Quick take: One multi-state EMS license pitched

EMS officials are hoping to eliminate state regulatory borders with a proposed law allowing them to honor other licenses


The National Association of State Emergency Medical Services Officials is working to pass a law that would allow EMTs and paramedics to acquire one license recognized by multiple states that join a compact. The draft legislation was distributed to state EMS directors around the country in October.

Executive Director Dia Gainor said at EMS World that it started as part of a Department of Homeland Security initiative to make sure federal employees working in multiple states were operating legally, and the benefits became obvious for EMS, especially for air medical services, and agencies that serve a multi-state footprint.

Ten states have to adopt the legislation and join the compact to activate it. EMS providers that join the compact then gain immediate recognition in those states.

Memorable Quote

"The state line essentially becomes invisible."

Key takeaways

States must:

  • Require initial licensing through the NREMT exam.
  • Require a criminal history check that includes fingerprinting.
  • Have a process for receiving and investigating complaints.
  • Notify the compact of any adverse actions or investigation of an EMT or paramedic.

Individuals must:

  • Be at least 18 years old.
  • Have a current unrestricted license in a member state.
  • Practices under the supervision of a medical director in his or her home state.

Joining the compact eliminates the headache and expense of holding multiple state licenses, creates a clear ability to manage personnel, and creates a uniformity of rules for multiple states, Gainor said.

In the case of an adverse event, such as misconduct, the EMS provider's home state is the only state that can suspend an EMS provider's license. If the adverse event occurs in a member state, that state can strip providers of the privilege to practice, which also extends to those in the compact. The provider can, however, practice in states outside the compact. 

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