Massachusetts Department of Public Health Commissioner Monica Bharel issued three new orders concerning the COVID-19 emergency.  A summary of each order is provided below.

Reassignment of Physician Assistants

The Order permits employers of physician assistants (PAs) to designate a new supervising physician for the PA as necessary to respond to the public health emergency.  The new supervising physician and PA do not need to sign prescriptive practice or scope of practice guidelines; however, the PA’s prescriptive practice and scope of practice must remain within the PA’s areas of competence and scope of services for which the physician is qualified to supervise the PA. The PA’s employer must retain records of the name and scope of practice of the new supervising physician, as well as the physician’s consent to act as the PA’s supervising physician and the timeframe during which the physician will act as a supervisor. This Order applies only to PAs that are in good standing in Massachusetts and includes PAs whose license is subject to probation or non-disciplinary conditions.

Continuity of Emergency Medical Services

This Order revises minimum staffing requirements when a class I, II or V ambulance transports a patient needing basic life support, advanced life support and paramedic level of advanced life support. The minimum staffing requirements under the Order are:

• Basic Life Support: One EMT certified at the EMT-Basic level, and one first responder (other than lifeguards) who an affiliate hospital’s medical director has deemed qualified. The first responder will drive the ambulance.
• Advanced Life Support: One EMT certified at the EMT-Advanced level (or higher), and one first responder (other than lifeguards) who an affiliate hospital’s medical director has deemed qualified. The first responder will drive the ambulance.
• Paramedic Level of Advanced Life Support: One EMT certified at the paramedic level, and one first responder (other than lifeguards) who an affiliate hospital’s medical director has deemed qualified. The first responder will drive the ambulance.

Opioid Use Disorder Treatment

In order to allow redeployment of nurses as needed to meet the growing demands of the COVID-19 crisis, the DPH Commissioner issued an Order permitting pharmacists and pharmacy interns who are licensed by the Massachusetts Board of Pharmacy to administer methadone and buprenorphine to treat opioid use disorder. Such administration must take place in a federally certified and Bureau of Substance Addiction Services (BSAS) licensed opioid treatment program (OTP) or in an acute treatment service that is BSAS-licensed and OTP-certified. Pharmacists and pharmacy interns administering the medications must receive training in the privacy regulations set forth in 42 CFR Part 2 and they must administer the medication in compliance with the federal Substance Abuse and Mental Health Services Administration.

These Orders remain in effect until the Massachusetts state of emergency is lifted or until the Orders are rescinded by the DPH Commissioner.