The EMS Compact for EMS Professionals

EMS personnel seeking to practice under the EMS Compact must be 18 years of age, practice under the supervision of a medical director in their home state, and have an unrestricted license at or above the level of EMT in a member state. The term “license” includes states that still use “certification” for EMS personnel credentials. Members of the military that are separating from active duty, their spouses, and veterans will find an expedited process for licensure in states that have passed the REPLICA legislation. This includes members of the National Guard.

The EMS Compact is not a form of EMS licensure reciprocity. The EMS Compact extends a privilege for EMS personnel from member states to practice on a short-term, intermittent basis under approved circumstances in other member states.

Examples of these circumstances include:

  • Response areas for EMS personnel that cross state lines
  • Staffing for large scale responses that are not at the level of a governor’s declaration of a disaster, including details in support of federal agencies examples including wild-land firefighting teams, homeland security
  • Staffing for large scale planned special events examples such as concerts and sporting events

The REPLICA legislation was written to cover all the variations in operational scenarios found in state EMS laws and rules in the United States, this includes:

  • The individual initiates a patient transport in a home state and transports the patient to a remote state (A -> B)
  • The individual originates in the home state, enters a remote state to pick up a patient and provide care and transport of the patient back to the home state (A -> B -> A)
  • The individual enters a remote state to pick up a patient and provide care and transport to a third member state (A -> B -> C)
  • The individual enters a remote state to provide patient care and/or transport within that remote state (A -> D)

EMS personnel providing patient care in a remote state will function within the Scope of Practice that is authorized in their home state unless modified by an appropriate authority.   The Interstate Commission for EMS Personnel Practice will further address the Scope of Practice discussion and appropriate authority in the rule writing process.  All rule writing by the Commission will be during public sessions, with periods open for public comment and testimony. This is the same practice utilized by states and the federal government to create Administrative Rules.

Listen to an interview with Dia Gainor , Executive Director of NASEMSO about REPLICA, courtesy of the Professional Ambulance Association of Wisconsin (PAAW) The advantages to you as a patient care provider, an ambulance service and the state are discussed during this interview featured on “EMS to the Point”. (14 minutes in duration)

Individual Eligibility

Once the EMS Compact is operational (estimated for 2020), individual EMS Personnel are required to meet the following eligibility requirements:

  • Licensed, in good-standing, as an EMT, an AEMT (or a level between EMT and Paramedic), or a Paramedic in a Compact state
  • Have an EMS Medical Director
  • At least 18 years old