Leveraging the EMS Compact for Recruitment and Retention in Colorado EMS
By Donnie Woodyard, MAML, NRP
Executive Director, United States EMS Compact

Colorado made history in 2015 by becoming the first state to pass legislation enacting the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact—more commonly known as the United States EMS Compact. In the decade since, 24 other states have followed suit, creating an unprecedented legal framework for multistate EMS clinician practice. Today, more than 400,000 EMS professionals have a Privilege to Practice in Colorado under the Compact.
The EMS Compact is a practical, underutilized asset that provides Colorado EMS clinicians and employers powerful new tools to address two of the most pressing challenges in our profession: recruitment and retention.

The Power of Immediate License Recognition
Under the EMS Compact, Colorado recognizes EMS licenses from the 24 other Compact member state as valid and legal for practice instantly. This license recognition is not temporary, conditional, or provisional. It is immediate, continuous, and embedded in Colorado state law.
The concept works similarly to how driver’s licenses function: if you have a valid license in your home state, you can legally drive in Colorado. Likewise, suppose an EMT or paramedic is licensed in Texas, Utah, Virginia, or any of the other 24 Compact states. In that case, their EMS license is fully recognized in Colorado the moment they affiliate with a local EMS agency. No redundant paperwork. No application fees. No bureaucratic delay.

Recruitment Advantage: Lateral Transfers Without Friction
For EMS agencies, especially fire departments conducting lateral recruitment across state lines, the EMS Compact is a game-changer. Say you’re hiring a paramedic from South Carolina or an EMT from Kansas. If their license is current in their home Compact state and they become affiliated with your agency, they can begin practicing immediately in Colorado—no delays, no additional paperwork, no redundant licensure process.
There’s no requirement to apply for a new license from the Colorado Department of Public Health and Environment (CDPHE). Their Privilege to Practice is already in place, embedded in Colorado law through the Compact. That said, we encourage EMS clinicians who choose to make Colorado their long-term home to obtain a Colorado EMS license eventually. Doing so provides added continuity if their home state license lapses and helps them more fully integrate into local systems, including CE processes and agency credentialing.
For employers, this legal recognition allows you to dramatically reduce the “onboarding gap” between hiring and deployment—a critical advantage in a workforce environment defined by staffing shortages and urgent operational needs. It’s especially beneficial for agencies that need to scale quickly in response to seasonal surges, winter tourism, or wildland fire deployments.

How to Validate Privilege to Practice
Verifying that an out-of-state clinician holds a valid Privilege to Practice is simple:

This system provides legal confidence and real-time transparency. The validation tool is established in state law and is backed by the Coordinated Database—a shared, national verification system managed under the Compact and secured through state licensing boards.
A few states, such as Tennessee and Indiana, are still in the process of integrating their data into the Coordinated Database. If a clinician from one of these states does not appear in the system, don’t worry—the Compact provides for a manual validation process. This simple procedure, outlined in Administrative Rule 4.3, can be initiated via email and completed in under 48 hours. It confirms the license is valid and the clinician has Compact privileges.

Retention Strategy: Workforce Flexibility for the GenMobile Era
Beyond recruitment, the EMS Compact is also a strategic retention tool. Today’s workforce—especially younger clinicians—values mobility, flexibility, and meaningful work. The Compact creates new ways to meet those expectations without losing your team.
Consider these possibilities:

• Burnout prevention: Allowing a full-time employee to work per diem in another Compact state for a season or special event can offer a refreshing change of pace without requiring resignation or re-licensure.
• Professional growth: Supporting clinicians in taking temporary assignments elsewhere—such as wildland deployments, major events, or national disaster responses—builds experience while reinforcing their value to your agency.
• Lifestyle accommodations: The Compact supports clinicians who split time between states, such as those with family in another region or a desire to live in a mountain town during ski season or at a beach location during the summer.

When clinicians see that their employer understands and supports multistate opportunities, they are more likely to stay, recommend your agency, and reinvest in your mission.

Agency Affiliation Is Key
One important caveat: to activate their Privilege to Practice in Colorado (or any other Compact state), a clinician must be affiliated with a licensed local EMS agency operating under Colorado medical direction and protocols.
This isn’t just a formality—it’s a critical safeguard built into the Compact. While the Compact provides a legal bridge for practice, each state retains complete control over how EMS is delivered, under whose supervision, and following which standards.
In Colorado, that means every Compact clinician must operate under the authority of a Colorado EMS medical director and follow Colorado protocols through a properly authorized agency.
No Time Limit. No Red Tape. Just Readiness.
Unlike temporary or disaster waivers, the EMS Compact is not dependent on a declared emergency or a limited duration. There is no expiration on the Privilege to Practice as long as:

• The clinician’s home state license remains valid
• The clinician remains free from disciplinary restrictions
• The clinician is affiliated with a Colorado EMS agency

This creates a level of legal certainty and long-term planning that EMS agencies have never had before. It empowers chiefs, directors, and hiring managers to recruit confidently, plan seasonally, and support the professional aspirations of their workforce.

What About Education, Medical Directors, and QA?
Compact-recognized clinicians are fully licensed and credentialed in their home state. Colorado agencies should still:

• Orient new hires to Colorado protocols and equipment
• Ensure compliance with local credentialing policies
• Integrate clinicians into your existing QA/QI processes and training

The Compact does not replace local onboarding—it streamlines it. It removes the unnecessary barrier of duplicate licensure while preserving all state-specific requirements for safe practice.

EMS Compact: A Tool Worth Using
Colorado led the nation in adopting the EMS Compact. Now it’s time to lead in using it.
Whether you’re a rural ambulance service looking to recruit from Kansas, a Front Range fire department offering lateral transfers from Arizona, or a ski resort EMS system preparing for winter staffing surges, the EMS Compact offers immediate, legal, and reliable solutions

The EMS Compact is a living workforce strategy for the modern EMS environment
If your agency would benefit from an in-service training on how to operationalize the EMS Compact in your hiring or retention programs, please don’t hesitate to reach out. My office is happy to support your team, answer questions, and connect you with the resources you need.

Let’s keep Colorado at the forefront of innovation—and keep our EMS clinicians empowered to serve, grow, and thrive.
Contact for Training or Questions
Donnie Woodyard, MAML, NRP
Executive Director, United States EMS Compact