Health Care

Health Care Policy and Processes

LWVAL Action Priority Level II - Monitoring occurs; action dependent on opportunity and available resources.

Click a bill to see sponsor(s), synopsis, link to the bill, League action and justification for that action, and progress of the bill through the legislative process.

Legend:

= LWVAL's support for the legislation.

= LWVAL's opposition to the legislation.

= new bill activity; change from previous week's report such as new progress in the legislature and/or League action. Bill may be one newly added to the report. These updates are in green font.

Contact information for legislators and committees referenced in the bills below:
Representatives Standing House Committees Senators Standing Senate Committees Find my legislators

LWVAL has taken a position on these bills:

HB48 - Income tax credits, increase for rural physicians and dentists, Secs. 40-18-130 to 40-18-132, inclusive, am'd.

Sponsor(s): Representative Weaver

Synopsis: Under existing law, a state income tax credit of $5000 is given to rural physicians who practice and reside in rural communities. This bill would increase from five to 10 the number of years the state income tax credit is given and extend the tax credit to dentists who reside and practice in small rural communities.

See HB48 and history with any amendments or substitutions.

League Action and Justification: Support. This bill creates a method of allocating resources as endorsed by the LWVAL support position on health care because in theory this tax credit aids with recruitment & retention of medical practitioners and dentists to rural Alabama.

Bill Progress in Legislature:
02/07/2017: First Read and assigned to House committee on Ways & Means Education (W&ME)

SB131 - Advanced practice nursing, titles and definitions revised, clinical nurse specialists authorized to collaborate with physicians, Sec. 34-21-90.1 added; Secs. 34-21-80, 34-21-81, 34-21-83 to 34-21-92, inclusive, am'd.

Sponsor(s): Senator Gerald Dial

Synopsis: Under existing law advance practice nurses are licensed by the Board of Nursing. This bill would review the titles of certain types of advanced practice registered nurses and revise the scope of practice of advanced practice nursing. It would authorize clinical nurse specialists to engage in collaborative practices with licensed physicians in certain circumstances. The bill would also prohibit an individual from engaging in the practice of advanced practice nursing unless he or she is certified by the Board of Nursing and provide for penalties.

See SB131 and history with any amendments or substitutions.

SB134 - Nursing, Board of, loan repayment program for advanced-practice nurses, loan program authorized for certain currently certified nurses, Sec. 34-21-96 am'd.

Sponsor(s): Senators, Dial, McClendon & Reed

Synopsis: Under existing law, the Board of Nursing administers a loan repayment program for advanced practice nurses who contract with the board to work in medically underserved areas. This bill is drafted to rectify an error in the original legislation for the Advanced Practice Loan Repayment Program which was passed in the 2016 regular session. The intent of that legislation was to expand access to health care in rural Alabama by granting loans to prospective advance practice nurses.

Per the Alabama Board of Nursing newsletter: ". . . a minor flaw in the drafting of the bill led to an opinion from the Alabama Attorney General's office which bars those recent graduates from participating." As stated, this bill corrects that omission.

See SB134 and history with any amendments or substitutions.

League Action and Justification: Support. League positions call for an equitable health care planning regulatory system and access to care.

Bill Progress in Legislature:

02/09/2017: First Read and referred to Senate committee on Health & Human Services (H&HS)

03/09/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from H&HS

03/16/2017: 3rd Reading Carried Over to Call of the Chair; McClendon motion to Carry Over adopted by Voice Vote; 3rd Reading Passed; Motion to Read a 3rd Time and Pass adopted by Roll Call

House Action:

03/16/2017: Read for the first time and referred to the House committee on Health

04/20/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from Health

SB81 - Taxation, $5,000 income tax credit given to certain rural certified registered nurse practitioners

Sponsor(s): Senator Bussman

Synopsis: Under existing law, physicians who practice and reside in certain rural areas of the state may claim a $5,000 income tax credit for a limited number of tax years. This bill would grant the same tax credit to rural nurse practitioners. The bill defines a rural community as one having less than 25,000 residents according to the latest decennial census and has a hospital with an emergency room. The tax credit is limited to no more than 5 years.

