The United States EMS Compact, officially the Recognition of EMS Personnel Licensure Interstate Compact (REPLICA), is an interstate compact that enables day-to-day practice by licensed emergency medical services personnel across member state lines by recognizing a privilege to practice. The compact was formalized on October 11, 2017, when Georgia became the tenth state to enact the REPLICA model legislation, establishing the Interstate Commission for EMS Personnel Practice.
As of October 2025, 25 states have enacted the compact.
The compact is grounded in Article I, Section 10, Clause 3 of the United States Constitution, known as the Compact Clause, which authorizes states to enter into agreements with other states with Congressional consent. In Virginia v. Tennessee (1893), the Supreme Court held that not all interstate compacts require explicit Congressional approval.
Interstate compacts are enacted as state law in each participating jurisdiction. The legal mechanism for the privilege to practice is established in Section 4(A) of the REPLICA model legislation.
The compact establishes the Interstate Commission for EMS Personnel Practice, a multistate governmental entity composed of one gubernatorial appointee from each member state. The commission administers and enforces the compact's provisions, including rulemaking authority as provided by the compact and member state law.
The commission is recognized in federal interagency documents as playing a role in coordinating EMS workforce policy across state lines.
Each member state's governor appoints one commissioner to represent the state, typically the senior executive branch official overseeing emergency medical services. Every state has equal representation with one vote per state on all matters before the commission.
As of October 2025, the chair is Kraig Kinney and the executive director is Donnie Woodyard Jr.
The commission's responsibilities include:
The commission meets regularly throughout the year, with both virtual meetings and an annual in-person meeting.
The United States EMS Compact Commission is governed by an Executive Committee elected by the seated state commissioners. Since its formation in 2017, the Commission has been led by the following officers.