Guidance on COVID-19 

As Massachusetts continues to react to the outbreak of the novel coronavirus, COVID-19, we are compiling resources for behavioral health providers on this page.

COVID-19 Vaccine (Last Updated 1.29.2021)

Vaccine distribution in Massachusetts is occurring in a phased approach. There are three phases that reflect several priorities: protecting our most vulnerable, maintaining health care system capacity, and addressing inequities in health care access and COVID-19 burden. Phases may overlap to some extent.

Phase 1 Includes:

  • Clinical and non-clinical health care workers doing direct and COVID-facing care:
  • Long term care facilities, rest homes and assisted living facilities
  • Emergency medical services, police, and fire, Congregate care settings
  • Health care workers doing non-COVID-facing care

As of January 21, 2021, all individuals in Phase 1 became eligible for vaccinations.

The Department of Public Health (DPH) has launched a website that includes extensive information on the vaccine deployment, Phases 1 – 3, and is updated frequently. It has a specific page for Phase 1, including information on current vaccination sites. Click here to access this page.

Phase 1 Vaccination Settings:

  • Individuals currently eligible for vaccination in Phase 1 can visit mass.gov/CovidVaccineMap to view vaccine locations, including mass vaccination sites, sign-up and eligibility information. Sites will continue to be added with appointments released on a rolling basis
  • First responders can visit mass.gov/FirstResponderVaccine for COVID-19 vaccine locations and more information.
  • Individuals living and working in long term care will be vaccinated as part of the Federal Pharmacy Partnership Program.
  • Staff and residents of congregate care settings, such as shelters and prisons, can visit COVID-19 Vaccinations for Congregate Care Settings.
  • Many additional vaccination sites will be made available for other populations

For your convenience, we have listed additional vaccine information below.

Self-Administering COVID-19 Vaccines

Qualifying organizations that can self-administer vaccinations may work with the Department of Public Health to provide vaccines on-site at the place of employment. This option is available to congregate care providers. Organizations that choose to vaccinate their own staff must follow the Guide to Applying to Administer the COVID-19 Vaccine.

In order to self-administer the COVID-19 vaccine, providers must meet the following requirements:

  • Massachusetts COVID-19 Vaccine Program (MCVP) Agreement - All organizations or providers receiving COVID-19 vaccine must execute the MCVP Agreement. Among other things, this Agreement obligates providers to administer COVID-19 vaccines in accordance with the terms of the applicable EUA and to report certain vaccine recipient information. Sites enrolling in the MCVP must also register with the Massachusetts Immunization Information System (MIIS).

  • Massachusetts Immunization Information System (MIIS) Site and User Agreements - Pursuant to G.L. c. 111, s. 24M and 105 CMR 222, licensed healthcare providers who administer immunizations are required to report certain information to the Department’s MIIS. COVID-19 vaccine providers must meet this reporting requirement by registering with the MIIS, which will include executing the MIIS Site and User Agreements. BSAS licensed entities must ensure that required reporting requirements under the EUA and MIIS do not run afoul of obligations under 42 CFR Part 2; BSAS-funded providers should consult with their legal counsel with any questions.

Process for Providers That Self-Administer Vaccines

The Commonwealth initiated a new vaccine ordering process as of January 25, 2021 for those that directly order, receive and administer the COVID-19 vaccine, week to week. The information attached and below is most relevant and particularly important to Providers who have chosen to implement the “self-administration” option to vaccinate their own staff and age-eligible residents in their programs. If you are pursuing the “self-administration” option and are vaccinating your own staff/residents, using your own medical personnel, resources and capacity, please be aware of the following information:

  • Vaccine administrators, i.e., self-administering sites, must submit vaccine orders by 5:00 p.m. on Tuesday of each week via Casetivity (the online vaccine ordering system) to receive the vaccine the following week
  • The document "COVID-19 Vaccine Request Process – Guide for Providers" describes the revised process, including timelines and actions need to order and manage vaccines
  • In this instruction, Providers are defined as those who are ordering and administrating vaccine.

