My April 2015 Firehouse column centered on a new initiative called REPLICA (Recognition of EMS Personnel Licensure Interstate CompAct), which seeks to resolve issues related to using a paramedic license in different states. At the time, if I had a paramedic license in one state, I was not allowed to use the license in another state unless I applied for a license in that state and then went through that state’s application process. Imagine if I had to do this with my driver’s license. I would not be allowed to drive a car outside of Illinois, where I live, without applying to another state, and then go through their application process before I would be allowed to drive in that state.
This problem was exacerbated at the federal level within the Department of Homeland Security (DHS). DHS has more than 5,000 personnel who have EMT or paramedic licenses in various areas, including the Coast Guard, Customs and Border Protection, Secret Service, FEMA and other agencies. Imagine if a Border Patrol agent who was also a paramedic and was stationed and licensed in Arizona was transferred into an area in New Mexico. The paramedic license was not valid unless the Border agent applied to the New Mexico State EMS agency for a paramedic license.
Finding a solution
To resolve these quandaries, DHS turned to the National Association of State EMS Officials (NASEMSO). NASEMSO saw not only an opportunity to find a solution for DHS employees, but also for military personnel bridging into civilian life, and public and private EMS providers. The eventual solution was to create an interstate compact for the licensure issue.
Working with the Council of State Governments National Center for Interstate Compacts, NASEMSO formed a national advisory panel representing 23 different EMS organizations. That group was directed to establish a framework and put together a drafting team. The drafting team then took the framework, worked through the details and challenges, and after several reviews and edits, REPLICA was created.
REPLICA basics
REPLICA is not a form of EMS licensure reciprocity. REPLICA basically extends a privilege for EMS providers from participating states to practice on a short-term, intermittent basis under approved circumstances. This could apply to agencies that operate along the border of another state and get dispatched to a call and the call is actually in the neighboring state. Other circumstances include staffing for large-scale responses that are not at the level of a governor’s disaster declaration, agencies that are sent to other states to assist wildland firefighting teams, or other large events, such as a Papal visit, which could draw huge crowds. Other examples include routine transfers that originate in one state and end in another.
In essence, the compact allows paramedics and EMTs from one member state to treat patients in another member state without having to be licensed in the other state. There are quite a few requirements in place to which states must adhere, and there are built-in checks and balances for states to maintain control over EMS operations within their state.
REPLICA does not allow an EMT or paramedic who has had action taken against their license by one state to hop to another state and continue to function as a provider. The home state maintains the exclusive authority to suspend, revoke and restrict an EMS personnel license. If a home state takes action on an EMS personnel license, all other compact member states are informed and can act on that EMS provider’s privilege to practice.
Big news
REPLICA needed 10 states to adopt the legislation for it to become official, and on May 8, 2017, that’s exactly what happened when the governor of Georgia signed Senate Bill 109 into law. Other states include Colorado, Texas, Idaho, Virginia, Mississippi, Kansas, Tennessee, Utah, and Wyoming.
As the EMS profession continues to evolve, the implementation of REPLICA is just one more step of the evolutionary process of a profession. For more detailed information on REPLICA, visit nasemso.org/Projects/InterstateCompacts/index.asp.
Gary Ludwig
GARY LUDWIG has served in three fire departments over his career: St. Louis, Memphis, and Champaign, IL. His fire, EMS and rescue career spanned a total of 46 years, and he has been a paramedic for over 44 years. Ludwig served as president of the International Association of Fire Chiefs in 2019-20. He has a Master’s degree in Business and Management, has written over 500 articles for professional fire and EMS publications and is the author of seven books.
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