Education Required for Addiction Counselor Credentialing

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

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Licensed Professional Counselor Ability to Diagnose

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

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Number of Nurse Practitioners Prescribing Buprenorphine

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

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Number of Physician Assistants Prescribing Buprenorphine

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

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Peer Support Specialist Certification or Credentialing Authority

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

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Practice Authority

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

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Prescriptive Authority

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

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Nurse Practitioner as a Primary Care Provider

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

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Authority to perform ophthalmic procedures

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

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Injectable Authority

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

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Prescription of controlled substances

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

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Dental Hygienists with Direct Access

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

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Dental Therapists

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

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Practice of Teledentistry

Alabama does not explicitly allow for the practice of teledentistry.

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Administration of COVID-19 Vaccine

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.

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Prescription Adaptation

Alabama does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

Alabama does not allow pharmacists to prescribe hormonal contraceptives.

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Prescription of Tobacco Cessation Aids

Alabama does not allow pharmacists to prescribe tobacco cessation aids.

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Supervision Requirements

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

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Prescriptive Authority for Physician Assistants

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

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Scope of Practice Determination

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

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