See SB81 and history with any amendments or substitutions.

League Action and Justification: Support. LWVAL’s Health Care positions call for: Greater use of Nurse Practitioners/Advanced Practice Nurses and Physicians Assistants and recognition that evidence supports the fact that Nurse Practitioners/Advanced Practice Nurses can safely deliver some of the same services as those provided by physicians. League also believes that greater use of Nurse Practitioners/Advanced Practice Nurses in underserved areas of the state may help to aleave inequities in delivery of health services.

Bill Progress in Legislature:

02/07/2017: First Read and referred to Senate committee on Finance and Taxation Education (F&TE)

03/02/2017: 2nd Read and placed on the calendar with 1 Amendment (183278-2); pending 3rd Read and favorable from F&TE with 1 amendment; F&TE 1st Amendment Offered

[NOTE: The amendment would terminate the act in 2022 unless the legislature acts to extend it. The May 2nd amendment clarifies the year is the tax year, not the calendar year.]

05/02/2017: 3rd Reading Carried Over to the Call of the Chair; Bussman motion to Carry Over to the Call of the Chair adopted by Voice Vote; Further Consideration; F&TE 1st Amendment (183278-2) Offered

05/09/2017: 3rd Read Passed; F&TE 1st Amendment Offered; Bussman motion to Adopt adopted by Roll Call; Bussman Amendment (186354-1) Offered; Bussman motion to Adopt adopted by Roll Call; Motion to Read a Third Time and Pass adopted by Roll Call; Engrossed

House Action:

05/09/2017: Read for the first time and referred to the House committee on Ways and Means Education (W&ME)

HB160 - Physician Manpower Initiative, phase in of AL. College of Osteopathic Medicine medical students, scholarships for students who commit to practice family medicine in underserved areas of state, AL. Medical Education Consortium to administer, Dept. of Public Health to fund

Sponsor(s): Representatives McMillan, McClammy, Scott, Lee, Davis, Shiver, Polizos, Baker, Boothe, Chesteen, Jackson, Standridge, Beech, Morrow, McCampbell and Tuggle

Synopsis: This Alabama Physician Manpower Initiative bill creates The Alabama Medical Education Consortium (a 501C3 corporation) with funds allocated to the Alabama Department of Public Health to administer. The purpose is to increase availability of family practice doctors in underserved areas of the state. Recipients must be enrolled in the Alabama College of Osteopathic Medicine. The scholarship recipient will work in the rural area for five years after graduation.

See HB160 and history with any amendments or substitutions.

League Action and Justification: Support. - Similar to other legislation to recruit/retain healthcare providers in rural Alabama, the bill is in line with League position on healthcare.

Bill Progress in Legislature:

02/09/2017: First Reading and referred to House committee on Ways and Means

SB335 - Physician Initiative, phase in provision of 100 scholarships per year, scholarships for students who commit to practice family medicine in underserved areas of state, AL. Medical Education Consortium to administer, Dept. of Public Health to fund

Sponsor(s): Senators Stutts, Smith, Albritton, Beasley, Shelnutt, Dial, McClendon, Holley, Marsh, Pittman and Reed

Synopsis: This bill would establish the Alabama Physician Initiative. It would provide scholarships for certain medical students who are enrolled in and attending any college of medicine in Alabama and who contract with the Alabama Medical Education Consortium to practice for five years after the completion of their residency in rural areas of the state with the greatest need for physicians with funds allocated through the State Department of Public Health.

See SB335 and history with any amendments or substitutions.

League Action and Justification: Support. Similar to other legislation to recruit/retain healthcare providers in rural Alabama, the bill is in line with League position on healthcare but broader in cove rate than HB160.

