Three Additional States Enact the U.S. EMS Compact Legislation
Three States Enact EMS Compact Legislation, Bringing the Compact to 28 Participating States
Connecticut Becomes the 26th Participating State; Arizona the 27th; Alaska the 28th — with Arizona Next in Line for Full Operationalization
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WASHINGTON, DC. (1 JUNE 2026) — The United States EMS Compact today announced that three additional states — Connecticut, Arizona, and Alaska — have passed the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact legislation. The actions will bring the total number of EMS Compact Participating States to 28 and reflect the broadening national consensus that licensed EMS professionals should be able to function as EMTs and Paramedics where they are needed most, without unnecessary licensing barriers.
Enactment is the essential first step toward full Compact participation. Each state must also complete administrative implementation, including appointing a Commissioner and connecting its EMS personnel licensure system to the National EMS Coordinated Database, before the Privilege to Practice becomes active for its clinicians. A separate announcement will be issued when each state reaches full operationalization.
Connecticut, the 26th State — with a Regional Activation Strategy
Governor Ned Lamont signed HB 5514 (Public Act 26-13) into law, which included the EMS Compact in a broader omnibus public health bill. The legislation was a policy priority of the Governor and was strongly supported by the Connecticut EMS community. The bill passed the House 142 to 4 on April 28, 2026, and the Senate 35 to 0 on May 1, 2026.
Connecticut’s law includes a deliberate conditional activation provision. The EMS Compact takes effect in Connecticut, and the Privilege to Practice becomes valid one year after a bordering state also enacts the EMS Compact law. This approach reflects a proactive regional strategy designed to accelerate Compact adoption across New England and create a connected multistate EMS workforce throughout the Northeast Corridor. The Commission views this model as an innovative example of how states can use Compact adoption to accelerate regional collaboration.
Connecticut’s EMS system is administered by the Department of Public Health, Office of Emergency Medical Services. It serves a densely populated Northeast Corridor state with strong regional partnerships and a long tradition of public health coordination. These characteristics make Connecticut a natural anchor for a broader New England Compact network.
Arizona: 27th State to Enact — Next in Line for Operationalization
Governor Katie Hobbs signed SB 1235 (57th Legislature, Second Regular Session) into law on May 22, 2026, making Arizona the 27th state to enact the EMS Compact. The legislation passed the Arizona House 45 to 10 and the Senate 27 to 3.
Arizona is actively completing the administrative steps required to bring the EMS Compact into full operation. Once a Compact Commissioner is appointed and Arizona’s licensure system is connected to the National EMS Coordinated Database, the Privilege to Practice will be recognized and a separate announcement will follow. The Commission anticipates Arizona will be the next state to reach full operationalization.
Arizona’s EMS system, administered by the Arizona Department of Health Services Bureau of EMS and Trauma System, serves a complex landscape: dense urban centers, expansive rural communities, and tribal lands. The state operates one of the busiest aeromedical transport networks in the country. Compact participation will expand the qualified workforce available to serve all of those communities.
The Commission acknowledges Senator John Kavanagh for sponsoring SB 1235 and Representative Selina Bliss for her leadership on the companion House legislation.
Alaska: 28th State to Enact — Effective January 1, 2027
The Alaska Legislature passed HB 110, an omnibus healthcare licensing compact bill that includes five healthcare licensure compacts, including the EMS Compact. The bill is anticipated to be signed by Governor Mike Dunleavy shortly. The legislation passed the House 39 to 0 on concurrence and the Senate 13 to 7. Alaska’s statutory participation takes effect January 1, 2027.
Alaska’s EMS system presents a unique operational picture. Administered by the Alaska Department of Health, Division of Public Health, Section of Rural and Community Health Systems, the state combines urban systems with some of the most challenging rural and frontier EMS operations in the nation. Aeromedical transport and tribal health partners are essential infrastructure. The EMS Compact will support Alaska’s workforce mobility into and across this system at a time when rural EMS capacity is a national priority.
The Commission will work with Alaska through the months ahead of the January 1, 2027 statutory effective date to support full implementation readiness.
What This Means for the Compact Network
With these three new additions, 28 states have now passed EMS Compact legislation. The Compact serves more than 450,000 EMS clinicians across the country. Each new state that joins expands the network, reduces administrative burden on the mobile workforce, and strengthens emergency response capacity in communities that rely on EMS professionals who live, work, and move across state borders.
As Arizona completes its administrative implementation and Alaska approaches its January 1, 2027 effective date, the Commission will continue to support each state’s transition and will issue formal operationalization announcements as milestones are reached.
“EMS professionals deserve a licensure system that keeps pace with how they live and serve. Connecticut’s forward-thinking regional strategy, Arizona’s enactment, and Alaska’s advancing legislation each reflect something important: state leaders understand that workforce mobility and public safety are not competing priorities. They go hand in hand.”
— Donnie Woodyard Jr., MAML, NRP, WP-C, Executive Director, Interstate Commission for EMS Personnel Practice
About the Interstate Commission for EMS Personnel Practice
The Interstate Commission for EMS Personnel Practice is the governmental body established under the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact (REPLICA) to administer and enforce the Compact across Participating States. The Commission is committed to protecting the public while advancing a mobile, qualified EMS workforce nationwide. For more information, visit www.emscompact.gov.
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