September 30, 2025 • 33 mins
Borders shouldn’t slow lifesaving care, and they don’t have to! In this episode, we sit down with Donnie Woodyard Jr., Executive Director of the Interstate Commission for EMS Personnel Practice, to unpack how the EMS Compact turns a single EMS license into a recognized privilege to practice across member states. From wildfires and hurricanes to staffing shortages and training rotations, we explore how this always-on compact accelerates response without sacrificing public protection.
We walk through the legal backbone of state compacts, why identical legislation across states matters, and how the Commission operates as a government regulatory body: open meetings, one‑state‑one‑vote governance, and deliberate rule-making designed to build consensus. Donnie shares how administrative rules focus on interstate practice, why the Commission publishes position papers, and what it takes to balance clinician mobility with accountability. If you’ve ever wondered who sets the standards, how decisions get made, or where your voice fits in, this conversation brings the process into the daylight.
For clinicians and administrators, the practical guidance is clear: use your National EMS ID to verify your privilege at EMSCompact.gov, select your agency in a member state, and follow the local scope and protocols where you’re working. We break down real‑world scenarios that make scope of practice intuitive, highlight education resources and connection opportunities, and hear about the technology upgrades in the coordinated database - from deduplicated workforce counts, to employer alerts that prevent costly billing reversions. We also discuss EMS Compact expansion: why some states haven’t joined yet and how stakeholders can move legislation with a simple, focused ask.
If this conversation helps you see how smarter regulation can speed care and open careers, share it with your team, subscribe for future episodes, and leave a review to help others find the show! Stay inspired with Know Your Regulator.
Get more information, details and resources on Know Your Regulator - https://www.belolaw.com/know-your-regulator
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
This podcast is for educational purposes only, does
not constitute legal advice, anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
SPEAKER_01 (00:13):
Welcome back to Know Your Regulator, the podcast that
inspires you to engage.
I am your host, Simone Murfrey,and today we're exploring one of
the most dynamic tools foremergency medical professionals,
the EMS Compact.
Whether you're an EMS licenseholder, a healthcare
administrator, or just EMScurious, today's episode is
going to connect the dotsbetween Interstate Licensure,
(00:33):
Emergency Response, andProfessional Mobility.
Our guest today is DonnieWoodyard Jr., Executive Director
of the Interstate Commission forEMS Personnel Practice, the body
that administers the EMSCompact.
Thank you so much for joiningus, Donnie.
SPEAKER_00 (00:48):
Yeah, it's a joy to be here.
And as always, you know, anytimeI get to talk about the EMS
Compact, uh, it makes my day.
SPEAKER_01 (00:55):
Awesome.
Well, let's start at thebeginning.
Can you kind of outline what theEMS Compact is and and why it
was created?
How did it get started?
SPEAKER_00 (01:05):
Yeah, absolutely.
I mean, that that's a pretty bigquestion.
So let me tackle the first partof it on well, what is the EMS
Compact?
And to do that, I have to goback to, well, what are compacts
anyway?
And one of the things that Ilike to tell people is that
compacts, in many ways, in theUnited States, is that secret
sauce that puts the United inthe United States.
(01:27):
Now, I can really nerd out onhistory, but I'm going to keep
this short.
So if we go back even before theUS Constitution, when we had
individual colonies, they foundout they had to actually
cooperate on things.
They had their sovereignty, butthey had to figure out a way to
like cooperate with theirneighbor or their neighbor's
neighbor.
And that eventually formed thisconcept of a compact that came
(01:50):
into the Constitution as acompact clause.
And that is basically, itrecognizes state sovereignty, it
recognizes federal supremacy,but it's the legal mechanism for
states to enter into contractualagreements to outline terms to
accomplish a purpose amongstates.
Now we have all kinds ofcompacts.
(02:11):
We have driver's licensecompacts and water compacts and
airports, many airports arecompacts and you know uh
transportation systems andeducation.
The list goes on and on and on.
EMS is one of 250 plus compacts.
It's important to us because theEMS compact allows for one state
(02:32):
EMS license of a state that'sentered into this contractual
agreement to be recognized inother states.
Think about it like yourdriver's license.
Your driver's license, issued inTexas or Colorado or wherever
you may be, is recognized inother states.
Well, that's because stateslargely are part of a compact.
(02:52):
They've agreed to standardizedterms.
They have a contract between thestates that says, I recognize
your license, you recognizemine.
If someone breaks your law, thisis how we're gonna adjudicate
it.
And that is the model used forthe EMS compact.
Now, your question also went onto well, why did we even need
this compact and what was theorigins?
(03:13):
So if you go back uh now about12, 13 years ago, and at the
time, uh we have a largefederal-based EMS workforce,
everything from air marshalsthrough Secret Service through
FBI, um, all kinds of homelandsecurity uh initiatives.
And our federal workforce said,well, wait a second, we don't
(03:35):
want to be in violation of statelaw, uh, but at the same time,
it's just not practical for meto carry 50 different licenses.
And so they looked at solutions,and the best solution was to
form an occupational licensecompact.
Now, at the time, the only onesthat had done that in
occupational license wasnursing.
(03:57):
So the Department of HomelandSecurity funded a project to
explore this, explore the legalfoundations of it, and actually
create uh the foundation forwhat is today the MS Compact.
So that's the origin, kind of ina nutshell, really quick, but it
really started out of a need tofigure out how do we solve this
(04:19):
issue, which by the way was muchbigger than just federal
officials.
I mean, I at one point in time Iheld seven state licenses.
I meet people who have 20, 25state licenses.
So we needed a solution forthat.
And today there are 17occupational uh license
compacts.
EMS was number two, and we helpopen the door for so many other
(04:42):
professions.
SPEAKER_01 (04:43):
And that's awesome.
And when you lay it out likethat, it just makes sense,
right?
You think about, yeah, ofcourse, we're gonna have to
interact with each other, and ofcourse, you know, personnel are
gonna have to cross state lines.
And like you said, it just itjust makes sense to um to have
it all compact, not not carrying50 licenses at one time.
Yeah.
SPEAKER_00 (05:03):
You know, just to add on to that real quick, I
mean, uh another thing that wehave to realize is that our
society is mobile.
You know, we don't think aboutcrossing a state border, and the
public has an expectation thatan EMT in their backyard will
provide them the same level ofcare as an EMT when they're on
vacation four states over, orthat a paramedic in one state is
(05:26):
pretty much similar to aparamedic in the in another
state.
Same thing for nursing andphysicians.
So we look at health care on anational basis for standards.
Therefore, it only makes sensethat my license in one state can
easily be recognized in anotherstate.
SPEAKER_01 (05:44):
Right.
Yeah, exactly.
So, you know, we kind of talkedbefore um that this is goes
beyond what you see just onpaper.
We talked about some, you know,um natural disasters, some big
mass casualty events.
I would imagine that this couldreally help save some lives in
in real time by crossing statelines when you've got situations
(06:06):
like hurricanes and you know,maybe even some staffing
shortages.
I know that's a big issue.
SPEAKER_00 (06:13):
So the the EMS compact is valid 24 hours a day,
seven days a week, 365 days ayear.
There's no application, there'sno um, you know, you don't have
to like buy a compact license.
Yeah, it's on the basis of youhaving a home state license,
which is a state that's part ofthe compact.
