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State Department: Arkansas

If you’re an EMS worker who is thinking of relocating or just wants to learn more about life across the U.S., EMS World’s State Department is worth a look. We start with “snapshots” of featured states, then bring you exclusive guidance from local EMS leaders. Our goal is to highlight everyday aspects of potential destinations from a prehospital provider’s point of view.

Arkansas Snapshot

  • Approximate number of EMS providers: 4,200 EMTs, 120 AEMTs, 2,200 paramedics
  • Average straight-time wages: EMT $9.28/hour, paramedic $14.62/hour1
  • Cost of living index: 88.8 (U.S. average = 100)10
  • Recertification cycle: 2 years
  • National Registry certification: Required for initial license and reciprocity
  • Opportunities for volunteers: Many throughout the state
  • Large EMS employers: Pafford Medical Services (Hope); Metropolitan EMS (Little Rock); LifeNet EMS (Hot Springs)
  • Paramedics with degrees: 42% of EMS providers have at least an associate degree
  • State EMS website (protocols)
  • Approximate state population: 3,004,000
    • Change since 2010: +3%
    • Average population per provider: 461
  • State area: 53,179 square miles
    • Average population per square mile: 58
    • Rank (↓): 34
  • Most populous cities (approximate): Little Rock 194,000; Fort Smith 86,000; Fayetteville 74,000
  • Violent crime one-year change: Little Rock +22%2
    • State violent crime rank (↑): 453
    • State property crime rank (↑): 463
  • Health rank (↓): 484
  • Top state income tax: 6.9%6
  • Average sales tax: 9.4%6
  • Average property tax: 0.63%6,7
  • Median home value: $121,8008
    • One-year change: +4.5%8
  • Median monthly rent: $1,0758
  • Average cost of electricity: $0.10/kwh9
  • Average temperatures: Summer 79ºF, winter 42ºF5

Arkansas Lifestyle

Greg Brown gets around. A self-proclaimed “military brat,” Arkansas’s Branch Chief for Trauma, Preparednesss, and EMS lived in Taiwan; Washington, D.C.; Norway; New Jersey; South Korea; and Virginia before settling in Arkansas 35 years ago. “I really like the people and sense of togetherness here,” the 53-year-old paramedic says. “Everyone is treated like family.”

Brown and two colleagues—EMS Section Chief Christy Kresse and Public Information Officer Meg Mirivel—spoke of their state’s easygoing lifestyle. The take-home message was that whether you prefer a night at the theater, a small-town rodeo, or something more hands-on, Arkansas can meet your needs.

“Our nickname is the Natural State,” says Mirivel. “Anyone who likes the outdoors is going to find plenty of hiking, fishing, and camping, especially in the Ozarks.” That rugged mountain range extends diagonally from southern Missouri to northeast Oklahoma, including a 3,300-square-mile stretch through northwest Arkansas. The state’s southwest region features boating, hot springs, and horse racing, while the upper and lower deltas in the east are best known for hunting, fishing, and gaming. Central Arkansas is dominated by Little Rock, a commerce and cultural center.

Although Arkansas’s subtropical climate isn’t for everyone, Brown encourages visitors to explore his state’s many attractions: “At any time you can find somewhere to go and something to do. It’s easy to get involved, whether you’re in a small town or a big city.”

Arkansas EMS

Relocating to Arkansas doesn’t present any unusual problems for EMS personnel. National Registry certification is required, along with an application and background check. With your existing state card, those get you an Arkansas EMS license good for two years. To renew you must either maintain your NREMT standing or accumulate the following CME:

  • EMT: 40 hours;
  • AEMT: 50 hours;
  • Paramedic: 60 hours.

“Some of that time involves Arkansas-specific policy,” says Brown. As an example he mentions the state’s trauma system, which allows prehospital providers to call in for real-time advice about transport decisions. “They can get updated capacities and capabilities of hospitals in and around their locations. I don’t know another state that does that as a matter of routine.”

Kresse, also a paramedic, praises the involvement of volunteers, especially in remote areas. “In one county we have 120 volunteer fire departments,” she says. Brown adds that volunteering is robust and well-organized in some parts of the state but less structured in others: “You’ll meet some rural first responders who are just regular folks with little formal training.”

Brown summarizes Arkansas as a mixture of big and small. “One side of the state is very populous, with a well-supported infrastructure,” he says. “The other side is the opposite: mostly farmland with few hospitals. That’s where you find the highest mortality rates for things like stroke, STEMI, and trauma.

“But those rural areas have close communities. If you’re an EMT or paramedic in a town with only a few thousand residents, your patients are going to be the same people you shop and go to church with. Your kids will go to school with their kids. Most everyone appreciates what EMS contributes. That might be a nice change from wherever you’ve been.”


1. EMS World. EMS World Salary Survey 2018,

2. FBI. Uniform Crime Reporting System, 2017 National Incident Based Reporting System,

3. Ibid., 2016.

4. America’s Health Rankings, United Health Foundation. 2017 Annual Report,

5. Current Results. Average Annual Temperature for Each U.S. State,

6. Tax Foundation. Facts and Figures: How Does Your State Compare?,

7. Ibid., Property Taxes Paid as a Percentage of Owner-Occupied Housing Value.

8. Zillow. United States Home Prices & Values,

9. Choose Energy. Electricity Rates by State in 2018,

10. Missouri Economic Research and Information Center. Cost of Living Data Series, 2018 Annual Average,

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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