Illinois could leave rural federal funding on the table without PA workforce modernization

By Timothy Kinsey, DMSc, PA-C

Illinois is staring down an access-to-care crisis.

According to the US Health Resources and Services Administration (HRSA), more than 3.3 million Illinois residents live in communities classified as Health Professional Shortage Areas (HPSAs). This is a real-world problem for rural communities. Delayed care often shifts patients into higher-cost settings, including emergency departments.

At the same time, the federal government is signaling that rural health funding isn’t just about need—it’s increasingly about whether states have built modern workforce policies that let care teams deploy quickly and efficiently. The Rural Health Transformation Program—created under the Trump administration—is a prime example: $50 billion over five years, with annual allocations that depend in part on how states deploy their clinical workforce to “work at the top of their license.” Illinois taxpayers help fund these federal programs and our state should be competing to win and bring those dollars back to Illinois.

Illinois is already in this competition. The Illinois Department of Healthcare and Family Services has described the program and the state’s application efforts publicly, and Illinois has already secured initial awards. But funding alone won’t improve access if Illinois keeps preventable bottlenecks in place when staffing and deploying clinicians.

One of the most fixable bottlenecks is hiding in plain sight: outdated statutory requirements that force physician assistants (PAs) to practice under state-filed, physician-tethered structures that no longer match how care is delivered in real clinics and hospitals—paperwork requirements that create delays when staffing needs change.

Team-based care is how medicine works now, and Illinois law should reflect that

In today’s health systems, care is delivered by teams, working under institutional credentialing, privileging, and quality oversight.

Illinois PAs aren’t asking to change that model. The Illinois Academy of Physician Associates (IAPA), the state’s professional academy for PAs, is explicit: Illinois PAs are not seeking independent practice and support team-based practice with physicians and other clinicians. The problem is that Illinois law still imposes administrative “tethers” that can make staffing more fragile than patient safety requires.

IAPA, on their advocacy site PAsCare.org, summarizes the core issue bluntly: PAs are “the only health care providers legally required to have their licenses tied to another provider,” and that requirement limits PA practice in ways that harm access to care.

In practice, when workforce rules are built around state filings and delegated authority, routine changes, like multisite staffing or physician turnover, can create delays and compliance churn that distracts from patient care and makes recruitment harder.

Illinois has a clear modernization path, without changing scope of practice

Illinois doesn’t need to invent a radical new framework. The roadmap is already on the table:

1. Modernize PA practice requirements for experienced PAs: end state-filed, physician-specific paperwork
2. Eliminate “delegated prescriptive authority” as a legal bottleneck: let practices set privileges with accountability
3. Keep guardrails that reinforce team-based care: maintain structure for newer PAs

This is a low-cost capacity expansion: it uses the workforce Illinois already has without creating new programs.

These priorities are not speculative. They’re exactly what the IAPA describes as the plan for Illinois: a focus on reducing administrative friction, stabilizing the workforce, and enabling team-based deployment where patients need care most.

And Illinois residents are with them. Survey data show 89% of Illinois residents support updating PA practice laws to help states and systems use their workforce fully.

This is a pragmatic workforce decision with real fiscal consequences

The federal rural-health funding environment is moving toward competitive scoring based on workforce readiness. Illinois should not handicap itself by clinging to administrative structures that don’t reflect modern care delivery, especially when the state is trying to maximize every available dollar to support rural communities.

Updating PA laws won’t solve every shortage. But it’s one of the fastest ways to add capacity with the workforce Illinois already has.

Illinois lawmakers should treat PA modernization and compact participation for what they are: strategic, pro-patient, pro-rural updates that strengthen access, improve staffing flexibility, and help Illinois compete in a funding landscape where policy readiness increasingly matters. The public expects common-sense modernization that expands access without lowering standards.

THE ASK: co-sponsor and move PA modernization this session—cut red tape, protect team-based care, and get rural Illinois the workforce that it needs.