It is critical that all states, territories, and jurisdictions implement uniform Federal Bureau of Investigation (FBI) compliant biometric criminal history records checks for all individuals seeking licensure as an EMS Practitioner in the United States. The national EMS leadership organizations together wrote the Model Legislation for the Recognition of EMS Personnel Practice Interstate Compact (REPLICA) – the EMS Compact, which requires all Compact Member States to perform an FBI-compliant biometric criminal history check as a prerequisite for state licensure. Twenty-four states have adopted this model since 2014. Its core justifications include Commitment to Public Health, Safety, and Welfare; Upholding Professional Standards and Ethics; Necessity of Public Trust; and Unique Challenges of EMS Service Delivery.