And then you can immediatelypractice in any of the other
(06:35):
states in the compact.
For it could be disasters, itcould be surge events, you could
have, you know, a staffingshortage in an area, but it can
also be for day-to-day work, itcould be for going and you know
gaining educational experience.
It could be, hey, my familymoved, or I'm in the fire
department, I did a lateraltransfer.
(06:55):
Um, when it comes to disasters,you know, there's another
compact out there that many ofthe listeners might be aware of.
And it's the EMAC, it's theemergency management assistance
compact.
And in disasters, you know,states E Mac resources all the
time.
Well, EMAC requires a disasterdeclaration.
(07:15):
You have to request resourcesthrough the state-to-state
channel, and it's it's awonderful compact.
Our compact ball references EMACand the two work in synergy.
The key with the EMS Compact,though, is you don't have to
have a disaster declarationbecause it's on, it's turned on
24 hours a day.
(07:36):
So if a hurricane was to hit astate tomorrow or a wildfire, uh
you know, you could bring peoplein right away and they have the
legal authority to practice, butalso public protection remains
intact because there's amechanism for accountability,
for standards, for knowing likescope of practice.
(07:58):
All of that's worked out inadvance.
So it really takes the responsetime down to a zero um delay on
response.
Now, even this week, I havenon-compact states who are
bringing in EMS resources forthings like wildfires and other
types of disasters.
(08:19):
And it's not uncommon forresources to actually have to
wait a few days to go throughthe licensure process.
The EMS compact solves that.
It's good for uh state publicprotection and good for the
workforce.
SPEAKER_01 (08:32):
Yeah, no, it sounds absolutely like it's good.
I am I am seeing no cons.
I mean, this is just fantastic.
And I want to go back tosomething you said a little bit
earlier that, you know, uh thepublic expects that the EMS
personnel in their backyard isgoing to be able to provide
them, you know, the the samelevel of care or same um uh
(08:56):
attention to care um as assomeone who's licensed in that
state as their home state.
So I think, you know, yeah,you've just all the way around,
it it sounds great.
You've got the the public isprotected and you've got uh
personnel who want to grow andlearn in their profession who
are able to, you know, superquickly.
(09:18):
So it's it's awesome.
Let's talk structure of thecompact.
So um the EMS Compact is backedby a commission.
Can you talk about who makes upthe Interstate Commission for
EMS personnel practice?
SPEAKER_00 (09:33):
Yeah, absolutely.
So, I mean, the first thing iswe have to clarify that the EMS
Compact is a governmental body.
And so sometimes people, youknow, think, well, you know, are
you like an association?
Are you a nonprofit?
What are you?
No, we're we're a governmentregulatory body, uh, established
through the compact clause ofthe constitution.
(09:55):
And in the state law that everystate passes, which by the way,
and I said this subtly, but Iwant to emphasize it, is also a
contract state to state.
So it's governed under bothcontract law and state law and
federal law.
And because it's a contract,every state law is the same.
So if you want to join acompact, and like I said,
(10:18):
there's many of them out there,every state passes the same law,
so you have the samerequirements.
One of the things in that statelaw is it creates the
commission.
And through that law, itprovides the commission certain
authority and sorts, certainpowers.
In every state, it's thegovernor or the governor's
(10:38):
office that appoints thecommissioner.
Now, we have defined in thestate law that the commissioner
has to be a subject matterexpert that's part of the
executive branch of governmentthat's responsible for licensing
EMS personnel.
So in almost every state, it'sthe state EMS director.
But the key is this duty isappointed on behalf of the
(11:01):
governor of the state.
And think about it kind of likeyou know, maybe that of like a
senator.
Um, and so, you know, thisperson is accountable for
representing the needs of theentire state, the views of the
state.
Um, every state has one vote.
So when we make decisions as agovernmental body, every state
(11:23):
has one vote.
That person casts the vote.
Maybe it represents theirpersonal view, but more
importantly, it needs torepresent the view of the entire
state and all the stakeholders.
So that's the structure.
Now, within the commission, uh,you know, as with any government
body or organization, you haveto have day-to-day operations.
(11:44):
And so those day-to-dayoperations are carried out by an
executive committee, which isfive of the commissioners that's
been voted and appointed by allthe commissioners collectively.
So those five commissioners meetevery month and they handle the
day-to-day operationaldecisions.
SPEAKER_01 (12:03):
Nice.
Okay.
You mentioned voting.
Can you talk to us about, youknow, how decisions are made?
Is it a vote?
Or um, you know, are there somemaybe some subcommittees that
are kind of broken up?
SPEAKER_00 (12:17):
Oh, absolutely.
So, you know, as as a governmentbody, we also have the uh
authority to do administrativecode, administrative rule, which
has the effective law in 25states, because that's the
number of states in the compactright now.
Now, our administrative code islimited to in scope to the
interstate practice of EMS, youknow, so we don't write, you
(12:40):
know, code or rules uh on thatinfer on state sovereignty.
But when it comes to interstatepractice, that's what we're
accountable for.
And usually, like if we are um,you know, coming up with a
administrative rule, uh, wereally believe that slow is fast
and fast is slow, meaning thatwe slow down, we uh do a long
(13:03):
stakeholder process.
All of our meetings are open tothe public, they're all public
noticed.
Uh, we uh, you know, forinstance, if we're we're looking
at a rulemaking process rightnow, um, you know, we've been in
that process for nearly a year.
Um, countless meetings,countless drafts, uh, lots of
input.
And then it comes out ofcommittee, and so it'll be voted
(13:25):
out of committee, which thisrulemaking has been done.
And then that is publiclynoticed for 90 days.
Um, it's published on everystate website that's out there,
and then we go through, and onNovember 5th, we will have a
vote on this administrativerule, and we'll see if it
carries or not.
Um, most of our rules, by thetime they get to the final
(13:49):
process, um, they passunanimously just because we've
put in so much effort to workthem out in advance.
But you know, that's arulemaking committee, but we
also have other committees.
Um, the government body of thecommission has put out position
papers.
So that's one of the tools weput out, and and these are
(14:10):
non-binding positions of thecommission.
So, for instance, we put out acommission paper recently on
code of conduct.
Um, so we we put out, hey, thisis the code of conduct.
If you want to be an empt or aparamedic, this is what we
believe professional conductlooks like.
And so it's um uh the positionof of the commission and
(14:34):
representing the 25 states.
This is what this is what itmeans to be a paramedic or an
EMT and and treat your patientswith compassion and dignity and
stuff that we all know.
SPEAKER_01 (14:44):
Right.
SPEAKER_00 (14:45):
But it hadn't been written down before.
So we wrote it down.
We have another one aboutprotecting the EMS workforce
against uh you know things likedoxing and cyber hacks and
cybersecurity, and how do we uhensure that nation states are
not gaining access to EMSpersonnel records?
So, you know, we do a lot ofthings.
Um, all of those require votes.
(15:07):
And uh, like I said, we do ourbest to make sure we represent
all the stakeholders.
Currently, it's about 500,000EMS personnel in the United
States that's uh got a privilegeto practice through our office.
SPEAKER_01 (15:20):
That's awesome.
No, it sounds like you guys aredoing a really good job of
making sure, you know, I'm sureit's a delicate balance, but
you've got to make sure that youprotect the public, but also
make the profession itself moreaccessible, better than it was
before, and just keep buildingupon that.
