Executive Committee Meeting

INTERSTATE COMMISSION FOR EMS PERSONNEL PRACTICE

EXECUTIVE DIRECTOR'S REPORT

Executive Committee Meeting | October 14, 2026

Submitted by Donnie R. Woodyard, Jr., MAML, NRP, WP-C, Executive Director. This report covers activity from July 7 through October 9, 2026.

1. SUMMARY OF ACTIVITY SINCE JULY

MEMBERSHIP AND NEW STATE ONBOARDING

Twenty-eight states have enacted the Compact, and it is in force in twenty-seven. Arizona's law took effect on September 12, 2026, and Dr. Gail Bradley was seated as Arizona's Commissioner. The Commission announced a delay in Alaska's implementation on September 21. Alaska then went live on October 9, 2026, with Todd McDowell seated as Commissioner. Connecticut remains enacted, with activation conditioned on a bordering state also enacting the model legislation.

Onboarding work included a full-day Compact onboarding session with Arizona in Phoenix on August 31 and an Arizona question and answer session on October 6. I also held eighteen individual meetings with state and partner Compact contacts during the period.

MEETINGS AND GOVERNANCE

The Executive Committee met July 15 and held an executive session that day. It held further executive sessions on August 27 and October 8. The regular August and September Executive Committee meetings were canceled. The Q3 Full Commission Meeting was held August 19. On September 23 the Commission announced that the Q4 Full Commission Meeting moves from November 18 to December 9, 2026.

The Bylaws and Rules Committee met on July 29 and August 26, and the Compliance Committee met on August 17. The Committee is bringing only the Bylaws revision to the December 9 meeting. The proposed Administrative Rules changes carry over to the Q1 2027 meeting.

FEDERAL, LEGISLATIVE AND STAKEHOLDER ENGAGEMENT

I traveled to Montana July 7 through 10, where I gave in-person testimony to the legislative committee and met with stakeholders. I represented the Commission at the NCSL Legislative Summit July 27 through 29, and met with FEMA and the Department of Homeland Security in Washington, D.C. on July 30. I attended the Council of State Governments compact administrators meeting on August 17.

At the EMS World Expo, September 27 through October 1, I presented to the NAEMT Board of Directors on September 28, held Compact collaboration and introduction sessions on September 29, and met with NASEMSO on September 30 to discuss the relationship between the two organizations. A draft position paper on that relationship is before the Committee at agenda item V.a. I also took part in the Joint National EMS Leadership Forum on July 14 and, in person, on October 1, and attended the California Ambulance Association annual conference in Anaheim on September 23 and 24.

I take part in a standing every-other-Tuesday morning EMS and Government Forum, a routine collaboration with EMS industry leadership.

I met with CAPCE on September 18 about its support for the Compact. The proposed joint position paper on the National EMS ID, which CAPCE would sign with the Commission, NREMT and NASEMSO, is before the Committee at agenda item V.b.

COORDINATED DATABASE AND COMPLIANCE

Arizona began transmitting license data to the Coordinated Database on September 10. The October 2026 Administrator Report shows Oklahoma and Pennsylvania still not transmitting, and Alaska had not yet transmitted as of that report's October 1 date. I attended NEMSCD training for the National Registry certification team on August 21. Terrie Godde of the National Registry is the Commission's new NEMSCD contact, and I met with her on September 17.

I reviewed the data available to the Commission office on clinicians with adverse actions in one participating state and licenses in another. The NEMSCD web portal cannot list adverse actions by state, so a complete answer requires a data export or read access from the National Registry. A written request to NREMT is in preparation, and technical assistance for Commissioners is being drafted.

COMMUNICATIONS AND THE COMMISSION WEBSITE

The redesigned emscompact.gov launched this quarter. The Commission issued announcements on the new Arizona and Alaska Commissioners, on the Professional Code of Conduct as a binding requirement for the Privilege to Practice (September 18), on the Alaska delay, and on the Q4 meeting date. The public notice for this meeting was distributed by email, and the agenda is posted on the website. The newsroom list is at Tab 21 of the Meeting Book.

2. ENGAGEMENT LOG

Dates are from the Executive Director's calendar for July 7 through October 9, 2026. This log is not an all-inclusive list of the Executive Director's activity.

