Austin, TX
States are making it easier for physician assistants to work across state lines • Louisiana Illuminator
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Mercedes Dodge was raised by first-generation immigrant parents from Peru in a modest home in a rural part of southeastern Texas, where there weren’t many health care providers. Sometimes they had to travel to Houston, over an hour and a half away, to get basic health care.
Partly because of that experience, Dodge became a physician assistant. Since 2008, she has provided psychiatric and primary care services to adults and children, many of whom come from communities like hers.
Dodge, who now lives in Austin, Texas, has built up a loyal base of patients, including many who are part of military families. But when any of them move out of Texas, she has to stop treating them, even via telehealth, unless she gets a license to practice in that state.
“I do my best and collaborate with them, but they already feel alone,” Dodge told Stateline. “I wonder, ‘Why can’t I be the glue? Why can’t I step over state lines and provide the care that they deserve?’”
Physician assistants, commonly known as PAs, are licensed clinicians who have a master’s degree and can practice in a range of specialties. Their three years of training typically includes 3,000 hours of direct patient care, and they are an increasingly critical part of the health care workforce, which in many states isn’t keeping pace with a growing and aging population.
By 2028, the nation as a whole will be short some 100,000 critical health care workers — doctors, nurses and home health aides — according to a new report from Mercer, a management consulting firm.
The looming shortage is one reason why 13 states have joined the PA Licensure Compact, a multistate agreement that allows PAs to practice in any participating state, without having to get an additional license.
Delaware, Utah, and Wisconsin enacted the legislation in 2023. Colorado, Maine, Minnesota, Nebraska, Oklahoma, Tennessee, Virginia, Washington and West Virginia followed suit this year. Ohio became the latest state to enact it in July.
The PA compact is one of several that have emerged over the past several years, especially since the expansion of telehealth services during the COVID-19 pandemic. There are similar compacts for doctors, nurses, occupational therapists and social workers.
One challenge has been completing the background checks required for providers who want to practice under the compacts. For example, Pennsylvania’s participation in the nursing and medical licensure compacts was delayed as the FBI denied the state access to its fingerprint database. They later reached an agreement on how to move forward.
The PA compact grants a “privilege to practice,” allowing PAs to practice in participating states without getting an additional license. The nursing compact gives nurses a multistate license, while the physician licensure compact just expedites the licensing process.
I wonder, ‘Why can’t I be the glue? Why can’t I step over state lines and provide the care that they deserve?’
– Mercedes Dodge, physician assistant
Some large states, such as California and New York, don’t participate in compacts for doctors, nurses, social workers or PAs. Some state lawmakers in those states say joining interstate compacts would reduce the quality of their states’ health care workforces, because other states require lower standards of education and training.
“We are proud that New York’s high standards have resulted in our state being an international destination in health care,” New York Democratic Assemblymember Deborah Glick wrote in an op-ed last year for the Times Union newspaper in Albany. “While it’s possible that it may make sense at some point for New York to join a licensure compact, we should pause before we allow a quick fix to lower New York’s standards.”
In other states, such as Texas, doctors who have succeeded in limiting the “scope of practice” of Texas PAs oppose the compact because they believe it might allow out-of-state PAs to go beyond those limits for their patients who reside in Texas. The American Medical Association and its state affiliates argue that allowing PAs to provide care traditionally provided by physicians puts patients at risk.
Dr. G. Ray Callas, president of the Texas Medical Association, said he values the role that physician assistants play in the health care system, but that his organization objects to any measure that might “give PAs authority to do more in health care than they are trained to do.”
“TMA is not opposed to appropriate, expedited licensure, but we do oppose these compacts when they expand scope of practice and create a patient safety issue, lowering the standard of care in Texas,” Callas said in a statement.
Supporters of the compact say that fear is unfounded, and that the agreement has no effect on state scope of practice rules. The model legislation for the compact specifies that PAs who treat patients in another state can only do so “under the Remote State’s laws and regulations.”
Last year, the Texas legislature considered legislation to join the PA compact, but it died in the state Senate.
Monica Ward, president of the Texas Academy of Physician Assistants, said her group will keep pushing for the bill.
