Recognition of EMS Personnel Licensure Interstate CompAct “REPLICA”

Q: What is REPLICA?

A: REPLICA is an interstate compact that recognizes the day-to-day movement of EMS personnel across state lines.  REPLICA extends a privilege to practice under authorized circumstances to EMS personnel based on their home state license as well as allows for the rapid exchange of licensure history between Compact member states..

Q: What is a compact?

A: A compact is an agreement between two or more states that act jointly to solve issues presented by state lines/boundaries. States maintain their sovereignty, act in a unified manner , and as a result avoid unnecessary federal intervention. There are over 200 interstate compacts active today, including the Driver License Compact, Emergency Management Assistance Compact (EMAC), and Nurse Licensure Compact (NLC). An update map of compact memberships is available from the National Center for Interstate Compacts (NCIC)

Q: Why is REPLICA needed?

A:  As the EMS profession has evolved, so too have the capabilities of EMS personnel. This includes the need to respond across state lines in both day-to-day duties as well as in large-scale events that do not rise to the level of a Governors declaration of a disaster. (staffing concerts and races or federal agencies dispatching contracted provider to support details). This has generated a renewed discussion on the importance of establishing a universal mechanism to assure a legal, practical, and consistent pathway for EMS providers to have privileges to practice extended across state lines.  REPLICA also provides a mechanism for states to access and rapidly share EMS personnel licensure information, and thus achieves a new level of accountability within the EMS profession.

Q: Who does REPLICA apply to?

A:  REPLICA applies to individual EMS personnel, 18 years of age, with an unrestricted license in a member state as an EMT, AEMT or, Paramedic whose license was issued following the successful completion of a National Registry of EMT exam. The EMS personnel must practice under the supervision of a medical director.  Members of the military separating from active duty and their spouses would be eligible for an expedited pathway to licensure in REPLICA states.  This includes the National Guard and Reserves.

Q: How does a state join REPLICA?

A: To participate in REPLICA, each state must pass and enact model legislation with no material changes.  States must  utilize the NREMT exams at the EMT and Paramedic levels.  Additionally, REPLICA requires that within 5 years of the date the 10th state enacts REPLICA, each participating state EMS office must utilize an FBI compliant criminal background check based upon biometric data (e.g. fingerprints)

Q: Why an FBI Background Check with Biometric Data?

A: Holding EMS personnel to the highest standards to protect the public and their coworkers is a priority for REPLICA.  EMS providers have unparalleled access to patients and personal property. Biometric identification uses unique data, such as fingerprints, to provide identification that excludes an individual’s name and demographics.

Q: Is REPLICA the same as Reciprocity?

A: No.  EMS personnel must obtain and maintain a license in their home state of practice.  REPLICA extends privileges to practice under authorized circumstances to EMS personnel based on their home license.  To remain active under REPLICA, EMS personnel must follow their home state rules for recertification and perform under supervision of medical director.

Q: How will REPLICA be administered?

A: After the 10th state passes the model REPLICA legislation and the Governor signs the bill into law, the Compact will become operational and a Commission will be established. The United States Constitution allows for and recognizes this  “joint public agency”  as means by which states can jointly address common problems in need of a solution. The Commission will create bylaws, promulgate rules, and develop policies and procedures of which the scope is narrowed to Compact related.  This rule writing does not interfere with other state EMS laws and rules.  Each REPLICA state will have one representative and one vote on the Commission.   All meetings, materials and proceedings are public.  Each state that passes RELPLICA after the first ten will all have a seat on the Commission and participate readily in all proceedings.

Q: Does REPLICA replace or supersede state EMS laws and rules?

A:  No.  REPLICA is an agreement between member states that formally recognizes and extends a practice privileges to EMS providers from other Compact states. These privileges are based on the home state EMS license and under authorized circumstances.  REPLICA does not create an alternative pathway for licensure nor change a states existing EMS statute or rules.  Compacts promote the laws and rules of member states and enable them to collectively act as one.

Q. What will happen if an EMS Provider has action taken against their license?

A: Action taken against an EMS personnel license by any member state is subject to action by all member states.  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 workers privilege to practice.  If a remote state has a concern regarding a licensed EMS workers practice, they have the ability to take action that may restrict those privileges.  All member states will be notified.  The Compact also addresses EMS personnel that are participating in an alternative program dealing with substance abuse issues.

Q: Under what Scope of Practice do providers perform while providing care in another Compact member state?

A: An individual providing patient care in a remote does so within the scope of practice authorized by the home state unless modified by an appropriate authority in the remote state. The rules for such changes will be  defined in the rules to be promulgated by the Compact Commission.