South Dakota Joins PA Compact in Third RHTP-driven Win for PAs
March 10, 2026
South Dakota is now the 23rd state to enter the PA Licensure Compact, following the signing of (H.B. 1146).
This win comes on the heels of the state’s pledge to enter the PA Licensure Compact as part of its application for Rural Health Transformation Program (RHTP) funds.
South Dakota Academy of PAs (SDAPA) Legislative Chair Kayla Frank said that following the success of its PA practice modernization bill in 2025, SDAPA had originally planned to use the 2026 legislative session to redirect their grassroots efforts and educate legislators about the PA Licensure Compact for the 2027 session.
Implementation of the RHTP led them to change course.
“The Rural Health Transformation Program created an opportunity to pursue the PA Compact earlier than expected, with significant support from Governor Rhoden and the South Dakota Department of Health,” Frank said.
“The momentum from our 2025 legislative win, paired with the Rural Health Transformation Program’s workforce focus, created an optimal environment to not only pass HB 1145 for the PA Compact with little opposition, but also to continue promoting the essential, high-quality care PAs provide in South Dakota.”
South Dakota and multiple other states signaled their intention to enact the PA Licensure Compact and PA practice modernizations in their RHTP applications as a result of the profession’s unwavering advocacy over the years.
In many states, the implementation of the RHTP is giving efforts to modernize PA practice laws an added push to get legislation across the finish line.
AAPA commends SDAPA for its leadership, partnership, and commitment to seeing this effort through. AAPA also thanks the members of the South Dakota Legislature for recognizing the importance of licensure modernization in strengthening access to care across the state, and Governor Larry Rhoden for delivering on South Dakota’s commitment to enact the PA Licensure Compact.
This marks the third RHTP-driven legislative win for PAs and is a significant step forward in expanding licensure portability for physician associates (PAs) and strengthening the healthcare workforce nationwide.
With the bill now signed into law, South Dakota joins a rapidly growing number of states committed to modernizing licensure frameworks to better reflect how healthcare is delivered today.
The PA Licensure Compact allows eligible PAs to obtain a compact privilege to practice in other participating states without applying for and maintaining multiple, separate licenses. The model is designed to reduce administrative burden, accelerate workforce mobility, and improve access to care.
As the PA Compact continues to gain momentum nationwide, the development of the required operational infrastructure remains underway through the PA Compact Commission. This critical step, expected to be complete in early 2027, must be complete before compact privileges can be issued to individual PAs.
Additional states are expected to take up compact legislation this legislative session, driven in part by new incentives tied to the federal RHTP, which recognizes the PA Licensure Compact as a rural workforce-strengthening strategy. Currently, 10 other states are considering bills to join the PA Licensure Compact this year. In addition to South Dakota, Arizona, North Dakota, and New Jersey have enacted compact legislation in 2026, signaling that states are moving quickly to remain competitive.
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