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.

EOHHS Congregate Care

As of March 31, 2023, congregate care surveillance testing is no longer required in congregate care settings.

• EOHHS will transition to offer only over the counter (OTC) rapid antigen tests to any congregate care settings that needs tests for outbreak or symptomatic/exposure testing.
• Tests may be requested at the following link: bit.ly/covidtestrequestMA
  • Download self-test instructions in multiple languages, or find more information about at-home COVID-19 tests on COVID-19 testing information

Guidance for Congregate Care Programs

• Congregate care providers must continue to comply with federal and state COVID-19 guidance. This includes, but is not limited to, guidance on COVID-19 Isolation and Exposure for the general public, and for Personal Protective Equipment.
• Consistent with CDC guidance, congregate care providers should have an established plan for thorough cleaning and disinfection of all areas of the setting.
• Effective October 3, 2022: EOHHS COVID-19 guidance for organizations that operate congregate care programs

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, May 11, 2023: Prepackaged Medication Administration by Non-MAP Certified Staff in Registered Community Programs

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

Visit Congregate Care Infection Control Resources 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.

Health Care Professionals

• DPH Guidance, updated May 3, 2024: Guidance for Health Care Personnel with SARS/CoV2 Infection or Exposure

Clinicians

• Information for providers about therapeutic treatments for COVID-19, including antiviral IV therapy or oral antiviral medications
• 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.

School health professionals

DPH guidance for school nurses and other school personnel:

• Handwashing/Sanitizer Guidance and Limited Waiver of 105 CMR 210.000 Related to Sanitizer, June 10, 2021

Health Care Organizations

• Strategies to Address Healthcare Capacity, January 9, 2024
• DPH Guidance, May 5, 2023: Organizational Policies and Procedures for Mitigating Respiratory Illness
• DPH Guidance, May 5, 2023: Updated Comprehensive Personal Protective Equipment
• 90-Day Strategies to Address Healthcare Capacity, December 8, 2022
• 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, October 10, 2024: Updated Hospital Capacity Data Reporting Requirements
  • Appendix A – Data Elements
• DPH Guidance, September 10, 2024: Vaccination of Admitted Patients
• DPH Guidance, April 23, 2024: Updated Guidance Regarding Implementation of Alternate Acute Inpatient Care Space
• DPH Memorandum, September 18, 2023: Updated Guidance Regarding Implementation of Alternate Acute Inpatient Care Space
• DPH Guidance, May 3, 2023: Space on Hospital Premises for Outpatient Patient Treatment of Respiratory Viruses
• 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 Guidance, updated January 28, 2022: Procedures and Requirements for Hospitals/Clinics Dispensing COVID-19 Oral Antivirals
• Information for providers about therapeutic treatments for COVID-19, including antiviral IV therapy or oral antiviral medications
• DPH Guidance, September 17, 2021:  COVID-19 Resurgence Planning and Response Guidance for Acute Care 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 26, 2022: Vaccination of Admitted Patients
• DPH Guidance, October 13, 2022: Caring for Non-Acute Care Hospital Patients

Clinics

• DPH Guidance, May 3, 2023: Clinic Space for Respiratory Virus Testing, Treatment and Vaccine Administration

Dialysis Facilities

• DPH Guidance, May 9, 2023: 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 

Caregivers

• DPH guidance for all healthcare facilities, September 25, 2020: Updated Anterior Nares (Nasal Swab) Specimen Collection by Unlicensed Healthcare Personnel

For long term care facilities

Signs for Facilities:

• Caution Signs for Isolated Individuals in Long-Term Care Facilities (updated March 14, 2023)
  • 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
• Hand Hygiene and PPE Observations

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

• DPH Guidance, May 10, 2023: Update to Infection Prevention and Control Considerations When Caring for Long-Term Care Residents
• DPH Memorandum, November 18, 2022: DPH Limits on Admissions for Outbreaks or Clusters in Long-Term Care Facilities
• 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
• 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

• 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
• 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 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 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

For human service transportation

• Effective October 10, 2022: EOHHS COVID-19 Guidance for Human Service Transportation

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

Homeless Shelters

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

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.

Last updated:	April 18, 2023