Senate Committee Hears SB 80 to Require Physicians in Emergency Rooms; Vote Delayed

Senator Stutz introduced SB 80, a two-page bill that would require hospital emergency rooms to be staffed by a physician while the ER is open, and the Senate committee heard supporters and critics but agreed not to vote on the measure at this meeting.

The sponsor, Senator Stutz, told members the intent is simple: "a doctor should be there and primarily responsible for what goes on in the ER if the ER is open," and he said the committee could refine language about whether the physician must be "physically present" or merely "immediately available." He asked members to discuss language with him before a planned vote next week.

Emergency physicians who testified cited patient-safety risks when a physician is not immediately available. "When emergency departments operate without a physician present, patient outcomes suffer and disparities increase," said Dr. Sean Van Landingham, an emergency physician who identified himself as president of Alabama ASAP. Van Landingham described a recent case in a rural hospital in which he said he "intubated her. I put it in a chest tube, activated a massive transfusion protocol," and that the patient survived because a physician was present.

Jaren Raper, another emergency physician, urged support and addressed a common concern that the requirement could force rural hospitals to close. "South Carolina, Indiana, Virginia, they've all passed physician presence requirements beginning in 2023. To date, none of those hospitals in those states have had to close as a result of this legislation," Raper said. He also noted that when a hospital converts to Rural Emergency Hospital (REH) status it "receives about $3,500,000 per year in support, from the CMS," and argued those funds are intended to sustain emergency care and could cover physician staffing costs.

Committee members asked for data on how many hospitals currently lack 24/7 physician coverage. Senator Roberts asked for numbers; Dr. Van Landingham said he knew of two facilities without continuous physician presence but acknowledged "there's not really any kind of mechanism for tracking this data" and that other committee members had heard estimates ranging from "5 to 15." Members asked staff and witnesses to follow up with concrete lists and hour-by-hour coverage details.

Opponents — or members expressing reservations — cautioned the committee about unintended consequences for rural and critical-access hospitals. Senator Weaver thanked ER doctors but said she could not support the bill as written because it could impose state regulations stricter than federal requirements and because rural hospitals operate under tight budgets: "To impose another regulation like this in a time where our money is already tight, I just I can't support this bill." She cited ongoing work on a rural roadmap initiative for rural health care.

Supporters and skeptics agreed the committee should refine language. Senator Stutz said wording that requires a physician to be "available" rather than strictly "physically present" could be discussed; Senator Coleman Madison and others emphasized public expectations that hospitals offer physician-level care when patients present to an ER.

The committee did not take a vote on SB 80 at this meeting; the chair said the bill will be brought back and likely voted on next week. Members were asked to consult with the sponsor on language and to provide follow-up information about which facilities lack continuous physician coverage and how many hours of the day are affected.

Questions remaining include a comprehensive count of hospitals without continuous physician coverage, the precise drafting the committee will adopt (physical presence vs. immediate availability), and whether federal REH funding will practically cover any new staffing requirements. The committee adjourned with the item continued to a future meeting.