During the COVID-19 public health emergency, in order to ensure Massachusetts’ health care system had the capacity to address the pandemic, some health care services and procedures were limited or temporarily put on hold, while many services were conducted remotely using telehealth. Emergency services and other essential health and human services continued during this time.
Phase 4: As Massachusetts begins Phase 4, Part 1 on Monday, March 22, 2021, the Executive Office of Health and Human Services released a series of new guidance documents for health care and human services providers, which are outlined below. This guidance supersedes previously issued guidance in Phases 1, 2 and 3.
Phase 4 Guidance Updates for DDS and Providers
On Monday, March 22, the Commonwealth entered Phase 4 in the reopening process.
As part of the Phase 4 reopening of health and human services, key COVID-19 guidance documents on visitation, residential congregate care, surveillance testing, day programs, and transportation have been updated after review by DPH and the Command Center. New guidance around Phase 4 reopening for health care providers and the new Massachusetts Homebound Vaccination Program were also released.
Please find guidance summary for each below.
Visitation Guidance for DDS Residential Programs
Summary of key points and changes:
- Clarification that visitors are not required to be tested or vaccinated, or show proof of such as a condition of visitation.
- Updated guidance for fully vaccinated residents and visitors: when both residents and visitors are fully vaccinated, social distancing is not required on the visit.
- All individuals, including fully vaccinated individuals, should continue to wear face coverings in public settings or settings in which some individuals may not be vaccinated.
- Allowance for an increased number of visitors if all visitors are of the same household.
- Update that visits are no longer required to be scheduled in advance, but may be at the program’s discretion based upon safety considerations.
- Additional clarifications regarding off-site visits for fully vaccinated residents.
Residential and Congregate Care Program Guidance
Summary of key points and changes:
- Fully vaccinated residents are not required to self-quarantine following close contact.
- All residents may participant in congregate activities, and fully vaccinated residents may participate without social distancing.
- Small groups of residents who are fully vaccinated may dine together at a table without social distancing.
- All individuals, including fully vaccinated individuals, should continue to wear face coverings in public settings or settings in which some individuals may not be vaccinated.
- Facemasks, such as surgical masks, should be provided to and worn by all staff.
- Programs continue to report COVID-19 cases and deaths to DDS.
EOHHS Congregate Care Surveillance Testing Guidance
Summary of key changes:
- Clarification that previously positive staff should participate in surveillance testing IF it has been more than 6 months since their original infection
- Clarification about the flexibilities allowed to providers when facing materials constraints, including target of 90% compliance
- Removal of outdated transition language
Find this guidance online here: COVID-19 Public Health Guidance and Directives | Mass.gov
Day Program Guidance
Summary of key points and changes:
- Removes language requiring 113 square feet per person capacity limitations.
- All staff, participants, and visitors must wear face coverings as consistent with DPH guidance. However, the provider may consider waiving the requirement for face coverings for participants in special circumstances consistent with applicable guidance.
- Day Programs must have a food safety plan that identifies how the provider will maintain appropriate safety and social distancing during meals. Meals shall not be served family style.
Transportation Guidance
Summary of key points and changes:
- Updated Transportation Plan Checklist for Reopening of DDS, Day Habilitation, DMH Clubhouse and Early Intervention Programs.
- Updated Guidelines for Demand Response Transportation Shared Rides and Single Trips.
- Routes will be planned, and seats assigned to maintain social distancing (3 feet) on board the vehicle.
- No passengers will sit up front with the driver.
- Passengers can sit one rider per seat, placed on opposite ends of the seat (diagonally).
- All passengers will wear masks or face coverings. If a consumer is unable to wear a mask or face covering, they must be socially distanced 6 feet from other passengers unless they have been fully vaccinated.
New - DPH Phase 4 Reopen Approach for Health Care Providers Guidance
Summary of key points:
- Overarching guidance on PPE, workforce safety, patient and client safety, and infection control.
- During Phase 4, health care providers must continue to comply with all state COVID-19 guidance. This includes, but is not limited to, DPH guidance on: a) Updated Comprehensive Personal Protective Equipment b) hospital visitation, c) considerations for health care personnel after vaccination, and d) return to work guidance for all workers.
New - Massachusetts Homebound Vaccination Program
Summary of key points:
- In-home vaccinations are now available to individuals who are not able to leave their home to get to a vaccination site, even with assistance.
- These homebound individuals either:
- Require ambulance or two-person assistance to leave the home, or
- Are not able to leave the home for medical appointments under normal circumstances, or
- Have considerable difficulty and/or require significant support to leave the home for medical appointments
- Refer homebound individuals to the State Homebound Vaccination Central Intake Line (1-833-983-0485) to be screened for appropriateness for an in-home vaccine.
- Please note, many local Boards of Health are managing their own homebound vaccination programs for their community. The Central Intake Line will help connect any homebound individual from across the Commonwealth with the right resource.
- If in-home vaccination is appropriate, individuals will be registered with the State Homebound Vaccine Provider, Commonwealth Care Alliance, or referred to their local Board of Health based on where they live.