Health care professionals in Texas are advocating for a policy that would add the state to interstate agreements allowing certain professionals to practice in other states without getting another license.

According to advocates, these compacts could reduce administrative burdens and improve access to quality health care.

One of the compacts, the PA Licensure Compact, was recently passed by the Texas House of Representatives and could help address a looming shortage of primary care physicians projected by the National Center for Health Workforce Analysis.

Zooming in

Under the Interstate Compact Coalition’s plan, Texas would join compacts for nine professions: audiology and speech pathology, cosmetology, occupational therapy, counseling, dentistry, dietetics, respiratory care, social work, and physician assistants.


Texas health care workers could provide care out of the state, and out-of-state workers could practice here.

Texas is currently a member of 38 compacts, including the Interstate Medical Licensure Compact and Nurse Licensure Compact.

As of May 5, the PA Licensure Compact, House Bill 1731, has been referred to the Texas Senate’s Business and Commerce Committee.

Leticia Bland, director at large for the Texas Academy of Physician Assistants, said the compact could reduce administrative barriers for PAs when it comes to getting a new license. For PAs who have to travel or relocate, like military families, Bland said the process of being able to start a new job can be time-consuming.


“That process of establishing work and establishing your license and credentials [would not be] quite as long, and so [the compact] would be a much better help in moving,” said Bland, who has been a licensed PA in Texas for around 12 years.

Bland said the compact’s ultimate outcome would be increasing quality health care access and maintaining a "continuity of care” for patients, especially primary care patients in rural areas and areas where there may be language or cultural barriers.

Bland said that the compact will not expand the “scope of practice” of a physician-led team or change the supervision requirements for Texas PAs.

“It's merely an authorization to practice from a more facilitated administrative perspective,” she said. “For us to be able to get through those licensing administrative burdens. But we must still comply with Texas licensing, regulatory and practice-based statutes and rules, and that applies to the other states that we extend our service into.”


By the numbers

The Texas Department of State Health Services projects a shortage of physicians to worsen through 2036. Specifically, the demand for primary care physicians in Central Texas will exceed its supply.


“Primary care is an important field, but we're seeing less providers go into that field for whatever reason it is,” Bland said. “It might be due to the increasing age of providers that are already in those fields that are now getting close to retirement ... or more individuals that are now graduating from medical school and other health care professions are going into specialties, rather than general practice or family practice or primary care practice, which is where the need is.”

According to Texas DSHS, the increase in demand is due to the state’s aging and growing population. Demand is the number of workers required to provide a certain level of service to the patient.


Despite the shortage of providers, the PA workforce is expected to grow 67% by 2036 from 2022. According to the Bureau of Health Workforce, PAs may help ease some of the hardships felt by the primary care physician shortage.

Bland said the PA Licensure Compact can help strengthen the physician-PA teams that work together to ensure patients have access to the quality care they need, wherever they are.

“Our primary focus is the people. It's the community,” Bland said.