Physical Therapy: This bill would eliminate the physician referral requirement and allows for physical therapy direct access without any restrictions. A tentative agreement was reached on a substitute bill (SB104); however, it was made clear to the sponsor, the entire Senate Health Committee, and the PT Association that this was not a final agreement from the Medical Association on the language. The Medical Association has tentatively agreed to the following stipulations: (1) Extending the current timeframe for which a referral is good for (from 90 days to 120 days); (2) Allowing PT without a referral for a patient with a diagnosed chronic condition under physician management for that condition as long as intermittent PT is appropriate for that patient; and (3) Allowing PT without a referral for restorative exercises and the like if the patient doesn’t initially present with new-onset pain, illness or injury. The substitute bill has passed the Senate Health Committee and awaits a vote by the full Senate.
Podiatry: These bills (HB198 & SB279) allows podiatrists who have completed a 2-year or 3-year residency to perform ankle surgery. HB198 was referred to the House Health Committee but has yet to be placed on the calendar.
Optometry: This bill (SB66) amends current law to allow optometrists to perform surgeries on the eye and gives the Alabama Board of Optometry the sole power to define and regulate what is considered to be the practice of optometry. The bill was unfortunately passed by the Senate Health Committee (watch this video) and now heads to the floor.
Licensure of Imaging Personnel: This bill (SB171) provide for the licensing and regulation by the State Radiation Control Agency of health care personnel performing radiologic imaging or radiation therapy for diagnostic or therapeutic purposes.SB171 has been referred to the Senate Health Committee and is expected to be placed on the calendar in the coming weeks.
NP, PA & LMW Collaborative Practice: As introduced, this bill (SB114) would have allowed physician collaboration with an “unlimited” number of full-time equivalent nurse practitioners or nurse-midwives; but, after significant input from the Medical Association, the number was capped at nine (9). The amended legislation passed the Senate and now moves to the House.
Athletic Trainers: These bills (SB93 & HB141) provide 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. SB93 passed the Senate and will now be considered by the House. The Association worked with the ATs prior to the session and are supporting these bills.
Mental Health
Bills from a package of mental health access initiatives announced by the Alabama House have passed the House. The overall package will:
Create and fund three mental health 24-hour crisis care centers in Alabama;
Create a process for a “72-hour hold” for individuals believed to have mental illness and pose a threat to themselves or others under 72-hour protective custody, to include transportation to a facility (to include one of the three new crisis care centers) for evaluation and treatment;
Require each school system to employ a mental health service coordinator;
Require the certifying body for law enforcement to provide mandatory crisis intervention training and continuing education to officers; and
Encourage all 67 counties to implement the Stepping Up initiative, which aims to reduce the number of individuals in jail with mental illness.
Public Health
Immunization Registry (ImmPrint): This bill (SB56 & HB103) 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. The bill has been passed by the Senate Health Committee and now heads to the floor.
Maternal Mortality Review Committee (MMRC): In response to the rise of Alabama’s maternal death rate, The Medical Association of the State of Alabama is spearheading an effort to secure funding for the Maternal Mortality Review Committee (MMRC). We are proud to be leading the charge in spotlighting this tragic issue and grateful to Governor Ivey for including this funding in her budget.
Maternal Health Awareness Day: The House of Representatives has introduced a resolution (HJR115) which designates Mother’s Day (May 10, 2020) as “Maternal Health Awareness Day” in the State of Alabama, in order to raise public and professional awareness about important maternal health, safety, and mortality issues and encourage the development of new programs and initiatives designed to positively impact maternal health and mortality.
Medical Cannabis: Last year, a bill authorizing medical cannabis created a study commission to make recommendations for this session. Those recommendations have been put to paper and new legislation (SB165) has been passed by the Senate. Due to the length of the bill, we will not be listing a full synopsis here.
Certificate of Need Laws: This bill (HB126) would repeal the certificate of need program and abolish the state agencies, councils, and boards that exist to operate and support the certificate of need program. HB126 has yet to be considered by the House Committee on State Government. The Association supports this bill.
Needle Exchange: This bill (SB235) would allow for the creation of a “needle exchange” for at-risk populations to stem the spread of disease that comes from dirty needle sharing from drug use in Jefferson County. The bill has passed the Senate Health Committee and now moves to the Senate floor for a vote.
School Seizure Plans: This bill (HB385) allows for the creation of a seizure management plan for individual children to have on file at the school and for the training of school personnel to manage seizure episodes in children passed out of the House Health Committee and awaits a vote by the full House.
Transgender Therapy: Known as the Vulnerable Child Compassion and Protection Act, this bill (SB219) prohibits gender change therapy for minors, prohibits the withholding of certain related information from parents, and establishes criminal penalties for health care providers and others who violate the act. The bill passed the Senate and has been sent to the House. The Association believes that criminalizing the practice of medicine – no matter what the topic – sets a dangerous precedent and interferes with the physician-patient relationship.
Rural Health
Rural Physician Tax Credit: This bill (SB195) will amend the current definition of rural, strengthen the residency requirement, and extended the tax credit to include dentists. The legislation has passed out of the Senate Committee and now heads to the floor.
Board of Medical Scholarship Awards (BMSA): The Association is has been working with BMSA to request additional funding for this highly successful program. We are proud to see the funding including in the initial budget and will continue advocacy efforts to ensure it remains in the final version.
Medicaid Expansion
Medicaid Expansion Bills: Rep. Laura Hall introduced a bill (HB448) to extend Medicaid coverage for new and expectant mothers for up to a year post-partum, while Rep. Mary Moore introduced a bill (HB447) to fully expand Medicaid coverage. Rep. Neil Rafferty introduced two resolutions supporting his colleague’s bills and urging Gov. Ivey to expand Medicaid.
Coronavirus (COVID-19)
The Alabama Legislature has provided an additional $5 million to the Alabama Department of Public Health to assist in responding to the spreading pandemic. These funds will help supplement the Federal funding, which totals $8.1 million to date. The funds will go toward numerous priority issues, including the creation of local centers for screening, expenses related to telehealth, and covering the costs for the testing and treatment of uninsured citizens. The Association thanks the legislature for acting so quickly.
