What is the EMS Compact?

The EMS Compact facilitates the day-to-day movement of EMS personnel across state boundaries in the performance of their duties. EMS personnel, including EMTs and Paramedics, licensed in a compact member state are granted a Privilege to Practice in the other compact member states. The EMS Compact is a legal agreement between states, enacted by state legislation in over 20 states. A Member State is a state that has passed the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact (REPLICA) legislation.  

The EMS Compact:

  • increases access to patient care
  • protects the public
  • reduces administrative burden for EMS personnel and states
  • enhances the Emergency Medical Services system in the United States.

Components of the EMS Compact


EMS Compact States

Member states agree to standardized requirements for EMS personnel licensure, including:
  • Require FBI background checks when applying for an initial state EMS license
  • Require National EMS Certification (NREMT) for an initial state EMS license
  • Collaborate on investigations involving EMS personnel

Overview of the EMS Compact

Background Information

Since the early 1970’s, state EMS offices have been issuing licenses to prehospital care personnel. As a means of regulating the practice and protecting the public, EMS personnel licensure is as necessary and important as that of physicians, nurses and members of allied health care professions. The profession continues its evolution and the role of EMS personnel has seen significant growth. Today regional systems of response with multi-state footprints, staffing for large scale responses that are not at the level of a governor’s declaration of disaster, and planned special events (concerts, sporting events) are common. This multi-state need has refocused the discussion how to formally recognize an EMS providers ability to practice in multiple states without having to carry multiple licenses.

The Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA) is the collective solution to cross border-licensing issues that have been managed by state EMS Offices in various ad hoc manners for years. With the implementation of an Interstate Compact, EMS will join the ranks of other professionals such as physicians, nurses and emergency managers. The Emergency Management Compact (EMAC) is a well-known example with which EMS personnel are familiar. Compacts create agreements between states outside of the federal government, allowing for states to preserve “home rule” and flexibility in the management of these entities. The United States Constitution, grants the right for the states to enter into multistate agreements for a common benefit. Every state in the nation has joined a minimum of five compacts as a means of addressing issues they share that are in need of a common solution.

According to the National Center for Interstate Compacts (NCIC) at the Council on State Governments (CSG), over 200 compacts exist in our nation today. The National Council of the State Board’s of Nursing is home to the Nursing Licensure Compact (NLC) and Federation of State Medical Boards home the physicians Interstate Medical Licensure Compact.

  • Emergency Management Assistance Compact
  • Nurse Licensure Compact
  • Interstate Medical Licensure Compact
  • Drivers License Compact