Q&A with Donnie Woodyard, Jr., Executive Director of the U.S. EMS Compact

Q: What is the United States EMS Compact, and why is it important?
A: The United States EMS Compact is an agreement between states that allows licensed EMS clinicians to practice in any of the 24 Compact Member states without requiring additional licenses. It provides a "Privilege to Practice," enabling clinicians to work in multiple states while maintaining public safety and professional accountability.

The Compact removes administrative barriers, allowing clinicians to focus on what matters most—delivering high-quality care to patients, regardless of geographic boundaries.

Q: How does the EMS Compact operate in Colorado? A: Colorado holds a unique distinction as the first state to enact the EMS Compact, setting the stage for what is now a coalition of 24 states. In Colorado, the Compact is codified in state law under Colorado Revised Statutes § 24-60-3502, making it both a state law and a contractual agreement with other Compact states.

This dual nature ensures that the Compact functions as both a regulatory framework and a collaborative agreement, allowing Colorado’s EMS Clinicians to provide care across state lines while adhering to local rules. Additionally, the Compact allows the national EMS workforce from Compact states to work in Colorado, enhancing the state’s access to trained clinicians.

This mobility has been especially valuable for seasonal workers and in times of surge resource needs, such as during wildland fire seasons. The Compact ensures that Colorado can quickly deploy or receive EMS support, strengthening its ability to respond to both everyday and large-scale emergencies.

Q: What are the primary benefits of the EMS Compact for Colorado EMS clinicians?
A: The Compact brings several key advantages to Colorado EMS clinicians and agencies:

1. Workforce Mobility:
   The EMS Compact provides unique opportunities for both clinicians and EMS agencies. Employers can attract and recruit personnel by marketing the lifestyle benefits of their communities. For instance, some agencies across the U.S. are running targeted recruitment campaigns such as:
   "Are you a paramedic who loves skiing, fly fishing, hiking, or camping? Come work in our community for 3–6 months and enjoy these activities on your days off!"

This approach appeals especially to 20-30-year-old EMS clinicians who want to explore the world and experience different work environments. These short-term, job-share opportunities also help Colorado attract talented seasonal workers, filling gaps in the EMS workforce during peak demand times.

2. Enhanced Emergency Response:
   Unlike agreements such as the Emergency Management Assistance Compact (EMAC), the EMS Compact does not require a disaster declaration for EMS clinicians to provide care across state lines. The Compact offers 24/7 mobility, ensuring that clinicians can respond to emergencies or routine mutual aid requests whenever needed. This capability is particularly critical during wildfire seasons or other events requiring rapid, cross-border coordination.
3. Economic and Professional Growth:
   The Compact strengthens Colorado’s workforce by creating new avenues for professional growth and development. Colorado EMS clinicians can gain experience in diverse work environments across other Compact states without being hindered by additional licensing requirements. This flexibility helps retain talent by offering expanded career opportunities while still ensuring that Colorado remains an attractive place to work.
4. Public Safety:
   The Compact’s national database ensures transparency and accountability. Colorado regulators can verify the licensure and disciplinary status of any EMS clinician practicing in the state, safeguarding public trust and ensuring high standards of care.

The EMS Compact empowers Colorado to maintain a strong, adaptive, and mobile EMS workforce while enhancing its ability to respond to both local and regional challenges.

Q: How does the EMS Compact handle differences in state regulations and protocols?
A: This is a critical aspect of the Compact that ensures both flexibility and accountability. The EMS Compact has provisions allowing clinicians to follow either their home state scope of practice and protocols or the scope of practice and protocols of the remote state, depending on the circumstances.

The simplest way to understand this is that an EMS clinician follows the protocols and scope of practice for the agency they are affiliated with at the time of patient care:

• If you are working with a Colorado-based agency and responding in Wyoming, you would continue to follow Colorado protocols and medical direction.
• However, if you moonlight or take on extra work with a Utah-based agency, you would follow that agency’s protocols and medical direction while working there.

This flexibility ensures consistency in patient care, reduces liability for the clinician, and respects the integrity of both home and host state regulations. The Compact strikes a balance between supporting clinician mobility and maintaining patient safety and regulatory compliance across states.

Q: What role does the EMS Compact Commission play?
A: The EMS Compact Commission is the governmental body responsible for the implementation, oversight, and governance of the EMS Compact. It ensures that the Compact operates smoothly and consistently across member states. The Commission’s key responsibilities include:

• Enforcing Compliance: Ensuring all member states adhere to the Compact’s rules and regulations.
• Resolving Disputes: Addressing disagreements or conflicts between member states related to interstate EMS practice.
• Maintaining Infrastructure: Managing the systems and processes, such as the national EMS licensure database, that support seamless interstate practice for clinicians.

Each state participating in the Compact is represented on the Commission by a Governor-appointed Commissioner, who serves as the voice of their state. In most cases, the appointed Commissioner is also the state’s EMS Director or a high-ranking EMS official.

In Colorado, Mike Bateman, the State EMS Director, serves as the Governor-appointed Commissioner. His role ensures that Colorado’s unique EMS needs, challenges, and perspectives are represented in all decisions made by the Commission.

