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:
- Order: Providing Accelerated Licensing of Physicians Educated in Foreign Medical Schools
- Order: Authorizing Nursing Practice by Graduates and Senior Students of Nursing Education Programs
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:
- COVID-19 Testing Guidance | Doc, issued May 13
- Notification to Test Contacts Regardless of Symptoms | Doc, issued May 11
- Statewide Advisory Committee Recommendations for Standards of Care, updated April 20
- COVID-19 PUI Criteria PDF | Doc, updated April 2
- 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.
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
- COVID-19 Guidance for SDV Programs, updated April 23
- COVID-19 Reimbursement Question Form, 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
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:
- Referral information: COVID-19 Isolation and Recovery Sites
- EOHHS Guidance, updated May 27: Notice of Dedicated Care Capacity at Nursing Facilities for Patients Who Do Not Have COVID-19
- EOHHS Guidance, updated May 27: Notice of Dedicated Care Capacity at Nursing Facilities for COVID-19 Patients
- DPH Guidance, May 21: Comprehensive Personal Protective Equipment
- This guidance replaces DPH’s Comprehensive Personal Protective Equipment guidance released April 5.
- EOHHS Guidance, May 18: Expanded Care Capacity at Sub-Acute Sites for COVID-19 Patients (This guidance replaces guidance issued on April 29).
- DPH Guidance, updated May 7: Healthcare Personnel: Occupational Exposure & Return to Work Guidance
- DPH Guidance, April 28:
- Reminder about the importance of newborn screening and testing, April 14: Newborn Screening and COVID-19
- Temporary changes in policy for newborn hearing screening, April 17: Letter to Birth Hospitals
- Information for Academic Medical Centers, April 4:
- 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.
- DPH Guidance, April 3:
- DPH Guidance, April 2: Integrating Anesthesia Staff and Anesthesia Machines into COVID-19 Intensive Care Work Streams
- DPH Guidance, March 30: N95 Filtering Face Piece Fit Testing Requirements
- DPH guidance memo, March 22: Guidance regarding implementation of alternative acute inpatient care space during the COVID-19 state of emergency
- DPH emergency credentialing and licensed staff transfer procedures order, March 17: Credentialing and Staffing Order
- DPH hospital visitation restriction order, March 15: Hospital Visitor Restrictions Order
- DPH guidance memo, March 16: Hospital Visitor Restrictions Guidance
- DPH non-essential elective procedures order, March 15: Elective Procedures Order
- DPH guidance memo, March 17: Guidance Regarding the Elective Procedures Order
- DPH guidance letter, March 4: Updated Guidance on Strategies to Optimize Use of Personal Protective Equipment (PPE)
- CDC guidance: Resources for Healthcare Facilities
- CDC steps to take: Steps Healthcare Facilities Can Take Now to Prepare for COVID-19
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:
- Hand Sanitizer Pharmacy Order
- This order replaces a previous March 15 order by the Department of Public Health.
March 24 emergency order regarding modifications to pharmacy practice:
- Pharmacy Practice Order
- COVID-19 Central Fill Guidance
- COVID-19 Emergency Prescription Refill Guidance
- COVID-19 Pharmacist Emergency Authorization Guidance
- COVID-19 Pharmacist Garb Guidance
- COVID-19 Pharmacy Remote Processing Guidance
March 18 emergency order regarding the administration of certain medications for the treatment of opioid misuse disorder:
Substance Addiction Service Providers
DPH guidance:
- Screening Patients for COVID-19 Cases in BSAS-licensed/contracted Programs, April 28, 2020
- Personal Protective Equipment (PPE) in BSAS-licensed/contracted ATS, CSS, TSS, OTP, OBOT, and Outpatient Service Programs, April 20, 2020
- Personal Protective Equipment (PPE) in BSAS-licensed/contracted Residential Programs, April 20, 2020
- For DEA-Registered Practitioners: Alert Regarding Use of Telemedicine during Public Health Emergency-COVID-19, updated April 10
- Waiver from Certain Regulatory Requirements, April 7, 2020
- Reporting/Mitigating COVID-19 Cases in BSAS-licensed/contracted Programs, April 6, 2020
- Consent for Treatment/Data Submission in BSAS Licensed and Contracted Programs, April 3
- For Section 35 providers: Section 35 Visitor Guidance, March 23
- For Opioid Treatment Programs: Alert Regarding COVID-19 for Opioid Treatment Programs, March 18
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:
- CDC updated guidance for all first responders, including law enforcement, fire services, emergency medical services, and emergency management officials, who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work, March 10: CDC’s Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for 2019-nCoV in the United States and information about recommended EPA-registered disinfectants that meet the criteria for use against SARS-CoV-2: List N: Disinfectants for Use Against SARS-CoV-2.
