# Central Cal EMS



## Outskies (May 31, 2014)

Hey all! If any one has info on any good prospects of EMS agencies to work for in Central California, I want to hear what you have to provide! I am a medic in CO and looking to possibly move back home. 
I've been looking at American in Fresno, Riggs in Merced, and Pistoresi in Madera. 
Any info helps guys! 
I'd appreciate it.


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## CBRMEDIC (Jun 1, 2014)

dont know anything about american or Pistoresi. riggs is the sole als provider in merced county, fire is bls there. great place to learn with a decent amount of calls. you just missed the deadline to file application, there doing their hiring this month or so


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## Outskies (Jun 1, 2014)

So I take it they will probably hire again in another 6 months or so? 

I've been reading what small amount of info I can acquire about American. They have a specialized rescue team. That is definitely a perk to be employed there and the fact they have their own flights. From my understanding there aren't any other ALS providers in Fresno county. No solid info on that though.


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## Angel (Jun 1, 2014)

riggs will hire again in about 3 months, maybe, i think theyre contract expires in august so i guess it depends on who puts in a rfp and wins. 

as far as american, im also applying there though i have heard they like to hire their own. guess well see.

have you considered hall in bakersfield?


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## Outskies (Jun 1, 2014)

Bakersfield is a little far for my possible commute.

It seems like Riggs hires often. Kind of a bad sign to me for their attrition rate. 

Is American a renowned service for them to only hire internally? 
I've looked at the Medic programs in that area a few years ago and was not impressed. Hopefully it's not because they send them to those programs haha.


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## Outskies (Jun 1, 2014)

@ Angel. Any idea when American will start a round of hiring?


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## CentralCalEMT (Jun 1, 2014)

What's wrong with medic programs in that area?


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## CBRMEDIC (Jun 2, 2014)

Angel said:


> riggs will hire again in about 3 months, maybe, i think theyre contract expires in august so i guess it depends on who puts in a rfp and wins.
> 
> as far as american, im also applying there though i have heard they like to hire their own. guess well see.
> 
> have you considered hall in bakersfield?



riggs won the rfp against amr


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## m0nster986 (Jun 2, 2014)

Why would anyone in their right mind return back to California EMS?


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## Angel (Jun 2, 2014)

Outskies said:


> Bakersfield is a little far for my possible commute.
> 
> It seems like Riggs hires often. Kind of a bad sign to me for their attrition rate.
> 
> .



For paramedics, I think only ~50% pass the FTO period. It's basically another internship (480 hours) which is why they are a last resort for me. 




CBRMEDIC said:


> riggs won the rfp against amr



Correct. I believe that was last year. I was told the contract is up for bid again this year. 




Outskies said:


> @ Angel. Any idea when American will start a round of hiring?



No I'm not sure...hopefully soon though


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## Outskies (Jun 2, 2014)

CentralCalEMT said:


> What's wrong with medic programs in that area?



 Not going to harp on the programs that I did not attend. But from when I looked at their pass rate stats, accreditation, and personal opinion of the medics that came out of those 2 programs around fresno (not all the graduates) seemed to me that something was wrong with faculty or method of getting information across in an academic setting. That was back in 2010, but even now they had one good year of 1st attempt passing rate in the 90's. That's what is not impressive to me. I mean come on, the Nat Reg was a little too easy in my opinion. So something must be wrong if they can't instruct students well enough to pass it the 1st attempt.


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## Outskies (Jun 2, 2014)

m0nster986 said:


> Why would anyone in their right mind return back to California EMS?



Haha yes! Definitely a big difference going from CO to CA. But who in EMS would you say is in their right mind?


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## Outskies (Jun 2, 2014)

Angel said:


> For paramedics, I think only ~50% pass the FTO period. It's basically another internship (480 hours) which is why they are a last resort
> 
> Are you serious? I wonder why the FI process has such a high turn over.
> Where else have you looked besides Fresno and Merced? Hall?
> ...



If I had to guess I would anticipate around fall time. That seems to be a typical hiring process time. Twice a year, once every 6 months maybe.


