# Best states for EMS?



## IRIDEZX6R (Sep 15, 2011)

Okay, so I'm getting excessivly frustrated with the lack of emt jobs in california. And I've always wanted to get away from good o'l so-cal... 

What states would you guys suggest for more EMS jobs, decent protocols, pay, ect. I'm more leaning toward southern states but I'm definitly open to suggestions. I'm looking for 911 experience and I need my hours for medic school. 

Thanks in advance you guys! ^_^


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## benjack (Sep 15, 2011)

Delaware


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## socalemt123 (Sep 15, 2011)

I've heard Texas...


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## atropine (Sep 15, 2011)

Stay in Cali the weather alone is well worht it. The midwest sucks and the east has crapy weather and now earthquakes.


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## socalemt123 (Sep 15, 2011)

So Cal does have the best weather. I must agree. 

Are you looking to work for a 911 company or do you mind working IFT until you get called for 911? Because I have a few friends who have been working IFT while they wait for a call from AMR and it's only been 3-6 months depending on what AMR's you applied for.


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## atropine (Sep 15, 2011)

Iam still a license Paramedic, Iam just going to RT school now, used to work for a large metro fire department in the los angeles area.


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## adamjh3 (Sep 15, 2011)

atropine said:


> Stay in Cali the weather alone is well worht it. The midwest sucks and the east has crapy weather and now earthquakes.



The weather is worth having to either work three jobs or fight your way into the rare fire-medic job that pops up to make a decent salary?

As far as the east having earthquakes:


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## NomadicMedic (Sep 15, 2011)

benjack said:


> Delaware



+1.

http://www.co.kent.de.us/Departments/PublicSafety/EmergencyMedicalServices.htm

http://nccde.org/ems/home/webpage1.asp

http://www.sussexcountyde.gov/dept/ems/

DE is a great place if you like tax free shopping, great beaches, close proximity to Baltimore, DC, Philly and NY and fresh from the farm chicken. 

I moved here from the west coast, and love it.


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## Wes (Sep 15, 2011)

Texas is, without a doubt, one of the best places to be in EMS.  There are some excellent services here and we don't have a heavily regulated set of statewide or county protocols.  The medical directors for individual EMS services have the ability to set the protocols for their services.

The negative, however, is that, especially in some of the metro areas, there are some pretty shady private services.


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## EMT-23 (Sep 15, 2011)

does california take the same national registry as everyone else? ok well TEXAS is pretty good for EMS...


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## bigdogems (Sep 16, 2011)

Wes said:


> Texas is, without a doubt, one of the best places to be in EMS.  There are some excellent services here and we don't have a heavily regulated set of statewide or county protocols.  The medical directors for individual EMS services have the ability to set the protocols for their services.
> 
> The negative, however, is that, especially in some of the metro areas, there are some pretty shady private services.



The area that we are in is great for EMS. Thankfully we also have a good medical director. While I may disagree with some of his thinking he gives us the ability to deviate from protocols when justified as long as we call and tell him afterwards. We also all have his cell number and can contact him anytime for medical control if we have a question.

In general Harris County TX has someone hiring for 911 jobs at any given time. It will take some searching however just based on the size of the area and number of providers. There are a few good privates that from what I hear pay well. But as said above. Inside the City of Houston there are some really shady companies


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## thegreypilgrim (Sep 16, 2011)

Not California Not California Not California Not California...


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## IRIDEZX6R (Sep 16, 2011)

thegreypilgrim said:


> Not California Not California Not California Not California...



agreed


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## medic417 (Sep 16, 2011)

Not new jersey not new jersey not new jersey.


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## jjesusfreak01 (Sep 16, 2011)

bigdogems said:


> While I may disagree with some of his thinking he gives us the ability to deviate from protocols when justified as long as we call and tell him afterwards.



This is an unwritten rule with Dr. Myers in Wake County NC.


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## emt junkie (Sep 16, 2011)

bigdogems said:


> The area that we are in is great for EMS. Thankfully we also have a good medical director. While I may disagree with some of his thinking he gives us the ability to deviate from protocols when justified as long as we call and tell him afterwards. We also all have his cell number and can contact him anytime for medical control if we have a question.
> 
> In general Harris County TX has someone hiring for 911 jobs at any given time. It will take some searching however just based on the size of the area and number of providers. There are a few good privates that from what I hear pay well. But as said above. Inside the City of Houston there are some really shady companies



+1 on Texas


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## hoss42141 (Sep 17, 2011)

I know KY has openings like crazy for both EMT and medic. Depends on where you work pay starts out any where from 8.50-12.00 which isn't this at bad for KY. LOL.


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## atropine (Sep 17, 2011)

Go where the cash is my friend look, ems is ems, you start IV's in California you start IV's in Flordia, you give nitro in Texas you give the same nitro in Washington. Maybe Iam bias being born and raised in southern cali, but I got to say the weather is great, the money is good in excess of over 100k a year, and you only have to work about ten days out of the month and if you work more then you get more $$$$, and where else can you retire with 90 percent of your base pay (at least for now). Yeah you might have to fight fire every now and then, but those who can't whine I guess, anyways just my opinion.