Bill Progress in Legislature:

03/16/2017: First Reading and referred to the Senate committee on Finance and Taxation Education (F&TE)

05/03/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from F&TE

05/11/2017: 3rd Read Passed; Motion to Read a Third Time and Pass adopted by Roll Call

House Action:

05/11/2017: Read for the first time and referred to the House committee on Ways and Means Education (W&ME)

HB95 and SB185 - Health care providers authorized to decline to perform services that violate their consciences, exceptions, Health Care Rights of Conscience Act

HB95 Sponsor(s): Representative Mooney
SB185 Sponsor(s): Senator Sanford

Synopsis: This bill would give health care providers the following: The authority to refuse to perform or to participate in healthcare services that violate their conscience; immunity from civil, criminal, or administrative liability for refusing to provide or participate in a healthcare service that violates their conscience. The bill would declare it unlawful for any person to discriminate against health care providers for declining to participate in a health care service that violates their conscience. The bill would also provide for injunctive relief and back pay for violation.

Conscience is defined as the religious, moral or ethical principles held by a health care provider. The bill defines an expansive list of health care providers covered. Health care service is limited to abortion, human cloning, human embryonic stem cell research & sterilization and includes prescribing and dispensing. It is not clear whether the morning after pill or emergency contraception would be recognized as included services as has been the case in other similar legislation but it is very conceivable. The objecting provider must provide advance signed written notice “not less than twenty-four hours prior to any service or procedure objected to."

See HB95 and history with any amendments or substitutions.

See SB185 and history with any amendments or substitutions.

League Action and Justification: Oppose. LWVUS opposes attempts to limit healthcare contraceptive services based on religious exemptions.

Bill Progress in Legislature:

HB95

02/07/2017: First Read and referred to House committee on Health

02/09/2017: 2nd Read and placed on the calendar; pending 3rd Read and favorable from Health

03/16/2017: 3rd Read Passed; Motion to Read a 3rd Time and Pass adopted by Roll Call; cosponsors added; Pringle intended to vote “Yea”

Senate Action:

03/16/2017: Read for the first time and referred to the Senate committee on Health and Human Services (H&HS)

04/13/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from H&HS

04/20/2017: 3rd Reading Passed; Rules Committee Petition to Cease Debate adopted by Roll Cal; Motion to Read a 3rdTime and Pass adopted by Roll Call; Signature Requested

House Action:

04/20/2017: Passed Second House; Enrolled; Clerk of the House Certification; Forwarded to Governor on April 20, 2017 at 3:33 p.m. on April 20, 2017.

SB185

02/14/2017: First Reading and referred to Senate committee on Health and Human Services (H&HS).

03/07/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from H&HS

04/13/2017: 2nd Read and place on the Calendar; pending 3rd Read and Favorable from H&HS

05/17/2017: Indefinitely postponed.

HB455 - Infectious disease elimination, pilot programs by Dept. of Public Health and local health authorities authorized, limited criminal immunity granted

Sponsor(s): Representative Williams (JD)

Synopsis: Establishes Alabama Infectious Disease Elimination Act and authorizes ADPH to establish infectious disease elimination pilot programs; provides guidelines for infectious disease elimination pilot programs; provides limited criminal and civic immunity.

The goal is to reduce the spread of HIV, HCV & other infectious diseases based on evidence data showing all time high drug use for heroin (and sharing of needles & syringes) and high prescription misuse of opioid drugs in counties identified as having demonstrated need. The bill provides limited immunity from criminal liability for employees and active participants.

See HB455 and history with any amendments or substitutions.

League Action and Justification: Support. LWVAL’s position on Health Care includes the following: “Every Alabama resident should have access to a basic level of care that includes health maintenance and disease prevention. . . .” “Access would be achieved with the use of wellness clinics or programs throughout the state and through public education about healthy lifestyles.”

Bill Progress in Legislature:

04/04/2017: First Reading and referred to the House committee on Health

04/27/2017: 2nd Read and placed on the Calendar with 1 substitute (185876-2); pending 3rd Read and Favorable with 1 Substitute from Health

05/04/2017: 3rd Reading Passed; Health 1st Substitute Offered; Motion to Adopt adopted by Roll Call; Motion to Read a 3rd Time and Pass adopted by Roll Call; Engrossed

Senate Action:

05/04/2017: Read for the first time and referred to the Senate committee on Health and Human Services (H&HS)

05/11/2017: 2nd Read and placed on the calendar; Pending 3rd Read and Favorable from H&HS

05/17/2017: 3rd Reading Carried Over to Call of the Chair; Coleman-Madison motion to Carry Over to the Call of the Chair adopted by Voice Vote; Further Consideration

SB357 - Medicaid, dental services, administration by Medicaid agency to continue, Sec. 22-6-161 am'd.

