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Protectionist Bill Ends Program That Allows More EMS Workers in NH

A bill proposed by three Republicans and three Democrats would remove New Hampshire from the interstate EMS compact called ‘REPLICA’ (Recognition of EMS Personnel Licensure Interstate CompAct), which is currently comprised of 18 states. The compact was created in order to make it a little easier for ambulance providers to hire EMTs and paramedics who are certified in other compact states while maintaining state control over protocols and standards. Considering the dangerous shortage of EMTs and paramedics that every company in New Hampshire is facing at the moment, who would want to make it more difficult for companies to find workers who can legally work in the state?


Considering that none of New Hampshire’s neighbors (Maine, Vermont, & Massachusetts) have joined REPLICA yet, the EMS compact has not really been utilized. This is unfortunate, because EMS services in New Hampshire are desperate for EMTs and paramedics, offering sign-on bonuses as high as $10,000 and approving every request for overtime without hesitation. Paramedics in New Hampshire can earn six figures if they are ambitious and pick up ample overtime. Chair van drivers enjoy company-sponsored EMT school and EMTs are assisted with tuition for paramedic school by their employers. The goal of REPLICA is to make it a little easier for businesses to hire employees who are not yet licensed in the state, but who are licensed in their home state. Senate Bill 540 would withdraw New Hampshire from the interstate compact known as REPLICA.


Among the requirements for REPLICA are 1) that the EMT or paramedic be nationally certified by the NREMT; and 2) that they pass a criminal background check. These are essentially the same general criteria that the New Hampshire Dept. of Safety requires from applicants. This ensures that REPLICA could not possibly allow unqualified EMTs or paramedics to treat patients in New Hampshire. The program simply streamlines the reciprocity process. What the compact does not do is allow providers who are not licensed in New Hampshire to work long-term in the state.


The statute that caused New Hampshire to join the compact was itself somewhat protectionist (anti-market) in nature. Possibly influenced by the firefighters union, the sponsors of the bill ensured that the program would not cause too much competition for the paramedics (many of which work primarily as fire fighters already working in New Hampshire who enjoyed high wages – wages which are largely bolstered by the high demand for paramedics, the result of what is called a “shortage“. They misguidedly feared that a compact which streamlines reciprocity or allows non-residents to work as medics in the state would cut into their beloved overtime, which they understandably enjoy, at least financially. In order to satisfy these individuals and protect them from too much labor competition, the statute prohibited a REPLICA provider from picking up regularly scheduled shifts – they could only pick up shifts when they were truly needed on a per-shift basis.

Additionally, paramedics and EMTS are paid significantly more in Massachusetts than their counterparts in New Hampshire, so they would have little incentive to ‘steal jobs’ from New Hampshire providers. Vermont and Maine have so few providers and they live so far from New Hampshire’s population centers that they should not be considered competitive providers in the same market as New Hampshire’s major metro areas, which are in the Merrimack Valley. The only motive for this bill appears to be protectionism. All six of the bill’s sponsors were contacted and declined to comment on why they proposed this bill.

Considering that New Hampshire’s EMS services and patients are desperate for more EMTS and paramedics, any bill that would place more obstacles between patients and qualified providers should be opposed.

Please contact your Representatives and Senators, the Senate EDA Committee, SB540’s sponsors, and Governor Sununu today. Tell them that New Hampshire believes in a free market and does not want more barriers placed between patients and providers, especially in a time like this.

Reprinted with permission from Liberty Block.

Update: SB540 came out of committee with an Ought to Pass (OTP) recommendation. See docket for further updates.