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## Bluestar (Sep 17, 2011)

tennesse.. of course im a little bias....lol


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## thegreypilgrim (Sep 17, 2011)

atropine said:


> Go where the cash is my friend look, ems is ems, you start IV's in California you start IV's in Flordia, you give nitro in Texas you give the same nitro in Washington. Maybe Iam bias being born and raised in southern cali, but I got to say the weather is great, the money is good in excess of over 100k a year, and you only have to work about ten days out of the month and if you work more then you get more $$$$, and where else can you retire with 90 percent of your base pay (at least for now). Yeah you might have to fight fire every now and then, but those who can't whine I guess, anyways just my opinion.


 If you somehow manage to get a now pretty much extinct FF/PM job with LAFD (they're the only ones who pay anything like that excluding a handful of very small other departments, and some departments up in the Bay Area). And even if you do, this gravy train's heyday is coming to an end. People, including grand juries, are beginning to realize that this is unsustainable.


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## usafmedic45 (Sep 17, 2011)

Not Maryland.


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## medic417 (Sep 17, 2011)

Maybe it would be easier to make a list of the 49 worst states for EMS.


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## STXmedic (Sep 17, 2011)

atropine said:


> the money is good in excess of over 100k a year, and you only have to work about ten days out of the month and if you work more then you get more $$$$, and where else can you retire with 90 percent of your base pay (at least for now). Yeah you might have to fight fire every now and then, but those who can't whine I guess, anyways just my opinion.



Sounds exactly like my department, minus the :censored::censored::censored::censored:ty cost of living (and only 8 days a month)


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## firecoins (Sep 17, 2011)

A state of shock is the best state for EMS.




---
I am here: http://maps.google.com/maps?ll=40.754488,-73.898366


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## Flight-LP (Sep 18, 2011)

medic417 said:


> Maybe it would be easier to make a list of the 49 worst states for EMS.



Here you are:

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota 
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia  
Washington
West Virginia
Wisconsin
Wyoming 

LOL


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## hoss42141 (Sep 18, 2011)

What is the pay like in TN, if you don't mind me asking. Thinking about getting my TN license as soon as I get my national registry.


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## Tigger (Sep 19, 2011)

Wes said:


> Texas is, without a doubt, one of the best places to be in EMS.  There are some excellent services here and we don't have a heavily regulated set of statewide or county protocols.  The medical directors for individual EMS services have the ability to set the protocols for their services.
> 
> The negative, however, is that, especially in some of the metro areas, there are some pretty shady private services.



Honestly I have no issue with statewide protocols because they establish a minimum degree of competency for each of level of provider allowing providers to transfer between services a little bit easier. 

The Massachusetts protocols are not set in stone either. Those services that think they are capable of providing more education for their providers to expand their scope can apply for waivers from state protocols. I think this is great for stuff like RSI where some places do not have the call volume or geographic necessity to see that their providers actually use the intervention. It's the same for expanding a basics scope. A private IFT service has little reason to have their providers give albuterol nebs or nasal narcan simply because of how unlikely these interventions are to be needed. But basics working a busy urban 911 truck have plenty of use for these skills so those services just get a waiver and provided the necessary initial and continuing education.


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## Flight-LP (Sep 19, 2011)

Tigger said:


> Honestly I have no issue with statewide protocols because they establish a minimum degree of competency for each of level of provider allowing providers to transfer between services a little bit easier.



A protocol is by definition an established code of procedure. While it may provide a minimum competency level (and I emphasize minimum), it also restricts promotion and growth by its very definition of the procedure. Why waste time on waivers and variances when you could have guidelines instead that allow a provider to utilize an autonomous thought process with a bit of critical thinking?

This is a huge issue with state wide protocols. They allow minimal autonomy and localization of efforts. Should you have a crappy board of MD's writing these state wide protocols (as some states currently do, no names mentioned), then you cannot have any discernable level of QA/QI through your local agency as your Medical director really has no level of oversight within his /her right to practice medicine. He / She has to conform to what others wrote. "No thank you" say's I...................I'll stick with delivering sound quality medicine under a physician who takes an active progressive role in the care of our patient's and community.


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## NREMTB12 (Sep 19, 2011)

IRIDEZX6R said:


> Okay, so I'm getting excessivly frustrated with the lack of emt jobs in california. And I've always wanted to get away from good o'l so-cal...
> 
> What states would you guys suggest for more EMS jobs, decent protocols, pay, ect. I'm more leaning toward southern states but I'm definitly open to suggestions. I'm looking for 911 experience and I need my hours for medic school.
> 
> Thanks in advance you guys! ^_^


Paducah KY, town of about 30,000 and 10,000 in the county have a private service here i work for we are the only service in county and do all IFT, emergency, standyby...etc.. on our way to hit over 14,000+ runs this year.


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## Shishkabob (Sep 19, 2011)

Flight-LP said:


> A protocol is by definition an established code of procedure. While it may provide a minimum competency level (and I emphasize minimum), it also restricts promotion and growth by its very definition of the procedure. Why waste time on waivers and variances when you could have guidelines instead that allow a provider to utilize an autonomous thought process with a bit of critical thinking?
> 
> This is a huge issue with state wide protocols. They allow minimal autonomy and localization of efforts. Should you have a crappy board of MD's writing these state wide protocols (as some states currently do, no names mentioned), then you cannot have any discernable level of QA/QI through your local agency as your Medical director really has no level of oversight within his /her right to practice medicine. He / She has to conform to what others wrote. "No thank you" say's I...................I'll stick with delivering sound quality medicine under a physician who takes an active progressive role in the care of our patient's and community.