3. LOOKING AHEAD

The Q4 Full Commission Meeting is Wednesday, December 9, 2026, at 3:00 PM Eastern. The 30-day Bylaws notice for the December 9 meeting is due November 9, and the Administrative Rules changes carry over to Q1 2027. Nominations for Chair, Treasurer and Member-at-Large close November 1. National Collegiate EMS Week is November 9 through 15, and a resolution is before the Committee at agenda item V.g. I will bring any further developments on the NREMT data request and the national database's future to the Committee as they mature.

INTERSTATE COMMISSION FOR EMS PERSONNEL PRACTICE

The United States EMS Compact | www.EMSCompact.gov

July 30, 2026

TO: Commissioners of the Interstate Commission for EMS Personnel Practice

FROM: Bylaws and Rules Committee

RE: Proposed Revision of the Commission Bylaws, for Consideration at the Q4 2026 Full Commission Meeting

Dear Commissioners,

On behalf of the Bylaws and Rules Committee, I am pleased to transmit the enclosed proposed revision of the Commission's Bylaws, presented in an official redline format that shows every proposed change against the current Bylaws as amended November 15, 2023.

This proposal is the product of many months of sustained work by the Bylaws and Rules Committee. Over the course of its review, the Committee examined the current Bylaws article by article and evaluated them against the Recognition of EMS Personnel Licensure Interstate Compact (REPLICA), the model legislation enacted into law by each Participating State, as well as the Commission's Administrative Rules and governance best practices from established interstate compact commissions. The Committee's guiding principle was fidelity to the statute. Section 10.C of the enacted legislation directs the Commission to prescribe bylaws addressing specific subjects, and several of those statutory requirements are not fully implemented in the current Bylaws. The proposed revision closes those gaps, conforms existing language to the enacted text, and cites the governing statutory provision throughout so that every requirement can be traced to its source.

A summary of the key changes, each tied to the enacted legislation, follows:

• Reorganization and renumbering. The Bylaws are restructured from Articles I through XI into Sections 1 through 14, with consistent decimal numbering to simplify citation and future amendment. (Implements the Commission's general bylaw authority under REPLICA Section 10.C.)

• Standardized terminology. References to "Member State" are standardized to "Compact State" throughout, with an express definition anchored to the enacted definition of a state that has adopted the Compact. (REPLICA Sections 2.J and 10.A.)

• Governmental status and interpretive hierarchy. New provisions confirm the Commission's status as a body politic and instrumentality of the Compact States and establish that the enacted Compact and duly adopted Administrative Rules control in any conflict with the Bylaws, consistent with the statute's standing as law in every Participating State. (REPLICA Sections 10.A.1 and 13.A.1.)

• Commissioner appointments, vacancies, and proxy voting. New provisions address Commissioner vacancies and delegate status gaps, reflecting the statutory requirement that each state's delegate be the responsible official of the state EMS authority or designee, and expressly prohibit proxy voting as the enacted legislation requires. (REPLICA Sections 10.B.1, 10.B.2, and 10.C.3.)

• Officer nominations and removal. A structured, informational nomination process supports informed officer elections, and officer removal now requires cause, written notice, an opportunity to respond, and a two thirds vote. These provisions implement the statutory directive that the Bylaws establish the titles, duties, authority, and reasonable procedures for the election of officers. (REPLICA Section 10.C.4.)

• Executive Director role and personnel policies. The Executive Director's duties, accountability, and limitations are defined, and a new personnel policies section implements the statutory mandate that the Bylaws exclusively govern the Commission's personnel policies and programs, notwithstanding any civil service or similar laws of any Compact State. (REPLICA Sections 10.C.5 and 10.D.5.)

• Qualified immunity, defense, and indemnification. The immunity, defense, and indemnification provisions are conformed word for word to the enacted text, extending coverage expressly to the executive director, employees, and representatives of the Commission. (REPLICA Section 10.F.1 through 10.F.3.)

• Meetings. New provisions address emergency meetings, recorded votes, quorum calculation based on seated Commissioners, closed session certification by counsel with sealed minutes, and adoption of Robert's Rules of Order. These implement the statutory requirements for open public meetings, reasonable advance notice, enumerated closed session conditions, and recorded votes to close a meeting. (REPLICA Sections 10.B.3 through 10.B.6, 10.C.3, and 12.L.)

