EMS Compact

How States Join the EMS Compact

Interstate Compacts are legislative and contractual agreements between states, districts (like the District of Columbia), and U.S. territories. Compacts serve as formal legal mechanisms for states to cooperate and collaborate on various issues to address shared concerns and achieve common goals. (One of the most common interstate compacts is the Driver's License Compact.) States must pass specific legislation to become a party to an Interstate Compact.

Joining the EMS Compact

States seeking to join the EMS Compact must take the following steps:

  1. Introduction and Enactment of REPLICA Legislation: The state legislature must introduce and enact the "Recognition of EMS Personnel Licensure Interstate Compact" (REPLICA) bill, which authorizes the state's participation in the EMS Compact.

  2. The REPLICA legislation must match the Uniform Model Legislation: Because interstate compacts also function as contractual agreements between participating states, each state seeking to join the compact must pass the model legislation. This uniformity ensures consistency in the legal framework and obligations between all member states.

By adhering to these steps, states ensure that their participation in the EMS Compact is based on a standardized legal foundation, promoting uniformity and cooperation among all members.

Three key terms central to understanding the EMS Compact are:

  • Member State - a state that has passed and enacted the EMS Compact legislation.
  • Home State - a member state where an individual EMS provider is licensed to practice emergency medical services as an EMT, Paramedic, or at a state-designated level between an EMT and Paramedic (example: Advanced-EMT, EMT-Intermediate).
  • Remote State - an EMS Compact member state in which an individual is not licensed

EMS Compact Member State Requirements

  • Utilize the National Registry (NREMT) examination at the EMT and Paramedic levels for initial state licensure
  • Utilize an FBI-compliant background check with biometric data (e.g., fingerprints) within 5 years of Compact activation. (States must require FBI background checks for EMS personnel implemented before March 15, 2025.)
  • Have a process to receive, investigate, and resolve complaints and share information with other Compact states via the National EMS Coordinated Database (NEMSCD).
  • Enact the model REPLICA legislation.

Member State Benefits

  • A Member State gains authority over EMS personnel from other compact states when practicing in the Member State.
  • A Member State joins other compact states in the governmental “Commission” to promulgate universal rules governing the cross-border, interstate practice of EMS personnel.
  • Member States gain access to the National EMS Coordinated Database (NEMSCD), which enables
    immediate notification of significant investigatory information and adverse action against EMS personnel licensed in the Member State and for EMS personnel practicing in other states.
  • Member States maintain exclusive authority over the license issued by their State EMS Office/Authority, including the ability to take disciplinary action against any licenses issued by that state per their state law and regulations.
  • Member States gain the authority and legal framework to investigate complaints against EMS personnel from other compact states when practicing in the Member State, combined with the authority to suspend an EMS Provider's Privilege to Practice.