Honestly, if I had things my way, RNs and Paramedics wouldn't have "protocols", as it'd instead be "Here's your license, you can do what's within your scope whenever you deem necessary, so long as it fits current medical practice" (or 'nursing practice')


No more medics being stuck at agencies still doing stacked shocks because that's what "protocol" states and they haven't updated them in a while.  It's silly to think you can trust someone with making decisions, such as RSI, only on duty and under very strict rules, but that they would somehow lose all critical thinking the moment they're off duty or protocols are taken away.




If you can't trust them to do their job or practice their certification well, then why hire / certify them?




In my experience, Texas, compared to most (if not all other states) has the right idea with EMS.... even though there has recently been some representatives that want to do statewide protocols, under the guise of "Every other state is, so why are we different?"


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## Tigger (Sep 19, 2011)

Linuss said:


> Honestly, if I had things my way, RNs and Paramedics wouldn't have "protocols", as it'd instead be "Here's your license, you can do what's within your scope whenever you deem necessary, so long as it fits current medical practice" (or 'nursing practice')
> 
> 
> No more medics being stuck at agencies still doing stacked shocks because that's what "protocol" states and they haven't updated them in a while.  It's silly to think you can trust someone with making decisions, such as RSI, only on duty and under very strict rules, but that they would somehow lose all critical thinking the moment they're off duty or protocols are taken away.
> ...



At least here in Mass, the protocols are updated at the very minimum annually, if not monthly. I'd rather this than every service having its own protocols that lax QA personnel keep forgetting to update. Maybe it's just me, but it sure seems like there are too many crappy providers out there incapable of utilizing critical thinking skills. Until they are gone (read: a mandate for more education), I just don't feel comfortable having everyone being able to work completely free within their scope of practice. Some of the low-acuity/high risk interventions should not be available to every provider, either because they lack the education or the opportunity to ever use them


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## Shishkabob (Sep 19, 2011)

Then limit the scope per level, don't limit the scope.


Afraid of not enough intubations?  Take it away from Intermediates, and don't have 100 Paramedics on each scene.


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## 46Young (Sep 19, 2011)

jjesusfreak01 said:


> This is an unwritten rule with Dr. Myers in Wake County NC.



Wake County EMS is one of the best places to work for, from what I've heard, but they don't pay much, like most other departments in the Carolinas, unfortunately. Maybe low 30's/yr for medics to start, IIRC.  

I tried that in Charleston, but I found out that the lower cost of living only applied to housing. Everything else was as expensive or more so than in a major metropolitan area. 30 something grand isn't going to get you very far, unless you live with your parents.


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## 46Young (Sep 19, 2011)

emt junkie said:


> +1 on Texas



I would have done Texas if my wife would have agreed to it.


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## 46Young (Sep 19, 2011)

If you're strictly single role, I'd go with Texas. If you prefer fire based, I'd go with Virginia. Especially after the BRAC re-alignment, money keeps coming into the area due to the close proximity to D.C. We don't have a lot of the financial issues other areas do. Plenty of resources, two OMD's, bi-annual protocol/guideline updates with field input, and all the tools we need to do our job sans RSI, which the flight medics have, along with Fairfax City. The drawback is that we have too many medics, spread out with our all ALS system, which is a combo of double medic training units and medic/EMT rigs, with only four BLS buses. 

If you want to not have to worry about salary and retirement, I'd look in Northern VA and in MD near D.C.

Alexandria Fire and EMS are single role EMS with FD benefits, with a 24/48/24/96 schedule, definitely worth taking a look. You can get 3000 sf homes an hour and a half away (you're only working two days out of every eight) for well under 300k.


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## Jon (Sep 20, 2011)

Any idea how busy Alexandria EMS is? I've been looking for single-role EMS in DC Metro area.


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## Chief Complaint (Sep 20, 2011)

46Young said:


> If you're strictly single role, I'd go with Texas. If you prefer fire based, I'd go with Virginia. Especially after the BRAC re-alignment, money keeps coming into the area due to the close proximity to D.C. We don't have a lot of the financial issues other areas do. Plenty of resources, two OMD's, bi-annual protocol/guideline updates with field input, and all the tools we need to do our job sans RSI, which the flight medics have, along with Fairfax City. The drawback is that we have too many medics, spread out with our all ALS system, which is a combo of double medic training units and medic/EMT rigs, with only four BLS buses.
> 
> If you want to not have to worry about salary and retirement, I'd look in Northern VA and in MD near D.C.
> 
> Alexandria Fire and EMS are single role EMS with FD benefits, with a 24/48/24/96 schedule, definitely worth taking a look. You can get 3000 sf homes an hour and a half away (you're only working two days out of every eight) for well under 300k.



Im a Nothern VA guy and i agree with most of your post.  If you get on with one of the 5 main counties life will be pretty good.  The problem is actually landing the job.  Its VERY difficult to get a paid gig around here, especially if you are a white male.

There is no gaurantee that every county will be putting a recruit class through each year either, so there is a ton of waiting involved in the application process.  Its pretty common for all of the counties to be on a hiring freeze.  