But it sounds like you guys havean awesome plan and and that you
(15:40):
uh have a lot of, like you said,stakeholder input, that there's
a lot of options for EMSpersonnel to get involved and um
and kind of shape the future oftheir profession.
SPEAKER_00 (15:52):
Yeah, you know, there's a lot of opportunity.
We invite people, please come toour meetings, uh, make your
voice heard.
Uh, you know, if there'ssomething that you know works or
doesn't work, let us know.
And then I think the otherthing, you know, this would be a
great time to point out in ourenabling legislation, and when I
talk about the compact, most ofthe conversation is about the
(16:14):
mobility of EMS personnel.
How do I go from you know Texasto Colorado to Virginia to West
Virginia, what whatever.
But the compact law alsoincludes another section that's
very important, and that sectionis that every state is committed
to collaboration on everythingrelated to EMS personnel,
(16:39):
license and standards and um howthe EMS system works.
So, you know, our commission ischarged with unifying states,
unifying solutions.
Um, EMS is no longer on thisfragmented path of everyone
doing whatever they want.
No, through legislation, we havebound together to look at things
(17:03):
through a larger nationalcollective lens, and that's
about advancing the professionand improving it for everyone.
SPEAKER_01 (17:11):
Absolutely.
Very well said.
unknown (17:13):
Yeah.
SPEAKER_01 (17:14):
So let's say that I am a licensed EMT or a paramedic
and I'm in a compact state.
What does this mean for me?
SPEAKER_00 (17:22):
Yeah.
So I mean, uh a lot of the500,000, you know, EMS personnel
that have a privilege ofpractice may not even know the
power that the gift that they'vebeen given by 25 states.
So, you know, why don't we breakdown as to like how you can use
the privatity practice and whatdoes it mean for you
(17:42):
individually?
And the very first thing is youneed to know what your national
EMS ID number is.
Now, uh, this has a fascinatinghistory, but you know, at one
point in time I went through andlike found all my individual
license numbers andcertification numbers, and I had
something like 20, 25, right?
(18:04):
I mean, it was a huge amount.
One of the keys about thecompact is you have a
coordinated database, whichwe'll hopefully talk about in a
minute, but you have to be ableto share licensure information.
So the way that we do that isthrough this new national EMS
identification number.
It's a 12-digit number.
And the easiest way to find itis either through your state
(18:27):
website or through the NationalRegistry website.
And it's printed right there andyou can see it.
So it's 12 digits, kind of lookslike a credit card number.
Um, and so it's 4-4-4.
You can put that in on ourwebsite and it will show if you
have a privilege to practice ornot.
So if you have a privilege topractice, and after you put that
(18:48):
number in, that means that yourlicense is now valid everywhere
else.
Now, how do you use thatprivilege?
Well, there's a few key things.
One is you have to have theprivilege, it has to be visible.
Your home state license has tobe unrestricted, so you can't be
under discipline.
If so, your privilege topractice status will have a red
box around it.
(19:09):
And and then you have to be withan agency.
Now, I get a lot of questionsabout this requirement.
And at the core, it's not even apure compact issue.
It's just about being an EMT orparamedic.
But the core is you have to bewith an entity, an agency.
Uh, we don't have independentpractice in EMS.
(19:30):
Um, you know, yeah, I'm aparamedic.
I can't just go and freelance asa paramedic, right?
I have to have an agency, andthat agency has things like DEA
licenses and the ability to buythe stuff and insurance and
medical direction and a patientcare reporting system, and and
all of that is part of anagency.
So the compact requires you'rewith an agency.
(19:51):
And it's really as simple asthat.
So the moment an agencyaffiliates you in another state
that's part of the compact, yourhome state license is valid and
you can work on that agency.
It's the agency's responsibilityto make sure that you're
competent and that you know thelocal scope of practice and that
you know the local protocol.
(20:13):
But that's also a personal,professional, uh, ethical
responsibility.
As a healthcare professional,you've got to know what your
scope of practice is whereyou're working, and you adhere
to that.
SPEAKER_01 (20:26):
Absolutely.
Speaking of that scope ofpractice, what are those
limitations and thoseresponsibilities that EMS
personnel should have on theirtop-of-mind awareness?
You know, those really big onesthat could could cause some some
major damage.
SPEAKER_00 (20:42):
Yeah.
Well, let me go back to thedriving example.
You know, I I love living inwestern uh United States right
now.
And, you know, we have roadshere where you know the speed
limit is 85.
And um, and you know, there'seven a few roads out where you
know there's no real postedspeed limit.
Um but you know, say that I goback and I'm driving on the I-95
(21:06):
corridor, um, you know, up onthe east coast, and I decide,
well, you know, my speed limitin Colorado is 85, I'm gonna do
that here.
That's not gonna work, right?
And and so, and it's real key tounderstand that if I'm
exercising my driving privilegein another state, I have to know
and follow the laws of thatstate.
(21:26):
Same thing with working in theEMS Compact.
Yeah, you have a license topractice, you have a privilege
to practice, but you have toknow the law of that state and
you're held accountable to thelaws of that state.
So let's take a scope ofpractice issue.
Um, you know, I have a privilegein all 25 states.
Um, and one state, um, as aparamedic, I can do surgical
(21:49):
crikes, I could do uh fingerthoracotomies, um, I can
administer blood.
Um, and that would be part of myscope of practice.
Another state that may not be inthe scope.
So I have to know and understandthat.
So I don't get to uh you knowignore the local scope or law.
(22:11):
So when I accept an employmentopportunity, uh paid or unpaid,
um, then I have to know whatthat scope is, and I follow that
local scope of practice with mylocal medical director.
Um now, you know, this this alsoone of the examples or one of
the questions I get is reallykind of I can break this down
(22:32):
into two scenarios.
Let me say that I am a Virginiaparamedic on a Virginia
ambulance service and Itransport a patient to West
Virginia.
What protocols do you think I'mgonna follow for the duration of
that patient care?
I'm gonna follow my Virginiaprotocol.
I work for a Virginia service ina Virginia ambulance.
I happen to be transporting apatient into another state, my
(22:54):
compact license is valid, I'mgood to go.
Scenario B.
I'm a Virginia paramedic, butI'm hired in Texas for a Texas
service.
What scope of practice and whatprotocol do you think I'm gonna
follow?
Texas.
SPEAKER_01 (23:09):
Texas, yes.
SPEAKER_00 (23:11):
Absolutely.
So it really the the answer tothe question is to like scope of
practice and you know what doyou follow?
Well, you follow the scope ofpractice and the protocols of
the your primary employer thatyou're working for at the time.
SPEAKER_01 (23:24):
Yeah, no, that makes sense, and thank you for laying
it out like that.
Because absolutely, I'm surethat there may be some listeners
going, oh no, but um, yeah, no,that that that does make sense.
And it seems kind of easy tofollow when you think about it
like that.
So let's talk about some toolsto help license holders be aware
of, you know, maybe some ofthese regulatory pitfalls.
(23:47):
What kind of resources does theEMS Compact Commission offer to
help EMS professionals navigateinterstate practice?
SPEAKER_00 (23:55):
Yeah, well, first and foremost, it's our website.
So and that's EMS Compact, oneword.gov.
