Seven states have enacted legislation that negatively affects EMS jobs and wages. Colorado, Idaho, Kansas, Tennessee, Texas, Utah, Virginia and Wyoming have all approved the Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA) over the past year, which poses a serious threat to IAFF affiliates everywhere, compromises quality care and service to the communities they serve. States such as Michigan, Minnesota, Mississippi, Missouri, New Mexico, Oregon have seen initiatives underway.

However, several states have successfully prevented REPLICA from passing, including Louisiana, Nevada and Wisconsin.

The IAFF believes EMS services should be locally driven and that REPLICA reduces control over patient care. The legislation poses a threat to IAFF affiliates everywhere, compromising quality care and services to the communities. It would also negatively affect the wages of EMS workers and put their jobs in jeopardy.

REPLICA is also a threat because…

  • Even if a state’s fire department does not provide or support fire-based EMS, passage in another state may affect other states that do offer fire-based EMS ambulance services.
  • If the Trump administration decides that Medicaid should be under state control – it could mean that states get less assistance over the next several years.

The legislation allows ambulances to cross state lines to not only pick up patients, but also transport them to other states or back to the state of origin.

The National Association of State EMS Officials (NASAMSO) authored the legislation in response to the federal government’s request to improve response to federal law enforcement activities and to emergency incidents, such as wildland fires. The federal government aims to ease restrictions to make it easier for EMS personnel to provide services across state lines that involve high-level security response from the FBI, Department of Homeland Security and other law enforcement to emergencies. The IAFF understands the need to make access more convenient, but REPLICA in its current form makes government bigger and more bureaucratic. In addition, current legislation exceeds the scope and extends the legislation to include day-to-day EMS response, which could include non-emergency inter-facility work.

We believe this could allow private entities and rival organizations to position resources near state borders to access multiple communities and take work away from IAFF affiliates in their jurisdictions and inadvertently create a parity gap in wages for states that enter such agreements.

Although the IAFF was a stakeholder organization during the creation of this model legislation, it is evident that our position was not inserted. We have stated our opposition to the rest of the stakeholders and authors of the model legislation.

Here are some of our chief concerns:

  1. The bill is a threat to jobs and wages. It creates a situation that benefits large for-profit ambulance companies by allowing their workforce to easily traverse state borders.  Frankly, it opens the door for out-of-state scab labor.
  2. It disadvantages low wage EMS workers by increasing their workload and travel distances without the benefit of breaks.
  3. It reduces the need of for-profit EMS companies to create jobs because they can re-route resources across state lines to fill open shifts rather than hiring.
  4. If these workers are allowed to migrate, what protections are in place to ensure that the state receives the taxable revenue it should receive if a worker is assigned to one state for a day or more?
  5. The REPLICA commission seeks funding from State’s for its operation but eliminates access to open public comment.
  6.               a) Although the current commission has stated it will ensure transparency, the law is written to restrict it. As such, subsequent commissions could opt to again restrict public comment access.
  7.               b) Fee could ultimately be passed along to the provider/municipality/agency by raising certification and renewal fees
  8. Some States are unable to pay the fair share, yet they will be allowed to vote.
  9. Many of the topics discussed within the bill are already provided by many states.
  10. It represents a loss of control of public safety resources.
  11. Because it potentially reduces costs for large ambulance companies, it creates a situation where private services could underbid fire departments.

We have offered compromises to the authors of the legislation, but they have not been accepted. Additionally, we are aware of a law that allows federal resources to enter the state to work without applying for reciprocity. In lieu of joining a compact that directly affects local EMS services, we encourage a model that allows local communities to keep their autonomy and the federal government to do what it needs to do without applying for reciprocity.

A potential solution is to look at states such as Indiana, which has adopted language to address the issue:

An agency or instrumentality of the United States and any paramedic, emergency medical technician, emergency medical technician-basic advanced, or ambulance of the agency or instrumentality of the United States does not include a person operating under a contract with the government of the United States. (Indiana Emergency)

The IAFF passed a resolution at its Centennial Convention in 2018 to oppose REPLICA legislation until IAFF modifications are met.