And when they do open up for hiring, it is extremely competetive.  Even being a medic (I/P) will only get you so far.  Prince William County just had over 700 people sit for their written exam, Chief says that he will be looking to fill 15-20 spots. 

NoVa is a great place to work, its just very hard to get a job.



Jon said:


> Any idea how busy Alexandria EMS is? I've been looking for single-role EMS in DC Metro area.



Not sure about exact call volume, but i understand that they stay pretty busy over there.  Word on the street is that Alexandria is in the process of merging fire and EMS in the near future.  Im sure something like that would take forever to implement and i have no idea if its actually true or not, but thats what people are saying.  Just something to think about.


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## 46Young (Sep 20, 2011)

Jon said:


> Any idea how busy Alexandria EMS is? I've been looking for single-role EMS in DC Metro area.



There was a scare a while back about wanting to merge fire and EMS. I can't say for sure, but I think that passed. IIRC, you need to pass the CPAT (we do Alex's CPAT's in Chantilly), but they hired a couple of medic classes recently, and they didn't have to go to the fire academy. 

The pay is listed in the 40's, but it's really in the 50's when you include everything, from what I've been told. 

It's a busy system, you're running most of the day, the nights are hit or miss, but you only have to work two days out of eight. They have a 12 hour rig that covers units that go OOS for CEU's. No need to pursue con-ed off duty, unless you like to do extra, which is always a good idea. There are mandatory holdovers, though. As far as burn out, all of these systems are combined systems, so you've got extra bodies to carry your equipment and also carry your patients much of the time, so that definitely helps. I've done the six floor walkups for the 300 lb diff breather with just me and my partner back in NY. It's much better for the EMS crew this way, it saves your body and helps with stress, although having extra hands onscene can paradoxically extend scene times if you don't know the crews, and they don't know how you like things to go. 

I haven't seen any animosity between EMS and fire, so co-habitating should be amicable. 

You'll run into my county from time to time if you're on M205 or M208. You can also run in to Arlington.


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## 46Young (Sep 20, 2011)

Chief Complaint said:


> Im a Nothern VA guy and i agree with most of your post.  If you get on with one of the 5 main counties life will be pretty good.  The problem is actually landing the job.  Its VERY difficult to get a paid gig around here, especially if you are a white male.
> 
> There is no gaurantee that every county will be putting a recruit class through each year either, so there is a ton of waiting involved in the application process.  Its pretty common for all of the counties to be on a hiring freeze.
> 
> ...




In general, the budgets in our area have rebounded in a positive fashion. Business is coming into the area, and the BRAC re-alignment definitely helps. We're getting a lot of development in Tyson's in FXCO ourselves. All our neighboring counties have re-implemented COLA's, and we expect step increases to resume next year. They've been frozen since 2009, as well as COLA's. We're now going back to running back to back recruit schools, which are a combo of medic and EMT. From the 127th to the 130th, it was just medics. My old partner from NYC EMS just graduated the 131st. Fairfax only hires EMT-P's, degree preferred, but we're giving incumbents the EMT-I through NOVA CC with a pre-requisite of Human Biology 150 and HLT 250 Pharmacology. Other counties have been hiring as well. In fact, Loudon, Alex, and Arlington gave better COLA's than we received. Things look to be turning around.

Just apply everywhere, and don't forget Montgomery and Howard Counties in MD.

Edit: That 700:20 ratio is for basic FF's. Your chances as a medic are much greater. Also realize that out of those 700, many will fail the CPAT right off the bat (38 out of 40 for one of ours), others will fail the Poly, some will even manage to fail the written exam! They also have to get through the psych exam. As a medic, you should do much better than the average cat.


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## Chief Complaint (Sep 20, 2011)

46Young said:


> In general, the budgets in our area have rebounded in a positive fashion. Business is coming into the area, and the BRAC re-alignment definitely helps. We're getting a lot of development in Tyson's in FXCO ourselves. All our neighboring counties have re-implemented COLA's, and we expect step increases to resume next year. They've been frozen since 2009, as well as COLA's. We're now going back to running back to back recruit schools, which are a combo of medic and EMT. From the 127th to the 130th, it was just medics. My old partner from NYC EMS just graduated the 131st. Fairfax only hires EMT-P's, degree preferred, but we're giving incumbents the EMT-I through NOVA CC with a pre-requisite of Human Biology 150 and HLT 250 Pharmacology. Other counties have been hiring as well. In fact, Loudon, Alex, and Arlington gave better COLA's than we received. Things look to be turning around.
> 
> Just apply everywhere, and don't forget Montgomery and Howard Counties in MD.
> 
> Edit: That 700:20 ratio is for basic FF's. Your chances as a medic are much greater. Also realize that out of those 700, many will fail the CPAT right off the bat (38 out of 40 for one of ours), others will fail the Poly, some will even manage to fail the written exam! They also have to get through the psych exam. As a medic, you should do much better than the average cat.



Im going through the process with PWC as well as Fairfax right now, not very far into either though.  Passed the CPAT for Fairfax last week and ill be taking it for PWC this weekend.  ALS candidates who pass the CPAT will be able to take the polygraph the following day for PWC.  I was amazed at the number of people who couldnt pass the CPAT.  There were people that showed up to take it who were very fat and out of shape and obviously didnt prepare at all.

