencies Rates, February 16, 2021

Health Care Organizations

• 90-Day Strategies to Address Healthcare Capacity, December 8, 2022
• DPH Guidance, January 14, 2022: Provider Credentialing and Transfer of Clinical Staff at Healthcare Facilities
• COVID-19 Vaccination Letter to Health Care Facilities and Organizations - Medicare and Medicaid Programs, November 19, 2021
  • This DPH letter to providers communicates the COVID-19 vaccination requirements for healthcare care facilities and organizations that participate in the Medicare and Medicaid program.
• Considerations for Health Care Personnel After COVID-19 Vaccination, December 16, 2020
• Updated Anterior Nares (Nasal Swab) Specimen Collection by Unlicensed Healthcare Personnel, September 25, 2020

Hospitals

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

• DPH Memorandum, December 22, 2022: Skilled Nursing Facility Short-Term Rehab Temporary Program
  • This memorandum replaces the memorandum issued on December 8, 2022, August 10, 2022, February 18, 2022, and January 25, 2022.
• DPH Guidance, November 14, 2022: Updated Guidance Regarding Implementation of Alternate Acute Inpatient Care Space
  • This guidance replaces guidance issued by the Department on June 10, 2022, April 6, 2022, February 23, 2022, December 10, 2021, August 31, 2021, June 28, 2021 and June 14, 2021.
• DPH Memorandum, October 31, 2022: Management of Pediatric Respiratory Illness Patients during times of Capacity Constraints
• DPH Guidance, July 28, 2022: Capacity Planning and Response Guidance for Acute Care Hospitals
• DPH Hospital Visitation Guidance, updated October 13, 2022
  • This guidance replaces guidance issued by the Department on February 23, 2022, January 5, 2022, July 22,2021, March 16, 2020, June 6, 2020, September 16, 2020, and June 14, 2021.
• DPH Guidance, February 23, 2022: Guidance Regarding Non-Essential, Non-Urgent Scheduled Procedures 
  • This guidance replaces guidance issued by the Department on February 4, 2022, December 21, December 10, November 26, 2021 and November 23, 2021.
• DPH Guidance, updated January 28, 2022: Procedures and Requirements for Hospitals/Clinics Dispensing COVID-19 Oral Antivirals
• DPH Guidance, January 5, 2022: Hospital Transfer and Discharge Guidance 
  • This guidance replaces guidance issued by the Department on December 31, 2020. 
• DPH Guidance, December 10, 2021: Space on Hospital Premises for Patient Treatment
  • This guidance replaces the guidance released on October 26, 2021 and  June 14, 2021
• Monoclonal antibody (mAb) therapy information for providers, including guidance, Monoclonal Antibody Report & Request Form, and the Monoclonal Antibody Therapy Locator
• DPH Guidance, September 17, 2021:  COVID-19 Resurgence Planning and Response Guidance for Acute Care Hospitals
• DPH Guidance, July 30, 2021: WebEOC Data Reporting for COVID-19
  • Attachment – WebEOC COVID Questions
• DPH Guidance, May 26, 2022: Vaccination of Admitted Patients
  • This memorandum replaces the memorandum released by the Department on May 24, 2021.
• DPH Guidance, July 31, 2020: Update to Defining Aerosol Generating Procedures and Recommended PPE
• Reminder about the importance of newborn screening and testing, April 14, 2020: Newborn Screening and COVID-19
  • Temporary changes in policy for newborn hearing screening, April 17, 2020: Letter to Birth Hospitals 
• Information for Academic Medical Centers, April 4, 2020: 
  • The Massachusetts Board of Registration in Medicine (BORIM) has authorized expediting full licensure for clinical fellows. Please find additional information from BORIM regarding physician licensure, including an emergency temporary 90 day license application for physicians who have completed training seeking a full license: ​​​​​Emergency Physician Full License Application.

