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 was sent to the Governor for signature.
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. This bill has passed the Senate GA Committee. Ask your legislator to oppose this bill.
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 to oppose this legislation.
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 and 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 carried over to the call of the chair.
COUNTY HEALTH OFFICERS: These bills (SB184 and HB168) 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. HB168 passed out of committee this week.
ABOLISHING MLC & RESTRUCTURING BME: 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. The Senate Healthcare Committee held a public hearing and vote on Wednesday. The bill was defeated by a vote of 8-3. Thank you to everyone who contacted their Senator and told them to oppose the bill!
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 passed the Senate Health Committee and awaits consideration from the full Senate. Ask your legislator to oppose.
IMMUNIZATION REGISTRY (ImmPrint): This bill (HB184) by Rep. Paul Lee would require health care providers to report immunization data to the ImmPrint registry and to review the registry before a vaccine is administered. Annual influenza vaccinations are exempt from the review requirement for adults, but are still required to be reported. The Association worked with members of our President’s Council and other specialties in support of this bill. It passed the House this week and moves to the Senate.
COMMUNITY PARAMEDICINE: These bills (HB141 and SB115) would authorize ADPH to establish and administer a community paramedicine program that allows paramedics to provide certain services to patients. The Association worked ACEP and other specialties in drafting the bill. It passed the House this week and moves to the Senate.
MEDICAL MARIJUANA: This bill (SB46) by Sen. Tim Melson, M.D. (R—Florence) would authorize medical marijuana in the state. The House Judiciary Committee, the first of two House committees expected to vet the bill, conducted a public hearing Wednesday. Rep. Mike Ball (R—Madison), a Judiciary Committee member and retired law enforcement officer, is shepherding the bill in the House. The committee is scheduled to vote on SB46 after spring break, and the bill appears to be in a better position than in years past.
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. It passed the committee and awaits a full vote by the Senate.
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. A House Judiciary committee amendment was added to narrow the focus of the bill and remove “counseling” a patient and “dispensing” medication to a patient from the list of prohibited activities. SB10 passed the House Judiciary Committee and awaits a vote from the full House. Read more on these bills at AL Daily News, AL.com, and KFF.
BORN ALIVE ABORTION: This bill (HB237) would make it a Class A felony if a physician does not exercise reasonable care to preserve the life of a child born alive after an abortion or attempted abortion in an abortion or reproductive health center. HB237 passed the House and moves to the Senate.
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 a 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. HB252 passed out of committee and awaits a full vote from the house.
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 includes (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. The Senate Judiciary Committee discussed the bill last Wednesday but, due to opposition from Sen. Larry Stutts, M.D., Sen. Roger Smitherman, and others, it did not receive a vote.
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). HB170 was signed by the Governor.
MEDICAID EXPANSION: On March 11, 2021, President Biden signed the American Recovery Act of 2021. The legislation includes a short provision outlining that states, for a length of five years, can extend Medicaid eligibility to women for 12 months after giving birth. The bill also provides an incentive for states that newly expand Medicaid by temporarily increasing the state’s base FMAP by 5% for two years. Please join the Cover Alabama Coalition in supporting Medicaid expansion in Alabama.