If you’re an EMS provider 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.
Approximate number of EMS providers: 1,500 EMTs, 320 paramedics
Average straight-time wages: EMT $17.13/hour, paramedic $24.75/hour1
Cost of living index: 106.0 (U.S. average = 100)10
Recertification cycle: 2 years
National Registry certification: Required for paramedics and EMTs
Opportunities for volunteers: Outside of Wilmington and Delaware, EMTs ride mostly with volunteer fire departments
Large EMS employers: New Castle County, Kent County, Sussex County, St. Francis Healthcare
Degrees for paramedics: About half of Delaware’s paramedics have college degrees
Most populous cities (approximate): Wilmington 71,000; Dover 38,000; Newark 34,000
Violent crime one-year change: Not available2
State violent crime rank (↑): 423
State property crime rank (↑): 343
Health rank (↓): 314
Top state income tax: 6.6%6
Average sales tax: 0%6
Average property tax: 0.56%6,7
Median home value: $237,3008
One-year change: -1.1%8
Median monthly rent: $1,3508
Average cost of electricity: $0.12/kwh9
Average temperatures: Summer 74ºF, Winter 36ºF5
Small State, Big Opportunities
If you’re a paramedic or would like to be one, Delaware offers an exceptionally favorable employment outlook. The second-smallest state’s EMS system, only 28 years old, is preparing for unprecedented turnover.
“Most of our medics can take retirement after 25 to 30 years,” says EMS Director Diane Hainsworth. “That means lots of opportunities for out-of-state replacements.”
Local EMTs benefit too; they make up 40% of each paramedic class at Delaware Tech, the state’s primary source of new recruits.
Almost all Delaware medics ride for county 9-1-1 systems and do ALS intercepts from fly cars. “They usually work two 10–12-hour days and two 12–14-hour nights, then have four days off,” says Hainsworth, who is an RN and a former paramedic.
EMTs either join private agencies in the cities of Wilmington and Dover or serve as paid ambulance crews with volunteer fire departments. Those who don’t necessarily want to make EMS a career can work part time or per diem.
Paramedics and EMTs need NREMT certification. Medics seeking reciprocity have to be affiliated with an ALS agency and go through field training—usually a four-month process. EMTs must meet BLS criteria specified by their employers.
Delaware’s prehospital protocols are influenced by feedback from responders. All EMS workers are eligible to contribute. “It’s an interesting process,” says Hainsworth. “Anyone, even someone new to the system, can make recommendations to our medical directors.”
Off duty there’s plenty for paramedics and EMTs to do. It helps to be familiar with the state’s geography.
Recreation at a Discount
Delaware is less than 100 miles from top to bottom with only three counties—fewer than in any other state—stacked north to south. New Castle County, the northernmost, boasts 60% of Delaware’s population and is primarily industrial; Kent, in the middle, combines urban and rural elements; and Sussex is best known for its beaches along 25 miles of Atlantic coastline.
Hunting, fishing, hiking, biking, and boating are popular pastimes, easily accessible to residents throughout the state. Hainsworth, a Maryland native, enjoys Delaware’s natural attractions. “We live up north in New Castle County, but I’m not a city person,” she says. “If my family and I want to go fishing or to the beach in the summer, it’s no more than an hour’s drive [to Sussex]. And we’re only an hour and 15 minutes from Baltimore’s inner harbor or Philadelphia.”
Delaware also offers a cost-saving perk common to only three other states: no sales tax. Hainsworth says it’s a shock to pay extra when she travels. “I cross the state line, and it’s like, ‘Wait a minute—you want more money than what’s on the price tag?’”
Hainsworth sees Delaware as a distinctive mix of professional, financial, and recreational attributes. “My husband and I came here as paramedics,” she says. “We thought it would be 5–7 years, then we’d go back to Maryland or somewhere else. Thirty years later we’re still here. It’s been a great experience.
“If you want to be a paramedic, but not necessarily in a fire-based environment, we have some great opportunities in Delaware. It’s a progressive system with competitive pay.”