Position Paper on Criminal Convictions and EMS Licensure Adopted

Interstate Commission Unanimously Adopts Position Paper 2026-01,
Establishing a National Framework for Criminal Convictions and EMS Licensure Decisions

Download a PDF of this Position Paper

WASHINGTON (17 FEB 2026)— The Interstate Commission for EMS Personnel Practice, representing 25 member states, today announced the unanimous adoption of Position Paper 2026-01: Criminal Convictions and Licensure of EMS Personnel at the Commission’s Q1 2026 meeting. The position paper is the first document of its kind in the 50-year history of modern Emergency Medical Services, providing a comprehensive, evidence-based framework for how states evaluate criminal history when making EMS licensure decisions.

The position paper was developed through a rigorous process that included public comment, a survey of all member state practices, and careful consideration of established legal precedents, criminological research on recidivism and rehabilitation, and the constitutional sovereignty of each state. The result is a monumental achievement—a balanced framework that protects the public while recognizing the potential for individual rehabilitation, and that provides powerful guidance for state EMS officials across the country.

“When someone calls 911, they place their life in the hands of a stranger,” said Donnie Woodyard, Executive Director of the Interstate Commission for EMS Personnel Practice. “This position paper ensures that every state has access to a clear, research-based, and legally defensible guide for evaluating criminal history—balancing the public’s expectation of safety with fairness for individuals who have demonstrated genuine rehabilitation. This will be a powerful guide for state EMS officials as they review criminal history information and make determinations related to EMS licensure.”

Position Paper 2026-01 builds on the Commission’s prior Position Paper 2023-01: Biometric Criminal History Checks for EMS Personnel, which called on all states to perform an FBI-compliant biometric criminal history check on all EMS personnel prior to licensure. That requirement reflects the minimum expectation of the public and is now required by law in all 25 EMS Compact member states. With the foundation of universal background checks in place, this new position paper provides the essential next step: a comprehensive framework for how states should evaluate the criminal history information those checks reveal.

Transparency was key to the development of both position papers. The Commission invited and considered public comment throughout the process, ensuring that the perspectives of state officials, EMS professionals, and the public informed the final product. This open, collaborative approach directly fulfills one of the seven legislative mandates of the EMS Compact: to “encourage the cooperation of member states in the areas of EMS personnel licensure and regulation.”

A Landmark for Public Protection

The position paper establishes a four-tier framework that categorizes criminal convictions based on their severity and relationship to patient safety. The framework provides state EMS licensing officials with clear, actionable guidance for making determinations related to EMS licensure—from permanent disqualifiers for the most serious offenses to discretionary review pathways that recognize rehabilitation. It includes detailed example scenarios, procedural safeguards, applicant rights, and recommendations for public accountability and reporting.

Critically, the framework carefully recognizes the individual sovereignty of each state. While it establishes a best-practice standard for public protection, it preserves every state’s independent constitutional authority to determine who may hold an EMS license within its jurisdiction. States may voluntarily adopt, adapt, or exceed the recommendations based on their own statutory frameworks and policy priorities.

Respecting State Sovereignty While Strengthening National Standards

Achieving unanimous adoption across 25 states with diverse legal traditions, political landscapes, and regulatory approaches required extraordinary collaboration and compromise. The Commission navigated the complex task of establishing meaningful national best practices without infringing on the authority that each state retains under the Tenth Amendment to the U.S. Constitution. The position paper reinforces that licensure is created and governed by state law, and that Compact participation is a voluntary contract between sovereign states.

50 Years in the Making

Since the advent of modern EMS in the 1970s, no national body has produced a comprehensive, consensus-driven framework for evaluating criminal history in EMS licensure. States have operated with widely varying standards—some with detailed statutory disqualifiers, others with broad discretionary authority, and many with limited or no formal guidance. The Commission’s survey of member states revealed significant disparities: only 52% had mandatory disqualifiers, look-back periods ranged from 5 years to lifetime, and just 35% used continuous criminal record monitoring.

This position paper addresses those gaps by providing a model that balances public protection with public expectation—ensuring that EMS patients can trust that the clinician who responds to their emergency has been thoroughly evaluated, properly licensed, and held accountable to transparent standards.

About the Position Paper

Position papers produced by the Interstate Commission for EMS Personnel Practice document the official positions of the Commission. While position papers are not binding administrative rules or regulations, they represent the official consensus position of the Commission and its 25 member states. They are intended to guide and inform state policymakers, licensing officials, EMS professionals, and the public on matters of policy and best practice.

About the EMS Compact
The Interstate Commission for EMS Personnel Practice is a governmental body established by the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact (REPLICA). The EMS Compact facilitates the interstate practice of EMS personnel while strengthening public protection through coordinated data sharing, real-time notification of disciplinary actions, and cooperative investigations. The Compact currently includes 25 member states, whose legislatures enacted the legislation with overwhelming bipartisan support—3,250 total “YES” votes against 61 “NO” votes, representing 98% legislative approval. For more information, visit www.EMSCompact.gov.

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