I dont have high hopes for Fairfax but it will be good to have my information in their system for future recruitment.  I will be taking their written exam on Thursday, any idea whats on it?  The PWC written was easy, im hoping that Fairfax uses a similar test.

Montgomery and Howard counties arent accepting applications right now but ill be checking in with them often.

Having my medic definitely helps, but im a white guy, thats going to work against me for sure.  Such a shame.


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## 46Young (Sep 21, 2011)

Chief Complaint said:


> Im going through the process with PWC as well as Fairfax right now, not very far into either though.  Passed the CPAT for Fairfax last week and ill be taking it for PWC this weekend.  ALS candidates who pass the CPAT will be able to take the polygraph the following day for PWC.  I was amazed at the number of people who couldnt pass the CPAT.  There were people that showed up to take it who were very fat and out of shape and obviously didnt prepare at all.
> 
> I dont have high hopes for Fairfax but it will be good to have my information in their system for future recruitment.  I will be taking their written exam on Thursday, any idea whats on it?  The PWC written was easy, im hoping that Fairfax uses a similar test.
> 
> ...



It's crazy how many people fail the CPAT. It isn't anywhere near as physically demanding as what you 'll go through in the academy, let alone in a real fire. It's like these people just woke up one morning and out of the blue said, "Gee, I'd like to be a firefighter today." 

Firehouse.com has a Fairfax County hiring thread. Matter of fact, FH.com has hiring threads for all the surrounding areas as well.


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## 46Young (Sep 21, 2011)

Hey Jon, you don't work for Suburban EMS, do you? One of my old partners from NY works there, at some station near exit 71 off of rt 78.

Edit: Palmer Township


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## 46Young (Sep 21, 2011)

phillybadboy said:


> how do i start a thread?



I think you need ten posts or some similar number before you can start threads. 

It's there for a reason - to prevent spambots, especially ones that use target marketing or phishing. Some of these are hyperlinks intended to boost search engine ranking.


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## Slinky (Sep 28, 2011)

All jokes aside, the Boise area of Idaho is great.  I used to work for Ada County Paramedics and it is an awesome place to work.  Starting salary (without experience) is the low 40s but the cost of living is very reasonable.  Protocols are progressive with almost everything you could imagine (subclavian/IJ/femoral central lines were recently removed in favor of IO, but we didn't do many central lines each year anyways).  Medical direction is very paramedic friendly and the focus is always on learning and improving.  

Oh, and EMS anywhere is certainly not EMS everywhere, as was mentioned earlier.  I have seen Boise FD's version of EMS (paramedic level), and it is taking a blood pressure and getting a name.


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## Fish (Sep 28, 2011)

I used to work as a Medic in California, and it is horrible for Medics as far as Pay, Protocols, Treatment. Weather is not worth barely paying your bills.

Texas, North Carolina, Delaware in my opinion are the best states for EMS, pay, protocols, and actual competency of Medics are A LOT higher in those states.


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## NomadicMedic (Sep 28, 2011)

If you're thinking about Delaware, I'd highly encourage you to come visit Sussex County and spend a day riding with one of our crews. It's a very different kind of system and certainly not for everyone. 

However, if you want to do prehospital medicine in a fast paced, progressive (compared to most of the east coast) provider focused system that values education and job satisfaction among the medics... Then this is a place you should investigate. I found it by accident, and it's the best move I've made. 


Sent from my iPhone.


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## atropine (Sep 28, 2011)

Fish said:


> I used to work as a Medic in California, and it is horrible for Medics as far as Pay, Protocols, Treatment. Weather is not worth barely paying your bills.
> 
> What are you talking about all the medics in my department are able to pay their bills


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## Shishkabob (Sep 28, 2011)

atropine said:


> What are you talking about all the medics in my department are able to pay their bills


Those aren't Paramedics, those are firefighters with a Paramedic certification.


And by God, they'll let you know that.


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## Fish (Sep 28, 2011)

Linuss said:


> Those aren't Paramedics, those are firefighters with a Paramedic certification.
> 
> 
> And by God, they'll let you know that.





hahaha


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## 46Young (Sep 29, 2011)

Linuss said:


> Those aren't Paramedics, those are firefighters with a Paramedic certification.
> 
> 
> And by God, they'll let you know that.



It's sad that many departments make the P-card a de facto requirement to get hired. I's also sad that most others will only see a decent salary and benefits if they sell out and leave their single role EMS job and instead do their EMS through a FD (what I did).

If EMS had a real, attainable career ladder, and a better salary (four years in for me, 80k+/yr base, promotion already), I probably never would have even looked to work anywhere else than my previous hospital based EMS job, or perhaps even the county ALS 911 job in Charleston.


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## 46Young (Sep 29, 2011)

atropine said:


> Fish said:
> 
> 
> > I used to work as a Medic in California, and it is horrible for Medics as far as Pay, Protocols, Treatment. Weather is not worth barely paying your bills.
> ...


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## Fish (Sep 29, 2011)

46Young said:


> atropine said:
> 
> 
> > Did you get laid off from your FD job? IIRC, you referred to that gig in past tense recently.
> ...


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## 46Young (Sep 29, 2011)

Fish said:


> 46Young said:
> 
> 
> > Me? I moved away from Ca for work, Texas pays EMS professionals what they should be paid with a proper retirement and promotional ladder. Well, the City and County based services do. I do not have experience with the Privates out here.
> ...