Revised Process Highlights:

  • Use of Casetivity/MCVP Survey - Requests for vaccine will only be considered when submitted through the survey.
  • First/second doses - Vaccine administrators must indicate both the first and second doses they are requesting via the survey.
  • Order Confirmation: Your state agency Point of Contact (POC) will be in touch with you if your request for vaccine cannot be fulfilled; Vaccine allocation will be confirmed through a MCVP email on Friday and/or Monday.
  • Order delivery timing: Confirmed orders will be placed on Friday and Monday, with doses arriving to vaccine administrators no later than Tuesday and Wednesday, respectively.
  • Clinic scheduling: Appointments should not be confirmed until Providers receive an order confirmation.
  • Vaccine Usage: Vaccine doses received must be used within ten days of receipt.
  • Coordinate with your state agency Points of Contact: Please coordinate with your agency Points of Contact (POCs) regarding intended vaccine orders, issues with the Casetivity/MCVP survey, or any other question:
    • Vaccine administrators who have not received a Casetivity/MCVP survey link must inform POCs in order to receive the link
    • Each week, communicate to your POC the number of first and second doses you are requesting each week so that your POC can best support your order requests and vaccination administration plan.

Congregate Care and Residential Care

Congregate Care and residential provider organizations should provide staff and residents with a letter verifying that the individual meets Phase 1 Residential Congregate Care and Shelter eligibility guidelines as specified by the Commonwealth of Massachusetts. The eligibility letters should:

  • Be on organizational letterhead
  • Identify the individual by name
  • Remind individuals to bring employee identification or state or federal issued identification to the site.

Home-Based Healthcare Workers and Non-COVID-Facing Health Care Workers

Home-based Healthcare Workers and Non-COVID facing Healthcare Workers (e.g., behavioral health clinicians, substance use disorder treatment program staff, Clubhouse staff, and Recovery Center Staff) are eligible to receive vaccines. Provider organizations are encouraged to utilize the mass vaccination and local vaccination sites which can be found here. Please check the site list daily as new sites are added frequently. Appointments are required at all sites.

Eligibility will be confirmed through a simplified process referred to as “self-attestation”. Individuals can complete this process by filling out the COVID-19 Massachusetts Vaccination Attestation Form here. Individuals must be prepared to show the Attestation Form at their vaccination appointment. Please note:

  • It is acceptable to display the confirmation email on your phone at your appointment.
  • You may print out the online form, fill it out and bring it with you to your appointment.
  • If you cannot print out the form or complete it online, you may fill it out at the vaccination site.

Individuals may be asked for the following documentation at their appointment:

  • Insurance card. Vaccination is free whether you have insurance or not. if you have insurance, please bring that information with you.
  • Identification, examples include:
    • Employer-issued ID card that includes your name and title; or
    • Government-issued identification or license; or
    • Recent paystub

To access Considerations for Healthcare Personnel after Receiving Vaccine, click here.

Those residents who are under the age of 18 are only eligible to receive the Pfizer vaccine; please check with the location you have selected regarding what vaccine they are administering before sending residents under the age of 18. As a reminder, those residents under the age of 18 placed by DMH require a signed consent form; those residents under the age of 18 in the care and custody of DCF do not require a consent form as the vaccine is considered to be a routine medical procedure.

As available vaccines require two shots, staff and residents must return to the same vaccination location for their second scheduled date shot.

Documenting COVID Vaccine Doses for DCF Youth in the Virtual Getaway

It is essential that the delivery of the COVID vaccination is documented for DCF youth. The DCF COVID Vaccination Guide provides step-by-step instructions for documenting vaccinations for DCF youth. This documentation is especially important because DCF youth may move before receiving their second dose of the vaccine. To ensure their health, DCF needs good documentation of what dose of the vaccination DCF youth have received. Please support this work to ensure their health by entering vaccination information into the Virtual Gateway within 72 hours of vaccination delivery

Surveillance Testing Guidance (Last Updated 1.29.2021)

On December 17th, EOHHS issued revised surveillance testing guidance for organizations that operate residential congregate care programs, veteran’s shelters, and residential schools. This guidance contains significant changes regarding how testing will be accesses by providers, including:

  • In order to facilitate continued access to testing for Covered Programs, after December 31st, 2020, EOHHS will offer two testing options (“testing access options”) to Covered Programs.
    • Enrolling to receive PCR tests from Color Genomics, Inc. (“Color”). Color Genomics, Inc. (“Color”) would provide access to convenient, self-administered, highly sensitive molecular test at no cost to Covered Program; or
    • Enrolling to receive Abbott BinaxNOW Rapid point-of-care tests (“BinaxNOW tests”). BinaxNOW tests are rapid antigen tests which produce results in 15 minutes, and which can be administered by any trained staff member.
  • Covered Programs will only be able to access testing through one of the two mechanisms outlined above (i.e., Covered Programs which received tests from Color Genomics will not be eligible to receive BinaxNOW tests, or vice versa).
    • Once enrolled, organizations will not be able to change the chosen testing access option for at least 8 weeks after tests are received.
    • Enrolled programs will no longer need to complete the online testing survey.
  • As programs transition to one of the two testing access options, EOHHS will allow for limited, conditional extension of the current reimbursement contracts through January 20, 2021.

