Ala. Admin. Code r. 610-X-5-.16
Current through Register Vol. 43, No. 1, October 31, 2024
Section 610-X-5-.16 - Limitations Upon Utilization Of Certified Nurse Midwives(1) A physician may enter into a collaborative agreement with certified nurse midwives not exceeding a cumulative three hundred and sixty (360) hours (nine FTEs) per week. The physician shall not collaborate with or supervise any combination of certified registered nurse practitioners, certified nurse midwives and/or assistants to physicians Physician Assistants exceeding three hundred and sixty (360) hours per week (nine full-time equivalent positions). "One fulltime equivalent" (FTE) is herein described as a person/persons collectively working forty hours a week, excluding time on call.
(a) A physician collaborating with more than four FTEs per week shall engage in documented quality assurance review with each CRNP every month for six (6) months following the commencement of a collaborative practice with a new CNM. (b) A physician shall disclose to the Board of Medical Examiners the existence of all collaborative and supervisory agreements to which the physician is a party, including collaborative and supervisory agreements in other states, and shall not be eligible to collaborate with or supervise any combination of certified registered nurse practitioners, certified nurse midwives and/or assistants to physicians Physician Assistants exceeding three hundred and sixty (360) hours per week (nine full-time equivalent positions), inclusive of collaborative and supervisory agreements existing in other states. Agreements with an individual certified registered nurse practitioner, certified nurse midwife, and/or Physician Assistants in multiple states shall only be counted once for purposes of calculating the total number of full-time equivalent positions.(2) Employees of the Alabama Department of Public Health and county health departments are specifically exempt from the requirements of paragraph (1) of this rule.(3) A physician in collaborative practice may request approval for additional full-time certified nurse midwife positions by the Joint Committee, with consideration given to the following factors to ensure that an acceptable standard of care is rendered: (a) Availability of the physician.(b) Practice settings and staffing needs for extended hours of service.(d) Educational preparation, specialty and experience of the parties in the collaborative practice.(e) Complexity and risk of procedures to be performed.(4) A physician in collaboration with CRNP, CNM or supervising Physician Assistant personnel totaling 360 hours per week (nine (9) FTEs) may request a transitional allowance increasing the total weekly hours for the purpose of orientation of the incoming CNM. The transitional allowance shall not exceed 45 days. The physician shall request the transitional allowance in writing and specify the starting date for this FTE allowance.(5) Any certified nurse midwife engaged in practice with a collaborating physician prior to the effective date of this rule may not be denied approval for continued collaborative practice with that physician based on the ratio established in this rule.Ala. Admin. Code r. 610-X-5-.16
New Rule: Filed August 25, 2003; effective September 29, 2003.Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 10, July 31, 2015, eff. 8/6/2015.Amended by Alabama Administrative Monthly Volume XXXIX, Issue No. 07, April 30, 2021, eff. 6/14/2021.Rule .15 was renumbered to .16 as per certification filed July 2, 2015; effective August 6, 2015.
Author: Alabama Board of Nursing
Statutory Authority:Code of Ala. 1975. § 34-21-87.