Senate Committee Approves Collaborative Practice Ratio Increase

Last Wednesday, the Senate Health Committee approved an amended version of legislation dealing with the ratio of physicians to nurse practitioners in a collaborative practice.

Originally, the bill would have allowed physician collaboration with an “unlimited” number of full-time equivalent nurse practitioners or nurse-midwives. However, after significant input from the Medical Association, the legislation deletes “unlimited” and instead increases the number of nurse practitioners and physician assistants with whom a physician may collaborate.

Specifically, the amended legislation:

• Deletes “unlimited” and instead increases the current ratio of FTEs from 1:4 to 1:9;
• Adds physician assistants to the total collaborative ratio;
• Maintains the collaborating physician’s autonomy and authority within the collaborative practice agreement;
• Maintains the ability for exceptions to this new 1:9 ratio through regulation; and,
• Maintains the current regulatory structure for physician assistants, nurse practitioners, nurse midwives, and collaborating physicians.

Collaborative practice is not “one-size-fits-all” and this newly-amended bill allows for flexibility in collaboration while also preserving physician authority. The compromise was a joint effort between the Medical Association, the Nurse Practitioners Alliance and the Alabama Physician Assistants’ Association. We now support this legislation.

The legislation (SB114) now moves to the Senate floor for a vote.