• Executive Committee. The revision clarifies the Executive Committee's reserved powers, requires ratification of interim emergency actions within ninety days, makes the immediate past chairperson a voting member, and establishes vacancy procedures, a quorum standard, and notice requirements. These provisions implement the statutory directive that the Bylaws govern any general or specific delegation of Commission authority. (REPLICA Section 10.C.2.b.)

• Standing committees. Four standing committees are established: Rules/Bylaws, Finance/Audit (chaired by the Treasurer), Compliance/Investigations, and Elections/Nominating, implementing the statutory requirement for reasonable standards and procedures for the establishment and meetings of committees. (REPLICA Sections 10.C.2.a and 10.D.11.)

• Finance and reporting. A new annual report provision implements the statutory requirement that the yearly independent audit be included in the Commission's annual report, and the debt limitation language is conformed to the enacted prohibition on incurring obligations before funds are secured or pledging the credit of any Compact State. (REPLICA Sections 10.E.4, 10.E.5, and 10.C.9.)

• Ethics and whistleblower protections. A new section adopts a Code of Ethics with annual conflict of interest disclosures and establishes whistleblower protections. The Code of Ethics is an express statutory mandate that the current Bylaws do not implement: the enacted legislation requires the Commission to promulgate a code of ethics addressing permissible and prohibited activities of Commission members and employees. (REPLICA Section 10.C.6.)

• Records, transparency, and data access. A new section aligns Commission records management with the enacted requirements governing the coordinated database, state designated confidential information, expungement, and protection of personally identifiable information. (REPLICA Section 11.)

• Rulemaking cross-reference. A new section confirms that all Commission rulemaking follows the statutory rulemaking process, under which rules have the force and effect of law and bind all Compact States. (REPLICA Sections 12 and 10.D.1.)

• Withdrawal, default, and termination. The withdrawal and termination provisions are updated with precise citations to the enacted withdrawal and default procedures. (REPLICA Sections 14.C and 13.B.)

• Dissolution and wind-up. The dissolution provisions are updated and detailed wind-up procedures are added. This addition satisfies a direct statutory requirement: the enacted legislation directs that the Bylaws provide a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds after payment or reserving of all debts and obligations. The current Bylaws contain no such mechanism. (REPLICA Section 10.C.7.)

• Publication and filing. Upon adoption or amendment, the Bylaws must be published and filed with the appropriate agency or officer of each Compact State within thirty days, implementing the enacted publication and filing requirement. (REPLICA Section 10.C.8.)

The Committee welcomes your feedback on any aspect of this proposal. Comments and questions may be directed to the Committee through the Executive Director at Donnie.Woodyard at EMSCompact.gov. Feedback received in advance of the meeting will allow the Committee to prepare responses and, where appropriate, propose refinements for the Commission's consideration.

The proposed Bylaws will be presented for consideration and action at the Q4 2026 Full Commission meeting. This transmittal, which includes the full text of the proposed action, is provided to all Commissioners consistent with the thirty day written notice requirement for bylaw amendments.

Thank you for your continued service to the Compact and to the more than 450,000 EMS clinicians practicing across our Participating States.

Respectfully,

Donnie Woodyard, Jr., NRP, WP-C, MAML

Executive Director

Interstate Commission for EMS Personnel Practice

On behalf of the Bylaws and Rules Committee

Enclosure: Proposed Bylaws Revision (Official Redline)

July 2026 Executive Committee Meeting Summary

Date: Wednesday, July 15, 2026 Time: 3:00 PM ET

Location: Virtual Meeting via Microsoft Teams

Attendance

Executive Committee Members Present:

• Chair Kraig Kinney, Indiana

• Vice Chair Wayne Denny, Idaho

• Secretary Mark Herrera, Utah

• Treasurer Brad Vande Lune, Iowa

• Member at Large Michael Johnson, Georgia

Absent:

• Immediate Past Chair Joe Schmider, Texas (excused – conflicting hearings)

Staff:

• Donnie Woodyard, Executive Director

• Christie Mellott, PWW, Counsel

A total of 37 participants attended, including Commissioners, state officials, partner organizations, and members of the public.

Call to Order

Chair Kinney called the meeting to order at 3:00 PM ET and conducted roll call on behalf of the Secretary, who was traveling. A quorum was confirmed with five Executive Committee members present. Immediate Past Chair Schmider was unable to attend due to conflicting hearings. Chair Kinney reviewed the meeting norms, including public participation procedures and the two-minute public comment period.

