MASSACHUSETTS HOSPITALS STAND READY
All Massachusetts hospitals have
established policies for containing and treating contagious diseases and
for dealing with patient surges if the need arises. Hospitals are
dedicated to ensuring safe patient care and providing the men and women
who treat patients the safest possible environments to conduct their
work. MHA and its membership have been in regular contact with the
Massachusetts Department of Public Health and national health
organizations to ensure that the commonwealth is well-prepared to meet
the challenges presented by the COVID-19 novel coronavirus.
The Most Current Information
These state, federal, and global entities are continually updating their resources to provide the most current information on COVID-19.
The well-respected medical journal, The Lancet, has created a coronavirus research center that brings together content from across The Lancet’s many journals (for example, The Lancet Global Health, The Lancet Infectious Diseases, and The Lancet Respiratory Medicine) as it is published. The content on the website is free.
This 5-page list from the federal government details many links to federal agencies and their specific guidance related to COVID-19. It's a valuable resource.
Frequently Asked Questions About COVID-19
What is it? How does it spread? How do I protect myself? What about my pet and the novel coronavirus? Check here for answers to these and other common questions.
In certain circumstances, the Secretary of the Department of Health and Human Services using section 1135 of the Social Security Act can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. Click here to view a list of waivers relating to the COVID-19 pandemic.
State Executive Orders
The Baker Administration under the emergency order issued on March 10 has used its authority to grant a series of emergency orders and guidance documents to ease restrictions on providers responding to the pandemic. Click here for a list of these orders.
This section contains operational resources for hospitals that are
updating their airborne isolation plans, personal protective equipment
inventory, among other best practices to employ during widespread
contagion events. The resources are from around the U.S.
Click here for more resources
Ongoing Resources and Best Practices
Check back here frequently for regular updates from health agencies, as well as notable news alerts and stories of interest.
APRIL 7, 2020 -- CRISIS STANDARDS OF CARE. A Crisis Standards of Care Advisory Committee was convened by DPH Commissioner Monica Bharel, M.D. to prepare guidance in the event of the potential scarcity of necessary medical treatment resources in the commonwealth caused by a surge in need due to the number of people suffering from COVID-19. This committee included medical experts and ethicists from across the commonwealth, representing both large academic medical centers and community hospitals. The purpose of the document is to provide guidance for the triage of critically ill patients in the event that the demand for critical care resources outstrips the supply. The foundation of the commonwealth’s approach to crisis standards of care is that such tragically difficult decisions must be based on criteria that ensure that every patient has equitable access to any care from which they might benefit. These criteria must be as clear, transparent, and objective as possible, and must be based on biological factors related only to the likelihood and magnitude of benefit from the medical resources. The document states: “Factors that have no bearing on the likelihood or magnitude of benefit, including but not limited to race, disability, gender, sexual orientation, gender identity, ethnicity, ability to pay, socioeconomic status, perceived social worth, perceived quality of life, immigration status, incarceration status, homelessness or past or future use of resources, are irrelevant and not to be considered by providers making allocation decisions.” Read this important document by clicking here.
APRIL 5, 2020 – DPH’s LATEST PPE GUIDANCE. DPH issued its latest guidance on personal protective equipment, taking into consideration the need to optimize supplies. Topline messages include: DPH supports the extended use of face masks – that is, wearing the same facemask for repeated close contact encounters with several different patients, without removing the facemask between patient encounters. DPH is supportive of The Joint Commission’s statement on masks – that is, none of the current standards prohibit staff from bringing in their own PPE or wearing PPE throughout the day. As for gowns, DPH recommends shifting gown use towards cloth isolation gowns. Reusable (i.e., washable) gowns made of polyester or polyester-cotton fabrics can be safely laundered according to routine procedures and reused. The guidance is applicable only if certain conditions are met, which are laid out in full in this document.
APRIL 4, 2020 – CLINICAL FELLOWS LICENSURE. Due to the COVID-19 pandemic, the Massachusetts Board of Registration in Medicine has authorized expediting full licensure for clinical fellows. Additional information is here, including emergency temporary 90-day license application for physicians who have completed training and are seeking a full license.
APRIL 4, 2020 – DPH RE-FOCUSES LAB TESTING AT STATE LAB. Noting that “the epidemic has evolved,” DPH has announced new testing priorities for the state public health laboratory. When collecting a specimen from a patient that meets the DPH criteria 1-3 – that is, a member of the healthcare workforce, someone in a congregate living facility with respiratory illness, or hospitalized patients with fever and acute lower respiratory illness – it is not necessary to call the state lab for testing approval prior to submission. Other categories should be sent to commercial labs. Read the entire guidance here.