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## CentralCalEMT (Jun 2, 2014)

Have you looked at Tulare County? American Ambulance of Visalia (different from fresno American) is hiring. I know AMR Tulare County is also down medics. Exeter Ambulance might also be hiring. All of those companies follow CCEMSA protocols. (Fresno, Kings, Madera, and Tulare Counties have the same EMS administration.) Also, in Fresno County, there is also Sequoia Safety Council, and Sierrra Ambulance, both of which are good companies as well. Overall there are a lot of companies so usually someone is hiring. I work in both Tulare and Kern Counties so if you have any questions feel free to ask!


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## Outskies (Jun 2, 2014)

So you work for American but completely different operations? 
I'm actually really curious about those areas. What's the schedules like? 12's, 48's? 
Average transport times? 
Call acuity? 
Morale with every one in those ops? 
Of course pay? 
I'll probably have more questions later. Thanks!


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## Outskies (Jun 2, 2014)

Also, capnography. Is there only use of colormetric Capno for intubation confirmation? Or is there waveform available for all the other excellent applications?


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## CentralCalEMT (Jun 2, 2014)

I'm on a 48. When I get off tomorrow morning I'll give a detailed run down of Tulare County companies.


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## CBRMEDIC (Jun 2, 2014)

Angel said:


> For paramedics, I think only ~50% pass the FTO period. It's basically another internship (480 hours) which is why they are a last resort for me.
> 
> 
> 
> ...



Riggs won their rfp like a week or 2 ago. I maybe wrong but i believe they have a contract for the next 10 yrs. i know couple of people who worked there and said they are hiring this june because of work hour schedules changes from 56 to 48, so they need more employees


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## Angel (Jun 3, 2014)

Sweet. Yea your news is more recent than mine. Good for them, I've heard super good things about types of calls they run and how busy they are. But again, the FTO period sucks. And there's not much to do in the area but it pas decent.


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## CentralCalEMT (Jun 4, 2014)

*Tulare County Details*

About Tulare County: Tulare county is huge with over 4,000 square miles. The population is over 400,000 and the primary cities are Visalia (pop 150,000), Tulare (pop 60,000) and Porterville (pop 60,000). The rest is dispersed through rural farm towns. Like any county, it has its nicer areas, and gang infested high crime areas. There are major highways, a national forest, national park, lakes, rivers, and some of the richest farming areas in the country. Cost of living is low as far as apartments and houses go. If you are into the outdoors, there is great hiking, fishing, camping, and hunting all over the county.

About the system: the 5 companies (American Visalia, AMR, Lifestar, Exeter, and Imperial) operate a borderless dispatching system. There is one central county dispatch and the closest unit goes regardless of company. All 911 response units are ALS, usually with EMT/Medic. Generally, between the companies, there are 15-20 ALS units to cover that huge area. Despite the thin coverage, response times are surprisingly good. There are a lot of hardworking dedicated paramedics in the system. Most fire departments with the exception of Visalia Fire and Tulare city Fire are BLS departments so you are the only medic on scene. There are a whopping three hospitals in the county, with one being a STEMI and Level III trauma center. The others are small community hospitals. We have an ALS helicopter based in the county for the most serious cases. The system is part of CCEMSA (Freso, Kings, Madera, Tulare counties) so a paramedic license in one of those is good in all of those. 

Now on to the companies

AMERICAN VISALIA:
They cover Visalia and the surrounding rural areas. They are an extremely high call volume system with 90% or more 911 calls. 
What's the schedules like: 24s and some 12s
Average transport times? 5 minutes in town, 20 minutes in the rural areas or more.
Call acuity: Very many high acuity calls
Morale with every one in those ops: Morale is good from what I have heard. 
Of course pay: A little over 12/hour from what I have been told. 

AMR Tulare County
They cover Visalia and the surrounding rural areas. They are a high call volume system but more split 50/50 911 and transfer since they have the contract with the largest hospital in the county. 
What's the schedules like: 24s  with 12s mixed in at times.
Average transport times? 5 minutes in town, 20 minutes in the rural areas or more.
Call acuity: While they run less 911, they still are busy and get decent calls.
Morale with every one in those ops: Morale is high. 
Of course pay: A little over 12/hour to start and they are a union shop. 

