Bay Area, Central CA, NorCal EMS

RocketMedic

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So how does EMS work there? I know Kern = Hall/Liberty, Kings County = Fresno/American, and that Merced has Riggs, but what about the rest of the state? Who covers what, and how are they to work for?

How is it to live, work, go to school there? How is cost of living, schedule, expectations, etc?

Thanks!
 

CALEMT

The Other Guy/ Paramaybe?
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How is cost of living
Bay Area? Expensive as hell. More than what you'd make working for a private ambulance company. You'd be better off working for a FD if you want a livable wage for the Bay Area... then again this is coming from a southerner who doesn't have a whole lot of experience with the northern part(s) of the state.
 

RocketMedic

Earl of the Wheeled Chair
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Resuscitating this thread a bit:

So I've got my CA medic license and my wife and I are pretty fascinated by the concept of not living in Houston. We're looking strongly at the Central Valley area, running from Bakersfield to Sacremento; Fresno and Visalia/Tulare seem to be kind of the leaders in that category. Would consider Riverside or NorCal as well, but looking primarily at the Central Valley. NOT DELANO, the water there tastes like pesticide and I don't like Delano. Or Oildale, for that matter. We're also still considering Alameda County with a commute in, but we'd probably have to live in an RV or out in like Stockton or on a houseboat on the Pacific or something lol; rents are insane in the Bay Area.

What's the cost of living, life, etc like there? We're looking for relative proximity to parks/forests/nice things/lakes, culture, events/festivals, jobs in healthcare (quality management/insurance/improvement/scheduling/etc for her, probably paramedic for me although I'm also open to performance improvement positions). Also looking for a nearby community college and a university for more school and a local scene.

Also, how is it to work for American, Hall and Riggs? I'm not terribly concerned about the medicine or clinical side of things; I'm looking more at a morale, employee-satisfaction, how-we're-treated level, shift types and lengths, benefits, equipment, etc.

Thanks!
 

CALEMT

The Other Guy/ Paramaybe?
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What's the cost of living
I'll just go ahead and put it this way. I work for a FD and I'll clear 100k this year... theres a reason why I'm buying a house and moving to AZ.
 

RocketMedic

Earl of the Wheeled Chair
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I'll just go ahead and put it this way. I work for a FD and I'll clear 100k this year... theres a reason why I'm buying a house and moving to AZ.
Where are you living now?
 

Generic

Now in Dolby Digital
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Also look into Sequoia Safety Council out of Reedley (Fresno county). I believe they are a 3 station non-profit that covers 9-1-1 for the southeast part of the county. I have a friend that works at American and will post more in a few days when I have more time.
 

RocketMedic

Earl of the Wheeled Chair
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Also look into Sequoia Safety Council out of Reedley (Fresno county). I believe they are a 3 station non-profit that covers 9-1-1 for the southeast part of the county. I have a friend that works at American and will post more in a few days when I have more time.
Thanks!
 

CentralCalEMT

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Tulare County has 4 providers: Imperial, American Visalia (different from the Fresno one), Exeter, and Lifestar. They are all small companies with American Visalia being the biggest and Imperial the second biggest. The county as a whole is decently busy and all the companies operate as a unified system with a single consolidated dispatch center meaning the closest unit goes regardless of company or city. The Central Valley as a whole does not have a lot of cultural activities as far as theater, an arts district, music scene, etc. The one exception is if you are a country music fan in which case most of the artists will make a stop in the central valley during their tours (either in Bakersfield or Fresno). However, if you are the outdoors type of person, we have the Sequoia National Forest and Sequoia National Monument in our backyards with some of the best hiking and camping in the country as well as good fishing and good areas for hunting. There are multiple lakes and rivers. We also have many Giant Sequoia groves and other types of natural features you wont find most places in the country so if you are into that lifestyle we have a lot to offer there. I am most familiar with Imperial and their coverage area includes a large portion of the the Sequoia Forest and Monument so you would also run 911 calls there as well.

Cost of living is low for CA standards, but still probably higher than Texas and it is a more second amendment friendly than the bigger urban areas, but it is still CA so hunting is quite regulated. (The Tulare County Sheriff is pro CCW.) Real estate prices are also low for CA standards with new construction going for under 325K in new sub divisions. If you like a more rural lifestyle you can pick up a home with an acre or two of land for under 250K. You won't be able to do that in LA or the Bay Area.

All the Tulare County companies work mainly 24 hour shifts with some also having a couple of 12 hour day cars. Pay varies by company but usually starts in the 16.00-17.50 range and increases over time. I personally enjoy working in Central California because we have long transport times and a lot of high acuity calls as this area has limited access to primary care and specialists which results in an overall sicker population. We are also very involved in our communities with Sidewalk CPR, Stop the Bleed, community outreach, etc and I really enjoy the support we have from our community.

Overall, you have to find what you are looking for and makes you happy. It just depends on what you are looking for. Hall and American Fresno are excellent companies and I have friends at both companies that are very happy there. They are larger and have a greater variety of shifts and opportunities for promotion, but you do lose that small company feel. If you want to work for a small "mom and pop" style company, that is what Tulare County has, and a lot of people enjoy that.
 

RocketMedic

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I’m definitely looking for 12-hour shifts, promotional/educational opportunities and a company that doesn’t suck to work for. That’s one of the big draws of CA- better 12-hour options than most parts of Texas WRT 911 opportunities.
 

Generic

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What's the cost of living, life, etc like there? We're looking for relative proximity to parks/forests/nice things/lakes, culture, events/festivals, jobs in healthcare (quality management/insurance/improvement/scheduling/etc for her, probably paramedic for me although I'm also open to performance improvement positions). Also looking for a nearby community college and a university for more school and a local scene.