Sponsor(s): Senator Glover

Synopsis: Requires the Alabama Medicaid Agency to continue to provide dental services to Medicaid beneficiaries once a managed care system for Medicaid beneficiaries is implemented.

See SB357 and history with any amendments or substitutions.

League Action and Justification: Support. The LWVAL positions support access to basic health care services for all Alabama citizens.

Bill Progress in Legislature:

04/06/2017: First Reading and referred to the Senate committee on Finance & Taxation General Fund (F&TGF)

SB355 - Medicaid, expanded to include persons for whom matching funds are available under the Patient Protection and Affordable Care Act, Alabama Medicaid Agency to implement, appropriation

Sponsor(s): Senators Beasley, Dunn, Ross, Coleman-Madison, Sanders, Figures, Singleton and Smitherman

Synopsis: Expands the Medicaid program under the Patient Protection and Affordable Care Act AKA Obama Care to cover uninsured residents with incomes below 138% of the federal poverty limit. References the 2015 recommendation to the governor of the Alabama Health Care Improvement Task Force to expand Medicaid to previously uninsured.

See SB355 and history with any amendments or substitutions.

LWVAL is monitoring this bill:

HB505 - Sex education, curriculum contents revised, Sec. 16-40A-2 am'd.

Sponsor(s): Representative Todd

Synopsis: Under existing law, there are certain minimum contents that are included in sexual health education programs and curricula. This bill would revise the curriculum of sexual health education in public schools to comport with current data, science, and current law.

The bill updates the current law to require recent statistical and medical information be provided in school curriculum.

Any program or curriculum in the public schools in Alabama that includes sex education or the human reproductive process shall, as a minimum, include and emphasize the following:

Abstinence is the only completely effective protection from sexually transmitted diseases and pregnancy.
Abstinence is the expected social standard for unmarried school-aged persons.
Course materials should be age and culturally appropriate and medically accurate.
Emphasize sexual abstinence and delayed sexual activity.
Courses should include the latest medical information on the use of contraceptives to prevent both pregnancy and sexually transmitted diseases.
Information on the laws relating to financial responsibilities of pregnancy, childbirth, and child rearing.
Information on the laws prohibiting sexual abuse, the need to report such abuse, and the legal options available to victims of sexual abuse.
Information on how to cope with and rebuff unwanted physical and verbal sexual exploitation by other persons.
Psychologically sound methods of resisting unwanted peer pressure.
Comprehensive instruction in parenting skills and responsibilities, including the responsibility to pay child support by non-custodial parents, the penalties for non-payment of child support, and the legal and ethical responsibilities of child care and child rearing."

See HB505 and history with any amendments or substitutions.

League Action and Justification: Monitor. While we have concerns about the spread of sexually transmitted diseases and unwanted pregnancy, we have no specific positions on either but list the bill for information purposes.

This bill, while better that what we have had up to this point, is still dominated by the "abstinence only" policy which has proven to be ineffective in curbing sexual activity in teens. Pregnancy rates in states with abstinence only policies are higher than in states not emphasizing abstinence only. In most systems, because local boards of education are resistant to sex education courses, there is a minimum of information presented. This bill would dedicate an enormous amount of curriculum in a course, usually not designated as a sexual education course, to providing education on this topic. The bill seems to imply that all courses that even minimally cover the human reproductive cycle should cover all related topics. There is a Health course required in high school that each student must take before graduation that should meet the requirement.

Bill Progress in Legislature:

04/13/2017: Read for the first time and referred to the House Committee on Education Policy (EF)

04/27/2017: 2nd Read and placed on the calendar; pending 3rd Read and Favorable from EP with 1 Amendment; 1st EP Amendment (185982-1) offered.

[NOTE: The amendment adds self-control to the bill and removes the reference to culturally appropriate in relation to materials to be used in the classroom.]

05/17/2017: Indefinitely postponed.

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