Recognizing EMS Personnel Across State Lines

CHICAGO—Paul Patrick, the deputy division director of the Utah Department of Health, is eager to begin the enactment of an agreement that would recognize emergency medical services personnel from state to state.

“This is probably the greatest step forward for state EMS offices,” said Patrick. “It will bring EMS on par with other health care professions in recognition of the training and experience of its personnel.”

Several other groups, including nurses, already operate under licensure compacts that allow members to work across state lines. Sandra Evans, administration chair of the Nursing Licensure Compact, discussed the nursing compact, which was enacted in 1998.

But the EMS compact—known as Recognition of EMS Personnel Licensure Interstate Compact, or REPLICA—has a long way to go. That’s according to Rick Masters, who advises The Council of State Governments’ National Center for Interstate Compacts. He spoke about the compact at a June 10 briefing that included representatives from 27 states and Guam.

“The next set of challenges facing this compact include the need to provide timely and accurate information to legislators and staff and to review the final draft of the compact,” said Masters. “We want to make sure any remaining concerns with the draft raised in our meeting are appropriately resolved.”

When Dia Gainor became executive director of the National Association of State EMS Officials in 2012, she was looking for a solution to resolve issues facing members of her organizations.

“The leadership of (the National Association of State EMS Officials) was compelled to pursue a solution for a list of issues that keep our state officials up at night,” said Gainor.

One of the persistent problems is the lack of legal protection for emergency personnel that cross state borders on a short-term basis. Gainor said holding multiple licenses or practicing without a license are not feasible options.

“While looking at how compacts have solved this for other situations, this was the obvious solution,” she said.

So Gainor contacted CSG’s National Center for Interstate Compacts to begin discussion of a compact addressing EMS licensing. Representatives of the National Association of State EMS Officials attended the June briefing.

The intended purpose of REPLICA is to provide properly licensed individuals the legal privilege to practice in any member state in specific circumstances, such as during emergencies like forest fires and when directed by appropriate authorities.

“First and foremost, the goal is to protect patients,” said Gainor. “The way that the public gets protected is to have everyone meet and exceed a level of certification before they interact with patients.”

Ultimately, REPLICA is aimed to solve problems associated with day-to-day emergency deployment of emergency medical personnel across state borders.

The early phases of compact development included participation from 27 organizations with expertise in emergency services and EMS licensure.

Masters explained the role of compacts at the meeting this way: “Interstate compacts allow states to collectively exercise their sovereignty and uniformly regulate interstate matters without the need for federal intervention,” he said.

Gainor sees it this way with regard to her organization: “Every state playing by the same rules.”

Those in attendance at the compact briefing reviewed the proposed language prepared by the drafting panel for the compact and discussed next steps. The draft legislation should be ready for review by state legislatures in 2015.

The draft legislation includes language about the circumstances when REPLICA is applicable and situations that require state investigation. To participate, states must use the National Registry of Emergency Medical Technicians examination in the process of issuing initial licenses, require criminal background checks and have a mechanism for receiving and investigating complaints about individuals.

Individuals must be at least 18, possess a current unrestricted license from a participating state and practice under the supervision of a medical director to be covered under the compact.

Ten states must pass the legislation for the compact to be enacted.


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