Non-Acute Care Hospitals

• DPH Guidance, May 24, 2021: Vaccination of Admitted Patients
• DPH Guidance, October 13, 2022: Caring for Non-Acute Care Hospital Patients
  • This guidance replaces guidance issued on May 22, 2020 

Clinics

• DPH Guidance, October 26, 2021: Clinic Space for COVID-19 Testing, Treatment and Vaccine Administration
  • This guidance replaces the guidance released on June 14, 2021
• DPH Guidance, July 31, 2020: Update to Defining Aerosol Generating Procedures and Recommended PPE

Dialysis Facilities

• DPH Guidance, January 31, 2022: Implementation of Order of the Commissioner of Public Health Regarding Staffing at Out-of-Hospital Dialysis Units

Substance Addiction Service Providers

DPH guidance:

• Ensuring Access by Reducing Barriers to Admission Related to COVID-19, effective February 22, 2021.
• Required Reporting of COVID-19 Positive Cases by BSAS Licensees and Contractors, January 23, 2023
  • COVID-19 Required Notification Form
• Overdose Response and COVID-19 Transmission Risk, June 4, 2020
• Consent for Treatment/Data Submission in BSAS Licensed and Contracted Programs, April 3, 2020

Emergency Responders & Law Enforcement

DPH has issued guidance to emergency responders and has shared important guidance from the CDC, including:

• DPH Guidance, April 3, 2020:
  • Waiver for EMS Transport of Emergency Patients in Impending Childbirth or with Pregnancy Complications to Designated Alternate Sites on Hospital Grounds

Caregivers

• DPH guidance for all health care organizations and providers, December 16, 2020: Considerations for Health Care Personnel After COVID-19 Vaccination
• DPH guidance for all healthcare facilities, September 25, 2020: Updated Anterior Nares (Nasal Swab) Specimen Collection by Unlicensed Healthcare Personnel
• Guidance for family members of Nursing Facility, Rest Home or Assisted Living residents, April 9, 2020: Considerations for Moving a Loved One Home from a Nursing Facility, Rest Home or Assisted Living Residence

For long term care facilities

Signs for Facilities:

• Caution Signs for Isolated Individuals in Long-Term Care Facilities (updated January 25, 2022)
  • Caution Signs for Isolated Individuals in Long-Term Care Facilities - Spanish
  • Caution Signs for Isolated Individuals in Long-Term Care Facilities - Portuguese
  • Caution Signs for Isolated Individuals in Long-Term Care Facilities - Haitian Creole
• Caution Sign - Enhanced Precautions (updated February 2, 2022)
  • Caution Sign - Enhanced Precautions - Spanish
  • Caution Sign - Enhanced Precautions - Portuguese
  • Caution Sign - Enhanced Precautions - Haitian Creole
• Hand Hygiene and PPE Observations

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

• DPH Memorandum, November 18, 2022: DPH Limits on Admissions for Outbreaks or Clusters in Long-Term Care Facilities
  • List of Long-Term Care Facilities with Current Admissions Freezes, updated January 27, 2023 
• DPH Guidance, November 2, 2022: COVID-19 and Influenza Vaccination Guidance
• DPH Guidance, November 2, 2022: Updated Long-Term Care COVID-19 Personnel Vaccination Requirement
  • This guidance replaces guidance issued on September 28, 2022; March 25, 2022; January 14, 2022; September 24, 2021, August 16, 2021 and August 4, 2021 for nursing homes and guidance issued on September 24, 2021 for rest homes.
• DPH Guidance, updated October 13, 2022: Caring for Long-Term Care Residents during the COVID-19 Emergency
  • This guidance replaces guidance published on June 10, 2022, January 25, 2022, January 3, 2022, December 15, 2021, September 24, 2021, August 4, 2021, June 18, 2021, May 24, 2021, March 12, 2021, December 7, 2020, November 18, 2020, September 15, 2020, July 30, 2020 and April 29, 2020.
• DPH Guidance, December 1, 2022: Updates to Long-Term Care Surveillance Testing
  • This document replaces the June 10, 2022, September 24, 2021, August 4, 2021, May 5, 2021, March 12, December 7, November 23, October 5, August 27, August 17 and July 1 memoranda.
• DPH Guidance, April 4, 2022: Antigen Rapid Point of Care COVID-19 Testing for Long-Term Care Facility Visitors
• EHS/DPH Memorandum, January 6, 2022: Skilled Nursing Facility Short-Term Rehab Temporary Progra
• DPH Guidance, August 19, 2021: COVID-19 Additional Dose Vaccination Guidance for Immunocompromised Individuals
• DPH Guidance, July 30, 2021: Vaccination of Assisted Living and Long-Term Care Residents, Visitors, and Staff
  • This guidance replaces guidance released on June 22, 2021.
• DPH Guidance, March 5, 2021: Guidance Regarding Seasonal Influenza Vaccination of Healthcare Personnel at Massachusetts Nursing Homes and Rest Homes for the 2020-2021 Season 
  • This document replaces the December 23 and November 6 memorandum
• DPH Guidance, October 5, 2020: Point of Care Testing Devices for Nursing Homes
  • Reporting Template for Submitting Positive and Negative Test Results
  • EMS Regions for Long Term Care Facilities
• DPH Guidance, April 6, 2020: Personal Protective Equipment Requests, New Signage for COVID-19 Resident Rooms, and Reporting COVID-19 Deaths in Long-Term Care Facilities 
• DPH fact sheet: Alcohol-Based Hand Rub in Long Term Care Facilities