Public Comment

Chair Kinney opened the floor for comment on matters not on the agenda. Judson Bruno of ZPaper, accompanied by CTO Eric Stevens and the company’s medical director, presented on HealthScores.ai, a patient-controlled application supporting the CMS “Kill the Clipboard” initiative. The application consolidates patient medical information—medications, allergies, conditions, procedures, and emergency contacts—into a portable profile shareable with healthcare providers and EMS personnel via QR code and smart health link. ZPaper proposed a partnership with the EMS Compact to establish nationwide EMS credential verification using EMS ID, replacing its current state-based verification process and enabling verified EMS professionals to access additional patient-authorized information in the field.

Executive Director Woodyard noted that the administrative rules adopted in November 2025 created a category permitting qualified entities to use the National EMS Coordinated Database to validate EMS credentials, and that this request appears to align with that intended purpose, though the current software version does not yet support the capability. Secretary Herrera and Member at Large Johnson expressed support for further exploration. Chair Kinney directed the Executive Director to explore the opportunity and report back to the Chair and Vice Chair on how to proceed.

Approval of May 2026 Meeting Summary

The May 2026 Executive Committee meeting summary was presented for approval; the June 2026 meeting had been cancelled. Executive Director Woodyard reviewed the summary, which had been prepared in coordination with the Secretary and transmitted to the Treasurer. Member at Large Johnson moved to accept the summary as presented. Treasurer Vande Lune seconded the motion. With no objections or abstentions, the motion passed unanimously. The summary was approved for posting on the Commission website.

Treasurer’s Report

Treasurer Vande Lune presented the financial report. The previous balance was $117,338.58. Total debits for the month were $28,830.94, with no credits. The pending balance is $96,238.52. The report was accepted.

Chair’s Report

Chair Kinney commended Executive Director Woodyard for his extensive legislative outreach, which continues to drive the Compact’s growth, and highlighted the EMS Week campaign as one of the most innovative initiatives to date, with strong response nationwide. Chair Kinney welcomed Jody Ratliff, the new Commissioner from West Virginia, who introduced himself and recognized the contributions of his predecessor, David Weller. The Chair also noted the Executive Director’s continued national engagement with FEMA and the Department of Homeland Security.

Executive Director’s Report

Executive Director Woodyard provided updates on several key areas:

Legislative Updates:

Alaska and Arizona both enacted EMS Compact legislation, effective September 12 and September 20, 2026, respectively, with both states expected to be onboarded and fully participating by the end of September. Connecticut passed Compact legislation with a delayed implementation pending statutory trigger mechanisms. The Executive Director presented testimony last week at a joint House-Senate committee meeting in Montana, where a legislative sponsor is aligned and stakeholder support is strong; Montana is considered likely to be the next state to enact the Compact. New Mexico and Florida, where legislation passed the House but ran out of time in the Senate last session, are expected to reintroduce legislation in the coming session.

EMS Week Campaign:

With assistance from the National Registry, the Commission transmitted more than 400,000 unique emails, each including a certificate and a direct link to the recipient’s EMS Compact privilege information. The campaign was highly successful, generating thousands of direct responses and significantly increasing visibility of the Compact. A more automated process is planned for next year.

New Website:

The new Commission website is expected to launch within approximately two weeks. The site aligns with .gov accessibility and design requirements, features a robust privilege-to-practice verification tool that generates a timestamped secure PDF with a real-time map of authorized states, and provides tailored pathways for clinicians, medical directors, elected officials, and employers. Content is optimized so that AI platforms draw primary-source, validated information directly from the site. The National Registry is serving as technology partner for the launch.

Upcoming Travel:

The Executive Director will attend the National Conference of State Legislatures in Chicago next week, followed by a series of meetings with federal partners in Washington, D.C.

Agency Affiliation and Scope of Practice Analysis:

In response to a growing volume of inquiries about EMS personnel working in non-traditional settings—construction sites, industrial facilities, casinos, festivals, and disaster response organizations—the Executive Director completed a 50-state review of primary source law. The analysis documents that every state requires affiliation with an authorized agency or entity for EMS practice, and that 46 states additionally require physician medical direction. The Executive Director identified an opportunity, with 28 member states, to partner with NASEMSO or other organizations on a clarification white paper addressing what is required for practice under a state EMS license or Compact privilege to practice, what may be permitted under delegated practice, and what is not permitted. No formal action was requested; the item was presented for awareness and potential future collaborative work.

