In Kalamazoo, autonomy increases with seniority, as at most programs. In general, if you show that you know reasonably well what you're doing, the attendings let you handle the patients.
Different people might say differently, but my overall impression concerning procedures was that you'll get to do them, but not nearly as many as you would at the urban programs - there's often tension between EM and surgery residents for priority (chest tubes, lines, intubations). In defense of the program, they do have a pig lab every month, primarily for the medical student and rotators, to practice the invasive procedures. And there is a big airway conference each spring that goes over all relevant topics (difficult airways, combitubes, etc.).
There is not a huge Latino population in Kalamazoo, but there are a lot of migrant farm workers (mostly Mexicans) who come through the area. You'll probably see at least a couple each shift, but not as many as in other areas. For example, to the north, Grand Rapids has a much larger Spanish-speaking population. Chicago, of course, does as well.