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 National Advisory Panel 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 National Advisory Panel consisted of 23 individuals, each representing a stakeholder organization. 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 National Advisory Panel guidance and within a structured, time-tested process. The Drafting Team consisted of: The Drafting Team developed the EMS Compact's language and model legislation that was approved and released for consideration in June 2014. Key considerations from the Drafting Team for the EMS Compact included:
  • 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

Activation of the EMS Compact required the legislation to be enacted by ten state legislatures. An Advocate was hired by NASEMSO to educate stakeholders and support the development of strategies for the REPLICA legislation to be introduced, passed and signed by the Governor of each state.

Phase Four – Transition to Commission

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

October 7, 2017, The inaugural Commissioners for the first meeting of the Interstate Commission for EMS Personnel Practice. Front (L-R): Jeanne-Marie Bakehouse (Colorado), Donna G. Tidwell (Tennessee), Alisa Williams (Mississippi), Joe Schmider (Texas). Back Row (L-R): Wayne Denny (Idaho), Guy Dansie (Utah), Diane McGinnis Hainsworth (Delaware), Stephen Wilson (Alabama),  Andy Gienapp (Wyoming), Joe House (Kansas), Gary Brown (Virginia). Not pictured: Keith Wages (Georgia)


Compact Activation

At the regular meeting of the Interstate Commission for EMS Personnel Practice on Tuesday March 10, 2020, the EMS Compact Commission officially activated the EMS Compact. Although the National EMS Coordinated Database was not yet operational, the Commission recognized the public benefit for EMS Compact as EMS personnel were responding to the COVID-19 pandemic.