Recognition of Fallen Providers:

The Executive Director noted the wildfires burning across the nation, including in Colorado, where three wildland firefighters were killed and three critically injured, in addition to the recent loss of a wildland fire aviator. At least one of the fallen firefighters held a valid EMS Compact privilege to practice. Appreciation was extended on the record to those who practice every day and to those who have sacrificed their lives.

National EMS Coordinated Database Administrator Report

Ray Mollers provided the database update. Tennessee has not submitted updated data since last September, and work continues with the state. A data cleanup project is underway with Nebraska. Oklahoma and Pennsylvania remain pending database connectivity. The National Registry is standing by to connect the three newest states. Mr. Mollers announced his retirement effective October 22, 2026; the National Registry is interviewing three candidates for its partner and advocacy team, one or more of whom will assume support of the Compact. Chair Kinney thanked Mr. Mollers for his decades of service.

New Business

No new business was presented.

Stakeholder Updates

Dia Gainor of NASEMSO requested that, once the National EMS Coordinated Database analysis is finalized and approved by the Commission, a descriptive paragraph be provided, and invited the Executive Director to present to the NASEMSO Board of Directors, regional chairs, and the NASEMSO annual meeting in Anchorage during the week of April 11. The Executive Director welcomed the opportunity, noting that the database now covers every state, territory, and military outpost of the United States with at least one provider holding an EMS Compact privilege to practice, and that some non-compact states have more than 2,000 residents holding Compact privileges. Chair Kinney directed the Executive Director to move forward with the outreach.

Upcoming Meetings

The next Executive Committee meeting is scheduled for August 12, 2026; Chair Kinney noted he will likely be unavailable due to travel. The full Commission will meet on August 19, 2026, with additional information to follow.

Executive Session

Chair Kinney noted that an executive session had been certified by counsel as qualifying under applicable requirements. Vice Chair Denny moved to enter executive session with the Executive Director and counsel invited to attend. Treasurer Vande Lune seconded the motion. With no objections, the motion passed and the public meeting concluded.

Next Meeting: Executive Committee – August 12, 2026

The Commission and NASEMSO: Distinct Roles, Shared Purpose

Position Paper 2026-0X | DRAFT for Executive Committee review | October 2, 2026

PURPOSE

The Interstate Commission for EMS Personnel Practice and the National Association of State EMS Officials (NASEMSO) serve the same profession through different roles. This paper affirms the importance of that relationship, describes the distinct role of each organization, and states the Commission's commitment to collaboration.

The Commission is a governmental body. NASEMSO is a non-governmental professional association. Neither role is greater than the other, and neither organization can do the other's work. The EMS profession advances fastest when both are strong and working together.

A SHARED HISTORY

The EMS Compact exists because of NASEMSO. NASEMSO led the nationally funded project that convened the drafting team in 2013 and 2014, produced the model legislation released in June 2014, and supported states through enactment. The Commission is the governmental body that NASEMSO and its partner organizations designed.

The two organizations also share people. The Compact makes the responsible official of each State EMS Authority, or that official's designee, the state's delegate to the Commission. Many of those same officials are members and leaders of NASEMSO. The relationship is not between two separate communities. It is one community of state EMS officials working through two different institutions.

DISTINCT AND COMPLEMENTARY ROLES

Every licensed profession depends on two kinds of institutions: governmental bodies that carry legal authority, and non-governmental associations that carry the voice, expertise, and convening power of the profession.

The narrow scope of a governmental body is a constraint, not an advantage. An association can take up any issue its members consider important, in every state and territory. The Commission cannot. Many of the profession's most significant advances, including the Compact itself, began as the work of associations.

HOW COLLABORATION ADVANCES THE PROFESSION

The two roles are most effective when they are used together. An association can build consensus, develop national guidance, and advocate. A governmental commission can give interstate agreements the force of law and operate the systems that carry them out. Areas where the roles naturally align include:

• Education on the Compact. NASEMSO's network reaches every state and territory, including states considering enactment. The Commission can provide accurate legal and operational information.

• Support for state EMS officials. NASEMSO develops and connects state EMS leaders. The Commission supports those same leaders in their statutory role as Commissioners.

