Health & Occupational Licensure Compacts
Interstate Occupational Licensing Compacts
Interstate occupational licensing compacts are legislative agreements between states that facilitate the mobility of licensed professionals across state lines. These compacts have become the standard for occupational, health, and medical licensure portability in the United States. By joining these compacts, states create a collaborative framework that benefits both professionals and the public.
🏛️ Quick Summary for Policymakers
Interstate compacts allow states to address shared regulatory challenges without federal mandates. They promote licensure mobility, public protection, and state sovereignty, and they have been widely adopted across healthcare professions including EMS, nursing, and medicine.
What is an Interstate Compact?
Interstate compacts are formal agreements between two or more states that establish common standards, policies, or cooperative actions. Unlike federally imposed mandates, compacts are state-developed, legally binding contracts that empower states to collaborate while maintaining sovereignty.
How is an Interstate Compact Created?
Compacts function as contracts between states and must satisfy basic legal principles of offer and acceptance. One state makes the offer by passing the compact legislation; others join by enacting identical language. Once a required number of states enact the law, the compact becomes active. In some cases, congressional consent may be required, depending on the compact’s scope.
The Compact Development Process
- Advisory Group – State officials and stakeholders analyze the issue and recommend solutions.
- Drafting Team – A smaller group (usually 5–8 members) converts recommendations into compact language.
- Education – Stakeholders and legislators are briefed, and educational materials are distributed.
- Enactment – States introduce and pass the model legislation, activating the compact once the threshold is met.
- Transition – States organize the new commission or operational framework, including initial rules and standards.
Benefits of Interstate Compacts
- Establish formal legal relationships among states to solve common problems.
- Create independent, multistate governmental bodies (Commissions) for efficient oversight.
- Ensure uniform standards and shared accountability.
- Reduce costs through shared systems and economies of scale.
- Promote coordinated responses to national and regional priorities.
- Preserve state sovereignty while improving collaboration.
- Provide legal mechanisms to resolve interstate disputes.
List of Occupational Interstate Compacts
The following occupational compacts provide pathways for professionals to practice across state lines while maintaining strong regulatory oversight:
- Emergency Medical Services Compact
- Psychology Interjurisdictional Compact
- Counseling Compact
- Audiology & Speech-Language Pathology Compact
- Nurse Licensure Compact
- Advanced Practice Registered Nurse Compact
- Physical Therapy Compact
- Occupational Therapy Compact
- Physician Assistant / Associate Compact
- Dentistry & Dental Hygiene Compact
- Massage Therapy Compact
- Cosmetology Compact
- Social Work Compact
- Dietitian Compact
- School Psychologists Compact
- Interstate Medical Licensure Compact (Physicians)
These agreements streamline professional licensure, reduce redundancy, and ensure consistent standards of competency, ethics, and safety across state lines.