- DPH Guidance, updated May 23: Advisory 20/05/23 - Partial Lifting of In-Person EMS Course and Psychomotor Exam Suspensions and Memorandum 20/05/23 - Modification to EMT Psychomotor Exam Processes During COVID-19 State of Emergency
- These replace guidance issued on April 3.
- DPH Guidance, May 21: Comprehensive Personal Protective Equipment
- This guidance replaces DPH’s Comprehensive Personal Protective Equipment guidance released April 5.
- DPH Guidance, updated May 7: Non-Healthcare Workers: Occupational Exposure & Return to Work Guidance
- DPH Guidance, April 10: AR 2-305: Minimum Skill Requirements for Paramedic Training
- DPH Guidance, April 6:
- DPH Guidance, April 3:
- Updated EMT Recertification Guidance, April 1: DPH has temporarily extended EMT certifications that would have expired 4/1/2020, that had not been previously renewed and which were in good standing, until 90 days after the termination of the state of emergency. These replace guidance issued March 18.
- DPH Memo, March 31: Temporary Approval of Mobile Integrated Health Care (MIH) Programs
- DPH Emergency Waiver, March 29: Temporary Waiver for Non-Transport of Certain COVID-19-Only Patients
- Emergency Statewide Treatment Protocols:
- Emergency Update to Protocol 7.3: Medical Orders for Life Sustaining Treatment (MOLST) and Comfort Care/ Do Not Resuscitate (DNR) Order Verification - 4/3/20
- 1.3 Emergency Non-Transport Protocol – 3/29/20
- 1.3 Emergency Non-Transport Memo – 3/29/20
- 1.2 Patient At Risk for Coronavirus Disease 2019 (COVID-19) | Doc – updated 4/28/20
- DPH Guidance, March 24:
- DPH Guidance, March 20: Advisory 03-20-20: Unprotected Exposure Reporting to EMS Personnel and First Responders for COVID-19
- DPH Guidance: March 20: Emergency Measures Relating to EMS Due to COVID-19 Outbreak
- Continuing Education Limits on Distributive Education (March 18): Update to Administrative Requirement 2-212, to allow EMS personnel with certifications expiring in 2020 to complete all their remaining continuing education through distributive education.
- Emergency Waiver (March 20): Waiver issued to sections of 105 CMR 170.305 to reduce required staffing of each ambulance to one EMT and/or one Paramedic, depending on level of ambulance, with a driver who is a first responder, as defined in MGL c. 111, section 111C and 105 CMR 171.000 (excluding lifeguards).
- Order of the Commissioner of Public Health Regarding the Sharing of Critical Information with First Responders (March 18)
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:
- DPH Guidance, May 21: Comprehensive Personal Protective Equipment
- This guidance replaces DPH’s Comprehensive Personal Protective Equipment guidance released April 5.
- EOHHS Guidance, May 15: Description of EOHHS Nursing Facility Staffing and Technical Support Resources | Doc
- DPH Guidance, April 29: Update to Caring for Long-Term Care Residents during the COVID-19 Emergency
- DPH Guidance, April 28: Reporting Requirement Extensions for Health Care Facilities
- DPH/DMH Update, April 27:
- DPH Guidance, April 13: Extension of Time for Inspecting, Re-Stocking and Resealing of Emergency Medication Kit
- DPH Guidance, April 6:
- Sign for Facilities: Special Droplet/Contact Precautions
- DPH Guidance, March 30: N95 Filtering Face Piece Fit Testing Requirements
- DPH guidance letter pursuant to the Order of the Commissioner of Public Health, March 16:
Policies and Procedures for Restricting Resident Visitors in Nursing Homes and Rest Homes and Personal Protective Equipment Recommendation Updates during the COVID-19 Outbreak - DPH guidance letter, March 4: Updated Guidance on Strategies to Optimize Use of Personal Protective Equipment (PPE)
- CDC guidance: Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (LTCF)
- DPH guidance letter, February 27: COVID-19 Guidance: Nursing Home and Rest Homes
- CDC guidance: Resources for Healthcare Facilities
- CDC steps to take: Steps Healthcare Facilities Can Take Now to Prepare for COVID-19
- DPH fact sheet: Alcohol-Based Hand Rub in Long Term Care Facilities
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:
- Mold and Legionella Reopening Guidance, issued May 22
- Occupational Exposure & Return to Work Guidance, for all non-healthcare workers. Updated May 7.
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