• National standards. Association-led consensus work informs the profession's standards. The Commission's rules and the Coordinated Database rely on consistent national standards to function.

• Workforce data. The National EMS Coordinated Database can inform the workforce and policy work that associations lead, within the limits of the Commission's data rules.

• Public protection. Both organizations share an interest in consistent licensure practices, including background checks and the reporting of discipline.

THE COMMISSION'S LEGAL STATUS

Collaboration depends on each organization being described accurately. The Commission's status is set by statute in each of the 28 Participating States:

• The Compact states “create and establish a joint public agency known as the Interstate Commission for EMS Personnel Practice” (Section 10(A)).

• The Commission is “a body politic and an instrumentality of the Compact states” (Section 10(A)(1)).

• Commission rules have the force and effect of law and are binding in all Participating States (Section 10(D)(1)).

• The Commission's only members are states, each acting through a state official (Section 10(B)(1)).

The Commission is therefore a governmental body. It is not a non-profit, a membership association, or a quasi-governmental entity. This is the same structure used by the interstate compact commissions for physicians, nurses, psychologists, and other licensed professions.

The legislative directive of the Commission is to:

1. Increase public access to EMS personnel;

2. Enhance the states' 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 an 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 member state; and

7. Invest all member states with the authority to hold EMS personnel accountable through the mutual recognition of member state licenses.

That authority is limited to the interstate practice of EMS personnel under the Compact. The Commission does not set any state's scope of practice or education requirements, does not regulate EMS agencies, and does not speak for the EMS profession as a whole. Stating the Commission's legal status is a statement of fact. It is not a statement of rank.

POSITION OF THE COMMISSION

1. The Commission values NASEMSO as the national association of state EMS officials and recognizes its foundational role in creating the EMS Compact.

2. Strong, independent non-governmental associations are essential to the EMS profession and do work the Commission cannot do.

3. The Commission is a governmental body: a joint public agency, body politic, and instrumentality of the states that have enacted the EMS Compact. Its official actions represent those states on matters within the Compact, and only on those matters.

4. Describing each organization's role accurately does not diminish either one. Clear roles make collaboration stronger.

5. The Commission will actively seek collaboration with NASEMSO and other national EMS organizations wherever roles align.

Disclaimer: Position papers produced by the Interstate Commission for EMS Personnel Practice document the official positions of the Commission. They are not administrative rules and are not legally binding regulations or mandates.

Position Paper 2026-XX | DRAFT FOR COMMISSION CONSIDERATION

A position paper is a formal document that outlines an organization's stance on a specific issue, supported by research and analysis, with the goal of influencing decision-making or advocating for policy changes. It serves to clarify and communicate the organization's viewpoint to stakeholders, policymakers, and the public, while often calling for specific actions or solutions to address the issue. Position papers are essential tools for driving discussions, informing stakeholders, and promoting thoughtful, data-driven decisions.

Executive Summary

The EMS Compact extends a Privilege to Practice to qualified EMS clinicians across all Participating States and jurisdictions. As Compact membership grows, an EMS clinician licensed in one Participating State may lawfully practice in jurisdictions located in time zones far removed from the Home State. For example, a paramedic licensed in Virginia may practice under the Privilege to Practice in Alaska. In the future, if all states and eligible territories enact the EMS Compact legislation, an EMS Clinician from Virginia could practice in jurisdictions such as Guam, where local time differs from the Home State capital by fourteen hours or more.

This reality raises a simple but consequential question: when a Home State license expires on a stated calendar date, at what moment in time, and in which time zone, does that expiration take effect? Because the Privilege to Practice ends immediately upon expiration of the Home State license, the answer determines the precise moment a clinician’s authority to practice ends in every Participating State simultaneously.

The position of the Commission is that a Home State license, and the Privilege to Practice derived from it, expires at the moment the Home State licensure system reports the license as expired. Absent other guidance from the Home State, a Home State license, and the Privilege to Practice derived from it, remains valid through 11:59:59 PM local time on the license expiration date, as local time is observed at the capital city of the issuing state or jurisdiction. Under this default standard, the moment of expiration is fixed by the issuing jurisdiction’s capital city clock and does not shift based on where the clinician is physically practicing.

