By Thomas Tracy
New York Daily News
NEW YORK — Newly minted Fire Commissioner Lillian Bonsignore made a fiery pitch for EMS pay parity during a “State of the FDNY” breakfast, claiming it was time EMS is embraced “as an equal in the Fire Department and in the first responder community.”
“EMS is the lowest-paid first responders in the city, and that is unacceptable,” Bonsignore said at Thursday’s breakfast, which was sponsored by the FDNY Foundation. “The people staffing the ambulances deserve to be able save the lives that need them and still support their families in the city that they love.”
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“We have to let them know that they are also heroes,” she said.
Bonsignore, the first openly gay person picked to lead the department in its 160-year history, spent three decades as a city “Street Doctor” with the FDNY. In her 31-year career, she rose to chief of the EMS division, holding the top post for three years before retiring in 2022.
Her tenure as EMS chief overlapped with the COVID-19 pandemic, a period that saw the department’s EMTs and paramedics under tremendous strain.
She has no say over contract negotiations between City Hall and the unions representing city emergency medical technicians, paramedics and officers, but said the low pay has led to concerns about recruitment and retention.
Most of the 911 calls directed to the FDNY are for medical emergencies, so EMTs and paramedics are needed more now than ever, she said.
“Our call volume is exploding, we are up to over 2 million calls collectively in the Fire Department, in which 1.6 million are for medical emergencies. Everyone (in the FDNY ) is in the game on handling that,” she said.
Currently, an EMT coming out of the EMS Academy starts at a salary of $39,386, union officials said. After about five years, their salary increases to $59,000. By comparison, an FDNY firefighter earns $45,196 right out of the FDNY Academy and can earn around $110,000 after five years.
Contract bargaining sessions between EMS unions and City Hall are expected to continue later this month, members said.
In her address to the FDNY Foundation, Bonsignore also said the department needs to focus on upgrading its aging infrastructure.
“We have to keep up with the city that is growing around us,” she said. “The FDNY is 160 years old and some of our buildings are 100-plus years old. Our infrastructure is not what it used to be, and we have to make sure that our equipment and facilities and vehicles — everything that keep our rescuers moving — are updated and ready for the next 10, 20, 30 years.”
Still, she noted, “If we got evicted (from these facilities) on the same day, we would still be the FDNY.”
Past Fire commissioners have always supported EMS’ bid for equal pay, but few rarely spoke out on the subject since they have no control as to what happens at the bargaining table.
“Local 2507 appreciates the Fire Commissioner’s sentiment, which also matches that of former Commissioner Thomas Von Essen, that the EMS pay parity issue should have been addressed decades ago,” Oren Barzilay, the president of Local 2507 said. “This year marks the 30th anniversary of the FDNY and EMS merger, and our men and women are severely struggling, which is reflected in our staffing shortages and response times.”
An FDNY spokeswoman said Bonsignore has always been a champion for EMS pay parity, which didn’t change when Mayor Mamdani named her Fire commissioner.
“We are modernizing our technology, our equipment and our fleet, but the most critical piece of FDNY infrastructure is our people,” the spokeswoman said. “We are losing seasoned paramedics and EMTs to other career paths and the private sector because the current pay scale is unsustainable.”
“While the Fire commissioner does not sit at the bargaining table for contract negotiations, we cannot talk about recruitment and retention while ignoring compensation levels,” she said. “I hope a resolution can be reached soon.”
Fire Commissioner Lillian Bonsignore says low pay is driving recruitment and retention problems as EMS call volume continues to rise. In your experience, what would make the biggest difference in keeping experienced EMTs and paramedics in EMS?
EMS1 readers respond
“This should go national! A great start for the new Commissioner! I hope she keeps pushing for EMS parity.”
“If FDNY or any EMS system wants to recruit they need to pay their people! It’s the same all over the country. If a nurse was on the ambulance he/she would be making triple the pay! It’s disgusting what EMS gets paid whether on the street or in the emergency rooms. The majority of paramedics can run circles over most nurses and yet their pay is ridiculously low. These folks put their lives on the line daily and yet get a slap in the face for their pay.”
“She’s entirely correct. I’d like to know what the Mandami administration has planned to address this long-festering issue.”