Also, how is it to work for American, Hall and Riggs? I'm not terribly concerned about the medicine or clinical side of things; I'm looking more at a morale, employee-satisfaction, how-we're-treated level, shift types and lengths, benefits, equipment, etc.
American works a 48 hour work week with 4 12s or with seniority, 1 24 hour and 2 12s. The 24 hour is mostly in rural areas where it is generally slower but have some 24 hour stations closer to the metropolitan area where it is busier. The 12 hour units are in the Fresno metropolitan area. They use system status management so it is generally busy. The good thing is that not all posts are at street corners. The most commonly used posts are at office complexes so you are not always on a street corner. The county runs about 150,000 calls a year.

As CentralCalEMT has stated, American in Fresno is a larger company so the family aspect is not as prevalent as a smaller company but it is still there. It is not like it used to be but I think that happens when companies become larger. My friend says it is still a good company compared to other ambulance companies. My understanding is that pay and benefits are above average for the cost of living.

There is also snow skiing about an hour away in Shaver Lake. The beach is 2-3 hours depending on where you go. There is Fresno city college and California State University Fresno.

The weather is hot in the summer (100+ degrees) and there is dense fog in the winter.
 

RocketMedic

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Snow and beaches both sound amazing. I grew up in CA and miss it more every day.
 

CCCSD

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Just so you get grounded...WHAT you remember, is not what it’s like now.
 

RocketMedic

Earl of the Wheeled Chair
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Just so you get grounded...WHAT you remember, is not what it’s like now.
I know nostalgia tinges things, but I've still got a lot of friends out there, I'm pretty sure the mountains and ocean are still there, most of the forest hasn't burned down, and Knott's, Disney and Universal are still in business. Plus we're bored with Houston and I'm rapidly reaching the point where I'm ready to do more than 'just' EMS.

At least what I'm seeing is that Texas, despite its dazzling variety of places, is essentially the same model and place, repeated over and over again. County A = County B = St. Whoever EMS = Arbitrary Geographic Place/Feature EMS = Adverb EMS = Adjective EMS. Not just in terms of role, but in terms of how people are treated. Pay, schedules, benefits...it's all the same. 24-hour high-volume operations. Decent pay, but only because a lot of hours. RSI and New Clinical Hotness and transfusions, etc. In general, if you want to do 911 EMS on a 12-hour truck in Texas, you're either at MedStar, Acadian-Pasadena/San Antonio, Lubbock, Amarillo or AMR-Arlington (ewww!). The rest of it is 24s or longer. Eww! And although Rocketmedic of 2014 was impressed by the freedom and scope of what could be done, Rocketmedic 2019 realizes that we're being sent out to do some pretty incredible things with minimal preparation, not a whole lot of training or work to develop or ensure quality, and a whole lot of responsibility, and that's the normal here. Are there good places where this isn't necessarily the case? Yes, but I've spent years there, and it's still the same basic thing. A small group of trusted people, good old boys not meanin' no harm, inside a larger system. It gets exasperating. And I certainly haven't helped myself by flitting from one job to another (three total down here in five years, counting current gig) even though it's been beneficial to me from the standpoint of allowing me to go to school.

I'm not naive. I know everywhere has its own inner cliques, trusted people and mentors, and I know everywhere has its problems. I know I've largely been spared having to ask a nurse for permission to do something Paramedic-y and that I'm largely ignorant of the challenges of working with/for non-transporting, scene-commanding, some-are-more-equal-than-others ALS fire departments that allegedly treat EMS like gurney jockeys. I don't know what a normal American, Hall or AMR day is, aside from a guess it's pretty similar to an EMSA or Cy Creek day. But I see the good of CA, like the diverse fun experiences that aren't swamp or the not driving into frequent reminders of the Confederacy and the state's increased-as-compared-to-Texas emphasis on worker rights, and the 12-hour shift schedules that allow for paramedicine as a job instead of a lifestyle sound amazing. And compared to the "work 3-4 12-hour shifts then spend 2-3 days at the clear mountain lake, not exhausted", not being able to RSI someone or having to confirm a cardioversion or whatnot is pretty minor.

Also, CA apparently allows people to BLS calls. That alone is incredible. Pretty much my entire time in EMS, everything has been either medic-only or so limited in what could be released to BLS that it was insignificant. Being able to literally assign an entire call to a BLS crew sounds amazing.
 

CALEMT

The Other Guy/ Paramaybe?
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Being able to literally assign an entire call to a BLS crew sounds amazing.
This is going to vary wildly throughout every county. I have the option to downgrade to BLS, but only in certain cases where the 911 system in extremely busy. It's not a common thing here vs LACo. Now with that said, as a ALS provider on a transport rig have I "BLS'd" patients where I was attending, but didn't do any ALS procedures/ treatments, yeah plenty of times. Here if ALS treatment isn't warranted then you just monitor, reassess, and transport.
 

VentMonkey

Ajaw
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The “BLS handoff” in Kern Co. was designed to return ALS units back into service, and into the system.

If a paramedic gets on scene, deems the call BLS-able, they make base contact, confirm the order, and wait for the BLS unit to arrive. They have to contact med control for consult. It’s a thing apparently.

I have heard of paramedics waiting a ridiculous amount of time on scene just to turf the patient.

For me personally, I have never taken advantage of this particular option as I find most BLS-able patients to be an easy chart, and reprieve from all of the other “potentially critical calls”.

TLDR: Go get’em, tigers...
 
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