The RCIC is a legally binding agreement among states that allows licensed respiratory therapists in one member state to practice in other compact states without obtaining additional licenses. Modeled after successful nursing and physical therapy compacts, this initiative will streamline licensure, enhance workforce mobility, and expand patient access while maintaining robust professional and patient safety standards.
Once seven states enact the legislation, the next step is the establishment of the RCIC Commission, which will manage shared data systems, rulemaking, and a unified process for verifying and granting practice privileges.
Across the country, hospitals, clinics, and home health agencies are struggling to fill RT positions, particularly in rural and underserved areas. The RCIC helps deploy skilled clinicians where they’re needed most, without the costly and time-consuming burden of obtaining new licenses.
The compact strengthens emergency response. During pandemics, wildfires, or natural disasters, RTs can cross state lines immediately to provide critical care. It also supports telehealth and provides stability for military families, who often face employment disruptions when relocating between states.
Every RT using the compact must hold an active, unencumbered state license in their home state.
The RCIC was developed through a partnership between the American Association for Respiratory Care (AARC), the Council of State Governments (CSG), and the U.S. Department of Defense (DoD). The DoD’s Defense-State Liaison Office recognized the compact’s value to military families and provided a grant for its development.
The RCIC Legislative Policy Summit was held in August 2025 in Washington, D.C., and sponsored by the Department of Defense. The Summit convened legislators, respiratory therapy leaders, and DoD officials to highlight how the compact will improve patient access, strengthen workforce readiness, and ensure rapid response during emergencies. The Summit was aimed at States that were most likely to pass the legislation in 2026, with assistance from the RCIC partnership, to meet the DoD goals of establishing the compact as quickly as possible.
Iowa was among the first states to pass the RCIC, joining Alabama and Washington as early adopters. “It’s incredibly exciting to see Iowa among the first states to pass the RCIC,” said Colleen Reiland, MS, RRT, who helped lead Iowa’s advocacy effort. “This compact isn’t just about mobility, it’s about ensuring patients can receive expert care wherever they are and giving our profession the recognition and flexibility it deserves.”
As more states prepare to introduce RCIC legislation in 2026, the AARC is arming its volunteer-led affiliates with advocacy guides, talking points, and grassroots tools. Each new state that joins brings the profession closer to a modern, mobile, and unified respiratory therapy workforce ready to meet the nation’s evolving health challenges.
