July | August 2017







Interstate Compacts: A Solution For
Workforce Mobility

By Dan Logsdon, manager, National Center for Interstate Compacts
Two new professions are joining the growing ranks of occupational licensure interstate compacts. This fall, the Recognition of EMS Personnel Licensure Interstate CompAct, or REPLICA, a licensure compact for emergency medical service professionals, and the Physical Therapy Licensure Compact will convene their inaugural interstate commission meetings to begin the work of interstate cooperation.
REPLICA required ten states to trigger the activation of its compact agreement and the establishment of its intestate commission. Georgia Gov. Nathan Deal signed legislation last spring that made Georgia the 10th state to join REPLICA.
According to Sue Prentiss, the executive director of REPLICA, the formation of this interstate compact advances EMS personnel by increasing transparency and portability between states and by reducing barriers such as the need to acquire multiple licenses to work across state lines.
The compact allows EMS personnel to work under authorized circumstances in other states utilizing the license issued by their home state and expedites the exchange of licensure data between member states.
Prentiss said the nursing profession implemented a compact years ago, which is now currently the lead healthcare licensure compact for emergency medical services, but that REPLICA will place EMS personnel on a level playing field when it comes to license portability.
“We’ve got momentum for a few different reasons, one of which is because we are a compact now and everybody is looking to the commission to see what shape it will take, what role they will play in the nation of EMS … and as a national policy,” Prentiss said.
The Physical Therapy Licensure Compact also reached the threshold of member states to activate its compact in April this year. Oregon was the first state to join the compact in March 2016.
Jeff Rosa, managing director of post licensure services for the Federation of State Boards of Physical Therapy, attributes this success to the cooperative and transparent relationships that resulted from an inclusive process that is crucial to the success of any interstate compact effort.
“I think one of the reasons why we’ve been so successful is we definitely had a partnership with the professional associations,” Rosa said. “I think, even going back to the advisory taskforce, we recognized that if a compact is going to work in physical therapy it can’t just be the regulators that see the benefit, the profession itself needs to see the benefit and they need to be a copartner in getting member states and licensees interested in this and throughout the entire process.”
Rick Masters, special counsel to CSG’s National Center for Interstate Compacts, said when the key components are in place, such as a governing structure, other states begin to take interest in joining the compact.
“If they have been sitting on the outside looking in because they are skeptical about whether it can work, the best evidence is the process actually taking place and multistate licensure actually occurring,” Masters said. “I think from that point forward … it will just be a matter of time before the other states find it in their interest to join the existing jurisdictions in issuing interstate licenses and facilitating licensing portability.”
According to Tennessee state Sen. Bo Watson, a lead architect and proponent of the physical therapist’s compact, the utility of interstate compacts and professional licensure portability is a trend that will continue, especially in the healthcare sector. 
“The physicians are working on a compact, or have a compact in place now; physical therapists and emergency medical people have a compact. We are going to see this occurring all along the healthcare continuum partly driven by mobility, partly driven by technology development, partly driven by the desire to increase access to healthcare,” Rosa said. “This is a way of using a constitutional right for states to form compacts while at the same time avoiding nationalism of licensure, which I believe just about every professional is against, and certainly every state is against.”