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## IRIDEZX6R (Sep 29, 2011)

Fish said:


> 46Young said:
> 
> 
> > Me? I moved away from Ca for work, Texas pays EMS professionals what they should be paid with a proper retirement and promotional ladder. Well, the City and County based services do. I do not have experience with the Privates out here.
> ...


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## Fish (Sep 29, 2011)

IRIDEZX6R said:


> Fish said:
> 
> 
> > what are you making outside CA?
> ...


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## Fish (Sep 29, 2011)

IRIDEZX6R said:


> Fish said:
> 
> 
> > what are you making outside CA?
> ...


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## Jon (Oct 3, 2011)

46Young said:


> Hey Jon, you don't work for Suburban EMS, do you? One of my old partners from NY works there, at some station near exit 71 off of rt 78.
> 
> Edit: Palmer Township



Nope - Thought about applying to a few squads up there at one time, though.
Now it looks like I might be headed south.


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## bcemr (Oct 5, 2011)

I left CA in March and couldn't be happier. Sure the sun is nice, but I find not much else is. I lived there 7 years and am glad to trade the sun for sanity.


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## hoss42141 (Oct 5, 2011)

I still say that KY isn't that bad. Cost of living isn't sky high, and pay is pretty good. I mean some places start out medics at 14.00+ and emt's at 10.00+


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## wolfwyndd (Oct 5, 2011)

Flight-LP said:


> Here you are:
> 
> [snip]
> Ohio
> ...



Ohio needs to be a lot closer to the top. 

I've lived in Ohio for about 10 years now and the FF/EMT jobs are pretty few and far between.  When one does appear, there's (almost) a riot with the applicants to get it.  Dayton, technically, you don't have to be certified in anything, they'll pay for your training.  In reality, there are so many applicants that are already FF 240 and paramedic certified and licensed that unless you're both AND have experience, you can pretty much forget it.  Same deal with Columbus and Springfield, OH.  Unless you're already FF level II AND paramedic, you can pretty much forget about getting on.  Don't know about the Cleveland area but I would assume it's pretty much the same way.  

The good news with Ohio is that it is a National Registry state.  You take the NREMT test for Basic and Paramedic and you automatically get your state license.


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## Tigger (Oct 5, 2011)

wolfwyndd said:


> Ohio needs to be a lot closer to the top.
> 
> I've lived in Ohio for about 10 years now and the FF/EMT jobs are pretty few and far between.  When one does appear, there's (almost) a riot with the applicants to get it.  Dayton, technically, you don't have to be certified in anything, they'll pay for your training.  In reality, there are so many applicants that are already FF 240 and paramedic certified and licensed that unless you're both AND have experience, you can pretty much forget it.  Same deal with Columbus and Springfield, OH.  Unless you're already FF level II AND paramedic, you can pretty much forget about getting on.  Don't know about the Cleveland area but I would assume it's pretty much the same way.
> 
> The good news with Ohio is that it is a National Registry state.  You take the NREMT test for Basic and Paramedic and you automatically get your state license.



How does this make Ohio a good state for EMS? If every firefighter is a medic, there is not going to be a lot of excellent medics, because no one sees sick patients with any regularity.


Sent from my out of area communications device.


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## Fish (Oct 5, 2011)

bcemr said:


> I left CA in March and couldn't be happier. Sure the sun is nice, but I find not much else is. I lived there 7 years and am glad to trade the sun for sanity.




Where did u move to?


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## Fish (Oct 5, 2011)

hoss42141 said:


> I still say that KY isn't that bad. Cost of living isn't sky high, and pay is pretty good. I mean some places start out medics at 14.00+ and emt's at 10.00+



Where at in KY?


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## Fish (Oct 5, 2011)

wolfwyndd said:


> Ohio needs to be a lot closer to the top.
> 
> I've lived in Ohio for about 10 years now and the FF/EMT jobs are pretty few and far between.  When one does appear, there's (almost) a riot with the applicants to get it.  Dayton, technically, you don't have to be certified in anything, they'll pay for your training.  In reality, there are so many applicants that are already FF 240 and paramedic certified and licensed that unless you're both AND have experience, you can pretty much forget it.  Same deal with Columbus and Springfield, OH.  Unless you're already FF level II AND paramedic, you can pretty much forget about getting on.  Don't know about the Cleveland area but I would assume it's pretty much the same way.
> 
> The good news with Ohio is that it is a National Registry state.  You take the NREMT test for Basic and Paramedic and you automatically get your state license.



This doesn't mean it is a good state for EMS, just means that jobs are hard to come by.


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## hoss42141 (Oct 6, 2011)

Fish said:


> Where at in KY?



http://www.hultgren.org 

just go to jobs and it will give you a list of all the positions available. I know that Bullitt Co. is 14.25 an hr.


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## hoss42141 (Oct 6, 2011)

Fish, Ambulance Inc. of Laurel Co. figures up to be a little over 19.00 an hr.  Madison Co. is close to that as well. There is currently around 20 positions posted just for medics. Hope this helps.


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## wolfwyndd (Oct 6, 2011)

Fish said:


> This doesn't mean it is a good state for EMS, just means that jobs are hard to come by.