1. Purpose

This position paper establishes a uniform, transparent interpretation of the moment at which an EMS license expires for purposes of the EMS Compact and the Privilege to Practice. Its purpose is to ensure clarity and predictability for EMS clinicians, employers, EMS agency medical directors, and State EMS Authorities, recognizing that a license issued in one time zone may support lawful practice in jurisdictions many time zones away. Above all, this paper ensures that EMS clinicians understand that practicing in a different time zone does not extend a license expiration beyond the date and time of the jurisdiction that issued the license.

2. Background and the Issue

State licensure systems record license expiration as a calendar date. They do not ordinarily specify a time of day or a controlling time zone, because a license used only within the issuing state presents no ambiguity. Interstate practice under the Compact changes this. Without a uniform interpretation, a clinician, employer, or State EMS Authority could reasonably reach different conclusions about whether a license, and therefore the Privilege to Practice, remains valid during the window of time created by time zone differences.

While this question may rarely arise in day-to-day operations, it is foreseeable, and the consequences of ambiguity fall on clinicians acting in good faith and on the officials responsible for verifying credentials. A shared, predictable standard protects clinicians, supports employers and medical directors in verifying credentials, and ensures the National EMS Coordinated Database reflects a single, consistent moment of expiration.

3. Position of the Commission

For purposes of the EMS Compact and the Privilege to Practice, the Commission adopts the following interpretation:

A Home State license, and the Privilege to Practice derived from it, expires at the moment the Home State licensure system reports the license as expired. Absent other guidance from the Home State, the license, and the Privilege to Practice derived from it, remains valid through 11:59:59 PM local time on the license expiration date, as local time is observed at the capital city of the issuing state or jurisdiction.

Under this default standard, a Virginia license is valid through 11:59:59 PM on its expiration date as observed in Richmond, Virginia. The moment of expiration is fixed by the issuing jurisdiction’s capital city clock and does not shift based on where the clinician is physically practicing.

Other guidance from the Home State includes any statute, regulation, or published policy of the issuing state or jurisdiction that establishes a different time or time zone standard for license expiration, as well as the actual reporting behavior of the Home State licensure system. Where such guidance exists, it controls for licenses issued by that state. This position paper supplies a default interpretation only where the Home State is silent.

Primary source licensure status. State licensure systems maintain their own software processes that change a license status from licensed to expired. The status recorded in the issuing state’s licensure system is the primary source and the single source of truth for licensure status, and it is reflected in the National EMS Coordinated Database consistent with the primary source equivalency provisions of the Commission’s Administrative Rules (Rule 11.1(B)). The standard described in this paper cannot be used to assert that a license remains valid after the primary source reports it as expired. Its purpose is to ensure that EMS clinicians understand that practicing in a different time zone does not extend the license expiration date beyond the date and time established by the jurisdiction that issued the license.

4. Rationale

• Home State control. The license is a creation of the issuing state. Anchoring expiration to the issuing jurisdiction’s own local time is consistent with the structure of the Compact, in which the Home State retains exclusive authority over the license itself.

• A single national moment of expiration. Fixing expiration to one clock produces one unambiguous moment at which the license and the Privilege to Practice end everywhere, rather than a rolling expiration that varies by the clinician’s location.

• The capital city resolves multi-time-zone states. Several states span two time zones. Anchoring to the capital city provides a single, objective reference point within every issuing jurisdiction.

• Local time resolves daylight saving variation. Because the standard follows the time actually observed at the capital city, jurisdictions that do not observe daylight saving time, such as Arizona, and those that do are treated identically and without special rules.

• Transparency and predictability. Clinicians, employers, medical directors, and State EMS Authorities can all determine the exact moment of expiration in advance, from public information, without individualized inquiry.

5. Practical Application

The examples below illustrate the default standard, which applies absent other guidance from the Home State.

Eastward-licensed clinician practicing west. A Virginia-licensed paramedic practicing in Alaska holds a license valid through 11:59:59 PM Eastern Time in Richmond on the expiration date. Because Alaska local time is four hours behind Richmond, that moment corresponds to 7:59:59 PM Alaska Time on the same calendar date. The clinician’s authority in Alaska ends at that moment, in the evening of the printed expiration date as observed locally, before the calendar date has ended in Alaska.

