Massachusetts Scope of Practice Policy: State Profile

Massachusetts credentials two types of addiction counselors. A Licensed Alcohol and Drug Counselor (LADC) I requires a graduate degree, complete relevant education courses and 6,000 hours of experience. A LADC II requires, at minimum, a high school diploma and complete relevant education courses. An individual with a bachelor’s degree may earn the credential after 4,000 hours of supervised practice and an individual without a degree will need 6,000. 105 Code of Mass. Reg. 168, Massachusetts Bureau of Substance Addiction Services and Massachusetts Board of Substance Abuse Counselor Certification

A licensed mental health counselor may provide services to individuals, families or groups. Counselors may assess, diagnosis and treat mental and emotional disorders. They may also use psychoeducational techniques aimed at prevention of such disorders, and consultation to individuals, couples, families, groups, organizations and communities. 262 CMR §2.02

As of August 2018, 239 NPs in Massachusetts have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority and with proper training or appropriate experience an NP can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Mass. Reg. Code § 244-4.02 and Mass. Reg. Code § 244-4.07(02)

As of August 2018, 53 PAs in Massachusetts have received a federal waiver to treat opioid dependency with buprenorphine-containing products. A Massachusetts PA may prescribe Schedule II-V controlled substances in accordance with written guidelines mutually developed and agreed upon by the PA and the supervising physician. Massachusetts PAs with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Mass. Reg. Code §263-5.04

The standards for the certification of peer specialists, including experience, training, and supervision requirements, are developed and administered by a third-party, non-profit certification provider.

A written collaboration agreement required between the NP and the supervising physician. This agreement must be mutually developed and agreed to by the physician and the NP. Mass. Reg. Code §243-2.10(4)

A written collaboration agreement must include prescriptive guidelines developed by the physician. Eleven items must be outlined in the agreement including the scope of the NP’s prescribing practice and the types of medication that may be prescribed. Mass. Reg. Code §243-2.10 (5)

NPs are recognized in state policy as primary care providers. If a health care carrier requires the designation of a primary care provider, the carrier must provide its insured with an opportunity to select a participating provider nurse practitioner as a primary care provider or to change its primary care provider to a participating provider nurse practitioner at any time during their coverage period. Mass. Gen. Laws Ann. §176R(4)

A dental hygienist who has at least three years of practice experience and a written collaborative agreement with a local or state government agency or institution, or licensed dentist may provide dental hygiene services without supervision in public health settings (e.g., hospitals, medical facilities, schools, community clinics, etc.). The patient must also be provided a written referral to a dentist and an assessment of future oral health needs. Mass. Gen. Laws Ann. Part 1 Chap. 112, Sec. 51

Statute does not identify dental therapists as an oral health provider.

Massachusetts does not explicitly allow for the practice of teledentistry.

Massachusetts does not allow pharmacists to modify prescriptions.

Massachusetts does not allow pharmacists to prescribe hormonal contraceptives.

Massachusetts does not allow pharmacists to prescribe tobacco cessation aids.

Supervision by a physician is required. Supervisory relationship is established between the PA and the physician and outlines how adequate supervision is accomplished. Mass. Reg. Code §263-5.05

A PA may prescribe drugs and Schedules II-V controlled substances in accordance with written guidelines mutually developed and agreed upon by the PA and the supervising physician. Mass. Reg. Code §263-5.04

A PA may perform any services under the supervision of a physician within the PA’s competency and scope of services. Mass. Reg. Code §263-5.04