Medical Examiners Board and Nursing Board collaborative practice; joint committee, membership and procedures revised
Summary
SB124 revises the Joint Committee of the State Board of Medical Examiners and the Board of Nursing for Advanced Practice Nurses, which advises on rules governing collaborative practice between physicians and certain advanced practice nurses. The bill changes the committee’s membership so that it includes two certified registered nurse practitioners in active collaborative practice and one certified nurse midwife in active collaborative practice, replacing the current structure that includes a registered nurse member and one CRNP member. It also updates appointment and term provisions, including staggered terms and replacement procedures for current members as of the bill’s effective date.
The bill further increases the per diem for committee members from $100 to $300 per day or portion thereof, while retaining reimbursement for travel and subsistence under state law. It also adds a formal process for either the State Board of Medical Examiners or the Board of Nursing to reject a joint committee recommendation only by a three-fifths majority vote, and requires the rejecting board to return the recommendation with proposed changes for reconsideration. The act would take effect on October 1, 2025.
Impact
SB124 would amend Sections 34-21-81 and 34-21-82 of the Code of Alabama 1975, changing the composition, compensation, and operating procedures of the joint committee that helps regulate collaborative practice agreements for certified registered nurse practitioners and certified nurse midwives. The bill would not directly expand or restrict scope of practice, but it would alter how rules affecting CRNPs and CNMs are developed and reviewed, and it would give the medical and nursing boards a clearer supermajority standard for rejecting committee recommendations. It also affects board-appointed members, professional nursing organizations involved in appointments, and the state boards responsible for paying per diem and administrative support.
Sentiment
The bill appears generally supportive of advanced practice nursing participation in the regulatory process, as reflected by the addition of active CRNP and CNM members to the joint committee and the formalization of procedures for handling recommendations. Because there are no recorded committee transcripts or votes in the provided materials, there is no documented public debate or recorded opposition in this dataset. The available text suggests an administrative and professional governance update rather than a controversial policy shift.
Contention
The main points of potential contention are the change in committee balance and the higher per diem. Physicians and medical board stakeholders may view the revised membership as shifting influence toward advanced practice nurses, while nursing stakeholders may support the added representation as more reflective of current collaborative practice. The new three-fifths vote requirement for rejecting recommendations could also be debated, since it makes it harder for either board to block committee proposals and may be seen either as a safeguard against arbitrary rejection or as a constraint on board oversight.