This structure ensures that the Commission reflects a collaborative effort among the states while providing strong governance and oversight for the Compact’s operations. Colorado’s participation reinforces its leadership in advancing EMS on a national scale.

Q: What challenges does the Compact face, and how are they being addressed?
A: One challenge is education and awareness. Not all clinicians and agencies fully understand how the Compact works or how it benefits them. We’re addressing this through outreach, training, and resources to ensure that everyone involved understands the Compact’s value.

The Compact only applies to the 24 member states. Clinicians traveling to non-Compact states must still follow traditional licensing processes, but we are actively engaging with non-member states to encourage broader adoption.

Q: What does the future hold for the EMS Compact in Colorado and nationally?
A: The EMS Compact represents a transformative step forward for the EMS profession. In Colorado, it strengthens the state’s EMS system by promoting collaboration, reducing administrative barriers, and enhancing public safety.

Nationally, the Compact is setting a standard for how states can work together to support EMS clinicians and protect the public. As more states join, the Compact will continue to evolve, creating even greater opportunities for innovation and collaboration.

For Colorado specifically, the Compact opens doors for the state’s EMS leaders, educators, and clinicians to use this framework as a platform for broader improvements—whether that’s in disaster preparedness, workforce development, or advancing the profession as a whole.

Q: Why should Colorado EMS agencies and clinicians embrace the Compact?
A: The EMS Compact is more than just a legal or regulatory tool—it’s a symbol of progress and unity within the EMS profession. By embracing the Compact, Colorado’s EMS community is leading the way in ensuring that clinicians can deliver care wherever it’s needed most, unhindered by borders or bureaucracy.

It’s about supporting our EMS clinicians, enhancing patient care, and building a stronger, more resilient EMS system. That’s something every agency and clinician in Colorado can be proud to be a part of.

Q: Why is the EMS Compact important for the future of medical licensure and professional mobility?
A: Interstate compacts, like the EMS Compact, represent the gold standard for professional licensure, especially in the medical and occupational fields. These agreements streamline licensure processes, enhance mobility, and ensure consistent standards of practice across state lines. Currently, there are 17 medical and occupational professional licensure compacts, and Colorado participates in 12 of them, including those for nursing, medicine, physical therapy, psychology, and now EMS.

It is essential that EMS clinicians, as medical professionals, have the same access to professional mobility as their colleagues in these other fields. The EMS Compact ensures that EMS clinicians can work across state lines with ease, whether responding to emergencies, taking advantage of job opportunities, or participating in collaborative healthcare efforts.

By aligning EMS licensure with other healthcare professions, the Compact affirms the critical role of EMS clinicians in the healthcare continuum and positions EMS as a modern, professionalized field. It’s about leveling the playing field and recognizing the vital contributions of EMS clinicians while providing them the tools and opportunities to succeed.

Colorado’s early adoption of the EMS Compact showcases the state’s commitment to professional mobility and workforce innovation, ensuring that EMS clinicians are recognized as an integral part of the broader medical community.

Q: Any closing thoughts?
A: The EMS Compact is a testament to what we can achieve when states come together with a shared vision. For Colorado, being the first state to enact the Compact is a point of pride and a call to action. We have an opportunity to continue leading the way, ensuring that our EMS clinicians are empowered to meet the challenges of today and tomorrow.

Through collaboration, innovation, and a commitment to excellence, the EMS Compact is shaping the next era of EMS in Colorado and beyond.

Q: Where can I find more information about the EMS Compact?
A: For additional information about the EMS Compact, visit www.emscompact.gov. The website offers a wealth of resources, including:

• Educational Materials: Videos, podcasts, and downloadable resources under the Resources tab, providing a comprehensive overview of the Compact’s provisions and benefits.

It’s particularly important for EMS clinicians at all stages of their careers—including those just entering the profession—to fully understand the Compact and its implications for their practice. EMS educators should also be well-versed in the Compact to help prepare the next generation of EMS professionals.

As a resident of Colorado, I am happy to participate in training sessions, whether in-person or virtual, to help agencies and educators better understand the Compact. Please don’t hesitate to reach out through the website or directly to me to arrange a session. The more we collectively understand the Compact, the better prepared we are to leverage its full potential for the EMS profession.

About Donnie Woodyard, Jr.
Donnie Woodyard, Jr., MAML, NRP, is the Executive Director of the United States EMS Compact. With over 30 years of experience in EMS, Donnie has served in leadership roles across the profession, including as the State EMS Director for Colorado & Louisiana and the Chief Operating Officer of the National Registry of EMTs (NREMT).

An accomplished author, Donnie has written two books, including a recent best-seller on the integration of artificial intelligence in EMS. He is a current Colorado-licensed paramedic and an active member of the EMS Association of Colorado (EMSAC).

A resident of Thornton, Colorado, Donnie is a passionate advocate for advancing EMS, modernizing systems, and empowering clinicians through innovation, professionalism, and mobility.

For more information about the EMS Compact, visit www.emscompact.gov.