“In the rural areas of Texas, there is absolutely a need and a shortage of health care providers,” Ward said. “We’re surrounded by multiple states, so it’s nice to be able to reduce those administrative burdens, paperwork and possibly fees for those that are looking to work in Texas.”
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It will take 18 to 24 months for the compact to become fully operational and for PAs to apply for the privilege to practice in other areas. The compact commission also needs to create a data system to keep track of licenses.
This model of licensure may not have worked even five years ago, said Tennessee Republican state Rep. Jeremy Faison, who sponsored his state’s compact legislation.
“It would have had major pushback and people would have asked, ‘What are you trying to do? We like to control what we’re doing in our state,’” said Faison. “But because we live in a global society and people move around so much more than ever before, I think the average person has embraced this.”
Faison told Stateline that for states such as Tennessee, which borders eight states, joining the compact makes economic sense because it will encourage people to move to the state.
Financial stability was 32-year-old Aneil Prasad’s motivation for getting a compact nursing license. He moved from New Orleans to Asheville, North Carolina, last year.
“It allows people to seek out better-paying jobs and move themselves ahead, buy houses and have better health and education and all that,” Prasad said. “And then the less competitive places are forced to raise their wages in order to attract people.”
After moving from Louisiana to North Carolina with his multistate license, Prasad said his wage increased from $21 an hour to $36 an hour. He notes that while the multistate license for nurses costs a bit more than a regular license, it would be much more expensive for him to apply for a new license in every state.
Since Texas hasn’t joined the PA compact, Dodge maintains active licenses in her home state as well as Alaska, California, Florida, New Mexico and Washington. She said the process to get them was expensive and time-consuming. Licenses can cost upward of $500 and can take three to nine months to obtain. Dodge said it’s been worth the trouble to help her patients, but she would appreciate an easier pathway.
“I got all these state licenses to follow my patients,” she said. “So when the PA compact license gets enacted in Texas, I hope it’s going to help me continue following my patients and I’ll be the glue that they need.”
This report was first published by Stateline, part of the States Newsroom nonprofit news network. It’s supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: [email protected]. Follow Stateline on Facebook and X.
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Austin, TX
Texas State Bobcats take down UTSA Roadrunners 49-10
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SAN MARCOS, Texas – The Texas State Bobcats have finally emerged victorious against I-35 rivals the UTSA Roadrunners.
The Bobcats defeated the Roadrunners 49-10 at UFCU Stadium in San Marcos on Saturday evening.
PREVIOUS COVERAGE: Texas State football team 1-point favorites over UTSA
Quarterback Jordan McCloud ran for two touchdowns and passed for two more. He was 18-of-27 passing for 309 yards with an interception. He also added 30 yards on the ground, providing the game’s first points with a 17-yard score and adding two more yards later in the first quarter for a 14-3 lead.
A couple of touchdowns helped the Bobcats lead 35-3 at halftime. Wide receiver Chris Dawn Jr. grabbed a pass at the 39 and turned it into a 46-yard score for a 21-3 lead; then running back Lincoln Pare burst through the line for a 45-yard touchdown and a 32-point bulge at the break.
Pare finished with 109 yards rushing on 11 carries and two scores. Dawn made five catches for 150 yards and two touchdowns.
The Bobcats rolled up 504 yards of offense to 334 for the Roadrunners.
UTSA’s Owen McCown started at quarterback, but Eddie Lee Marburger took over in the second half with a touchdown plus an interception.
The Roadrunners were a perfect 5-0 against the Bobcats all-time and both teams came into Saturday’s game 1-0 on the season.
Texas State is now 2-0 for the season, head coach GJ Kinne’s second with the Bobcats.
UP NEXT
Texas State will take on the Arizona State University Sun Devils on Thursday, Sept. 12 at 6:30 p.m. at UFCU Stadium.
UTSA will take on the Texas Longhorns on Saturday, Sept. 14 at 6 p.m. at DKR Memorial Stadium.
