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.
several states have successfully prevented REPLICA from passing, including Louisiana,
Nevada and Wisconsin.
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.
also a threat because...
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
the Trump administration decides that Medicaid should be under state control –
it could mean that states get less assistance over the next several years.
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
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.
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.
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
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.
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.
b) Fee could ultimately be passed along to the provider/municipality/agency by raising certification and renewal fees
6. Some States are unable to pay the fair share, yet they will be allowed to vote.
7. Many of the topics discussed within the bill are already provided by many states.
8. It represents a loss of control of public safety resources.
9. 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
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.