RCIC Reaches Milestone, Expanding RT Workforce Mobility

Momentum for the Respiratory Care Interstate Compact (RCIC) reached a critical milestone this week as the 7th state enacted legislation, officially triggering the compact’s activation. Soon after the minimum threshold was met, additional legislative approvals brought the total number of states that passed legislation to nine. AARC, in collaboration with the Council of State Governments (CSG) and the Department of Defense (DoD), is proud to announce the formal launch of the RCIC, which now establishes the Respiratory Care Interstate Compact Commission. This initiative marks a new era for the respiratory therapy profession, streamlining licensure across state lines to improve patient care and address critical healthcare staffing shortages.

The RCIC is a legally binding agreement among member states that allows licensed respiratory therapists (RTs) to obtain “compact privileges” to practice in other participating states. This eliminates the need for clinicians to maintain multiple individual state licenses-a process that has historically been costly, time-consuming, and a barrier to rapid healthcare response. The Commission will comprise a Commissioner from each participating state, who will come together to establish the RCIC bylaws, rules, and regulations.

“The launch of the RCIC Commission is a significant milestone for our profession and the patients we serve,” said AARC President, Dana Evans, MHA, RRT, RRT-NPS, FACE, FAARC, FNAP. “By reducing administrative burdens and increasing licensure portability, we are ensuring that highly qualified respiratory therapists can be deployed where they are needed most – whether it’s a rural clinic, a hospital facing a surge, or a military family relocating to a new state.”

Key Benefits of the Respiratory Care Interstate Compact:

• Enhanced Patient Access: Improves access to specialized respiratory care in underserved and rural areas.
• Workforce Mobility: Allows RTs to practice in multiple states quickly, facilitating better response to public health emergencies and seasonal surges.
• Support for Military Families: Streamlines the transition for military spouses and members who are respiratory therapists, allowing them to continue their careers without delay when relocating.
• Reduced Administrative Burden: Simplifies the process for state boards and practitioners through a shared data system and standardized requirements.
• Public Safety: Maintains high standards of care by ensuring all participating therapists hold an active, unencumbered license and undergo thorough background checks.

“During the height of the COVID-19 pandemic, Alabama was fortunate to receive critical support from highly skilled respiratory therapists across the United States. This experience highlighted the need to enable RTs to mobilize efficiently across state lines in response to public health emergencies,” Robert B Johnson, MS, RRT, AE-C, FAARC, Alabama Respiratory Care Society Advocacy member. “Through collaboration between AARC leaders and advocates, the RCIC initiative enabled Alabama’s legislative bodies to act swiftly, leading to its rapid passage and enactment. There is pride in Alabama’s role as an early adopter of the RCIC and excitement about the expanded opportunities it creates for interstate practice.”

Following the finalization of model legislation in 2024, AARC and the CSG developed a toolkit, and five states passed the legislation in 2025. These early adopters paved the way for some 20 affiliates to get the legislation introduced in 2026. Meeting the threshold of seven states passing the legislation, the Respiratory Care Interstate Compact has reached the milestone of initiating implementation and formally establishing the Commission to provide oversight. Additional states have active legislation that could pass in 2026 and are expected to join as adoption continues.

“The RCIC legislation moved at an accelerated pace compared to other Compacts. This is due in large part to the partnership among the AARC, the CSG, the DOD, and, most importantly, the state affiliates and the respiratory therapists in each state who want a compact. We are ahead of many other professional compacts,” said Miriam O’Day, AARC Senior Vice President of Government Affairs.