And so EMSCompact.gov, that'sthe primary place.
So that's where you as anindividual or as an employer,
you're gonna put in thatnational MS ID number.
You can validate that.
We have all of the uh links toall the states.
(24:17):
So if you're wondering, hey, ismy state part of it?
Absolutely.
You can see that map there.
And if you click on the map,you'll see who your
governor-appointed commissioneris and their contact
information.
Uh, we have another section ofresources and videos and
training material there that youcan download and look at.
We have information sheets.
Uh, so we have a wealth ofresources there.
(24:39):
We have a YouTube channel thathas some educational videos, um,
and also all of our uhcommission meetings are on
there.
So if you want to learn aboutgovernance and what we talk
about and how we vote, you know,you can go back and watch those.
Um, you know, get a good cup ofcoffee.
Um but uh, you know, those aresome of the main resources we
(25:00):
have, and they're available.
And I'd also say if you are in acompact state, then contact your
state office and ask them forsome help and resources as well.
And then um, I do a lot ofspeaking, and so you know, it's
very common.
I'm happy to speak to agenciesand customize.
(25:22):
You know, if you have an agencyand you have questions, I'm
happy to come and do anin-service for you and provide
some continuing ed.
Um, the EMS Compact Educationseries is counts for con ed
credit.
Um, it's part of operations, andit's a key part of that.
So those are some of theresources we have.
SPEAKER_01 (25:42):
That's fantastic.
Yeah, websites always a greatplace to start, but man, you
guys have a ton of resources.
A lot of I know video content isreally big right now, and so I
think that's awesome.
It sounds like you've gotcontent for everyone, for every
attention span, and any way theywant to digest it.
Fantastic.
So for those um who arelistening, you said that they
(26:05):
can check the website, right?
If they're not sure if theirstate is part of the compact.
Um, are there any states who areworking on maybe entering the
compact that you know of rightnow?
SPEAKER_00 (26:17):
Yeah, you know, that that's always a tough question
for me to answer.
So um I I can tell you that inthe past uh two months, we've
had 12 states request the copyof the law, uh, the contract.
And so, you know, at least 12states are looking at it.
I suspect some more are.
You know, but it let me pivot onthat question if if you allow
(26:39):
me, real quick.
I frequently get asked, well,you've got 25 states, but why
are the other 25 states not partof the compact?
And, you know, the simple answerto that is stakeholders in those
states have not asked theirlegislators to prioritize
passing this piece oflegislation.
Um, you know, as a governmentbody, I can't lobby, I don't
(27:02):
lobby.
Um, I can answer technicalquestions, but someone's got to
simply ask your statelegislators to do this.
And um, you know, statelegislators uh respond to their
stakeholders saying, hey, thisis a priority for me.
Um of the 25 states that's inthe compact, uh 98.8% of all
(27:24):
elected officials have voted yesfor this legislation.
It's one of the strongest, mostpartisan pieces of legislation
in the history of EMS.
Um, so ask your state, tell yourlocal officials, uh, tell your
elected officials that this is apriority for you.
And uh it's a pretty simple billuh in most states to get
(27:47):
through.
SPEAKER_01 (27:48):
Yeah, no, that's awesome.
I can absolutely see why it'sgot such strong backing from
both sides.
I mean, it's a no-brainer,right?
Um, so what is next for thecompact?
Are there any initiatives, anytrends, or any developments that
um we should keep our eyes on?
SPEAKER_00 (28:04):
Yeah, so I mean, first and foremost is more
education.
Um, and so, you know, we'retrying to work with our EMS
education partners and our coned partners.
Uh, every EMS clinician in theUnited States should know about
the compact.
And I would even go as far assaying every EMS clinician
should probably seek to getlicensed in an EMS compact
(28:27):
state.
I mean, it really opens upopportunities for you and it's a
safeguard for your future, andit's a new tool for recruitment
and retention and workforcemobility.
Um, really, really uh importantthings, especially when we
realize the average age of likean you know EMS clinician is
kind of in that you know youngerspectrum.
(28:50):
Um, and we know that that agegroup, just like you know, when
you are you and I are in thatage group, I mean we we want to
explore the world, we want tosee the US.
Uh, your license shouldn't, youknow, tie you down.
Um, and so the compact allowsyou to do that.
So education is number one onour awareness right now.
(29:13):
And then number two is actuallythe coordinated database.
So kind of like the centralbrain to the compact is what we
call the national MS CoordinatedDatabase.
And this is the system thattakes every state licensure
system, deduplicates it, puts itinto one system.
And that system is essential forthings like planning and
(29:35):
workforce understanding.
Do you know that right now inthe United States, no one can
answer the question how manyEMTs and how many paramedics do
we have?
No one knows.
Yeah, no one knows the answer.
And and there's a lot of reasonsfor that.
But you know, we have 50different state licensure
systems.
Um, people are licensed inmultiple states.
(29:56):
So if you just call every stateand say how many paramedics you
have, cool.
But how many of those arelicensed in 5, 10, 15, 20
states?
Our system deduplicates that.
So for the first time in thehistory across 25 states, we can
answer that question.
But we have some projects goingon on uh expanding that
coordinated database.
(30:17):
We want to add functionality, wewant to add new functionality
that's going to enhance the wayindividual clinicians use it.
And we want to add functionalityof how employers use that.
Um, we know that EMS across thenation, um, funding is a very
important issue for EMS.
And one of the biggest tragediesthat uh I see as a regulator is
(30:41):
when an EMS service has to dowhat we call insurance
reversions and repayments.
And that happens because someonelet their license expire or the
license wasn't valid, uh, youknow, your employer has to pay
that money back to the insurancecompany.
That is millions of dollarsevery year.
So we're working in on asolution in our database that
(31:04):
would allow employers to sign upfor a push notification that if
anyone on their roster has alicense that's not valid or it
becomes expired or becomessuspended, that they would know
immediately without delay.
So those are some of thetechnology things we're working
on.
And then finally, advancing EMSwith a unified voice.
(31:25):
And that's very important.
Um, you know, like I said, ouroffice is responsible for
interstate practice of EMS, butalso to uh, you know, reduce
barriers to align best practicesand to really come up with
common solutions.
And so that's what we're lookingforward to as well.
SPEAKER_01 (31:46):
Awesome.
Well, it sounds like you guyshave a ton of things that we can
keep our eyes on and see how ituh how it plays out.
That's great.
You know, um I I do want to goback, you said you mentioned um
talking about the database anduh that you have finally uh
solved the mystery of how manyEMS professionals are in um, you
(32:10):
know, you said across the US,right?
Or in the 25 states that are inthe compact, how many?
SPEAKER_00 (32:17):
I was afraid you to ask that.
I don't have it up in front ofme right now.
Um so I don't have that put upin front of me.
But you know, but the key is um,you know, the deduplication is
very important.
And to, you know, trulyunderstand what our workforce
looks like of those who arelicensed.
Um, you know, it's not good forme to be counted multiple times,
(32:41):
especially when we come to thinkabout things like, okay, what's
truly happening to ourworkforce?
Um are we growing as aworkforce?
I believe we are, but now youknow, we'll have data for that.
Um, so I'd say stay tuned.
Um, you know, as we continue toum advance uh the work that we
do.
