Respiratory Care Interstate Compact Next Steps

Right now, respiratory therapists have to get a separate license for every state they want to work in. This includes respiratory therapists doing telehealth.  That takes time, money, and paperwork. 

The RCIC fixes that by creating a simpler way to work across state lines, which: 

• Helps get care to patients faster 

• Makes it easier for therapists to travel or respond to emergencies 

• Improves access in rural and underserved areas  

In short: fewer barriers for therapists = better access for patients. 

• Securing a grant from the U.S. Department of War (formerly Defense) 

• Partnering with the Council of State Governments 

• Helping write the model legislation 

• Organizing experts and stakeholders to design the compact 

• Supporting state affiliates in advocacy to pass legislation 

In simple terms: AARC built the roadmap and helped states bring it to life. 

Now that the “activation threshold” has been passed the next steps include:  

1. Creating the Compact Commission (the governing body) 
2. Writing rules and building systems (like a shared database) 
3. Launching the application process 

This setup phase typically takes about 2–3 years after the threshold is reached. The earliest RTs may be able to obtain compact privileges would be late 2027. 

The timeline for applying for a compact license will not be immediate.  You’ll be able to apply after the Commission is fully set up and operational systems are built which could take 2-3 years.  

Think of it like this: 

• Law passed = green light 

• Commission + systems = engine built 

• Then applications open 

Yes—for now. 

• You must maintain your home state license at all times. 

• You may still need to renew existing licenses you already hold. 

• The compact will allow you to add new states more easily (with fees). 

Over time, many therapists may choose to drop extra licenses and rely on compact privileges instead – depending on how many states pass the legislation. 

Yes—that’s exactly what the compact is designed for. 

As long as: 

• Your home state is in the compact, and 

• You meet eligibility requirements 

You can apply for permission (“compact privilege”) to work in other participating states 

Commissioners are not elected by individuals. 

Each state appoints: 

• The executive director (or designee) of the state licensing board 

• Another state employee appointed by the Governor 

So, Commissioners are typically state regulatory leaders, not individual RTs.  

It depends on your primary state of residence (your “home state”). 

• If your home state is part of the compact → YES 

• If your home state is NOT part of the compact → NO (for now) 

The compact is based on your home state license, not just any license you hold. 

You can help bring it to your state by:  

• Working with your state respiratory society 

• Contacting your state legislators and asking them to sponsor an RCIC bill 

• Using AARC resources and toolkits to advocate 

• Sharing how the compact improves access to care and workforce mobility 

AARC provides advocacy tools and guidance to help states pass the legislation. If you are interested in getting involved, please email us at membermail@aarc.org.