Physician duties · CNM · Alabama
Signing for a Certified Nurse-Midwife in Alabama: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Alabama does not name a specific instrument.
Same indefinite collaborative-agreement structure as CRNP — jointly approved by the Board of Medical Examiners and Board of Nursing, with no independence pathway. Unlike the QACSC (renewed annually), the underlying collaborative agreement itself has no renewal requirement — it persists until amended or terminated.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
CNM with <2 years (4,000 hours) of collaborative-practice experience: On-site presence required
Described by ALBME/ABN as structurally parallel to CRNP's on-site phase (Ala. Admin. Code r. 610-X-5-.20) — not independently re-confirmed line-by-line against the rule text in this research pass.
CNM with ≥2 years (4,000 hours) of collaborative-practice experience: Available remotely (no on-site requirement)
Same twice-annual remote-site-visit structure described as parallel to CRNP — not independently re-confirmed line-by-line.
Supervision ratio
Up to 9 at a time (combined across provider types)
Same combined 360 hours/week (9 FTE) cap shared across CRNP, CNM, and PA per collaborating physician.
Chart review
Percentage set by agreement · Quarterly
Same quarterly QA standard as CRNP, described as parallel by ALBME/ABN.
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
QACSC chapter (540-X-18) explicitly covers 'CRNP and CNM' by its own title/scope.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same Title 10A same-profession-ownership framework as `np` — no independent-practice/ownership pathway without a collaborating physician.
Legal sources for these rules (3)
- Ala. Admin. Code r. 610-X-5-.20 — Collaborative Practice by Physicians and Certified Nurse Midwives
- Ala. Admin. Code Ch. 540-X-18 — Qualified Alabama Controlled Substances Certificate (CRNP and CNM)
- Alabama Board of Medical Examiners — CRNP/CNM Collaboration guidance
What physicians charge for this role
Typical monthly compensation in Alabama
$500 – $650
Estimate for one Certified Nurse-Midwife. This state's rules add a restrictive-tier premium.
About Alabama's rules
Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.
Other clinicians in Alabama: see the state overview.