As we noted in the last issue of On Scene, efforts are underway to have all fifty states adopt the Recognition EMS Personnel Licensure Interstate CompAct (REPLICA). Adoption of this interstate compact would allow EMS providers to continue caring for patients, even if they have crossed state lines due to transport or deploying as part of an out-of-state mutual aid event. Legislation in support of REPLICA has been introduced in a handful of states.
However, some questions and misunderstandings of REPLICA have arisen. Here are answers to some common questions you might hear in your state.
Q: What is REPLICA?
A: REPLICA is an interstate agreement which would allow EMS personnel licensed in one state to function as an EMS provider in any other REPLICA-member state. Legislation to adopt REPLICA must be passed at the state level rather than the federal level.
Q: Is there really a need for REPLICA in the fire service?
Is your fire department located near your state’s border? Do your personnel deploy as part of a USAR task force? Does your department ever provide mutual aid for a natural or manmade disaster in another state? If you answered yes to any question above and your personnel were only licensed in your home state, they likely were in violation of the law. REPLICA would mean that your personnel would not need to maintain multiple state EMS licenses and could easily respond to emergencies as part of an interstate mutual aid response. REPLICA would greatly ease a bureaucratic burden for EMS providers and fire department leadership.
Q: Does REPLICA contain regulations which could contradict state law?
A: No, in the event that Firefighter/Paramedic Smith travels from State A to State B to avoid disciplinary action from State A, REPLICA allows State A’s EMS Office to issue a subpoena, even if Firefighter/Paramedic Smith is now in State B. REPLICA would permit State B to enforce the subpoena in accordance to State B’s own state regulations. REPLICA does not allow, or facilitate, enforcement of subpoenas in any manner which contradicts the receiving state’s laws. This provision is nearly identical to provisions contained in various states’ nursing licensure compacts.
Q: Why are states charged fees to participate in REPLCIA?
A: This enactment of fees would defray the costs of operating the REPLICA compact and would assure that the activities of the compact are a state function and ultimately the responsibility of the state. The fee structure contained in draft legislation to adopt REPLICA is strikingly similar to other interstate compacts on issues such as adult offender supervision and educational opportunities for military dependents.
Q: If a state adopts REPLICA, can they maintain their own certification standards?
A: Yes, states can maintain their own certification standards as long as they use the National Registry examination as a condition for initial licensing in their state. Meeting this requirement helps ensure that patients continue receiving a consistent level of care throughout all REPLICA-member states.
Q: What are the individual requirements to be able to practice in a REPLICA state?
A: The individual must be at least 18 years old, possess a current, unrestricted license in a member state as an EMT, AEMT, paramedic or other state-recognized and licensed EMS provider level with a scope of practice and authority between EMT and paramedic; and practice under the supervision of a medical director.
Q: What will the individual be allowed to do in a REPLICA-member state if their protocols are different?
A: An individual providing patient care in a remote state shall function within their scope of practice authorized by their home state and medical director unless, and until, modified by an appropriate authority in the remote state.
Q: Are there any future requirements if a state adopts REPLICA?
A: Yes. If not already required within five years of adoption, the state will have to require background checks for all applicants seeking initial licensures. This background has to be FBI-compliant and based on the results of either fingerprints or some other biometric data check. The only exception will be for government employees who possess a national security clearance as defined in the U.S. Code of Federal Regulations.
Adoption of the REPLICA Compact is a great opportunity for the fire service to significantly reduce administrative burdens which complicate daily life for some fire and EMS departments as well as mutual aid responses for many fire and EMS departments. Since REPLICA must be adopted at the state level, make sure to find your state representative and senator and ask them to REPLICATE advancement for EMS across the nation!