The revised surveillance testing guidance can be found here: EOHHS Congregate Care Surveillance Testing Guidance (revised as of 12.31.2020). Additional resources are listed below:

Surveillance Testing Protocol (Last Updated 1.29.2021)

Massachusetts county positivity rate is published biweekly and is published under the “Additional COVID-19 Data” on the COVID-19 Response Reporting webpage. If the program testing results indicate there are no positive COVID-19 staff and the county positivity rate in which the Program site is located is below five percent as a 14-day rolling average (i.e., over the last 14 days), the Program site should conduct testing every two weeks on 50% of its staff. The staff to be included for testing should be a representative sample from all shifts and varying staff positions and should ensure that all staff are tested at least once a month. If the results of baseline testing or the previous testing period indicate that there are no positive COVID-19 staff and the county positivity rate in which the provider is located is at or above five percent as a 14-day rolling average (i.e., over the last 14 days), the provider should conduct testing every two weeks on all of its staff.

Reporting Positive Cases (Last Updated 1.29.2021)

This revision outlines the process for programs to report confirmed COVID-19 cases to their funding agency. The guidance embeds a daily tracker reporting tool and specifies that "each funding agency will identify the Agency Point of Contact to whom to report" and each provider agency is to designate a point of contact. There has been some confusion about this among ABH members. The reporting process for purchasing agencies most relevant to ABH membership are below:

  • Bureau of Substance Addiction Services
    • On April 1, 2020 BSAS clarified via email to providers that "[f]or BSAS funded and/or contracted programs, reporting should be done as part of the Required Notification process and programs should fax in" the COVID-19 tracker along with the Required Notification Form "for positive COVID-19 reporting for all programs (bedded and non-bedded)." The fax number is included in the Required Notification Form. BSAS clarified that "if faxing is not an option then programs can send via email to their BSAS Regional Managers the info. No identifying client personal info should be included."
  • Department of Children and Families
    • On March 26, 2020 the Department of Children and Families issued guidance requiring that Designated Program Leads send the completed spreadsheet to DCF's Agency Point of Contact by 1:00pm Monday - Friday. DCF's reporting point of contact is [email protected]. Read the full guidance here.
  • Department of Mental Health Reporting
In lieu of the spreadsheet, the Department of Mental Health (DMH) has adapted the reporting tool into two online survey instruments as of June 18, 2020:
    • DMH Congregate Care COVID Survey
      • Used for reporting for all congregate care (24/7) community locations (provider reporting only - does not include state operated programs).
      • Client reporting includes the following: New Test Administered, Positive Test Result Received, Meets Recovery Definition, Enrollment of a COVID-positive or COVID-recovery client and Disenrollment of a COVID-positive or COVID-recovery client.
      • The definition of COVID recovery is included here.
      • Staff reporting includes Positive Test Result Received only.
      • Survey link: https://www.surveymonkey.com/r/DMHCongregate
    • COVID-19 Reporting Tool for DMH Community Outreach Services
      • Used for reporting for all community-based outreach services (non-residential such as DMH Case Management, ACCS Integrated Team, Mobile Respite, PACT, Clubhouse, Homeless Support Outreach, Flexible Support Services, Day Services, and Continuum Services) for provider and state-operated services.
      • Client and staff reporting includes Positive Test Result Received only.
      • Survey link: https://www.surveymonkey.com/r/DMHOutreach
  • Department of Public Health Reporting Clarification - Clinics
    • Clinic staff that tests positive does not need to report to the Division of Health Care Facility Licensure and Certification.

Department of Public Health (DPH) Congregate Care Infection Control Webinar - Recording and Office Hours (Last Updated 2.2.2021)

Commonwealth Medicine, in coordination with EOHHS, DPH and state partner agencies, hosted the webinar Applying Infection Control Basics in Congregate Care Settings for program and state staff to prevent and control the spread of COVID-19. The webinar was intended for site/house managers and direct care staff, as well as individuals who could use materials to provide additional infection control training and education to program staff and residents.