“EMS budgets and salaries should not be tied in any way to the EMS budget and employee compensation. EMS is an essential public service, and the public as a whole should pay the cost of having the service, through appropriate jurisdictional taxation. If a service wants to bill and offset expenses, fine, AFTER the program has been fully from the general fund. Politicians and general management should stop relying on ‘Medicare and Medicaid don’t pay enough’ as an excuse. Medicare and Medicaid were never meant to pay the full cost of a community’s EMS just the marginal cost of serving their beneficiaries. They told us that back in the early 1990s and nobody listened — they just kept whining about it.”
“Increase the pay to what a registered nurse makes in NYC.”
“I have been a paramedic for 35 years. We are looked at as ‘temporary fixers giving someone a ride.’ In the large municipal city FD I work in, call volume is increasing, we don’t have enough ambulances and we’re understaffed. Mandatory OT is very very common. At least us paramedic officers received a 10% raise on top of our contractual raises. Call volumes and money plays a large role in losing experienced paramedics.”
“The pay difference is a big slap in the EMS workers’ faces. This action has to kill morale and I’m sure leads to providers. I would be interested in the pay comparison to NYPD salaries of personnel of the same rank. Shame on the union and city admin for allowing this too occur.”
“It’s the money. You can’t pay people peanuts and expect them to do the job. Why are firefighters paid so much more when most calls are medical? Pay the EMS what they are actually worth, and the other issues go away.”
“I am retired now, but during my career in EMS, I was employed by a county-run service, a private service with large city contracts, and a fire department EMS service. Although I went into EMS because I very much enjoyed the work, I soon realized that to stay in EMS, I would need a living wage/appropriate benefits, and of all the services I worked for, the fire department system was by far, the best paying and also had the best benefits. I also believe that the fire service system was also the best, with regard to equipment, training and working environment. I was also aware of the ‘business’ side of these services, and it became very apparent that the fire dept.-based system was the most effective, efficient and economical for the general public. Private services may advertise that they are the most economical for the public, but most often their individual service fees are outlandish, and they are still supported by public taxation to pay for ‘subsidies.’ I must admit that the private service I worked for had the very latest and best equipment, while at the same time had the poorest wages and staffing. In all honesty, we must admit that EMS services are expensive — learning to balance cost with effectiveness and efficiency should be the goal of any public/non-private system. As in most areas of life, we get what we pay for, and as an aging retiree, I will support the most advanced and efficient system we can afford! Before retirement, I had worked for a county system, and large city municipal system. Many issues contribute to what is ‘best’ patient care. Primarily, what size is the community with the municipal system? Is the community system able to staff, obtain expensive equipment, do continuing education and follow up, as the larger county system probably can and does? In my experience, our system was a county based system with all units located in the county seat. Each smaller community then had developed 1st responders, that would dispatched at the same time the ambulance would be dispatched from the county seat. Basic care would be provided until such time as the paramedic unit arrived and took charge of the patient. The outlying communities had their own response units, but did not transport any patients. This did make for some excessive response times, but there was really no way for these smaller towns to afford advanced care units or staff. As usual, one of the major issues comes down to finances. People can have whatever they want, if they are willing/able to pay for it.”
“If an EMT or paramedic works less that 96 hours in a 9-day work week there is no way they can afford to live based on the cost of living in most urban cities. Calling EMS a non-professional job like nursing, fire or police, comments like ‘it’s a stepping stone’ diminishes pay and respect for these jobs. An EMS provider should be able to make an above living standard and it should be considered a professional career pathway. EMTs make minimum wage, how can one afford to this job if they didn’t come from a rich up bringing? EMS needs to rethink its taxes budgets pay wages to make it a real career pathway that is sustainable for one to live.”
“One of the main reasons EMT and paramedic pay is low is due to the income for ambulance calls at the service level. Medicaid and Medicare makes up close to 80% of the run volume of most ambulance services. Medicaid pays approximately $.20 on the American dollar and Medicare pays approximately $.60 on the American dollar add that up to 80% of the income. There is your problem reimbursement of Medicare and Medicaid has to be raised.”
“While I support all of our prehospital providers, calling Commissioner Bonsignore a “street doctor” grossly dilutes the vast difference between an EMT who receives a few months of training and a physician who receives over a decade of training. With that said, I support the men and women of FDNY EMS and wish them luck on their fight to pay parity.”
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