The PA Licensure Compact

FigureWith presidential campaigns in full swing, it's safe to say the future of healthcare will take up a fair share of the national conversation for the next several months, with topics such as Medicaid expansion, reproductive health, and persistent healthcare workforce challenges at the forefront. As patient advocates, physician associates/assistants (PAs) have an obligation to engage in the national conversation, but we also have a duty to ensure that progress on PA-led policy continues at the state level. Discourse during a presidential election year has a way of sucking up all the oxygen, but in states across the country, active legislation remains before many legislatures. Although perhaps not as headline-grabbing as many of the pressing national priorities, the changes PAs are seeking to state laws would have a significant effect on how healthcare is delivered in communities throughout our country. For example, in 2024, our profession is well positioned to make significant headway on the PA Licensure Compact. By the close of 2023, three states—Utah, Delaware, and Wisconsin—had enacted the PA Compact, and legislation had been introduced in Maine, Michigan, New York, Ohio, Vermont, and Washington state. This progress demonstrates the power of partnerships, as collaboration with the Federation of State Medical Boards and the Council of State Governments was key to this strong start. The PA Licensure Compact, like other PA practice law modernizations, is a long overdue and commonsense way to make healthcare delivery in our country more efficient. After the compact is operational, licensed PAs will be able to make a single application for privileges to practice (in person or via telemedicine) in any state that has joined the compact, without the need to apply for licensure in each state. This would significantly reduce administrative burdens and may reduce licensing fees for PAs. However, most importantly, it would reduce delays in providing patient care and increase patient access. After seven states have adopted the compact model legislation, the compact will be activated and will begin the process to become operational. Historically, this process has taken 18 to 24 months after activation for other professions. The PA Compact is completely optional—PAs may use the compact to obtain privileges to practice in all states in which they wish to practice, or they may continue to obtain single-state licenses. Furthermore, the PA Compact will not change scope of practice—PAs using the compact must still abide by the state laws and regulations in the states in which they practice. The PA Compact also would establish a multistate data system that will enhance public protection by facilitating the sharing of licensure and disciplinary information across compact member states. Increased licensure portability is an urgent need for PAs who travel or relocate regularly, including military spouses. With an active interstate PA compact, a practicing PA can maintain licensure and avoid licensing-related downtime between jobs, as long as relevant states are members of the compact. For more information on the PA Compact, including updates on where your state is in the process, visit pacompact.org. I urge PAs who are not involved in advocacy to reach out to your state chapters. Breaking through the noise of an election year requires a loud, united PA voice. Every email, call, or meeting can make a difference.