Over 300 participants joined the webinar and submitted questions and discussion topics. For those who were unable to join, there is now a recording of the webinar available using following link: Congregate Care Infection Control Resources | Mass.gov.

As a follow up to the session, Commonwealth Medicine will also host “Office Hours” through February 17, 2021 to answer any questions about infection control in congregate care settings.

The February sessions are scheduled for:

  • Friday, February 5 from 11:30am - 12:30pm
  • Monday, February 8 from 9am - 10am
  • Thursday, February 11 from 9:30am - 10:30am
  • Wednesday, February 17 from 1pm - 2pm

As space is limited during these sessions, please register at: https://form.jotform.com/DCStraining/congregate-care-officehours.

Feel free to share questions that you would like addressed by contacting [email protected].

Department of Public Health (DPH) Guidance (Last Updated 1.29.2021)

The Department of Public Health (DPH) has issued General COVID-19 Guidance and Recommendations for various audiences here. We have linked Guidance for the following:

Medication Administration Program (MAP) Notices (Last Updated 1.29.2021)

National Council for Behavioral Health (Last Updated 1.29.2021)

The Department of Mental Health (DMH) Guidance (Last Updated 1.29.2021)

In the context of the evolving nature of the COVID-19 virus (also known as CoronaVirus), this email is providing clarification regarding service delivery within ACCS, particularly to individuals who are receiving Integrated Team services.  It remains important that ACCS providers continue to provide clinically indicated services to ACCS clients utilizing recommended precautions to maintain the health and safety of clients and staff.  More information on the most recent guidance can be found here:

Community-based behavioral health programs provide critically important lifesaving and life sustaining interventions for our Clients.  At this time when extra caution is required to contain spread of Corona Virus, DMH is recommending that ACCS providers continue to provide in-person assessment and active treatment services for those Clients who are not exposed to or presenting with Corona Virus symptoms.  Consistent with the Governor’s orders, DMH is recommending the use of telephonic and other remote methods of communication (e.g. Skype) as clinically indicated when face to face encounters are not indicated and may adjust service delivery to include a combination of face to face and alternative means as necessary to support our state-wide effort to contain spread of Corona Virus.    For billing purposes, the “Other, Telephonic/Collateral Rehab” codes (O, BO, AO) are  used.  It is expected that these contacts are intentional and consistent with clients’ treatment plan and therefore meet requirements of “R” day billing. 

MassHealth Resources (Last Updated 1.29.2021)

Please find MassHealth Bulletins below, and visit the MassHealth website here to remain informed. 

Bureau of Substance Addiction Services (BSAS) Guidance (Last Updated 2.2.2021)

SAMHSA will consider "blanket" exception requests for patients who are either pregnant or >60 and/or with a high-risk medical condition. One exception with comments about this general category of patients along with the specific patient IDs (maybe 20 per exception) will be appropriate. Please be sure to include lots of info regarding keeping methadone safe, the possibility of having a delegate pick it up, chain of custody, etc. It is also possible to make the date range of one month (x 2 weeks) with the total number of bottles at 13 or 14 so the patient/delegate picks up every two weeks with a possible check in. You can also add info re the tele counseling. Please feel free to call me with questions and please forward this email to the others you work with as needed.


DPH BSAS is accepting regulatory waiver requests from OTPs for waiving the state time in treatment for take homes regulations, aligning with federal OTP take home regulations. Please submit a simple email request to Jen Babich requesting this waiver. The federal OTP take home regulations can be found here​.

Please be sure that each OTP has an emergency program number posted on the window/door and or an outgoing voicemail message informing the caller who and how to contact the OTP staff when the program is closed for verification of dosing or a patient emergency. This is required by regulation and must be part of the OTP's disaster plan.  It is crucial especially now to ensure this is in place as patient's may be presenting at the emergency department, etc, diagnosed with COVID-19 and cannot return to the OTP, and they need a way to communicate ASAP with the OTP.

Clarification regarding blanket exception requests for patients that are in correctional facilities or nursing homes as identified in the recent SAMHSA guidance, or in residential treatment - OTPs do not need to submit individual requests they can list the patient numbers in the request to cover that group of patients or provide a statement for each location ex. Patients residing in a nursing home. Please ensure that these types of requests include the rationale, whether QSOAs are in place, how methadone will be transported and kept safe, chain of custody, patient leaving AMA/destruction, ongoing communication between facility and OTP re patient's overall wellbeing.

