Massachusetts

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.

Full independent practice and prescriptive authority.

Nurse midwives shall practice within a health care system and have clinical relationships with obstetrician-gynecologists that provide for consultation, collaborative management or referral, as indicated by the health status of the patient. Nurse midwifery care shall be consistent with the standards of care established by the American College of Nurse Midwives.

Nurse midwives may engage in prescriptive practice without guidelines or supervision. Mass. Reg. Code §244-4.06; Mass. Reg. Code §244-4.07

Full practice authority but transition to independent prescribing authority.

A NP will only practice in the clinical category(s) for which the CNP has attained and maintained certification. NPs with less than two years of experience need guidelines for prescriptive practice and will be supervised by a Qualified Healthcare Professional (physician or NP with independent practice authority). After this period, the NP may independently prescribe. Mass. Reg. Code §244-4.07

Although not codified, NPs are authorized to sign medical orders for life-sustaining treatment (MOLST) forms. Please see the Massachusetts MOLST website for more information.

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)

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Mass. Gen. Laws Ann. 112 §66

Optometrists may not administer medication through injection. Mass. Gen. Laws Ann. 112 §66B

Optometrists may not prescribe controlled substances. Mass. Gen. Laws Ann. 112 §66B

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 has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Massachusetts does not allow pharmacists to modify prescriptions.

As of August 4th, 2022, pharmacists can dispense emergency contraception pills (ECP) through a statewide standing order, pursuant to chapter 127 of the acts of 2022, An Act Expanding Protections for Reproductive and Gender-Affirming Care. There are two types of ECP that have been approved by the U.S. Food and Drug Administration (FDA) to prevent pregnancy after unprotected sex or sexual assault: ulipristal acetate (UPA or ella®) and levonorgestrel (LNG, Plan B One-Step®, or generic versions). The pharmacist shall provide the patient with instructions based on selected ECP.

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 §263-5.03

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