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HB268 Alabama 2022 Session

Updated Feb 26, 2026
Notable

Summary

Primary Sponsor
Wes Kitchens
Wes KitchensSenator
Republican
Session
Regular Session 2022
Title
Nurse Anesthetists, Certified Registered, scope of practice is in coordination with licensed physician or podiatrist, Sec. 34-21-81 am'd.
Summary

HB268 defines advanced practice nursing and sets CRNAs to practice in coordination with a physician, podiatrist, or dentist, while redefining roles for CRNPs, CNMs, and CNSs.

What This Bill Does

ItCreates four categories of advanced practice nurses (CRNP, CNM, CRNA, CNS) and places CRNPs and CNMs under collaborative practice requirements with physicians. It specifies that CRNAs must practice in coordination with a licensed physician, podiatrist, or dentist who is immediately available, and are not subject to the same collaborative practice requirements as CRNPs and CNMs. It restricts CNSs from performing delegated medical acts, from performing CRNP/CNM functions, and from prescribing drugs, while allowing nursing services as independent contractor work. It also establishes a Joint Committee to oversee advanced practice nursing and requires Protocols that define permissible CRNP/CNM functions, signed by collaborating physicians.

Who It Affects
  • Advanced practice nurses (CRNPs, CNMs, CRNAs, CNSs) in Alabama: CRNPs and CNMs must have collaborative practice agreements with physicians; CRNAs coordinate with physicians/podiatrists/dentists and are not bound by those agreements; CNSs face restrictions on certain medical acts and prescribing.
  • Physicians, podiatrists, dentists, and health care facilities: They must be immediately available to support CRNAs, participate in coordination and protocols, and may be involved in the Joint Committee overseeing advanced practice nursing.
Key Provisions
  • Defines advanced practice nursing and lists four categories: CRNP, CNM, CRNA, CNS.
  • CRNPs and CNMs require collaborative practice agreements with Alabama physicians to practice.
  • CRNAs and CNSs are not subject to collaborative practice agreements and are prohibited from engaging in the CRNP/CNM acts defined by this article.
  • CRNAs must practice in coordination with a physician, podiatrist, or dentist who is immediately available; patient care discussions and treatment decisions occur when a specialist is not present.
  • CNSs may not perform delegated medical acts, may not perform CRNP/CNM functions, and may not prescribe drugs; they can provide certain nursing services as independent contractors.
  • Protocols establishing permissible functions for CRNPs and CNMs must be approved and signed by collaborating physicians.
  • A Joint Committee of the State Board of Medical Examiners and the Board of Nursing is created with specified members to oversee advanced practice nursing.
  • Defines related terms (e.g., legend drug, prescribing, procedural ordering) and clarifies coordination requirements among the different professionals.
AI-generated summary using openai/gpt-5-nano on Feb 22, 2026. May contain errors — refer to the official bill text for accuracy.
Subjects
Nursing, Board of

Bill Actions

H

Forwarded to Executive Department

H

Conference Committee on HB268 2022RS first Substitute Offered

H

Assigned Act No. 2022-379.

S

Signature Requested

H

Enrolled

H

Clerk of the House Certification

H

Concurred in Conference Report

S

McClendon motion to Concur In and Adopt adopted Roll Call 938

S

Conference Report Concurrence Requested

H

Kitchens motion to Concur In and Adopt adopted Roll Call 817

H

Conference Report

H

Conference Committee Appointed

S

McClendon motion to Accede adopted Roll Call 760 P&PO appoints McClendon, Scofield and Hatcher

S

Conference Committee Requested

H

Kitchens motion to Non Concur and Appoint Conference Committee adopted Roll Call 725 House appoints Kitchens, Jones (M) and Scott

H

Concurrence Requested

S

Motion to Read a Third Time and Pass adopted Roll Call 668

S

Melson motion to Adopt adopted Roll Call 667

S

Melson Amendment Offered

S

Third Reading Passed

S

Read for the second time and placed on the calendar

S

Read for the first time and referred to the Senate committee on Governmental Affairs

H

Engrossed

H

Motion to Read a Third Time and Pass adopted Roll Call 371

H

Motion to Adopt adopted Roll Call 370

H

Boards, Agencies and Commissions first Substitute Offered

H

Third Reading Passed

H

Read for the second time and placed on the calendar with 1 substitute and

H

Read for the first time and referred to the House of Representatives committee on Boards, Agencies and Commissions

Bill Text

Download Enrolled PDF

Votes

HBIR: Kitchens motion to Adopt Roll Call 369

March 1, 2022 House Passed
Yes 99
Absent 4

Motion to Read a Third Time and Pass Roll Call 371

March 1, 2022 House Passed
Yes 102
Absent 1

SBIR: McClendon motion to Adopt Roll Call 666

March 17, 2022 Senate Passed
Yes 25
Absent 10

Melson motion to Adopt Roll Call 667

March 17, 2022 Senate Passed
Yes 25
Absent 10

Motion to Read a Third Time and Pass Roll Call 668

March 17, 2022 Senate Passed
Yes 25
Absent 10

Kitchens motion to Non Concur and Appoint Conference Committee Roll Call 725 House appoints Kitchens, Jones (M) and Scott

March 29, 2022 House Passed
Yes 99
Absent 3

McClendon motion to Accede Roll Call 760 P&PO appoints McClendon, Scofield and Hatcher

March 29, 2022 Senate Passed
Yes 33
Absent 2

Kitchens motion to Concur In and Adopt Roll Call 817

March 31, 2022 House Passed
Yes 99
Abstained 1
Absent 2

McClendon motion to Concur In and Adopt Roll Call 938

April 5, 2022 Senate Passed
Yes 30
Absent 5

Documents

Bill Text (Enrolled) HB268 Alabama 2022 Session - Enrolled
Bill Text (Engrossed) HB268 Alabama 2022 Session - Engrossed
Bill Text (Introduced) HB268 Alabama 2022 Session - Introduced

Source: Alabama Legislature