A national compact licensure signed into law in Washington State is the first to allow respiratory therapists to practice across state lines in other states participating in the compact.


RT’s Three Key Takeaways

  1. Historic Legislation: Washington state became the first in the US to sign a national compact licensure for respiratory therapists (RTs) into law on April 16, allowing licensed RTs to practice across state lines with other participating states.
  2. Pandemic-Inspired Reform: The urgent need for a national RT licensure compact was emphasized during COVID-19 surges when cross-state practice restrictions limited response efforts, with hopes now that enough states will join by 2026 to activate the compact nationwide.
  3. Key Advocacy Efforts: The legislation’s passage was driven by collaboration among the AARC, the Council of State Governments, the Department of Defense, and others.


Washington State made history by becoming the first state in the nation to sign a national compact licensure for respiratory therapists (RTs) into law, according to a press release from Providence Swedish North Puget Sound.

Signed into law on April 16, the legislation will enable licensed RTs to practice across state lines with other states that participate in the compact. According to the Washington State Legislature, the bill will go into effect on July 27, 2025.

The need for a national licensure compact was highlighted during the pandemic. At the time, due to licensing restrictions, RTs were unable to respond to COVID-19 surges occurring across state lines, which underscored the need for improved licensure portability. Now, with Washington state leading the way, it is hoped enough states will follow suit by 2026 to activate the compact nationwide and enable RTs to respond swiftly and effectively wherever they are needed.

“This is a huge win for respiratory therapists and healthcare organizations across the state,” said Kristy Carrington, chief executive of Providence Swedish North Puget Sound. “Thanks to the foresight of the American Association for Respiratory Care, the Council of State Governments, and the Department of Defense, along with Washington state’s leadership, our nation is on its way to being better prepared to care for respiratory therapy patients wherever the need is greatest.”

Governor Ferguson signs House Bill No. 1114, April 16, 2025. Relating to the respiratory care interstate compact.
Governor Ferguson signs House Bill No. 1114, April 16, 2025. Relating to the respiratory care interstate compact. (From right to left) Rep. Joe Schmick (bill co-sponsor), Tammie Perreault (from DoD), Gov. Bob Ferguson, Rep. Mari Leavitt, Ph.D. (prime bill sponsor), Carl Hinkson (Sr. Director of Ancillary Services for Providence Swedish North Puget Sound), Logan Hinkson (Carl’s son who wants to become an RT).
Source: Providence Swedish North Puget Sound

The signing ceremony on April 16th with Washington State Governor Bob Ferguson was attended by various legislators and health care professionals, including Carl Hinkson, senior director of Ancillary Services for Providence Swedish North Puget Sound. Hinkson played a crucial role in advocating for national RT licensure in his role as president of the American Association for Respiratory Care (AARC). His work with AARC, alongside the Council of State Governments and the Department of Defense, has been pivotal in drafting this model legislation, which is now available for introduction in other state legislatures, according to the press release from Providence Swedish North Puget Sound.