LIFESTAR
They cover the city of Tulare and the surrounding rural areas. They are an extremely high call volume system that calls for mutual aid hundreds of times a year. It is easily 80% of more 911 calls
What's the schedules like: 3 24 hour units and 1 12 hour unit daily.
Average transport times? 5 minutes in town, 30 minutes in the rural areas or more.
Call acuity: Their units in the city get lots of high acuity calls. The one rural unit they have is much slower but does get a lot of trauma calls from the highway and the high crime in some of the smaller towns. 
Morale with every one in those ops: Honestly I have heard mixed reviews. They do get run into the ground but no increased staffing has happened as of yet, 
Pay: I do not know but I know per diem make more hourly than full time. 

EXETER
They cover Exeter and the surrounding rural areas. They are a low call volume rural system that covers a small town that is very nice. 
What's the schedules like: 1 24 hour unit and 1 12 hour unit daily. 
Average transport times? There is no hospital in town so a minimum of 15 minutes.
Call acuity: They have a low call volume, but due to the nature of the county they do get their share of critical calls. 
Morale with every one in those ops: Morale is good from what I know. 
Of course pay: I have heard 13 or more, but do not quote me on that. They are not a private company but rather a healthcare district funded ambulance.

IMPERIAL
They cover Porterville and the surrounding rural areas including a large portion of the Sequoia National Forest and a large Indian Reservation. They are a moderate to high call volume system with 75% or more 911 calls. 
What's the schedules like: They have 3-5 24 hour units depending on the day. No day cars unless there is a standby for a special event. 
Average transport times? 5 minutes in town, 20 minutes in the rural areas or over an hour if in the mountains/forest. They also have occasional calls that require hiking to your patient, sometimes for hours or more.
Call acuity: Very many high acuity calls. They have a good mix of medical and trauma. Also, there is no ALS fire department unlike Visalia and Tulare.
Pay: $12.50 an hour to start. 
Morale with every one in those ops: Morale is good and they just got two new ambulances. 


If you have any more questions feel free to ask!


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## Outskies (Jun 4, 2014)

Thanks for the info on the south side! Imperial looks pretty prosperous. 

Any one here know the starting pay at American in Fresno/Kings for Medic?


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## Angel (Jul 2, 2014)

Outskies said:


> Any one here know the starting pay at American in Fresno/Kings for Medic?




Also I got called for an interview, she said they're hiring full time and work (4) 12s a week. 
I'm interested but the pay is a big concern because I would be uprooting myself from the Bay Area and moving by myself. 
If anyone has any updated info I'd appreciate it!

Thanks


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## Outskies (Jul 3, 2014)

My app got declined due to not having a CA license. So now I am currently going through the red tape. 
@Angel let me know what the interview is like please. Maybe I can catch the next hiring process. Good luck!!!


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## CentralCalEMT (Jul 3, 2014)

I asked my buddy who works for Fresno American. He said the interview questions are pretty typical with no curve balls really. He also stated that starting pay there he believes is around $12.50 for 12 hour shifts with no paramedic experience. He also said a lot of times you are on split shifts when you are new. (example, two days you work 1000-2200 and two days you work 1800-0600) Sometimes you work this schedule for months, but it is not that bad once you are used to it. They are pretty busy as well.


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## Angel (Jul 3, 2014)

That's what I was afraid of....it's a 3 hr drive to Fresno and they may not combine interview, skills and written test for me in which case I'm not sure I will be going. I have another interview at a local company which pays the same, and granted isn't all 911 but I know they have decent and high acuity "scene" calls (nursing home to er) so I am a bit torn as to what to do....

Outskies is your application processing? Maybe they can work something out to where you can still go through the process along log as you have your license before you start? Some places (riggs (another round of hiring in sept)) do that...


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## Outskies (Jul 4, 2014)

Are you kidding me?! $12 hourly rate for 12's. Wow that sounds miserable. I'm at almost $17 for 12 hour rates. Ugh idk if I could do that at all. 
Yeah I talked to the HR lady (isn't helpful on any level btw) and even called the HR Director with the same answer, "You have to have the CA license NO EXCEPTIONS". Pretty lame. 
Does any one here know how much Riggs starts off with pay? 
Angel Riggs might be worth the 480hr field training lol. 
I've been keeping in touch with Pistoresi but their turnover is very low and they just took on 2 medics right out of school last month. I guess I will have to try Sierra. Probably the same story as Pistoresi.


