House committee hears testimony on bill to join physician assistant licensure compact

Representative Preston introduced House Bill 4309 to amend Michigan’s public health code and join the Interstate Physician Assistant (PA) Licensure Compact, saying the compact “is designed to remove bureaucratic barriers” and to streamline licensure for PAs who live or practice across state lines.

The bill’s supporters told the House Health Policy Committee the compact would expand access to care in underserved and border communities, reduce administrative burdens for providers and benefit military families who relocate frequently. “It makes things more effective for the hospitals, more cost effective for the hospitals and for the PAs themselves,” said Jody McCollum, director of trauma services at UP Health System Marquette, describing cross‑border practice between Michigan and Wisconsin.

The compact grants a multistate “compact privilege” to PAs licensed in a member state; those using the compact must still follow the laws and regulations of the state where the patient is located. Representative Preston described the disciplinary structure: a PA’s home state retains sole authority to impose adverse action on the license, while other compact states can act against the PA’s compact privilege if the PA violates local laws.

Technical and practical details discussed at the hearing included: - Membership and activation: witnesses said about 16 states had enacted the compact and that the compact requires seven states to activate the commission; testimony estimated roughly a year to a year‑and‑a‑half between enactment and the compact becoming operational for new member states. - State implementation: Michigan would appoint a delegate to the compact commission; witnesses said the commission is administered by the Council of State Governments/National Center and would be managed operationally by the same national organization that oversees the physician compact. - Clinical and workforce impact: several clinicians from the Upper Peninsula and northern border communities described how the compact could reduce duplicative licensing fees and months‑long application waits (testifiers said obtaining a second state license can take three to six months) and increase timely access to telehealth and in‑person care.

Examples given to the committee illustrated local effects. Michael White, a PA in Marquette, described an arrangement in which Michigan PAs could work in Wisconsin clinics (Marshfield Clinic) under a compact arrangement and coordinate care with Wisconsin rheumatologists so that patients could receive more local follow‑up. Mandy Shellast, regional president for Marshfield Sanford’s Michigan region, said Wisconsin PAs were unable to help during a staffing illness at her hospital because they lacked Michigan licenses and that the compact would have made rapid cross‑border staffing possible.

The Department of Defense’s Great Lakes regional liaison, Shane Preston, urged approval and highlighted portability benefits for military spouses and service members, saying interstate compacts “streamline relicensing” and can help military families retain careers after moves.

Carl Sembs, deputy program director at the Council of State Governments’ National Center for Interstate Compacts, said the compact is voluntary for PAs and provides another pathway to practice across state lines while requiring practitioners to follow the rules of the state where the patient is located.

No formal committee vote on House Bill 4309 was recorded in the transcript; committee business moved on to other agenda items and votes later in the session.

The committee indicated it would continue to accept information and follow up with witnesses and staff before scheduling further action.