I anticipate we'll have some,you know, research that'll be
(33:03):
coming out and you know, be ableto answer some of those
questions in a more academic,scientific way here in the near
future.
SPEAKER_01 (33:10):
Well, awesome.
Well, thank you so much forjoining me today, Donnie.
This has been an awesomeconversation, just full of
insight.
And I think that it's reallygonna help EMS professionals
just understand how it canempower them in their practice.
So thank you again so much.
SPEAKER_00 (33:28):
Yeah, it was my honor.
Thanks for asking.
SPEAKER_01 (33:30):
And to our listeners, if you're a licensed
EMS professional, make sure tovisit emscompact.gov to see what
your rights and responsibilitiesare under the compact.
Thanks for tuning in to KnowYour Regulator.
And until next time, stayinspired and continue engaging
with your regulatory agency.
SPEAKER_00 (33:47):
Know your regulator, the podcast that inspires you to
engage.
This podcast is for educational purposes only, does
not constitute legal advice, anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
SPEAKER_01 (00:13):
Welcome back to Know Your Regulator, the podcast that
inspires you to engage.
I am your host, Simone Murfrey,and today we're exploring one of
the most dynamic tools foremergency medical professionals,
the EMS Compact.
Whether you're an EMS licenseholder, a healthcare
administrator, or just EMScurious, today's episode is
going to connect the dotsbetween Interstate Licensure,
(00:33):
Emergency Response, andProfessional Mobility.
Our guest today is DonnieWoodyard Jr., Executive Director
of the Interstate Commission forEMS Personnel Practice, the body
that administers the EMSCompact.
Thank you so much for joiningus, Donnie.
SPEAKER_00 (00:48):
Yeah, it's a joy to be here.
And as always, you know, anytimeI get to talk about the EMS
Compact, uh, it makes my day.
SPEAKER_01 (00:55):
Awesome.
Well, let's start at thebeginning.
Can you kind of outline what theEMS Compact is and and why it
was created?
How did it get started?
SPEAKER_00 (01:05):
Yeah, absolutely.
I mean, that that's a pretty bigquestion.
So let me tackle the first partof it on well, what is the EMS
Compact?
And to do that, I have to goback to, well, what are compacts
anyway?
And one of the things that Ilike to tell people is that
compacts, in many ways, in theUnited States, is that secret
sauce that puts the United inthe United States.
(01:27):
Now, I can really nerd out onhistory, but I'm going to keep
this short.
So if we go back even before theUS Constitution, when we had
individual colonies, they foundout they had to actually
cooperate on things.
They had their sovereignty, butthey had to figure out a way to
like cooperate with theirneighbor or their neighbor's
neighbor.
And that eventually formed thisconcept of a compact that came
(01:50):
into the Constitution as acompact clause.
And that is basically, itrecognizes state sovereignty, it
recognizes federal supremacy,but it's the legal mechanism for
states to enter into contractualagreements to outline terms to
accomplish a purpose amongstates.
Now we have all kinds ofcompacts.
(02:11):
We have driver's licensecompacts and water compacts and
airports, many airports arecompacts and you know uh
transportation systems andeducation.
The list goes on and on and on.
EMS is one of 250 plus compacts.
It's important to us because theEMS compact allows for one state
(02:32):
EMS license of a state that'sentered into this contractual
agreement to be recognized inother states.
Think about it like yourdriver's license.
Your driver's license, issued inTexas or Colorado or wherever
you may be, is recognized inother states.
Well, that's because stateslargely are part of a compact.
(02:52):
They've agreed to standardizedterms.
They have a contract between thestates that says, I recognize
your license, you recognizemine.
If someone breaks your law, thisis how we're gonna adjudicate
it.
And that is the model used forthe EMS compact.
Now, your question also went onto well, why did we even need
this compact and what was theorigins?
(03:13):
So if you go back uh now about12, 13 years ago, and at the
time, uh we have a largefederal-based EMS workforce,
everything from air marshalsthrough Secret Service through
FBI, um, all kinds of homelandsecurity uh initiatives.
And our federal workforce said,well, wait a second, we don't
(03:35):
want to be in violation of statelaw, uh, but at the same time,
it's just not practical for meto carry 50 different licenses.
And so they looked at solutions,and the best solution was to
form an occupational licensecompact.
Now, at the time, the only onesthat had done that in
occupational license wasnursing.
(03:57):
So the Department of HomelandSecurity funded a project to
explore this, explore the legalfoundations of it, and actually
create uh the foundation forwhat is today the MS Compact.
So that's the origin, kind of ina nutshell, really quick, but it
really started out of a need tofigure out how do we solve this
(04:19):
issue, which by the way was muchbigger than just federal
officials.
I mean, I at one point in time Iheld seven state licenses.
I meet people who have 20, 25state licenses.
So we needed a solution forthat.
And today there are 17occupational uh license
compacts.
EMS was number two, and we helpopen the door for so many other
(04:42):
professions.
SPEAKER_01 (04:43):
And that's awesome.
And when you lay it out likethat, it just makes sense,
right?
You think about, yeah, ofcourse, we're gonna have to
interact with each other, and ofcourse, you know, personnel are
gonna have to cross state lines.
And like you said, it just itjust makes sense to um to have
it all compact, not not carrying50 licenses at one time.
Yeah.
SPEAKER_00 (05:03):
You know, just to add on to that real quick, I
mean, uh another thing that wehave to realize is that our
society is mobile.
You know, we don't think aboutcrossing a state border, and the
public has an expectation thatan EMT in their backyard will
provide them the same level ofcare as an EMT when they're on
vacation four states over, orthat a paramedic in one state is
(05:26):
pretty much similar to aparamedic in the in another
state.
Same thing for nursing andphysicians.
So we look at health care on anational basis for standards.
Therefore, it only makes sensethat my license in one state can
easily be recognized in anotherstate.
SPEAKER_01 (05:44):
Right.
Yeah, exactly.
So, you know, we kind of talkedbefore um that this is goes
beyond what you see just onpaper.
We talked about some, you know,um natural disasters, some big
mass casualty events.
I would imagine that this couldreally help save some lives in
in real time by crossing statelines when you've got situations
(06:06):
like hurricanes and you know,maybe even some staffing
shortages.
I know that's a big issue.
SPEAKER_00 (06:13):
So the the EMS compact is valid 24 hours a day,
seven days a week, 365 days ayear.
There's no application, there'sno um, you know, you don't have
to like buy a compact license.
Yeah, it's on the basis of youhaving a home state license,
which is a state that's part ofthe compact.
And then you can immediatelypractice in any of the other
(06:35):
states in the compact.
For it could be disasters, itcould be surge events, you could
have, you know, a staffingshortage in an area, but it can
also be for day-to-day work, itcould be for going and you know
gaining educational experience.
It could be, hey, my familymoved, or I'm in the fire
department, I did a lateraltransfer.
(06:55):
Um, when it comes to disasters,you know, there's another
compact out there that many ofthe listeners might be aware of.
And it's the EMAC, it's theemergency management assistance
compact.
And in disasters, you know,states E Mac resources all the
time.
Well, EMAC requires a disasterdeclaration.
(07:15):
You have to request resourcesthrough the state-to-state
channel, and it's it's awonderful compact.
Our compact ball references EMACand the two work in synergy.
The key with the EMS Compact,though, is you don't have to
have a disaster declarationbecause it's on, it's turned on
24 hours a day.