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## CentralCalEMT (Jul 4, 2014)

Sierra and Pistoresi are both really good companies that get lots of applications. I do not know anyone currently at either but I do know some people who used to work for both, and they all spoke highly of both companies. Sierra also has low turnover and they start everyone out as part time and you have to work yourself into a full time position. 

What you could do is start with a Tulare County company and get some experience there while you wait for openings. Tulare is a CCEMSA county just like Fresno and Madera counties so your card is equally good in all those counties. It is easiest to get hired in Tulare County. You are allowed in that system to work for multiple companies, so work for the Tulare County company full time while waiting for openings or working part time/per diem at your 1st choice company whether it is Pistoresi, Sierra, Sequoia Safety Council, etc. Then, when you get offered full time at the company that is your 1st choice, take it. You will all ready be used to working under the same CCEMSA protocols and your transition will be smooth.


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## Angel (Jul 4, 2014)

Lol outskies I was just thinking the same thing about riggs! From a guy I talked to they pay 20 an hour 4-12s a week (so 48 Every week) and OT after 40. I know they are super busy and run lots of trauma. I have a bunch (4) apps in with AMR and remsa so if those fall through I'm definetly going to consider for sept. the fto bit will suck (or maybe it won't), but then again it doesn't have to be forever. 

12.50 as second job till something better comes along isn't terrible, but I just can't justify moving that far away for it when something is closer and I can keep the job I'm at now to help off set the costs. I just want to start getting some experience so I'm a bit more marketable but it's more challenging than I thought. 

Also I think it's an insult to pay medics that low RNs and even LVNs wouldn't settle for that junk. 



CentralCalEMT said:


> Sierra and Pistoresi are both really good companies that get lots of applications. I do not know anyone currently at either but I do know some people who used to work for both, and they all spoke highly of both companies. Sierra also has low turnover and they start everyone out as part time and you have to work yourself into a full time position.
> 
> What you could do is start with a Tulare County company and get some experience there while you wait for openings. Tulare is a CCEMSA county just like Fresno and Madera counties so your card is equally good in all those counties. It is easiest to get hired in Tulare County. You are allowed in that system to work for multiple companies, so work for the Tulare County company full time while waiting for openings or working part time/per diem at your 1st choice company whether it is Pistoresi, Sierra, Sequoia Safety Council, etc. Then, when you get offered full time at the company that is your 1st choice, take it. You will all ready be used to working under the same CCEMSA protocols and your transition will be smooth.


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## CentralCalEMT (Jul 4, 2014)

Yeah with all these supposed "openings" everywhere I was shocked at how hard it is to actually get a paramedic job. The reason I ended up in Tulare County was it is the first one to call me back and offer me a job after my interview lol. I knew nothing about the county, but just needed a job and it sounds like a lot of new medics are in that same boat. 

Just remember if either of you, or anyone else reading this, do come to the central part of the state, the cost of living is less. I make around $14 after a year here, but my company has 48 hour shifts and OT is available so I am not in the $12.50 club. However, the lower pay that is offset by the fact things are cheaper here than in NorCal or SoCal. My 4 bedroom house on a quiet dead end street costs me $1250 a month compared to $2,000 for the mediocre apartment I had when I lived in LA. It is all about finding the balance of experience, schedule, location, cost of living, etc. that will make you happy and it is definitely a crummy process.


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## BeachMedic (Jul 4, 2014)

AMR Santa Cruz is about to have massive turnover come August. We've already hired a ton of new people this year. If you're looking for a busy dual-medic 911 system by the beach you can apply here.


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## Angel (Jul 4, 2014)

why is that? are they union? whats hours and pay? ive applied to 3 or 4 amr positions and havent heard anything yet its a slow process i guess. why do they run dual medic? i figured amr was all medic/emt. how are the protocols? 