APRIL 3, 2020 – DMH’s APRN SCOPE OF PRACTICE EXPANDED. By this order, APRNs at DMH facilities who hold certification in the field of psychiatric mental health now have the same authority as qualified physicians to provide specific mental health services, including involuntary and voluntary admissions to inpatient psychiatric facilities and the authorization of restraints and seclusion. Such APRNs must meet relevant DMH requirements, be credentialed to provide such services by the facility which employs them, and shall have the same immunity as qualified physicians and qualified psychiatric nurse mental health clinical specialists. Here’s the guidance associated with the order.
APRIL 2, 2020 – N95 DECONTAMINATION. The Battelle N95 decontamination system that has received national press attention is scheduled to be operational in the Boston area on Monday April 6. The Battelle system uses FDA-approved N95 decontamination technology. It will be the fourth site operational in the U.S. The Battelle owned and operated system will be hosted by Partners HealthCare at the currently vacant Somerville K-Mart (77 Middlesex Road) that is adjacent to I-93. (Permitting on the site is being finalized.) The system can decontaminate up to 80,000 masks per day, which should cover all demand in Massachusetts. Current pricing is $3.25 per mask. Battelle has indicated it will reduce the price once it reaches national quantity levels.
APRIL 1, 2020 -- DPH ISSUES TESTING REMINDERS. COVID-19 testing is accelerating. As such, DPH is reminding providers about testing protocols. First, DPH encourages healthcare providers to provide tests to all patients that fall under Categories 1-8 as detailed in this DPH PUI guidance. Increased testing helps control the COVID-19 pandemic. Second, DPH reminds providers that they can send collected specimensin Categories 1-6 of the PUI guidance to the SPHL, and specimens in ALL categories 1-8 to the Broad Institute. Broad has significant testing capacity and is typically turning around test results in 1 day. To submit specimens to The Broad, please follow this submission process.
MARCH 31, 2020 -- DOI BULLETINS ON CREDENTIALING, PRIOR AUTH.The state Division of Insurance (DOI) has issued two bulletins to ease enrollment and to cut through the red tape that has impeded credentialing of physicians and patients being transferred out of facilities or receiving home care. Bulletin 2020-09 extends the deadline of the previously granted “special enrollment period” to allow the uninsured to sign up for insurance coverage. The new enrollment deadline is extended from April 25 to May 25. Bulletin 2020-10 expedites credentialing of new providers as well as those who will be performing different duties within the scope of their licenses. 2020-10 also suspends any prior authorization requirements for transfer from an acute care hospital to a lower level of care such as a SNF or rehab facility. The bulletin also suspends any prior authorization requirements that would impede patients from remaining in their homes to receive medically necessary home care.
MARCH 30, 2020 -- STATE AUTHORIZES PROCESS FOR NEW RATES, SUPPLEMENTAL PAYMENTS. By this executive order today, Governor Baker, citing the excessive demands COVID-19 has placed on healthcare providers has authorized the creation of “classes of health and human service providers” that will be issued “temporary rates and supplemental payments.” EOHHS will establish “new rate and payment methodologies and arrangements to reflect the new modalities through which providers are delivering their services.” The new payments and methodologies go into effect with the publication of Administrative Bulletins.
MARCH 30, 2020 -- STATE ORDER EXPANDS WORKFORCE. Licensed out-of-state providers in good standing, and those licensed in Massachusetts within the past 10 years whose license expired or wasn’t renewed, will be able to practice again under a new order issued yesterday by DPH Commissioner Monica Bharel, M.D. Those Massachusetts providers who had their licenses revoked, suspended, or surrendered aren’t eligible. But commonwealth providers who have retired or who let their licenses lapse, and providers from other states who can present evidence they’re in good standing, will be able to practice in Massachusetts.
MARCH 30, 2020 – DMH REDUCES REGULATORY REQUIREMENTS. DMH released guidance indicating reduced regulatory requirement for entities licensed by DMH. These provisions include the ability to reduce strict adherence to the DMH licensing minimum nursing care hours per patient day requirements if necessary due to workforce challenges, as long as certain requirements are met. Additionally, programs and facilities whose licenses are in good standing that would otherwise expire during the state of emergency will remain in effect for a period of 90 days after the termination of the state of emergency. DMH will be issuing letters to each facility affected by this order clarifying its status.
MARCH 30, 2020 -- DONATION SITE FOR PPE. The Baker Administration announced an online portal where individuals and companies can easily donate or sell personal protective equipment (PPE) and volunteer to support the COVID-19 outbreak in Massachusetts. The commonwealth’s COVID-19 PPE Procurement and Donation Program creates an easy portal allowing companies and organizations to sell or donate protective equipment that is in short supply given the global demands for such items.
Click here for more resources as well as guidance documents that have been superseded by more recent directives.