(07:36):
So if a hurricane was to hit astate tomorrow or a wildfire, uh
you know, you could bring peoplein right away and they have the
legal authority to practice, butalso public protection remains
intact because there's amechanism for accountability,
for standards, for knowing likescope of practice.
(07:58):
All of that's worked out inadvance.
So it really takes the responsetime down to a zero um delay on
response.
Now, even this week, I havenon-compact states who are
bringing in EMS resources forthings like wildfires and other
types of disasters.
(08:19):
And it's not uncommon forresources to actually have to
wait a few days to go throughthe licensure process.
The EMS compact solves that.
It's good for uh state publicprotection and good for the
workforce.
SPEAKER_01 (08:32):
Yeah, no, it sounds absolutely like it's good.
I am I am seeing no cons.
I mean, this is just fantastic.
And I want to go back tosomething you said a little bit
earlier that, you know, uh thepublic expects that the EMS
personnel in their backyard isgoing to be able to provide
them, you know, the the samelevel of care or same um uh
(08:56):
attention to care um as assomeone who's licensed in that
state as their home state.
So I think, you know, yeah,you've just all the way around,
it it sounds great.
You've got the the public isprotected and you've got uh
personnel who want to grow andlearn in their profession who
are able to, you know, superquickly.
(09:18):
So it's it's awesome.
Let's talk structure of thecompact.
So um the EMS Compact is backedby a commission.
Can you talk about who makes upthe Interstate Commission for
EMS personnel practice?
SPEAKER_00 (09:33):
Yeah, absolutely.
So, I mean, the first thing iswe have to clarify that the EMS
Compact is a governmental body.
And so sometimes people, youknow, think, well, you know, are
you like an association?
Are you a nonprofit?
What are you?
No, we're we're a governmentregulatory body, uh, established
through the compact clause ofthe constitution.
(09:55):
And in the state law that everystate passes, which by the way,
and I said this subtly, but Iwant to emphasize it, is also a
contract state to state.
So it's governed under bothcontract law and state law and
federal law.
And because it's a contract,every state law is the same.
So if you want to join acompact, and like I said,
(10:18):
there's many of them out there,every state passes the same law,
so you have the samerequirements.
One of the things in that statelaw is it creates the
commission.
And through that law, itprovides the commission certain
authority and sorts, certainpowers.
In every state, it's thegovernor or the governor's
(10:38):
office that appoints thecommissioner.
Now, we have defined in thestate law that the commissioner
has to be a subject matterexpert that's part of the
executive branch of governmentthat's responsible for licensing
EMS personnel.
So in almost every state, it'sthe state EMS director.
But the key is this duty isappointed on behalf of the
(11:01):
governor of the state.
And think about it kind of likeyou know, maybe that of like a
senator.
Um, and so, you know, thisperson is accountable for
representing the needs of theentire state, the views of the
state.
Um, every state has one vote.
So when we make decisions as agovernmental body, every state
(11:23):
has one vote.
That person casts the vote.
Maybe it represents theirpersonal view, but more
importantly, it needs torepresent the view of the entire
state and all the stakeholders.
So that's the structure.
Now, within the commission, uh,you know, as with any government
body or organization, you haveto have day-to-day operations.
(11:44):
And so those day-to-dayoperations are carried out by an
executive committee, which isfive of the commissioners that's
been voted and appointed by allthe commissioners collectively.
So those five commissioners meetevery month and they handle the
day-to-day operationaldecisions.
SPEAKER_01 (12:03):
Nice.
Okay.
You mentioned voting.
Can you talk to us about, youknow, how decisions are made?
Is it a vote?
Or um, you know, are there somemaybe some subcommittees that
are kind of broken up?
SPEAKER_00 (12:17):
Oh, absolutely.
So, you know, as as a governmentbody, we also have the uh
authority to do administrativecode, administrative rule, which
has the effective law in 25states, because that's the
number of states in the compactright now.
Now, our administrative code islimited to in scope to the
interstate practice of EMS, youknow, so we don't write, you
(12:40):
know, code or rules uh on thatinfer on state sovereignty.
But when it comes to interstatepractice, that's what we're
accountable for.
And usually, like if we are um,you know, coming up with a
administrative rule, uh, wereally believe that slow is fast
and fast is slow, meaning thatwe slow down, we uh do a long
(13:03):
stakeholder process.
All of our meetings are open tothe public, they're all public
noticed.
Uh, we uh, you know, forinstance, if we're we're looking
at a rulemaking process rightnow, um, you know, we've been in
that process for nearly a year.
Um, countless meetings,countless drafts, uh, lots of
input.
And then it comes out ofcommittee, and so it'll be voted
(13:25):
out of committee, which thisrulemaking has been done.
And then that is publiclynoticed for 90 days.
Um, it's published on everystate website that's out there,
and then we go through, and onNovember 5th, we will have a
vote on this administrativerule, and we'll see if it
carries or not.
Um, most of our rules, by thetime they get to the final
(13:49):
process, um, they passunanimously just because we've
put in so much effort to workthem out in advance.
But you know, that's arulemaking committee, but we
also have other committees.
Um, the government body of thecommission has put out position
papers.
So that's one of the tools weput out, and and these are
(14:10):
non-binding positions of thecommission.
So, for instance, we put out acommission paper recently on
code of conduct.
Um, so we we put out, hey, thisis the code of conduct.
If you want to be an empt or aparamedic, this is what we
believe professional conductlooks like.
And so it's um uh the positionof of the commission and
(14:34):
representing the 25 states.
This is what this is what itmeans to be a paramedic or an
EMT and and treat your patientswith compassion and dignity and
stuff that we all know.
SPEAKER_01 (14:44):
Right.
SPEAKER_00 (14:45):
But it hadn't been written down before.
So we wrote it down.
We have another one aboutprotecting the EMS workforce
against uh you know things likedoxing and cyber hacks and
cybersecurity, and how do we uhensure that nation states are
not gaining access to EMSpersonnel records?
So, you know, we do a lot ofthings.
Um, all of those require votes.
(15:07):
And uh, like I said, we do ourbest to make sure we represent
all the stakeholders.
Currently, it's about 500,000EMS personnel in the United
States that's uh got a privilegeto practice through our office.
SPEAKER_01 (15:20):
That's awesome.
No, it sounds like you guys aredoing a really good job of
making sure, you know, I'm sureit's a delicate balance, but
you've got to make sure that youprotect the public, but also
make the profession itself moreaccessible, better than it was
before, and just keep buildingupon that.
But it sounds like you guys havean awesome plan and and that you
(15:40):
uh have a lot of, like you said,stakeholder input, that there's
a lot of options for EMSpersonnel to get involved and um
and kind of shape the future oftheir profession.
SPEAKER_00 (15:52):
Yeah, you know, there's a lot of opportunity.
We invite people, please come toour meetings, uh, make your
voice heard.
Uh, you know, if there'ssomething that you know works or
doesn't work, let us know.
And then I think the otherthing, you know, this would be a
great time to point out in ourenabling legislation, and when I
talk about the compact, most ofthe conversation is about the
(16:14):
mobility of EMS personnel.
How do I go from you know Texasto Colorado to Virginia to West
Virginia, what whatever.
