Practicing EMS in Multiple States Could Soon Be a Lot Easier

December 5, 2014 (EMS World) - Wouldn’t it be great if you could take all of your experience, knowledge and skills as an EMS provider and instantly work in another state, without the hassle of having to get a license and everything that goes along with it in the remote state?

That day may be closer than you think.

The National Association of State Emergency Medical Services Officials (NASEMSO) has developed draft legislation—the Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA)—for states’ use through which states will share licensure authority related to EMS personnel. Enactment as state law would make it possible for an individual licensed in one state to enjoy immediate legal recognition in every other state that enacts the same legislation.

Dia Gainor, MPA, executive director for NASEMSO, discussed this in Nashville last month during EMS World Expo. The session, “One License, Multiple States: The Interstate Compact for EMS Personnel Licensure,” provided a detailed overview of the provisions and conditions within the compact and assessed its utility for EMS agencies operating on a multistate basis.

For anyone thinking this is a pipe dream, think again. Interstate compacts are already common—think driver’s licenses, the nurse licensure compact, EMAC and about 200 others—and a constitutionally granted right of the states.

The benefits to individual EMS providers, EMS agencies and the industry itself could be huge. Gainor said the compact would enable EMS personnel to function in another state on both an unanticipated and a regular basis, and would allow states to work together to more easily share resources in times of need.

According to Gainor, the compact is designed to achieve the following purposes and objectives:

  1. Increase public access to EMS personnel;
  2. Enhance the state’s ability to protect the public’s health and safety, especially patient safety;
  3. Encourage the cooperation of member states in the areas of EMS personnel licensure and regulation;
  4. Support licensing of military members who are separating from and active duty tour and their spouses;
  5. Facilitate the exchange of information between member states regarding EMS personnel licensure, adverse action and significant investigatory information;
  6. Promote compliance with the laws governing EMS personnel practice in each members state; and
  7. Invest all member states with the authority to hold EMS personnel accountable through the mutual recognition of member state licenses.

That last item is especially critical because it allows individual member states to retain sovereignty on matters concerning who is providing care within their borders.

As part of the compact, the “home” state would have a mechanism in place for receiving and investigating complaints about individuals licensed in that state who are providing care in other member states. The home state could then notify the compact administrative commission of any adverse action or significant investigatory information regarding an individual. The home state would have the exclusive ability to take disciplinary action against the license issued by that state in accordance with its own state law. If the home state acts, the privilege to practice in every other state would be immediately suspended.

There are pertinent negatives about the privilege to practice under the compact, admitted Gainor, namely:

  • The individual provider DOES NOT have to maintain national certification;
  • The individual CANNOT respond into another state and have legal privilege to practice unless the incident meets situational criteria;
  • The individual IS NOT automatically entitled to reimbursement under EMAC.

However, those conditions are not immediately outweighed by the positives of being able to practice in multiple states without having to jump through myriad hoops. This is especially helpful to multistate agencies because it’d allow for transferring employees on a short-term or intermittent basis from one location to another without any red tape.

The next steps in enacting the interstate compact are already in motion. The compact is currently in states’ hands in its final form. All it takes is for state legislatures to propose the idea and pass it as a bill, with the state governor subsequently signing it into law. Third parties are eligible to introduce the compact through a sympathetic legislator, which is where state EMS associations could be particularly helpful.


[This article was published in the December 2014 edition of EMS World.)