Participating States
Every state's current status in the United States EMS Compact, with the Privilege to Practice recognized across 27 operational states.
The Compact has been enacted in 28 states and is operational in 27, and 1 more has enacted it but is not yet operational.
The map below shows every state's current status in the United States EMS Compact. Select a state to jump to its detail, or use the table for a plain-text view. The Privilege to Practice is recognized in states where the Compact is in force: those that are participating and those that have enacted it and are implementing. A state that has enacted the Compact with a future effective date is not yet in force, so the Privilege to Practice is not yet valid there.
Hover over a state for details, or select it to open its page.
States by Status
Participating
Enacted and fully implemented. The Compact is in force and the Privilege to Practice is recognized here.
- Alabama Enacted 2017
- Alaska Enacted 2026
- Arizona Enacted 2026
- Arkansas Enacted 2025
- Colorado Enacted 2015
- Delaware Enacted 2017
- Georgia Enacted 2017
- Idaho Enacted 2016
- Indiana Enacted 2020
- Iowa Enacted 2019
- Kansas Enacted 2016
- Louisiana Enacted 2020
- Mississippi Enacted 2017
- Missouri Enacted 2018
- Nebraska Enacted 2018
- Nevada Enacted 2023
- North Dakota Enacted 2019
- South Carolina Enacted 2018
- South Dakota Enacted 2021
- Tennessee Enacted 2016
- Texas Enacted 2015
- Utah Enacted 2016
- Virginia Enacted 2016
- West Virginia Enacted 2020
- Wyoming Enacted 2017
Enacted, implementing
Enacted and in force, with database integration underway. The Privilege to Practice is recognized here.
- Oklahoma 23rd state to enact; effective November 1, 2023; not yet submitting data to NEMSCD
- Pennsylvania 22nd state to enact; SB 861 (P.L. 477, No. 45); not yet submitting data to NEMSCD
Enacted, not yet operational
Enacted but not yet operational. The Compact is not yet active here, so the Privilege to Practice is not yet recognized in this state.
Not yet
Not yet participating in the EMS Compact.
- California
- Florida
- Hawaii
- Illinois
- Kentucky
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Montana
- New Hampshire enacted REPLICA then REPEALED it; excluded from the participating-state count (see ORDINAL note in header)
- New Jersey
- New Mexico
- New York
- North Carolina
- Ohio
- Oregon
- Rhode Island
- Vermont
- Washington
- Wisconsin
Show all states as a table
| State | Status | Enacted |
|---|---|---|
| Alabama | Participating | 2017 |
| Alaska | Participating | 2026 |
| Arizona | Participating | 2026 |
| Arkansas | Participating | 2025 |
| Colorado | Participating | 2015 |
| Delaware | Participating | 2017 |
| Georgia | Participating | 2017 |
| Idaho | Participating | 2016 |
| Indiana | Participating | 2020 |
| Iowa | Participating | 2019 |
| Kansas | Participating | 2016 |
| Louisiana | Participating | 2020 |
| Mississippi | Participating | 2017 |
| Missouri | Participating | 2018 |
| Nebraska | Participating | 2018 |
| Nevada | Participating | 2023 |
| North Dakota | Participating | 2019 |
| South Carolina | Participating | 2018 |
| South Dakota | Participating | 2021 |
| Tennessee | Participating | 2016 |
| Texas | Participating | 2015 |
| Utah | Participating | 2016 |
| Virginia | Participating | 2016 |
| West Virginia | Participating | 2020 |
| Wyoming | Participating | 2017 |
| Oklahoma | Enacted, implementing | 2023 |
| Pennsylvania | Enacted, implementing | 2022 |
| Connecticut | Enacted, not yet operational | 2026 |
| California | Not yet | – |
| Florida | Not yet | – |
| Hawaii | Not yet | – |
| Illinois | Not yet | – |
| Kentucky | Not yet | – |
| Maine | Not yet | – |
| Maryland | Not yet | – |
| Massachusetts | Not yet | – |
| Michigan | Not yet | – |
| Minnesota | Not yet | – |
| Montana | Not yet | – |
| New Hampshire | Not yet | – |
| New Jersey | Not yet | – |
| New Mexico | Not yet | – |
| New York | Not yet | – |
| North Carolina | Not yet | – |
| Ohio | Not yet | – |
| Oregon | Not yet | – |
| Rhode Island | Not yet | – |
| Vermont | Not yet | – |
| Washington | Not yet | – |
| Wisconsin | Not yet | – |
Is your state not yet participating? Learn how states join the EMS Compact, or review the legislative resources for elected officials and their staff.