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?’”
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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.
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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?’
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– 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.”
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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.
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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.”
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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.
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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.
Global SEO Agency now offering deep-dive Audits, AI Ranking SEO, and Business Profile Optimization to local Austin companies seeking measurable digital growth on major search platforms.
AUSTIN, TX – December 17, 2025 – WebJi®, a leading SEO Agency with over two decades of international experience, has officially announced its expansion of service offerings to the Austin, Texas market. This strategic move brings WebJi®’s proven, remote-first strategies for digital growth to Austin’s local businesses and growing brands. The agency’s main goal is simple: to help companies show up higher in search results. This is achieved by fixing complex Technical SEO problems, growing qualified local traffic, and driving more real customers to client websites across the Austin area.
Solving the Visibility Problem for Austin Businesses
Many local businesses in the Austin area struggle to get noticed online. Their websites often face issues like slow loading speeds, poor user experience, or code that is unclear for the search engine robots. When these technical problems exist, the business cannot rank high in search results, even for customers searching nearby.
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The team has a strong history spanning over 20 years in search engine optimization, or SEO, successfully helping businesses globally. WebJi® now actively serves the greater Austin area, including Round Rock, Cedar Park, Pflugerville, and Buda. The team, composed of expert SEO specialists, content writers, and link building managers, operates virtually, ensuring every part of the SEO plan is handled professionally and efficiently, regardless of location.
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WebJi® offers comprehensive services focused on maximizing visibility specifically within the Austin market:
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Austin, Texas seeks offers of design, engineering, installation, operations and maintenance and decommissioning of solar projects on municipal facilities.
Anne Fischer
Image: Jan Van Bizar, Pexels
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Last spring Austin, Texas city council members approved a resolution to put solar on the rooftops of city-owned buildings. The resolution supports the Austin Climate Equity Plan that aims for net-zero community-wide carbon emissions by 2040 with an emphasis on cutting emissions by 2030. In keeping with that plan, the city is seeking a request for quotations (RFQ) for the solar projects planned for 111 municipal facilities.
Austin plans to make use of existing infrastructure by placing solar on rooftops and over parking lots. In addition to parking lots, the City-owned facilities on the site list designated for solar include at least seven fire stations, libraries, maintenance facilities, garages, recreation centers, city hall, and more.
Quotations on design, engineering, building, operations, maintenance and decommissioning are due by January 6, 2026 at 2 p.m. CST with questions due by December 22, 2025 at 5 p.m. CST. An online pre-offer conference will take place via Microsoft Teams on December 19, 2025 at 11 a.m. CST. Teams meeting ID: 277 171 690 189 99 Passcode 45Vf2kK3. Solicitation-specific questions can be directed to shawn.willett@austintexas.gov.
Austin’s electric customers are served by Austin Energy and connected to the Electric Reliability Council of Texas (ERCOT) grid.
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Joe Ely, a Texas singer-songwriter and guitarist, passed away at the age of 78 on Monday, as reported by Rolling Stone.
Ely, a pivotal figure in the 1970s progressive country movement, died at his home in New Mexico due to complications from Lewy Body Dementia, Parkinson’s, and pneumonia.
Ely’s influence on Austin’s music scene was profound. Known for his unique blend of country, rock, folk, and Tex-Mex, Ely was a driving force behind the city’s progressive country music scene.
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He was inducted into the Austin City Limits Hall of Fame in 2022, a testament to his enduring impact on the music community.
Born on Feb. 9, 1947, in Amarillo, Texas, and raised in Lubbock, Ely’s music was deeply rooted in West Texas. Despite his close association with Austin, he often returned to the wide-open spaces of West Texas for inspiration.
“Every time I start a new album, I head up to West Texas and drive around,” Ely told Texas Monthly in 2011.
Ely’s career began with the formation of the Flatlanders, a trailblazing country trio with fellow Texans Jimmie Dale Gilmore and Butch Hancock. Although their debut album, “All American Music,” was initially overlooked, the group later gained recognition as a quintessential display of West Texas country storytelling.
Throughout his career, Ely collaborated with a diverse array of artists, including Bruce Springsteen, Tom Petty, and the Clash. His live performances were legendary, captivating audiences from Lubbock to London. Ely’s contributions to music were recognized by the Texas Legislature, which named him the Official 2016 Texas State Musician.
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Reflecting on his journey, Ely once said, “I made it this far. I had teachers tell me I wouldn’t make it to 21 when I was going to high school, so I beat the odds, you know?” His legacy as a songwriter’s songwriter and a musician’s musician will continue to inspire generations to come.
