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State Department: Indiana

If you’re a paramedic or EMT who’s thinking of relocating or would just like to learn more about life across the U.S., EMS World’s State Department is worth a look. We start with data-driven “snapshots” of each state, then add a few paragraphs about regional practices and lifestyle. Our goal is to highlight everyday aspects of potential destinations from a prehospital provider’s point of view.

Indiana Snapshot

  • Link to state EMS website
  • Average straight-time wages: EMT $14.16/hour, paramedic $21.251
  • State area: 36,418 square miles
  • Approximate state population: 6,692,000
    • Rank (↓): 17
    • Change since 2010: +3%
  • Most populous cities (approximate): Indianapolis 863,000, Fort Wayne 266,000, Evansville 119,000
  • Violent crime one-year change: Indianapolis -8%, Fort Wayne +10%, Evansville -29%2
  • State violent crime rank (↑): 303
  • State property crime rank (↑): 243
  • Health rank (↓): 414
  • Average temperatures: Summer 72ºF, Winter 29ºF5
  • Top state income tax: 3.23%6
  • Average sales tax: 7.0%6
  • Average property tax: 0.82%6
    • Rank (↓): 306
  • Median home value: $146,1007
    • One-year change: +8.2%8
  • Median monthly rent: $1,1007
  • Average cost of electricity: $0.13/kwh8
  • Cost of living index: 90.5 (U.S. average = 100)9
  • Best states rank (↓): 3610
  • Approximate annual retirement cost per household: $56,00011

‘The Crossroads of America’

My wife and I have many things in common. We grew up in the Northeast—me in Boston, Helen in Brooklyn. We both chose careers in the essential services, crave any seafood that comes in a shell, and visited relatives in Indiana as teenagers during the summer of ’69. While I was exploring Indianapolis inside out from Monument Circle, Helen was vacationing with her cousins near Fort Wayne.

We enjoyed our Midwestern adventures. I liked the urban familiarity of “Naptown,” the 17th-most-populous city in the U.S.; Helen preferred the relative novelty of rural recreation and farm-fresh produce. A tree might grow in Brooklyn, but corn does not.

The Indiana of today retains a mix of major cities and off-the-grid countryside. The latter offers swimming, boating, and fishing in the summer, then snowmobiling and cross-country skiing in the winter across a relatively flat landscape (only 8% of the state sits above 1,000 feet).

Perhaps more important for those of you contemplating relocation is Indiana’s motto: The Crossroads of America. It backs that up, too, with Chicago, Detroit, St. Louis, Columbus, Louisville, Milwaukee, and Nashville all within 300 miles of Indianapolis via four interstate highways (suburban Chicago actually extends into the northwest corner of Indiana). Being a hub with many spokes makes it easier to connect with the state’s two major industries: manufacturing and agriculture. The percentage of non-farm workers employed in manufacturing is the highest in the nation.

If you move to Indiana, two things you’ll need to understand are basketball and Hoosiers. Basketball attracts more attention than any other major sport, and not just at the professional level; the state invented high school hoops in 1925. As for Hoosier, that’s what you call anyone from Indiana, even if they don’t play basketball. The term allegedly comes from the frontier practice of yelling, “Who’s here?” when you’re not sure whether to shoot at whatever’s coming closer. No, I’m not making that up.

Reciprocity for EMS Providers

Indiana has roughly 24,000 EMS providers among 800 agencies answering more than 2,000 calls a year. Here’s what you’ll need to join that system:

  • Proof of out-of-state licensure or certification;
  • Up to 31.5 hours of supplementary instruction in Indiana’s motor-vehicle laws, autism spectrum disorder, SIDS, geriatrics, WMD, and hazmat;
  • National registry and ALS affiliation for AEMTs and paramedics;
  • ACLS for paramedics.

Relicensure every two years requires the following:

  • EMTs: 40 hours of CME, including 6 hours of audit and review;
  • AEMTs: 56 hours of CME, including 10 advanced hours and 12 hours of audit and review, plus skills evaluation;
  • Paramedics: 72 hours of CME, including 12 hours of audit and review, plus skills evaluation and ACLS.

I found some of the above information attached to a cover letter from the office of Michael R. Pence, Governor, which sort of means Indiana’s EMS providers are serving at the direction of the vice president. I can see myself using that argument to expedite transport decisions.

Speaking of transports, they can be dangerous. All those road trips people take from Indiana to someplace else make MVCs the leading cause of death in the 5–24 age group. Forty-two percent of the hospitals capable of receiving those patients are in rural areas, where EMS is mostly fire-based and volunteer-staffed. The state’s 2,000-plus ambulances need at least one EMT to roll, plus one paramedic to be considered ALS.

One EMT and one paramedic—that could have been Helen and me. Maybe we should have stayed and raised a bunch of little Hoosiers.


1, EMS World. EMS World Salary Survey 2018,

2. FBI. Uniform Crime Reporting System, 2018 National Incident Based Reporting System,

3. Public Safety Rankings,

4. America’s Health Rankings, United Health Foundation. 2018 Annual Report,

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

6. Tax Foundation Facts and figures 2019,

7. Zillow. United States Home Prices & Values,

8. Choose Energy. Electricity Rates by State,

9. Missouri Economic Research and Information Center. Cost of Living Data Series, 2019,

10. Best States 2019: Ranking Performance Throughout All 50 States. U.S. News & World Report, 2019.

11. Hill C. This is exactly how much it will cost to retire well in every state in America. MarketWatch,

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

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