EMS Compact History

The initial work on the EMS Compact began in 2012 with the goal of developing a model interstate compact for states’ to use to solve the problem associated with day-to-day deployment of EMS personnel across state boundaries. Examples of day-to-day deployments include, but are not limited to:

• EMS Providers responding as part of an agency with a multi-state footprint
• Staffing for large unplanned events such as that do not reach the level of a Governor’s declaration of a disaster
• Staffing for large planned events such as concerts and races

The project was inspired by the interstate compacts that made it possible for multi-state recognition of nursing licenses and state drivers’ licenses on short term and/or condition-limited bases. 

Phase One – National Advisory Panel (NAP)

In January and March 2013 the National Advisory Panel met to guide the early process of Compact development and to create a structure to guide and protect the process.

The NAP served to guide the early policy analysis and formulate recommendations, which included:

• Move forward and develop a compact, preserve state sovereignty and collective control
• Create a system of self-regulation-by the states where by national policy can be put into place and data can be exchanged but remain flexible enough to change, as change continues to occur in the EMS industry
• Work closely with CSG’s National Center for Interstate Compacts

The NAP consisted of 23 individuals representing 23 stakeholder organizations. Issues and stakeholder experts from EMS agencies, federal partners and the EMS Industry included:

• American Ambulance Association
• American College of Emergency Physicians
• Association of Air Medical Services
• Association of Critical Care Transport
• Bureau of Land Management
• EMS Labor Alliance
• Federal Bureau of Investigation
• Federation of State Medical Boards
• International Association of EMS Chiefs
• International Association of Fire Chiefs
• International Association of Fire Fighters
• International Association of Flight & Critical Care Paramedics
• International Paramedic
• National Association of EMS Educators
• National Association of EMS Physicians
• National Association of EMTs
• National EMS Management Association
• National Governors Association
• National Registry of EMTs
• National Volunteer Fire Council
• USDA Forest Service

Phase Two: The Drafting Team

The Drafting Team met in June, August and October of 2013 and was composed of compact and other subject matter experts, a national group with diverse representation. This team was charged with crafting the Compacts language based the NAP guidance and within a structured, time-tested process. The Drafting Team consisted of :

• 5 members from National Association of State EMS Officials (NASEMSO)
• The Council of State Government, (CSG) National Center for Interstate Compacts (NCIC)
• Association of Air Medical Services (AAMS)
• International Association of Flight and Critical Care Paramedics (IAFCC)
• International Association of Firefighters (IAFF)
• National EMS Management Association (NEMSA)
• National Association of EMT’s (NAEMT)
• Vedder Price – legal counsel

The Drafting Team developed the Compacts language and model legislation that was approved and released for consideration as well as adoption state by state in June 2014. Key elements of the Compact include, but are not limited to:

• Creates a contract between states via passage of the same legislation in multiple states specific to EMS
• States extend a privilege to practice to individuals from other Compact states as though they were licensed in their state under specified conditions
• States gain authority over EMS personnel from other compact states when practicing in their state
• Compact states form a governmental “Commission” to promulgate universal rules
• Commission is home to a national, Coordinated Database

Phase Three – Education and Enactment

Since the model was released, twelve states have passed REPLICA’s legislation. In order to activate the compact, passage by a total of ten state legislatures was necessary. An Advocate was hired to support the development of strategies to get REPLICA legislation introduced, passed and signed by the Governor of each state. The Advocate and associated activities are supported through a grant to NASEMSO from the NREMT. Simultaneously, on-site and remote meetings with REPLICA states, friends of and staff are being held to prepare for the next phase, standing up the REPLICA Commission.

• Final Draft of Interstate Compact for EMS Personnel Licensure (February 18, 2014)
• Review of Final Draft for State EMS Directors and Invitees (February 14, 2014)
• REPLICA Technical Seminar Materials (June 10, 2014, Chicago, IL)

Phase Four – Transition to Commission

In anticipation of adoption by the required ten states, a level of technical assistance, training and staff support to full operation, or transition was put in place in August of 2016.

The inaugural meeting of the Interstate Commission for EMS Personnel Practice, the governing body of the EMS Compact, met on October 7 – 8, 2017 in  Oklahoma City, OK.