BeachMedic said:


> AMR Santa Cruz is about to have massive turnover come August. We've already hired a ton of new people this year. If you're looking for a busy dual-medic 911 system by the beach you can apply here.



central, yea i know what you mean, COL low so that may spread a little better than it would here. its just a staggering number to see. you have no issues paying bills or anything? im assuming OT is plentiful. im still not sure what i want to do yet...

answered my own question. if this is up to date

http://amr-southbay.com/santacruz.html


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## chaz90 (Jul 4, 2014)

^^
This dual paramedic service isn't doing 12 leads yet? Oh California. You never fail to surprise me.


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## TRSpeed (Jul 4, 2014)

Haha I was reading that!!


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## Angel (Jul 4, 2014)

i think (hope) its old, the copyright was 2008 and all the other links are up to '09....


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## Outskies (Jul 4, 2014)

Not to mention that no where in CA uses waveform Capno. At least not any where that I have looked. 

I will definitely avoid AMR like the plague if I'm relocating. Already work for them and it's all the same BS no matter where you're at.


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## BeachMedic (Jul 5, 2014)

chaz90 said:


> ^^
> This dual paramedic service isn't doing 12 leads yet? Oh California. You never fail to surprise me.



Been doing 12-leads and transmitting for years now. That website is pretty out of date.

The pay is a bit higher now too.

California scope is what it is. I'll never move out of state for, "better protocols" lol. EMS is my job, not my life. AMR Santa Cruz is fairly progressive and tries to remain up to do with the most current treatments that actually work. We're given a lot of free reign to make our own decisions too as long as we can justify them.

When I was working in Hawaii I had a much larger scope but some of the practices had some pretty old school thinking. (e.g. BACKBOARD EVERYBODY.)


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## BeachMedic (Jul 5, 2014)

Outskies said:


> Not to mention that no where in CA uses waveform Capno. At least not any where that I have looked.
> 
> I will definitely avoid AMR like the plague if I'm relocating. Already work for them and it's all the same BS no matter where you're at.



Alameda County, Santa Cruz County, and San Benito County all use waveform EtCo2. I can vouch for them because I've worked in these counties.

No idea where you are getting your information from but it's becoming pretty standard everywhere.

http://www.santacruzhealth.org/phealth/ems/3policyindexals.htm

Even some of those are out of date. Take atropine out of the PEA/Asystole protocol and swap out Lido for Amio in V-fib/v-tach arrest.

For those interested.


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## BeachMedic (Jul 5, 2014)

Angel said:


> why is that? are they union? whats hours and pay? ive applied to 3 or 4 amr positions and havent heard anything yet its a slow process i guess. why do they run dual medic? i figured amr was all medic/emt. how are the protocols?
> 
> 
> 
> ...



All of the AMR operations in the Bay Area are in the same union UEMSW(1600+ members strong locally). Aside from Monterey County (which is why their pay sucks.) We actually might be striking soon too if AMR doesn't play ball. You can apply to 3 or 4 AMR positions but each AMR operation is completely different and separate from the next. AMR gives it's local operations a lot of personal leeway in how they run their county as well as hiring practices. 

We run dual medic because it's the way it has always been. I believe we're one of the last two counties in California running that way. Will it remain that way forever? At least as long as our current medical director is in place and until the County wants to restructure the contract. Unfortunately, imo we're oversaturated with Medics. It's useful because there are a lot of BLS fire departments we run with. I still think a lot of skills get diluted due to most scenes having 4-5 medics on scene depending on the fire crews.

We're having a ton of turnover because about 10 people are leaving for nearby Fire departments.

We have 5 24 hour stations that operate on a 3 day Kelly schedule with a 4 days off between tours. We have one 12 hour car, two in the summer because our call volume goes through the roof with the beach tourists.

Top step medics (after about 10 years) make around 84k or so without OT. Starting, on a 24 hour car you'll probably make 19 an hour. 12 hour shifts are about 23 an hour.

Protocols are posted above. If you don't like the surfer brah attitude you'll have to adjust to Santa Cruz a bit haha.


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## RocketMedic (Jul 5, 2014)

Those protocols are so 2004. But not horrible.


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