Austin, TX
Texas Tribune Festival 2024 takes over downtown Austin streets
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Texas Tribune Festival 2024
The 14th annual Texas Tribune Festival filled the streets of downtown Austin for its final day, offering the public a free street fest including political figures, top Texas brands and more.
AUSTIN, Texas – The streets of downtown Austin were lined on Saturday for the conclusion of the 14th annual Texas Tribune Festival.
It featured events, conversations, and panels from over 300 big name speakers.
“It’s really evolved into a must-see, and must be at, event for anyone who cares about politics and policy. And who cares about Texas and the nation,” said Kerri Qunell, director of marketing & communications for the Texas Tribune.
The multi-day festival aims to get the community engaged in politics and public policy, and better informed on current events.
Saturday’s event, “Open Congress”, was free to the public and featured a free street fest including political figures, top Texas brands and more.
“We have panels all day that range from politics and policy. Talking about what’s happening on the border, getting out the young vote for the upcoming election. And we also have more cultural and fun panels going on,” said Qunell.
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Organizers stress the importance of events like these with the election coming up.
“Particularly this year, we have a lot of emphasis on what the upcoming election means for Texans. A lot of our, of our speakers, of our panelists are talking about how to get engaged in your community, and how to make a difference,” said Qunell.
Some big-name speakers included former House Speaker Nancy Pelosi, former U.S. Rep. Liz Cheney, Virginia Gov. Glenn Youngkin, film director Richard Linklater and more.
“It’s really nice to meet some of these lawmakers face to face, because you see them on TV all the time or, like, in these big campaign rallies. So, it really does make me feel like they’re trying to interact with the public. And so that’s why I really appreciate this festival is because they bring, you know, they bring the politics in the politicians to the people, which is what it’s all about,” said festival attendee Jill Ament.
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There is also something for everyone, no matter what side of the political aisle you are on.
“I think more people need it, especially the public, not just like politicians and journalists need to know what’s happening in, you know, the White House and in Congress, but in their state legislatures and in their city councils,” said Ament.
Paul Schmidt made the trip from Dallas for the event and says he’s seen the event evolve over the years.
“It’s just a really neat event where you get to see and hear a lot of issues and people that you might not get to interface with, ever on a personal level. And so, you get to hear them in person, unfiltered with great interviewers,” said Schmidt.
But at the end of the day, organizers say it goes beyond the speakers.
“Not just the people who are on stage, but also the other people who come to be engaged and to meet each other and to, to network and find out how they can collaborate with each other to, to make a difference in their communities, to get more engaged in politics and public policy, not just in Texas, but in the nation,” said Qunell.
Austin, TX
Texas football dominates Michigan in first half behind Quinn Ewers, defense: Social media reacts
![Texas football dominates Michigan in first half behind Quinn Ewers, defense: Social media reacts Texas football dominates Michigan in first half behind Quinn Ewers, defense: Social media reacts](https://www.gannett-cdn.com/authoring/authoring-images/2024/09/07/NAAS/75121748007-usatsi-24176070-1.jpg?auto=webp&crop=2319,1305,x0,y696&format=pjpg&width=1200)
Why Texas vs. Michigan is one of the best matchups of the year
Tony Garcia of the Detroit Free Press explains why Texas vs. Michigan is one of the best matchups of the year
Texas football came to play on Saturday.
The No. 3 Longhorns have dominated No. 9 Michigan through two quarters, heading into halftime with a 24-3 lead at the hostile Big House.
REQUIRED READING: Texas vs. Michigan football game: Live updates as Texas leads big at the half
Texas quarterback Quinn Ewers has been sensational, completing 18 of 26 passes for 203 yards with two touchdowns. He’s also in strong position to extend his streak of six consecutive games with 300 or more passing yards against ranked teams.
The Longhorns’ defense has also been strong in the first half, holding the Wolverines to only 88 total yards of offense while forcing two turnovers. Michigan quarterback Davis Warren is a lackluster 8 of 11 passing for 49 yards with an interception.
Here’s how social media reacted to Texas’ dominant first half against Michigan:
REQUIRED READING: Matthew McConaughey, Charles Woodson go face-to-face before Texas football vs Michigan
Texas dominating Michigan at halftime: Social media reacts
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