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SB110 INTRODUCED
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SB110
L5FV8YY-1
By Senator Elliott
RFD: Healthcare
First Read: 13-Jan-26
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L5FV8YY-1 01/12/2026 KMS (L)cr 2025-3676
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First Read: 13-Jan-26
SYNOPSIS:
Under existing law, the endorsement of a
certified registered nurse practitioner or certified
nurse midwife is deemed to be the endorsement of a
physician for certain health or medical related
documents.
This bill would specifically provide that the
endorsement of a certified registered nurse
practitioner or certified nurse midwife on a physical
examination form for participation of a student in K-12
school athletics is deemed to be the endorsement of a
physician.
This bill would also prohibit any public K-12
school from being a member of an athletic association
that refuses to accept physical examination forms for
participation in school athletics endorsed in
compliance with this bill.
A BILL
TO BE ENTITLED
AN ACT
Relating to certified registered nurse practitioners or
certified nurse midwives; to amend Section 34-21-93.1, Code of
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certified nurse midwives; to amend Section 34-21-93.1, Code of
Alabama 1975; to provide that an endorsement by a certified
registered nurse practitioner or certified nurse midwife on a
physical examination form for participation in school
athletics satisfies any requirement for the endorsement of a
physician on the required form; and to prohibit a public K-12
school from being a member of an athletic association that
does not accept physical examination forms for participation
in school athletics endorsed in compliance with this act.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Section 34-21-93.1 of the Code of Alabama
1975, is amended to read as follows:
"§34-21-93.1
(a) When any law or rule requires a signature,
certification, stamp, verification, affidavit, or endorsement
by a physician, the document shall be deemed to authorize a
signature, certification, stamp, verification, affidavit, or
endorsement by a certified registered nurse practitioner or
certified nurse midwife for the items listed in this section.
The authority in this section for a certified registered nurse
practitioner and a certified nurse midwife shall be subject to
an active collaboration agreement. This section applies to all
of the following:
(1) Certification of disability for patients to receive
special access parking or disability access parking tags or
placards.
(2) A signature required for any of the following:
a. The following documents that require a complete
history and physical examination consistent with the examining
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history and physical examination consistent with the examining
provider's scope of practice and certification:
1. Physicals for bus drivers in this state using State
of Alabama forms.
2. Physicals to verify eligibility for students to
participate in the Special Olympics.
3. Employment and pre-employment physicals for
Transportation Security Agency (TSA) employees at an airport
or for governmental employees such as firefighters and law
enforcement officers.
4. Adoptive parent applications.
5. College or trade school physicals.
6. Boy Scout or Girl Scout physicals or physical
required by similar organizations.
7. Physicals to verify eligibility for students to
participate in K-12 school athletic activities including, but
not limited to, interscholastic athletic activities.
b. Forms excusing a potential jury member due to an
illness.
c. Forms relating to absenteeism for employment or
school purposes, including, but not limited to, documents
associated with the federal Family and Medical Leave Act.
d. Authorizations for durable medical equipment.
e. Authorizations for diabetic testing supplies.
f. Authorization for diabetic shoes.
g. Home health recertification orders after initial
certification.
h. Within the state Medicaid system, any and all forms
for the ordering of medications, nutritional supplements, or
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for the ordering of medications, nutritional supplements, or
infant formulas, or referrals to providers of medical
specialties, home health services, and physical or occupation
therapy.
i. Death certificates.
j. Forms, including physical examination forms, needed
for certifications in residential or inpatient dwellings
within the Department of Mental Health.
k. Forms for ambulance transport.
l. Forms for donor breast milk.
m. Required documentation allowing a diabetic to renew
or obtain a driver's license.
(b) Additional forms may be approved by rule under the
Alabama Administrative Procedure Act by the State Board of
Medical Examiners, after consulting with the state
professional society of nurse practitioners, the state
professional society of nurse midwives, the state professional
society of physicians, or the Joint Committee of the State
Board of Medical Examiners and the Board of Nursing for
Advanced Practice Nurses as established by Section 34-21-81,
whichever is appropriate.
(c) This section shall not be construed to expand the
scope of practice for any certified registered nurse
practitioner or certified nurse midwife.
(d) This section does not expand the scope of a
collaborative physician's responsibility with regard to nurse
practitioners or nurse midwives under the laws of this state.
(e) Any document signed or otherwise endorsed by a
certified registered nurse practitioner or certified nurse
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certified registered nurse practitioner or certified nurse
midwife in lieu of a physician pursuant to this section shall
be accepted as valid and lawful by the organization or entity
requesting a physician's signature. "
Section 2. (a) For purposes of this section, an
athletic association has the same meaning as provided in
Section 16-1-52.1, Code of Alabama 1975.
(b) A public K-12 school may not be a member of an
athletic association that refuses to accept physical
examination forms to verify eligibility for students to
participate in K-12 school athletic activities which are
endorsed by a certified registered nurse practitioner or
certified nurse midwife in compliance with Section 34-21-93.1,
Code of Alabama 1975.
Section 3. This act shall become effective on October
1, 2026.
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