A bill to require that hospitals report whether doctors are present in their emergency rooms was sidelined by financial concerns during a Wednesday Alabama Senate committee hearing.
Senate Bill 297, sponsored by Senator Larry Stutts, R-Tuscumbia, was introduced after the Senate Healthcare Committee delayed reviewing SB80, a previous bill brought by the senator. SB80, which would have required that emergency rooms have a physician on site at all times, was heard by the committee in late January.
Despite endorsements from President of the Alabama Chapter of the American College of Emergency Physicians Dr. Sean Vanlandingham, alongside President-Elect of the Alabama Chapter of the American College of Emergency Physicians Dr. Jared Raper, the committee punted a review of Stutts’ bill, following fiscal concerns raised during the meeting by Senator April Weaver, R-Brierfield.
SB297 would require hospitals and freestanding emergency rooms to provide the Alabama Department of Public Health information on whether they have a physician “physically present” in their emergency department.
The bill would mandate that ADPH publishes the collected information on its website, and for hospitals to indicate whether they have a physician present in their ER, using physical signage within the department. ADPH would be licensed to revoke the licenses of institutions that fail to comply with the requirements of the act.
“The original bill I came with required that a doctor be present in the emergency room, and I think that’s what the public expects,” Stutts said. “I’ve not had a single person tell me that I go to the emergency room and don’t expect to find a doctor there. But anyway, that got a lot of people worked up about the whole issue.”
Stutts explained that SB297, alongside a substitute version of the bill he presented in the meeting, was drafted as an attempt to respond to concerns from the ALaHA regarding SB80.
“This is not anything new. Hospitals report data to the Department of Public Health all the time. Since I filed this bill, I have tried, I know at least four times, to meet with somebody from the hospital association that was opposed to it, and to no avail,” Stutts said.
“Even though they didn’t meet with me, I’ve listened to their concerns and the concerns they’ve been telling all of you,” the senator added. “They argued that ‘physically present’ was too demanding, that a doctor couldn’t go to the restroom, couldn’t go to the cafeteria to get something to eat. So, we distinctly defined for the purpose of this bill what ‘physically present’ means, and it’s not that onerous.”
The committee voted to adopt Stutts’ substitute, which removed language requiring hospitals to publish on their website whether an ER doctor is present. The substitute also gives ADPH the authority to choose whether to suspend a hospital’s license in addition to revoking it outright.
However, committee members ultimately voted 8-5 against giving SB297 a favorable report, following discussion of the bill’s potential fiscal implications.
The Legislative Services Agency fiscal note for the original version of SB297 projects that $126,100 would be necessary to develop software for ADPH to receive, review and compile quarterly reports regarding ER physician availability. The agency reported that an additional $105,000 would be required annually for staff to manage the reporting and publishing of collected data.
Weaver asked Stutts whether the fiscal note would be the same for the substitute version of SB297, expressing concerns regarding the potential cost of the act.
“The fact that we would spend $231,100 to collect the data on whether or not there’s a doctor in an ER or not, I think that there would be a lot better ways for us to spend $231,000,” Weaver said.
“I think that fiscal note is way too high, because they already collect a lot of data from hospitals,” Stutts argued.
Weaver, alongside Senator Robert Stewart, D-Selma, theorized the bill may push rural hospitals to take on additional expenses in order to consistently staff ER physicians.
“If I’m running a rural hospital, I am concerned that my community perception is tarnished if something like this happened,” she said of SB297.
The senator went on to reflect upon her experiences staffing specialized nurses as a hospital administrator, arguing the bill could benefit medical staffing agencies more than hospitals or their patients.
“I would get in a position where a nurse would resign from a position, go work for a staffing agency, I wouldn’t have a nurse to take care of that, so I would have to reach out to the staffing agency and I would get the same nurse, who just left, would come back and work the same shift and then I’m paying the staffing agency double to have somebody to cover that,” she said.
“In the end, I worry that we’re creating a system where the only people who win are these staffing agencies who provide emergency room physicians,” Weaver added.
Senator Lance Bell, R-Pell City, while agreeing with Stutts that the fiscal note likely overstated the financial burden of complying with the act, similarly argued that SB297 could put strain on rural hospitals’ finances.
“I don’t think the fiscal note is accurate, but if we’re putting costs on them, we know now they’re hurting, they’re suffering, if we’re putting costs on them, I believe we are to fund those costs if we’re going to ask for it—especially our rural places,” Bell said.
Stutts told the committee he would be open to potential amendments on the Senate floor to set an end date for the legislation and to fund the bill’s enforcement. However, he reiterated his belief that the legislation would not put undue financial burdens on Alabama’s hospitals.
“It is not an expensive ask for the hospital to enter one more piece of data to the Alabama Department of Public Health,” the senator said.
The Alabama state administrative code currently requires a registered nurse to be available in emergency rooms at all times.
If passed, SB297 will take effect on October 1, 2026.
