Alabama

Alabama credentials three levels of addiction counselors. Individuals with master’s degrees may qualify for the Qualified Substance Abuse Professional (QSAP) I if they hold a license in a health discipline or have a combination of education, experience and certification. Those individuals with a master’s degree in psychology, counseling, social work or psychiatric nursing (or with a master’s in another behavioral health field and sufficient coursework to establish equivalency), may work as a QSAP II under the supervision of a QSAP I.

Individuals with bachelor’s degrees may qualify for the QSAP II or III with a bachelor’s degree in psychology, social work, community rehabilitation, pastoral care or family therapy. Other behavioral health degrees may be accepted if they include relevant clinical coursework. Ala. Admin. Code §580-9-44

Licensed professional counselors in Alabama may provide individual counseling, family counseling, marital counseling, group therapy, school counseling, play therapy, rehabilitation counseling, art therapy, human growth and development counseling, couples counseling, chemical abuse or dependency counseling, career counseling, and vocational disability counseling. A licensed professional counselor or associate licensed counselor may diagnose and develop treatment plans but shall not attempt to diagnose, prescribe for, treat, or advise a client with reference to problems or complaints falling outside the boundaries of counseling services. Ala. Code §34-8A-2-5a

As of August 2018, 30 NPs in Alabama have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority, an Alabama NP with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine-containing products, as long as the collaborating or supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorders. Ala. Code §34-21-86 and Ala. Code §20-2-253

As of August 2018, 2 PAs in Alabama have received a federal waiver to treat opioid dependency with buprenorphine-containing products. In Alabama, Schedule III-V controlled substances may be prescribed by a PA as outlined by a supervising physician. A PA with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine, as long as the collaborating or supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Ala. Admin. Code §540-X-7-.28 and Ala. Admin. Code §540-X-7-.23

Peer support specialists are certified by the Alabama Department of Mental Health (ADMH) as Certified Recovery Support Specialists. Peer support specialists assist those who are in recovery and are authorized to provide the services as outlined in the ADMH Substance Abuse Services Billing Manual. Ala. Admin. Code r. 580-9-44-.02

Alabama does not have laws or regulations around POLST. Please see the Advance Directives Law for more information.

Certified registered nurse practitioners are subject to collaborative practice agreements with a physician. Collaboration requires professional oversight and direction as required by the rules and regulations of the State Board of Medical Examiners and the Board of Nursing. The agreement must include practice sites, prescriptions orders and quality assurance. This collaboration does not require direct, on-site supervision of the activities of a certified registered nurse practitioner by the collaborating physician. Ala. Admin. Code §610-x-5.09, Ala. Code §34-21-81

NPs with a collaborative agreement may prescribe prescription drugs provided that drug type, dosage, quantity prescribed and number of refills is authorized in an approved protocol signed by the collaborating physician and the drug that is on the list of medicines recommended by the joint committee and adopted by the State Board of Medical Examiners and the Board of Nursing. An NP may also prescribe Schedules III-V controlled substances. Ala. Code §34-21-86, Ala. Code §20-2-253

NPs are not explicitly recognized in state policy as primary care providers.

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Ala. Code §34-22-20

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. Ala. Code §34-22-1(4)

Optometrists may prescribe Schedule III-V controlled substances. Ala. Code §34-22-1(4)

Alabama does not allow dental hygienists to practice with direct access.

Statute does not identify dental therapists as an oral health provider.

Alabama does not explicitly allow for the practice of teledentistry.

Alabama has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Alabama does not allow pharmacists to modify prescriptions.

Alabama does not allow pharmacists to prescribe hormonal contraceptives.

Alabama does not allow pharmacists to prescribe tobacco cessation aids.

Rules in policy outline supervision requirements. Direct continuing and close supervisory relationship between a PA and a physician is required. Provisions must be made for medical coverage by a different physician if the supervising physician is not available. Guidelines and requirements must be outlined if the PA is practicing off-site. Ala. Admin. Code §540-x-7-.23

A PA may prescribe legend drugs and Schedules III-V controlled substances as outlined by the supervising physician. The PA and the physician must adhere to any written guidelines established by the State Medical Board. Ala. Admin. Code §540-X-7-.28, Ala. Admin. Code §540-X-7-.23

The State Medical Board determines a PA’s scope of practice. The PA can provide medical services delegated by the supervisory physician within the education, training and experience of the PA. Ala. Admin. Code §540-X-7-.25