But the compact law alsoincludes another section that's
very important, and that sectionis that every state is committed
to collaboration on everythingrelated to EMS personnel,
(16:39):
license and standards and um howthe EMS system works.
So, you know, our commission ischarged with unifying states,
unifying solutions.
Um, EMS is no longer on thisfragmented path of everyone
doing whatever they want.
No, through legislation, we havebound together to look at things
(17:03):
through a larger nationalcollective lens, and that's
about advancing the professionand improving it for everyone.
SPEAKER_01 (17:11):
Absolutely.
Very well said.
unknown (17:13):
Yeah.
SPEAKER_01 (17:14):
So let's say that I am a licensed EMT or a paramedic
and I'm in a compact state.
What does this mean for me?
SPEAKER_00 (17:22):
Yeah.
So I mean, uh a lot of the500,000, you know, EMS personnel
that have a privilege ofpractice may not even know the
power that the gift that they'vebeen given by 25 states.
So, you know, why don't we breakdown as to like how you can use
the privatity practice and whatdoes it mean for you
(17:42):
individually?
And the very first thing is youneed to know what your national
EMS ID number is.
Now, uh, this has a fascinatinghistory, but you know, at one
point in time I went through andlike found all my individual
license numbers andcertification numbers, and I had
something like 20, 25, right?
(18:04):
I mean, it was a huge amount.
One of the keys about thecompact is you have a
coordinated database, whichwe'll hopefully talk about in a
minute, but you have to be ableto share licensure information.
So the way that we do that isthrough this new national EMS
identification number.
It's a 12-digit number.
And the easiest way to find itis either through your state
(18:27):
website or through the NationalRegistry website.
And it's printed right there andyou can see it.
So it's 12 digits, kind of lookslike a credit card number.
Um, and so it's 4-4-4.
You can put that in on ourwebsite and it will show if you
have a privilege to practice ornot.
So if you have a privilege topractice, and after you put that
(18:48):
number in, that means that yourlicense is now valid everywhere
else.
Now, how do you use thatprivilege?
Well, there's a few key things.
One is you have to have theprivilege, it has to be visible.
Your home state license has tobe unrestricted, so you can't be
under discipline.
If so, your privilege topractice status will have a red
box around it.
(19:09):
And and then you have to be withan agency.
Now, I get a lot of questionsabout this requirement.
And at the core, it's not even apure compact issue.
It's just about being an EMT orparamedic.
But the core is you have to bewith an entity, an agency.
Uh, we don't have independentpractice in EMS.
(19:30):
Um, you know, yeah, I'm aparamedic.
I can't just go and freelance asa paramedic, right?
I have to have an agency, andthat agency has things like DEA
licenses and the ability to buythe stuff and insurance and
medical direction and a patientcare reporting system, and and
all of that is part of anagency.
So the compact requires you'rewith an agency.
(19:51):
And it's really as simple asthat.
So the moment an agencyaffiliates you in another state
that's part of the compact, yourhome state license is valid and
you can work on that agency.
It's the agency's responsibilityto make sure that you're
competent and that you know thelocal scope of practice and that
you know the local protocol.
(20:13):
But that's also a personal,professional, uh, ethical
responsibility.
As a healthcare professional,you've got to know what your
scope of practice is whereyou're working, and you adhere
to that.
SPEAKER_01 (20:26):
Absolutely.
Speaking of that scope ofpractice, what are those
limitations and thoseresponsibilities that EMS
personnel should have on theirtop-of-mind awareness?
You know, those really big onesthat could could cause some some
major damage.
SPEAKER_00 (20:42):
Yeah.
Well, let me go back to thedriving example.
You know, I I love living inwestern uh United States right
now.
And, you know, we have roadshere where you know the speed
limit is 85.
And um, and you know, there'seven a few roads out where you
know there's no real postedspeed limit.
Um but you know, say that I goback and I'm driving on the I-95
(21:06):
corridor, um, you know, up onthe east coast, and I decide,
well, you know, my speed limitin Colorado is 85, I'm gonna do
that here.
That's not gonna work, right?
And and so, and it's real key tounderstand that if I'm
exercising my driving privilegein another state, I have to know
and follow the laws of thatstate.
(21:26):
Same thing with working in theEMS Compact.
Yeah, you have a license topractice, you have a privilege
to practice, but you have toknow the law of that state and
you're held accountable to thelaws of that state.
So let's take a scope ofpractice issue.
Um, you know, I have a privilegein all 25 states.
Um, and one state, um, as aparamedic, I can do surgical
(21:49):
crikes, I could do uh fingerthoracotomies, um, I can
administer blood.
Um, and that would be part of myscope of practice.
Another state that may not be inthe scope.
So I have to know and understandthat.
So I don't get to uh you knowignore the local scope or law.
(22:11):
So when I accept an employmentopportunity, uh paid or unpaid,
um, then I have to know whatthat scope is, and I follow that
local scope of practice with mylocal medical director.
Um now, you know, this this alsoone of the examples or one of
the questions I get is reallykind of I can break this down
(22:32):
into two scenarios.
Let me say that I am a Virginiaparamedic on a Virginia
ambulance service and Itransport a patient to West
Virginia.
What protocols do you think I'mgonna follow for the duration of
that patient care?
I'm gonna follow my Virginiaprotocol.
I work for a Virginia service ina Virginia ambulance.
I happen to be transporting apatient into another state, my
(22:54):
compact license is valid, I'mgood to go.
Scenario B.
I'm a Virginia paramedic, butI'm hired in Texas for a Texas
service.
What scope of practice and whatprotocol do you think I'm gonna
follow?
Texas.
SPEAKER_01 (23:09):
Texas, yes.
SPEAKER_00 (23:11):
Absolutely.
So it really the the answer tothe question is to like scope of
practice and you know what doyou follow?
Well, you follow the scope ofpractice and the protocols of
the your primary employer thatyou're working for at the time.
SPEAKER_01 (23:24):
Yeah, no, that makes sense, and thank you for laying
it out like that.
Because absolutely, I'm surethat there may be some listeners
going, oh no, but um, yeah, no,that that that does make sense.
And it seems kind of easy tofollow when you think about it
like that.
So let's talk about some toolsto help license holders be aware
of, you know, maybe some ofthese regulatory pitfalls.
(23:47):
What kind of resources does theEMS Compact Commission offer to
help EMS professionals navigateinterstate practice?
SPEAKER_00 (23:55):
Yeah, well, first and foremost, it's our website.
So and that's EMS Compact, oneword.gov.
And so EMSCompact.gov, that'sthe primary place.
So that's where you as anindividual or as an employer,
you're gonna put in thatnational MS ID number.
You can validate that.
We have all of the uh links toall the states.
(24:17):
So if you're wondering, hey, ismy state part of it?
Absolutely.
You can see that map there.
And if you click on the map,you'll see who your
governor-appointed commissioneris and their contact
information.
Uh, we have another section ofresources and videos and
training material there that youcan download and look at.
We have information sheets.
Uh, so we have a wealth ofresources there.
(24:39):
We have a YouTube channel thathas some educational videos, um,
and also all of our uhcommission meetings are on
there.
So if you want to learn aboutgovernance and what we talk
about and how we vote, you know,you can go back and watch those.
Um, you know, get a good cup ofcoffee.
Um but uh, you know, those aresome of the main resources we
(25:00):
have, and they're available.
