CCOM simulcasts fire dispatch on 800 and VHF F-1 (don't have the freqs/TG handy). They still alert fire stations and personnel via tones on the VHF channel, and pretty much every firefighter in Clackamas County has a Minitor strapped to their hip. Interestingly, the tones themselves are only broadcast on VHF, so if you're monitoring 800 you'll hear a brief gap.
Us poor ambulance drivers have to make do listening to the voice dispatch and figuring out if we're closest.
AMR medic units in Multnomah County uses a pseudo tone-out on the 800 radios; when a unit is assigned a call the system alerts their portable radios -- which makes some noise! Fire, of course, is on the Zetron system. Everything is backed up by pagers and MDCs.