HD11 - Report on EMS Collaborative Agreements with Border States in Response to House Bill 311 [2016] – Emergency Medical Services Providers; Interstate Agreements

Executive Summary:
House Bill 311 was introduced in the 2016 Session of the General Assembly by Delegate Orrock. The bill, which passed both houses unanimously, directed the Secretary of Health and Human Resources (SHHR) to undertake efforts to establish collaborative agreements with other states, particularly those states that share a border with the Commonwealth, for the interstate recognition of certifications of emergency medical services (EMS) providers for the purpose of allowing EMS providers to enter into other states to provide emergency medical services. House Bill 311 directed the SHHR to report to the General Assembly regarding the status of establishing collaborative privilege to practice agreements with other states no later than November 1, 2016.

In order to assess the interest of states and determine the feasibility of entering into collaborative agreements with states that border Virginia, the Virginia Department of Health (VDH), Office of Emergency Medical Services (OEMS), developed a short, nine (9) question on-line survey.

Survey responses received from the states that border Virginia are contained in the RESULTS
section of this report and the respective appendix for each state.

There is great variability in rule from state to state related to the requirements for EMS personnel licensure. As a result of this variability, it is inconvenient and expensive for volunteer and career EMS personnel that cross state borders in their day to day operations to hold licenses from multiple states in order to practice in each state they provide care. In addition, the procedures, skills and techniques individuals are allowed to perform by their medical director differ from state to state, and medical treatment protocols may be established at a state, regional or local EMS agency level. For these and other reasons identified in this report, the differences that exist from state to state make the establishment of collaborative agreements impractical and extremely difficult.

OEMS did find however, there is strong support across the country among the EMS community for creating an EMS personnel licensure interstate compact that recognizes the ability of Emergency Medical Services (EMS) personnel to operate within their scope of practice across state lines. As of October 1, 2016, Recognition of EMS Personnel Licensure Interstate Compact (REPLICA) has been adopted in seven states (Virginia, Colorado, Texas, Utah, Idaho, Kansas, and Tennessee). Other states (Kentucky, New Mexico, Washington, Oregon, Mississippi, South Carolina, Missouri, Nevada, Georgia, Minnesota, and Wisconsin) are in various stages of process to present this measure to their legislatures. REPLICA creates a clear ability to manage and monitor EMS personnel by collective control and self-regulation through the creation of uniform rules, policies and procedures that multiple states will follow. The development of collaborative agreements with states that border Virginia and refer to uniform and consistent procedures to recognize an EMS provider’s privilege to practice is something that cannot be easily accomplished and would require tremendous time and effort.

In addition, a separate effort to establish individual collaborative agreements with other states to allow EMS providers to practice across state lines as called for by HB311 will duplicate the provisions and language of REPLICA that has been accepted nationally by the National Association of State EMS Officials (NASEMSO). Virginia adopted REPLICA during the 2016 Session of the General Assembly, and with the likelihood of a majority of the states that border Virginia expected to join REPLICA within the next one to five years, the concerns about recognizing an EMS provider’s privilege to practice across member state lines will be addressed.