And I'd also say if you are in acompact state, then contact your
state office and ask them forsome help and resources as well.
And then um, I do a lot ofspeaking, and so you know, it's
very common.
I'm happy to speak to agenciesand customize.
(25:22):
You know, if you have an agencyand you have questions, I'm
happy to come and do anin-service for you and provide
some continuing ed.
Um, the EMS Compact Educationseries is counts for con ed
credit.
Um, it's part of operations, andit's a key part of that.
So those are some of theresources we have.
SPEAKER_01 (25:42):
That's fantastic.
Yeah, websites always a greatplace to start, but man, you
guys have a ton of resources.
A lot of I know video content isreally big right now, and so I
think that's awesome.
It sounds like you've gotcontent for everyone, for every
attention span, and any way theywant to digest it.
Fantastic.
So for those um who arelistening, you said that they
(26:05):
can check the website, right?
If they're not sure if theirstate is part of the compact.
Um, are there any states who areworking on maybe entering the
compact that you know of rightnow?
SPEAKER_00 (26:17):
Yeah, you know, that that's always a tough question
for me to answer.
So um I I can tell you that inthe past uh two months, we've
had 12 states request the copyof the law, uh, the contract.
And so, you know, at least 12states are looking at it.
I suspect some more are.
You know, but it let me pivot onthat question if if you allow
(26:39):
me, real quick.
I frequently get asked, well,you've got 25 states, but why
are the other 25 states not partof the compact?
And, you know, the simple answerto that is stakeholders in those
states have not asked theirlegislators to prioritize
passing this piece oflegislation.
Um, you know, as a governmentbody, I can't lobby, I don't
(27:02):
lobby.
Um, I can answer technicalquestions, but someone's got to
simply ask your statelegislators to do this.
And um, you know, statelegislators uh respond to their
stakeholders saying, hey, thisis a priority for me.
Um of the 25 states that's inthe compact, uh 98.8% of all
(27:24):
elected officials have voted yesfor this legislation.
It's one of the strongest, mostpartisan pieces of legislation
in the history of EMS.
Um, so ask your state, tell yourlocal officials, uh, tell your
elected officials that this is apriority for you.
And uh it's a pretty simple billuh in most states to get
(27:47):
through.
SPEAKER_01 (27:48):
Yeah, no, that's awesome.
I can absolutely see why it'sgot such strong backing from
both sides.
I mean, it's a no-brainer,right?
Um, so what is next for thecompact?
Are there any initiatives, anytrends, or any developments that
um we should keep our eyes on?
SPEAKER_00 (28:04):
Yeah, so I mean, first and foremost is more
education.
Um, and so, you know, we'retrying to work with our EMS
education partners and our coned partners.
Uh, every EMS clinician in theUnited States should know about
the compact.
And I would even go as far assaying every EMS clinician
should probably seek to getlicensed in an EMS compact
(28:27):
state.
I mean, it really opens upopportunities for you and it's a
safeguard for your future, andit's a new tool for recruitment
and retention and workforcemobility.
Um, really, really uh importantthings, especially when we
realize the average age of likean you know EMS clinician is
kind of in that you know youngerspectrum.
(28:50):
Um, and we know that that agegroup, just like you know, when
you are you and I are in thatage group, I mean we we want to
explore the world, we want tosee the US.
Uh, your license shouldn't, youknow, tie you down.
Um, and so the compact allowsyou to do that.
So education is number one onour awareness right now.
(29:13):
And then number two is actuallythe coordinated database.
So kind of like the centralbrain to the compact is what we
call the national MS CoordinatedDatabase.
And this is the system thattakes every state licensure
system, deduplicates it, puts itinto one system.
And that system is essential forthings like planning and
(29:35):
workforce understanding.
Do you know that right now inthe United States, no one can
answer the question how manyEMTs and how many paramedics do
we have?
No one knows.
Yeah, no one knows the answer.
And and there's a lot of reasonsfor that.
But you know, we have 50different state licensure
systems.
Um, people are licensed inmultiple states.
(29:56):
So if you just call every stateand say how many paramedics you
have, cool.
But how many of those arelicensed in 5, 10, 15, 20
states?
Our system deduplicates that.
So for the first time in thehistory across 25 states, we can
answer that question.
But we have some projects goingon on uh expanding that
coordinated database.
(30:17):
We want to add functionality, wewant to add new functionality
that's going to enhance the wayindividual clinicians use it.
And we want to add functionalityof how employers use that.
Um, we know that EMS across thenation, um, funding is a very
important issue for EMS.
And one of the biggest tragediesthat uh I see as a regulator is
(30:41):
when an EMS service has to dowhat we call insurance
reversions and repayments.
And that happens because someonelet their license expire or the
license wasn't valid, uh, youknow, your employer has to pay
that money back to the insurancecompany.
That is millions of dollarsevery year.
So we're working in on asolution in our database that
(31:04):
would allow employers to sign upfor a push notification that if
anyone on their roster has alicense that's not valid or it
becomes expired or becomessuspended, that they would know
immediately without delay.
So those are some of thetechnology things we're working
on.
And then finally, advancing EMSwith a unified voice.
(31:25):
And that's very important.
Um, you know, like I said, ouroffice is responsible for
interstate practice of EMS, butalso to uh, you know, reduce
barriers to align best practicesand to really come up with
common solutions.
And so that's what we're lookingforward to as well.
SPEAKER_01 (31:46):
Awesome.
Well, it sounds like you guyshave a ton of things that we can
keep our eyes on and see how ituh how it plays out.
That's great.
You know, um I I do want to goback, you said you mentioned um
talking about the database anduh that you have finally uh
solved the mystery of how manyEMS professionals are in um, you
(32:10):
know, you said across the US,right?
Or in the 25 states that are inthe compact, how many?
SPEAKER_00 (32:17):
I was afraid you to ask that.
I don't have it up in front ofme right now.
Um so I don't have that put upin front of me.
But you know, but the key is um,you know, the deduplication is
very important.
And to, you know, trulyunderstand what our workforce
looks like of those who arelicensed.
Um, you know, it's not good forme to be counted multiple times,
(32:41):
especially when we come to thinkabout things like, okay, what's
truly happening to ourworkforce?
Um are we growing as aworkforce?
I believe we are, but now youknow, we'll have data for that.
Um, so I'd say stay tuned.
Um, you know, as we continue toum advance uh the work that we
do.
I anticipate we'll have some,you know, research that'll be
(33:03):
coming out and you know, be ableto answer some of those
questions in a more academic,scientific way here in the near
future.
SPEAKER_01 (33:10):
Well, awesome.
Well, thank you so much forjoining me today, Donnie.
This has been an awesomeconversation, just full of
insight.
And I think that it's reallygonna help EMS professionals
just understand how it canempower them in their practice.
So thank you again so much.
SPEAKER_00 (33:28):
Yeah, it was my honor.
Thanks for asking.
SPEAKER_01 (33:30):
And to our listeners, if you're a licensed
EMS professional, make sure tovisit emscompact.gov to see what
your rights and responsibilitiesare under the compact.
Thanks for tuning in to KnowYour Regulator.
And until next time, stayinspired and continue engaging
with your regulatory agency.
SPEAKER_00 (33:47):
Know your regulator, the podcast that inspires you to
engage.
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