Some little known information (from my point of view) about EMS (Emergency Medical Services) in Kern County:
Some of the Kern County firefighters as well as those working for the City of Bakersfield are Certified Emergency Paramedics.  However, when they respond to a medical aid call, they are restricted from performing their duties as a Paramedic--they are only allowed to perform as an EMT, which is basically administering first aid  and using the automatic defibrillation units that anyone with a current CPR card is trained to use.  Their paramedic skills, including starting an IV and administering life saving fluids and drugs, are unable to be used.
Why , you ask?
Well, that is because Hall has the contract to provide ambulance service in this county  and is not allowing anyone other than his paramedics to provide advanced life support services.  So, the firefighter/paramedics that respond and arrive first on the scene of a medical aid have to wait until the Hall paramedics get there.
Why is he doing this? 
The only reason I can think of is perhaps he is afraid someone else is going to get a piece of his pie.  He may be afraid that if  Kern County trains firefighters to be paramedics or allows the firefighters that are currently paramedics to use their skills, that they may eventually want to put ambulances at their fire stations, putting his sweet little monopoly to an end.  Now that the problem has been identified...
What is the solution?
Kern County firefighters need to be able to function as paramedics. In most California counties and cities, firefighters are paramedics also. They already respond to all medical aid calls, so providing advance life support services could easily be implemented.  That way, the Kern County firefighter/paramedic could immediatley begin to provide the advanced life support care that the people of Tehachapi and especially the outlying areas, need.  Once Hall's ambulance arrived on the scene, report can be given, both the Kern County firefighter/paramedic and Hall's paramedic can work together to stabilize the patient.   Once stabilized, care is transferred to Hall's paramedic and the patient is transported to the hospital by Hall's ambulance.  This frees the Kern County firefighter/paramedic to return to his fire station, and keeps the level of EMS/fire supression at the level it has always been.
Why isn't this being done?
Well, do you think the City of Bakersfield, with Hall as their MAYOR, are going to complain?  Who would they complain to?  The MAYOR, WHO ALSO OWNS THE AMBULANCE COMPANY?  Do you really think the Kern County Board of Supervisors are going to rock the boat and go up against Mayor Hall?  It would probably be the end of their political careers.
What are some other considerations?
Well, training a firefighter to be a paramedic can be costly to the county.  It takes that firefighter out of service while he attends the 6 mth paramedic program.  It would be a huge expense covering his shifts and paying for the program.  To minimize the financial impact, some cities/counties are now requiring  that any new firefighter recruit hired must have already have completed paramedic training as well as the required Fire Science degree.  But if the firefighter/paramedic training had been implemented years ago as it should have been, the impact would have been spread over a period of time.  However, it is not too late to begin to provide the same level of service that most Californians, even those residing in rural areas, receive every day.