Thank you, Fish.  That's exactly what I meant.  Ohio's a horrid state for EMS.


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## Fish (Oct 6, 2011)

Copy


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## 46Young (Oct 17, 2011)

Jon said:


> Nope - Thought about applying to a few squads up there at one time, though.
> Now it looks like I might be headed south.



Were you at Alexandria's CPAT this past Saturday? It was held at our Wel-Fit Center in Chantilly (Fairfax hold's and proctors Alex's CPAT's).


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## Straycoyote (Oct 21, 2011)

I was born and raised in Riverside, CA and moved out to Cape Cod a couple years ago. I actually like it out here better. As far as jobs go, I've seen quite a few posts talking about how people are on a long wait list for jobs out in so cal (unless you want to go out to the middle of nowhere). However, it seems that for Mass' long list of ambulance companies available to work at, none ever seem to be hiring (even when they are) and I've noticed that the state tends to favor the "who you know" instead of the "what you know". I will say though the jobs out here aren't bad, the average EMT-B pay is 11.25-11.75, which isn't that horrible depending on where you live. 

I was curious though about how Kansas or Oklahoma was. Anyone there have any advice on how those states are for EMS jobs (availability, regulations, salary, etc.)?


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## Tigger (Oct 21, 2011)

Straycoyote said:


> I was born and raised in Riverside, CA and moved out to Cape Cod a couple years ago. I actually like it out here better. As far as jobs go, I've seen quite a few posts talking about how people are on a long wait list for jobs out in so cal (unless you want to go out to the middle of nowhere). However, it seems that for Mass' long list of ambulance companies available to work at, none ever seem to be hiring (even when they are) and I've noticed that the state tends to favor the "who you know" instead of the "what you know". I will say though the jobs out here aren't bad, the average EMT-B pay is 11.25-11.75, which isn't that horrible depending on where you live.



Err say what? I knew no one at the company I worked at and had no prior ambulance experience but I got an interview scheduled as soon as I finished the application and an offer at the end of the interview. I am a college kid who can give them 4-5 months of work max. And they still hired me. If you want a job you have to make some sacrifices for it. That might mean applying to companies an hour a way in person, applying to less well known companies, or giving them a lot of availability. There is no better way to to get a job than to offer 100% availability. Tell them you'll work any shift with little notice and they'll love you. Sure it sucks in the beginning, but you want a job right? 

There is always a place that is hiring, it might not be the your top choice place. Oh well, sometimes a job is a job right? Not that many people live on the cape, so there not going to be many EMS jobs compared to Boston, and commuting to Boston from the cape sucks real bad. The only real trick to getting hired is to try harder than the next guy. If they hired me, they'll hire you, you just have to get to that point first.


Sent from my out of area communications device.


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## AmeriMedic21 (Oct 21, 2011)

Im in Kansas, where our Paramedics are called Mobile Intensive Care Technicians... For now, lol. We have some good services, and some cocky ones, but overall we rock our S*it like a bauce. lol


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## STXmedic (Oct 21, 2011)

AmeriMedic21 said:


> Im in Kansas, where our Paramedics are called Mobile Intensive Care Technicians... For now, lol. We have some good services, and some cocky ones, but overall we rock our S*it like a bauce. lol



How do these Mobile Intensive Care Technicians rock said S*it?


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## Straycoyote (Oct 21, 2011)

"There is always a place that is hiring, it might not be the your top choice place. Oh well, sometimes a job is a job right? Not that many people live on the cape, so there not going to be many EMS jobs compared to Boston, and commuting to Boston from the cape sucks real bad. The only real trick to getting hired is to try harder than the next guy. If they hired me, they'll hire you, you just have to get to that point first"

: ( I've applied to just about everywhere I could find. I've put in applications in new bedford, boston, even out in western mass. Everywhere I go they say they aren't hiring new EMTs because they want more skilled workers. Cape Cod ambulance is hiring right now for wheelchair cars (better than nothing) but I'm competing with about 17 people for 3 slots. You got any spare luck you wanna bottle for me? lol I'd love you for it.


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## MassEMT-B (Oct 21, 2011)

Straycoyote said:


> "There is always a place that is hiring, it might not be the your top choice place. Oh well, sometimes a job is a job right? Not that many people live on the cape, so there not going to be many EMS jobs compared to Boston, and commuting to Boston from the cape sucks real bad. The only real trick to getting hired is to try harder than the next guy. If they hired me, they'll hire you, you just have to get to that point first"
> 
> : ( I've applied to just about everywhere I could find. I've put in applications in new bedford, boston, even out in western mass. Everywhere I go they say they aren't hiring new EMTs because they want more skilled workers. Cape Cod ambulance is hiring right now for wheelchair cars (better than nothing) but I'm competing with about 17 people for 3 slots. You got any spare luck you wanna bottle for me? lol I'd love you for it.



Cataldo will hire without experience as long as you can pass the tests and they are holding prehire tests pretty much monthly. Alert will not be hiring in the Boston area any time soon as they just lost the Boston and Brockton VA contracts. I would apply at Brewster or contact them if you have already applied. With them picking up the VA contracts that Alert lost they will be looking for a lot more people. Someone here said they were most likely going to be doubling the amount of BLS trucks they have in the field for the VAs.


