South Dakota Cuts Red Tape, Expands Access to Healthcare with New Law Supporting Physician Associates

PIERRE, S.D. — A years-long effort to improve access to healthcare in South Dakota has finally paid off. As of July 1, Physician Associates (PAs) in the state no longer face outdated licensing requirements that many say limited their ability to serve patients, particularly in rural and underserved communities. 

For years, South Dakota law required PAs to have a specific supervising physician on file to obtain a state license. But that stipulation often became a catch-22: employers wouldn’t hire a PA without a license, and PAs couldn’t get a license without a job offer that included a named physician supervisor. 

Kayla Frank, a PA and one of the key advocates for the change, faced that very dilemma. “I came to the state with seven years of experience and couldn’t even get interviews,” she said. “I had the qualifications, but the red tape kept me from practicing.” 

The new law removes the requirement for a hard-copy supervision agreement with a physician, giving PAs greater flexibility and bringing their licensing process in line with that of nurse practitioners, who haven’t had the same restriction since 2017. 

Echo Kopplin, another PA who helped lead the charge, explained that the law doesn’t change educational or certification requirements for the profession. “Nothing about our training changes. This is about reducing unnecessary bureaucracy so we can do our jobs more efficiently,” she said. 

Both Frank and Kopplin emphasized that the change is especially critical in rural parts of the state, where healthcare providers are in short supply. PAs are often the only medical professionals serving communities, managing everything from clinics to emergency rooms and nursing homes. 

The road to success wasn’t easy. Advocates introduced similar bills in 2021, 2022, and 2023, all of which failed. It wasn’t until they stepped back in 2024, reevaluated their approach, and focused on building relationships with legislators that momentum finally shifted. 

“We took a year off from legislation, but we didn’t go away,” Frank said. “We were at the Capitol every week, meeting with lawmakers, listening, and explaining how this would benefit patients.” 

Concerns about “independent practice” surfaced during the legislative process, but advocates clarified that the change is about flexibility, not removing medical accountability. “PAs already work in collaborative teams,” Kopplin said. “This just removes outdated barriers that were holding us, and patients, back.” 

With the new law in effect, PAs can more easily work in multiple locations, respond to local healthcare needs, and reduce delays in patient care. For South Dakota, that could mean shorter wait times, more providers in hard-to-reach areas, and better outcomes for families across the state.