ATHLETIC TRAINERS: This bill (SB73) provides for the licensing and regulation of athletic trainers relationship with a supervising physician, creates a joint committee of the two state boards, and expands the ability of athletic trainers to treat injuries sustained by physically active individuals. The Association worked with the ATs prior to the session and are supporting these bills. SB73 passed the Senate and will now be considered by the House.
OPTOMETRY: This bill (SB174 & HB402) will allow optometrists (who do not undergo any surgical residencies anywhere in the U.S.) to perform surgeries and injections on the eye. This legislation is being pushed by Senator Jim McClendon, the chairman of the Senate Health Committee and an optometrist himself. You may recall the controversy surrounding similar legislation last year when Sen. McClendon rammed the bill through committee without calling a proper vote (video). We stand opposed to these bills and hope you will help us fight to ensure they are defeated once again.
PODIATRY: This bill (HB291) will allow podiatrists who have completed as few as 2 years of podiatric residency (significantly less than a general orthopaedist and orthopaedic surgeon) to perform surgery on the foot and ankle. The same legislation was introduced last year but failed to receive a vote. We are working with the Alabama Orthopaedic Society and others on both amendable amendments and an advocacy action plan.
PHYSICAL THERAPY: This bill (SB237) is brought by Sen. Jim McClendon and expands the services a licensed physical therapist can render without a prescription or referral in two ways: (1) it extends the current time limit for which services can be provided from 90 days to 120 days; and (2) it allows physical therapists to treat patients without referral upon their determination that the patient is “medically stable” and “deemed suited to receive physical therapy.” We believe that a medical diagnosis is important should always come before treatment.
EMERGENCY TIMEFRAME & AUTHORITY: This bill (SB97) limits the timeframe for which a state of emergency can be declared (by the State Health Officer or Governor) to only 14 days. The bill also gives the Legislature the sole authority to extend such declarations. SB97 was passed out of committee and awaits a vote by the full Senate.
SEXUAL ASSAULT SURVIVORS BILL OF RIGHTS: This bill (HB137) creates the Sexual Assault Survivors Bill of Rights and provides certain rights to all victims of sexual assault. The bill also creates a task force responsible for developing recommendations for improving the coordination of the dissemination and implementation of best practices and protocols to hospital administrators, physicians, forensic examiners, and other medical associations and leaders in the medical community. The Association worked with the bill sponsor to amend the bill and ensure physician liability was not expanded.
IMMUNIZATION REGISTRY (ImmPrint): This bill (HB184) would require health care providers to report immunization data to the registry and to review the registry before a vaccine is administered. Annual influenza vaccinations are exempt from the review requirement but are still required to be reported. We worked with ADPH and others in drafting the bill and are in full support of it passing.
COUNTY HEALTH OFFICERS: This bill (SB184) would prohibit a county health officer from issuing orders or directives during an epidemic or disease outbreak if the State Health Officer has issued one already. The bill also applies to orders or directives on the county level that are more protective than the state’s guidance. The Association supports County Health Officers and believes local physicians are best suited to make decisions for their local population.
ABOLISHING MLC & RESTRUCTURING MLC: This bill (SB239) is brought by Sen. Jim McClendon and would abolish the Medical Licensure Commission, have the Board of Medical Examiners take on the duties of the Commission, and forbid leaders of any physician specialty organization from serving on the “new” board. By consolidating two, separate agencies into a single regulatory body, this legislation overhauls the current congressional representation requirements, revokes the appointment powers of the Lt. Governor and Speaker of the House, and decreases the board composition by more than half. The amount of issues the Association has with this legislation are lengthier than the bill itself. We oppose.
ABOLISHING & RESTRUCTURING STATE BOARD OF HEALTH: This bill (SB240) is brought by Sen. Jim McClendon and would abolish the State Board of Health, the State Committee of Public Health, the County Boards of Health, and the position of the State Health Officer (among other things). With the two boards and physician oversight no longer existing, the bill creates a new State Health Advisory Board made up of a laundry list of individuals who have some type of relationship to healthcare. County Boards of Health are instantly gone, too, turning such over to the determination of the County Commission. Strangely enough, the State Health Officer position would not exist, but two roles take its place, with the highest (termed “Secretary of the Alabama Department of Public Health”) now appointed by the governor with no requirement that he/she be a physician. We support our state and local boards of health, we support our State Health Officer, and we will vehemently oppose this bill. It will be debated in the Senate Health Committee next week.
MEDICAID FALSE CLAIMS ACT: This bill (SB241) is brought by Sen. Jim McClendon and prohibits certain fraudulent activities affecting the Alabama Medicaid program. Furthermore, liability for violations of these prohibitions include (1) a civil penalty of $5,500-$11,000 per claim, and (2) treble damages. These prohibitions and penalties are different and much more drastic than what currently Medicaid and Medicare law provides, creating very serious liability and monetary concerns for physicians. We oppose.
Lawsuits & Liability
COVID-19 LIABILITY PROTECTION: This bill (SB30) provides liability protection to physicians, health facilities, and businesses from claims arising from COVID-19 and the state’s response to the pandemic. The Medical Association, with the help of Starnes, Davis, Florie, LLP, worked with Sen. Arthur Orr in drafting this bill. SB30 has officially been signed by the Governor.
GENDER CHANGE THERAPY: These bills (HB1 &SB10) would make it a felony for doctors to treat transgender youth with hormonal therapy and puberty blockers to help their transition. More specifically, the bills would prohibit the use of puberty-blocking drugs, hormonal therapy and surgery to treat transgender minors. Violators could face up to 10 years in prison. Any legislation setting new standards of care in statute is of serious concern to the Association. Read more on these bills at AL Daily News, AL.com, and KFF.
CHEMICAL ABORTION: This bill (HB137) expands a physician’s standard of care to mandate three types of required patient disclosures when performing or attempting to perform chemical abortions or abortions due to medical emergency. A physician performing or attempting to perform an abortion who violates these rules recklessly or knowingly is guilty of a Class C felony, and does not have a medical emergency exception authorizing abortion to be “a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function.” We oppose.
GENITAL MUTILATION: This bill (HB252) creates the crime of “genital mutilation” as a Class B Felony in Alabama. Although the list of acts that constitute “genital mutilation” is long, nothing in the bill applies to procedures medically necessary procedures or procedures performed during labor. The legislation adheres to the ACOG position on genital mutilation and also contains Medical Association language explicitly stating that nothing shall be construed to establish a standard of care for hospitals or physicians.
Finance & Taxation
CARES ACT TAX EXCLUSION: These bills (SB98 & HB170) exclude any money received from the CARES Act or other similar COVID-related relief measures from Alabama income tax. “We are not going to tax any of the stimulus monies that came in for businesses, for individuals, for anyone,” said Senator Dan Roberts (R-Mountain Brook).