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## fast65 (Oct 21, 2011)

AmeriMedic21 said:


> Im in Kansas, where our Paramedics are called Mobile Intensive Care Technicians... For now, lol. We have some good services, and some cocky ones, but overall we rock our S*it like a bauce. lol



Good Lord I hope you made that spelling error on purpose, otherwise, I'll be staying out of Kansas.

I'm in Oregon, and while I do like the fact that we require an AAS to be a paramedic, I don't know if it's the best state for EMS. A lot of EMS out here is fire-based, so of course with that you have some good, and some bad paramedics. There's a good mix of urban and rural EMS out here, and a lot of the private companies pay pretty well with decent benefits (my company starts around $40k/year with 100% matching 401K, medical, dental, and a few other goodies). Protocols here aren't anything extraordinary, most agencies that I know of have RSI protocols, surgical/needle crics, CPAP, etc.

That being said, there are places out there that are better for EMS, and places that are worse; however, I think Oregon is a pretty good place for EMS.


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## Steam Engine (Oct 21, 2011)

MassEMT-B said:


> Cataldo will hire without experience as long as you can pass the tests and they are holding prehire tests pretty much monthly. Alert will not be hiring in the Boston area any time soon as they just lost the Boston and Brockton VA contracts. I would apply at Brewster or contact them if you have already applied. With them picking up the VA contracts that Alert lost they will be looking for a lot more people. Someone here said they were most likely going to be doubling the amount of BLS trucks they have in the field for the VAs.



Any idea why they lost that contract?


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## Tigger (Oct 22, 2011)

Straycoyote said:


> "There is always a place that is hiring, it might not be the your top choice place. Oh well, sometimes a job is a job right? Not that many people live on the cape, so there not going to be many EMS jobs compared to Boston, and commuting to Boston from the cape sucks real bad. The only real trick to getting hired is to try harder than the next guy. If they hired me, they'll hire you, you just have to get to that point first"
> 
> : ( I've applied to just about everywhere I could find. I've put in applications in new bedford, boston, even out in western mass. Everywhere I go they say they aren't hiring new EMTs because they want more skilled workers. Cape Cod ambulance is hiring right now for wheelchair cars (better than nothing) but I'm competing with about 17 people for 3 slots. You got any spare luck you wanna bottle for me? lol I'd love you for it.



Could you join a combo or volunteer fire department on the cape? That would give you experience. I'm not sure I got lucky getting a job, I just didn't stop contacting companies (respectfully and in a non-nagging way) until they told me straight up they aren't hiring. No answer =/= not hiring.


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## Tigger (Oct 22, 2011)

Steam Engine said:


> Any idea why they lost that contract?



VA contracts go out to bid every few years (like most hospital networks), presumably Brewster underbid them, or offered more service for the same price. 12 BLS and 2 ALS ambulances have been added.


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## Shishkabob (Oct 22, 2011)

fast65 said:


> (my company starts around $40k/year with 100% matching 401K, medical, dental, and a few other goodies)



Hehehe, $43k AND 150% match to 401(a)  



Hmm.. shocking.  Not a single person has denied that Texas is one of, if not THE, best states for EMS.  Coinky-dink?


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## DesertMedic66 (Oct 22, 2011)

Linuss said:


> Hmm.. shocking.  Not a single person has denied that Texas is one of, if not THE, best states for EMS.  Coinky-dink?



Nah. California is the best state for EMS..... :rofl:


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## DV_EMT (Oct 23, 2011)

As everyone has already said.

Texas is good 

Not California - believe me the weather isn't worth the cost of living


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## Handsome Robb (Oct 23, 2011)

The thing Texas has going for itself is the ability for the Medical Director to determine the scope of his/her practitioners rather than fighting with the state or county.

The only reason we don't have an RSI protocol is because the state EMS office wont approve it, even though or MD has been fighting to get it for some time now. We have protocols for sedation post-intubation which, in theory, could be manipulated through some colorful documentation...but its not worth the risk. Give us the damn protocol.


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## fast65 (Oct 23, 2011)

Linuss said:


> Hehehe, $43k AND 150% match to 401(a)
> 
> 
> 
> Hmm.. shocking.  Not a single person has denied that Texas is one of, if not THE, best states for EMS.  Coinky-dink?



$43k/yr and 150% matching, and yet, you still haven't sent me any cookies...


Sent from my iPhone using Tapatalk


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## STXmedic (Oct 23, 2011)

NVRob said:


> The thing Texas has going for itself is the ability for the Medical Director to determine the scope of his/her practitioners



Along with many services with very competitive salaries and a low cost of living...

But yeah... What you said is nice too


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## firecoins (Oct 23, 2011)

Texas is the worst state to do EMS in. First of all, everything is bigger in texas. Than it's not New York. Worst of all, any system without me is terrible.


---
I am here: http://maps.google.com/maps?ll=40.815051,-73.957750


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## usalsfyre (Oct 23, 2011)

Pretty happy in Texas, and we've got some killer services.

Of course we also have TEEX and HFD and UTSW and DFD, so it's a little bit of a mixed bag sometimes.


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## KingCountyMedic (Oct 27, 2011)

Seattle/King County Washington ain't too shabby.


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## NomadicMedic (Oct 27, 2011)

KingCountyMedic said:


> Seattle/King County Washington ain't too shabby.



Depends on where in KC you work.


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