SB114 Alabama 2020 Session

Summary

Primary Sponsor

Jim McClendon

Republican

Session

Regular Session 2020

Title

Nurses, certified register nurse practioner and nurse midwife, collaboration agreements, ratio of physician to nurses, delete patient auth. to select provided, Sec. 34-21-87 am'd.

Summary

SB 114 lets patients choose a nurse practitioner, a nurse midwife, or an assistant to a physician as their designated health care provider and removes the requirement for a fixed physician-to-nurse ratio, while preserving some limits on collaborations.

What This Bill Does

If enacted, it allows patients to designate a CRNP, CNM, or an assistant to the physician as their health care provider when care is under the collaboration agreement. It removes the joint committee’s duty to recommend a specific physician-to-nurse ratio in model protocols. It still limits how many such practitioners a physician can collaborate with (nine or fewer, with possible exceptions) and requires the joint committee and boards to approve certain protocols and drug formularies for these providers, without expanding their authorized scope of practice.

Who It Affects

• Patients in Alabama: gain the option to designate a CRNP, CNM, or assistant to a physician as their health care provider under a collaboration agreement.
• Physicians: face a cap on the number of CRNPs/CNMs/assistants they collaborate with (nine or fewer, unless an exception is approved) and must adhere to new designation rules.
• Certified Registered Nurse Practitioners and Certified Nurse Midwives: may be designated providers under collaboration agreements and may prescribe drugs per a formulary established by the joint committee and approved by the boards.
• Assistants to physicians: become eligible as designated providers under collaboration agreements and are subject to the same collaboration caps and rules as other providers.

Key Provisions

• A patient may select a CRNP, CNM, or assistant to the physician as their designated health care provider when care is within the collaboration agreement, and this does not change the collaborating physician's autonomy.
• No licensed physician may collaborate with more than nine CRNPs, CNMs, or assistants to physicians (or their full-time equivalents) unless an exception based on good cause is approved by the joint committee and by both the State Board of Medical Examiners and the Board of Nursing.
• Section 34-21-87 is amended to require the joint committee to recommend model practice protocols and a formulary of legend drugs for CRNPs and CNMs, subject to approval by both boards, and to remove the requirement to establish a physician-to-nurse ratio in rulemaking (with floor ratio protections and exceptions).
• The rules may not expand the scope of practice for CRNPs, CNMs, or assistants to physicians, and the joint committee must establish rules for designating a covering physician when the primary collaborating physician is temporarily unavailable.
• The act takes effect immediately after the Governor signs it into law.

AI-generated summary using openai/gpt-5-nano on Feb 23, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Nurses and Nursing