 Plan Specific Guidance (Last Updated 1.29.2021)

These are intended as supplemental resources only. Please check with your plan for the most up to date information and additional details. 

Division of Insurance (DOI) Guidance (Last Updated 1.29.2021)

Center for Medicare and Medicaid Services (CMS) Guidance (Last Updated 1.29.2021)

  • Telehealth Developments in the 2021 Medicare Physician Fee Schedule:

    The Centers The Centers for Medicare and Medicaid (CMS) recently published its CY 2021 Medicare Physician Fee Schedule Final Rule (CMS-1734-F). In addition to updating Medicare’s payment policies for the upcoming calendar year, the Physician Fee Schedule (PFS) makes changes to Medicare covered telehealth services – some permanent and others temporary.

    As a reminder, prior to the COVID-19 public health emergency, Medicare’s telehealth benefit was extremely limited and restrictive in its coverage and availability. In response to the coronavirus pandemic, a series of temporary flexibilities were adopted to ensure access to virtual care.

    The current telehealth flexibilities allowed by Medicare are tied to two emergency declarations.

    First, on January 27, 2020, Sec. Alex Azar (HHS) declared COVID-19 a public health emergency (PHE) under the Public Health Services Act § 319(a) [42 U.S.C § 247d(a)].

    Second, on March 13, 2020, President Donald Trump declared the COVID-19 outbreak a national emergency under the National Emergencies Act (50 U.S.C. 1601 et seq.).

    The national emergency may be terminated by the President or by joint resolution of Congress. Once this presidential declaration was made, Sec. Azar was empowered to temporarily waive or modify certain requirements of Medicare, Medicaid, CHIP and HIPAA under Section 1135 of the Social Security Act [42 U.S.C. 1320b–5]. Under the law, the public health emergency determination must be renewed every 90 days by HHS. Unless it is renewed, the current PHE is set to expire on January 20, 2021.

    Absent the public health emergency determination, certain telehealth flexibilities that have been in place since April 30, 2020, will be discontinued. In its CY 2021 PFS, CMS acknowledges its limitations in making all existing telehealth flexibilities permanent, but adopts policy changes where it is authorized to do so. The PFS establishes classifies telehealth services into three groups which upon termination or expiration of the PHE will be affected differently:
    • Category 1: Permanently Covered Services
      • There will be no change to these services after the termination or expiration of the PHE.
    • Category 2: Temporarily Covered Services
      • After the PHE expires, these services will be covered for the remainder of the calendar in which the expiration takes place.
    • Category 3: Services Covered for the Duration of the PHE for the COVID-19 Pandemic
      • Group C services will cease to be covered once the PHE expires or is terminated.

 Telemedicine and Prescribing Guidance (Last Updated 1.29.2021)

Telehealth Related Websites (Last Updated 1.29.2021)

Substance Abuse and Mental Health Services Administration (SAMHSA) (Last Updated 1.29.2021)

Department of Early Education and Care (EEC) Guidance (Last Updated 1.29.2021)

Network of Care Massachusetts (Last Updated 1.29.2021)

The Blue Cross Blue Shield of Massachusetts Foundation - together with funding partners MetroWest Health Foundation and the C.F. Adams Charitable Trust - announced the launch of Network of Care Massachusetts, a comprehensive statewide online resource to help anyone find information on mental health and substance use supports and services in their community. Access this resource below: 

Network of Care - Massachusetts

Please find COVID-19 fact sheets that provide DPH guidance here:

Please find COVID-19 precaution guidance posters here: 

It is important to take precautions such as these listed below, in order to help prevent the spread of the flu and other respiratory illnesses:

  • Cover your mouth when you cough or sneeze, using a tissue or the inside of your elbow
  • Wash your hands for 20 seconds with soap and warm water frequently and use hand sanitizer
  • If you have a fever or feel sick, stay home and call your healthcare provider
  • Get the flu vaccine - it is not too late! Find more information on the flu and where to get a flu vaccine here

Please stay informed by visiting both the Massachusetts Department of Public Health (MDPH) and the Centers for Disease Control and Prevention (CDC) websites. The Association for Behavioral Healthcare is following the guidance provided by the Department of Public Health (DPH) relative to COVID-19. ABH will continue to monitor CDC and DPH recommendations and will provide more guidance as appropriate.