Westward-licensed clinician practicing east. An Alaska-licensed clinician practicing in Virginia holds a license valid through 11:59:59 PM Alaska Time in Juneau on the expiration date. That moment corresponds to the early morning hours of the following calendar day in Virginia. The clinician remains authorized in Virginia until that moment, even though the local Virginia calendar has already advanced past the printed expiration date.

6. Guidance

• EMS clinicians remain individually responsible for maintaining licensure, tracking expiration dates, and renewing before expiration, as reflected in the Privilege to Practice Code of Conduct. Clinicians should renew well in advance of the expiration date and should not rely on time zone differences to extend practice authority.

• Employers, EMS agencies, and medical directors verifying credentials near an expiration date should apply the capital city standard described in this paper and verify current status through the National EMS Coordinated Database at www.EMSCompact.gov using the clinician’s National EMS ID number.

• State EMS Authorities should note that the Coordinated Database reflects licensure status as submitted by the Participating State. Where a status question arises during the window created by time zone differences, the standard in this paper governs the interpretation of the expiration date for Compact purposes.

7. Frequently Asked Questions

Q: Does this position change when my license expires?

A: No. The expiration date of a license is established by the issuing Home State. This paper clarifies only the moment in time at which that expiration takes effect for interstate practice under the Compact.

Q: I am practicing in a time zone ahead of my Home State and my license expires today. When must I stop practicing?

A: Your authority ends at the moment your Home State licensure system reports the license as expired. Absent other guidance from your Home State, that moment is 11:59:59 PM as observed at the capital city of your Home State. Depending on where you are practicing, that moment may fall on a different local calendar date. Clinicians should plan renewals well in advance and should never schedule practice around the final hours of licensure.

Q: What if my Home State already specifies a time or time zone for license expiration?

A: The Home State’s guidance controls, whether established by statute, regulation, published policy, or the reporting behavior of the Home State licensure system. This position paper supplies a default interpretation only where the Home State is silent on the question.

State Sovereignty and Compact Compliance

This document provides a uniform interpretation for Compact purposes. States that have enacted the EMS Compact retain full sovereignty over their licensure systems, including the authority to establish, by statute or regulation, the effective time of license expiration for licenses they issue. Nothing in this paper modifies a state’s licensure laws or renewal requirements.

Disclaimer: Position papers produced by the Interstate Commission for EMS Personnel Practice are designed to document the official positions of the Commission. It is important to note that these position papers are not administrative rules. Instead, they are intended to provide perspectives and insights on various matters of policy. These documents are meant to guide and inform but should not be mistaken for legally binding regulations or mandates.

Resolution 2026-05 | National Collegiate EMS Week 2026

Recognizing November 9–15, 2026, as National Collegiate Emergency Medical Services Week

WHEREAS, emergency medical services are a vital public service; and

WHEREAS, the members of emergency medical services teams are ready to provide lifesaving care to those in need 24 hours a day, seven days a week; and

WHEREAS, access to quality emergency care dramatically improves the survival and recovery rate of those who experience sudden illness or injury; and

WHEREAS, the members of emergency medical services teams, whether career or volunteer, engage in thousands of hours of specialized training and continuing education to enhance their lifesaving skills; and

WHEREAS, the United States EMS Compact recognizes the importance of interstate practice for EMS clinicians, including those in collegiate programs who live, study, and serve across state lines, and the Privilege to Practice allows qualified clinicians licensed in one participating state to practice in the other participating states; and

WHEREAS, the National Collegiate Emergency Medical Services Foundation (NCEMSF) has proclaimed the week of November 9–15, 2026, as National Collegiate Emergency Medical Services Week; and

WHEREAS, it is appropriate to recognize the value and the accomplishments of collegiate emergency medical services organizations and their members;

NOW, THEREFORE, BE IT RESOLVED, that the Interstate Commission for EMS Personnel Practice hereby recognizes the week of November 9–15, 2026, as National Collegiate Emergency Medical Services Week; and

BE IT FURTHER RESOLVED, that the Commission commends the collegiate EMS clinicians and organizations across the nation whose service strengthens the EMS profession, enhances community safety, and fosters the next generation of EMS leaders; and

BE IT FINALLY RESOLVED, that the Commission encourages participating states and EMS agencies to join in recognizing and celebrating the contributions of collegiate EMS organizations, and the importance of interstate practice to the clinicians they train, during this week of national appreciation.

ADOPTED by the
Interstate Commission for EMS Personnel Practice
on this ____ day of October, 2026.