Skip to main content

State Department: Colorado

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.

Colorado Snapshot

  • Approximate number of EMS providers: 12,950 EMTs, 290 AEMTs, 450 EMT-Is, 4,650 paramedics
  • Average straight-time wages: EMT $15.76/hour, paramedic $25.83/hour1
  • Cost of living index: 107.3 (U.S. average = 100)10
  • Recertification cycle: 3 years
  • National Registry certification: Required for initial licensure
  • Opportunities for volunteers: Volunteers are most common in rural areas
  • Large EMS employers: AMR, fire-based municipal and county agencies
  • Paramedics with degrees: Not the norm
  • State EMS website
  • Approximate state population: 5,696,000
    • Change since 2010: +13%
    • Average population per provider: 311
  • State area: 104,094 square miles
    • Average population per square mile: 55
    • Rank (↓): 37
  • Most populous cities (approximate): Denver 705,000; Colorado Springs 464,000; Aurora 367,000
  • Violent crime one-year change: Denver +10%, Colorado Springs +15%, Aurora +7%2
    • State violent crime rank (↑): 233
    • State property crime rank (↑): 323
  • Health rank (↓): 74
  • Top state income tax: 4.6%6
  • Average sales tax: 7.5%6
  • Average property tax: 0.59%6,7
  • Median home value: $372,3008
    • One-year change: +6.8%8
  • Median monthly rent: $1,8768
  • Average cost of electricity: $0.12/kwh9
  • Average temperatures: Summer 65ºF, Winter 26ºF5

Home on the Range

When Randy Kuykendall, director of Colorado’s Health Facilities and EMS Division, was growing up in southern New Mexico, he figured the Cactus State was where he’d stay. “My family had been in New Mexico since the early 1900s,” the former paramedic says. “I didn’t see any reason to move until I saw Colorado. I dearly love it here.”

For Randy and branch chief Jeanne-Marie Bakehouse, Colorado is much more than an employer. “It’s a great place for people who love the outdoors,” Bakehouse says. “Whether you want to play in the mountains, hike the trails, or go boating, camping, or skiing, we have it all right here.”

Those recreational opportunities have lots to do with the region’s unique geography. The entire state is at least 3,000 feet above sea level, but it’s not as mountainous as you might think. Almost half of Colorado—on either side of the Rockies—is relatively flat and includes plenty of farmland and even desert.

Perhaps it’s the contrast between 14,000-foot peaks (53 of them), plains, sand dunes, and canyons that makes the setting attractive to those who grew up surrounded by steel and asphalt, but Colorado has an urban side, too: a 200-mile stretch between Pueblo and Cheyenne, Wyo. that accommodates 70% of the state’s population. Known as the front range, that corridor encompasses Denver, Colorado Springs, Aurora, and other major metropolitan areas. Front-range culture is rich, and so is the lifestyle, with Denver-area property values up 250% since 2010. “That’s the downside if you’re looking to buy or rent,” says Kuykendall.

Rocky Mountain Hiring

Another issue for some healthcare providers would be Colorado’s lack of reciprocity arrangements with other states. However, Bakehouse says she and her staff work closely with incoming EMS personnel to help get them certified. Requirements include NREMT credentials and CPR for all levels, plus ACLS for paramedics and EMT-Is (’99).

To renew every three years, providers need NREMT certification or skills verification and CME—36 hours for EMTs and AEMTs, 50 hours for paramedics and EMT-Is. Medics can earn supplementary endorsements for critical care and/or community paramedicine.

Overall Colorado has around 200 ground-ambulance agencies and transports approximately 400,000 patients a year, but its EMS system is divided into 11 regions with strong decentralized management. That delegation of authority permits protocols to be customized by location. “Agencies can apply for scope-of-practice waivers,” says Kuykendall. He mentions RSI as an example and credits layers of state, regional, and local medical direction for recognizing and meeting their communities’ needs.

Kuykendall thinks Colorado is ideal for ambitious EMS workers. “The quality of care here is as good as anywhere between St. Louis and San Francisco,” he says. “We do have shortages, though—at all levels. Unemployment is only 2.8%. If you’re looking for career opportunities, Colorado is an awesome place to be.”


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,

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

Back to Top