For assisted living residences

• DPH Guidance, June 10, 2022: Updates to Long-Term Care Surveillance Testing
  • This document replaces the September 24, 2021, August 4, 2021, May 5, 2021, March 12, December 7, November 23, October 5, August 27, August 17 and July 1 memorandums.
• Executive Office of Elder Affairs (EOEA) guidance, April 8, 2022: Integrated Guidance and Resources for Assisted Living Residences (ALRs) During the COVID-19 Pandemic  | Appendix B: COVID-19 Reporting Template
  • This replaces the August 9, 2021, June 14, 2021,  March 17, 2021, January 20, 2021, November 9, 2020, September 21, 2020, July 2, 2020, June 1. 2020 and March 16, 2020 Revised Guidance for Assisted Living Residences during COVID-19 memorandums
• Executive Office of Elder Affairs (EOEA) guidance, updated June 22, 2021: Vaccination Opportunities for ALRs Post Federal Pharmacy Partnership Program
• EOEA Guidance to implement the DPH Order regarding authorization for skilled nursing care and staffing updates in assisted living facilities, June 15, 2021.

For Early Intervention providers

Guidance for Massachusetts Early Intervention vendor agencies:

• COVID-19 - Massachusetts Early Intervention Telehealth Guidelines
• MA EI Telehealth Policy for Specialty Providers:
  • ABA Services
  • DIR/Floortime Services
  • Vision Loss and Deaf/Hard of Hearing

For in-home caregivers

• DPH Memo, November 21, 2022: Updated COVID-19 Personnel Vaccination Requirement
• Notice, February 24, 2022: Notice Extending Compliance Deadline for COVID-19 Vaccinations for Certain Staff Providing Home Care Services to March 21, 2022
• Guidance for agency based in-home caregivers & workers (e.g. Home Health Agencies, Personal Care Management Agencies, Home Care Agencies, Adult Foster Care, etc.):  Agency In-Home Care COVID-19 Guidance
• Guidance for agencies working with the DPH Bureau of Family Health and Nutrition: Reopening Massachusetts: Guidance for BFHN Home Visiting Programs, updated June 21, 2021
• Guidance for non-agency based in-home caregivers (e.g. PCAs, Independent Nurses, etc.): Non Agency In Home Care COVID-19 Guidance

For community day programs

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

• Updated October 13, 2022: EOHHS COVID-19 Guidance for day programs
  • This document replaces the August 16, 2022, July 1, 2022, August 4, 2021, July 26, 2021 and June 14, 2021 guidance.
• DPH Guidance, November 6, 2020: Guidance Regarding Seasonal Influenza Vaccination of Healthcare Personnel at Massachusetts Adult Day Health Programs for the 2020-2021 Influenza Season

For human service transportation

• Effective October 10, 2022: EOHHS COVID-19 Guidance for Human Service Transportation
  • This document replaces the guidance dated July 1, 2022 , June 24, 2021-June 30, 2022 and its EOHHS COVID-19 Human Service Transportation Checklist.

For hospice programs

• DPH Guidance, November 21, 2022: Updated COVID-19 Personnel Vaccination Requirements for Hospice Programs
  • Hospice Program COVID-19 Vaccination Questions
  • Appendix A: Hospice COVID Vaccination Template
  • This guidance replaces guidance issued on January 16, 2022 and September 24, 2021.

Businesses

DPH guidance:

• Mold and Legionella Reopening Guidance, issued May 22, 2020

Recreational Camps and Programs

DPH guidance: Recreational Camps and Programs Health and Safety Standards for Reopening

Homeless Shelters

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

Local government

Guidance for Town Meetings to Address COVID-19 PDF | Doc

Insurers

• Standing Order for Dispensing Over-the-Counter (OTC) Diagnostic Tests for SARS-CoV-2, issued November 16, 2022, pursuant to G.L. c. 94C, §19E.
  • This document replaces the order issued January 14, 2022.
• DPH Guidance to implement the DPH Order regarding access to certain immunization information for insurance carriers and MassHealth.