By Thomas Tracy
New York Daily News
NEW YORK — The FDNY’s new commissioner, who rose through the ranks as an EMT, will this week mark the 30th anniversary of the department’s controversial-at-the-time merger with EMS.
Lillian Bonsignore, the first former EMS responder ever picked to run the fire department, will join past and present firefighters and EMS members at Fort Totten in Queens to commemorate the shotgun wedding’s pearl anniversary on Monday.
“The initial pairing was uncomfortable,” Bonsignore told the Daily News. “But that would happen any time you try to merge two histories and entities together. There were some tough times, but now looking back 30 years it really has been pretty wonderful. There were lots of things that happened that were great and continue to be.”
“Uncomfortable” is a bit of an understatement. When Mayor Giuliani forced the two agencies together on St. Patrick’s Day 1996, in an effort to reduce response times and improve working conditions for both busy agencies, few thought it would last.
EMS members, who were working under the city’s Health and Hospitals Corp. at the time, saw the merger as a hostile takeover. Firefighters also decried the move, complaining that they would be asked to respond to medical calls, which they didn’t sign up to do.
Tony Bernardo, president of the union representing the EMTs at the time, opposed the merger.
“EMS is one of the most efficient services in the city,” he remarked at the time. “How is that going to fit in the Fire Department, which has never been credited with good management and efficiency?”
“Painting all the ambulances red doesn’t do it,” he added.
The merger made the FDNY the largest fire department-based provider of emergency medical care in the country. It also gave Bonsignore, who was working as an EMT in the Bronx when the merger was finalized, an instant boost in recognition with the public she served
Once City Hall signed off on the merger, EMS members had to trade in their uniforms — green pants and white shirts — for FDNY blue uniforms, she remembered.
“They gave us a light blue shirt and dark blue pants,” she recalled. “So I was sitting in my ambulance in the South Bronx and someone came up to us and said, ‘Thank God you guys are here!’”
“We love the fire department!” that grateful woman said to the two EMTs.
“I thought, well, you’re in good hands anyway,” Bonsignore said. “We’re all the same people even if we were wearing different colors. But the world saw a brand they respected and recognized.”
After a few years, Bonsignore saw the new partnership with FDNY “less of a merger and more of a fold in.”
“We got to know the [firefighters], and we eventually taught them first responder medicine and they started responding to medical calls,” she said. “We were always both optimistic and cautious. We didn’t see it as a terrible thing, but a necessary thing.”
EMS benefitted from the merger by having their ambulances and facilities upgraded. They were also given the opportunity to create new lifesaving programs.
Yet EMS always felt secondary to the city’s firefighting force, especially when it came to pay. EMTs and paramedics make far less than their FDNY counterparts.
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.
Bosnignore hopes the pay gap’s days are numbered.
“We’ve spent 30 years investing in equipment, in vehicles, stations and technology and now we should invest in the people,” said Bonsignore, who is a strong advocate of pay parity even though she has no say in increasing EMS salaries.
EMS unions told City Hall on Friday that a third of their members plan to leave by the end of the year if they don’t see a boost to their salaries.
But Bonsignore believes the best is yet to come. As part of the ceremony Monday, she will help plant a tree she hopes will grow in years to come — as FDNY and EMS members continue their path to the future together.
“Just sitting in the commissioner chair proves things have gone full circle and these pathways are now open for EMS,” Bonsignore said. “That speaks to the cohesion and the cooperation of one department.”
Should EMS be part of the fire department, or operate as a separate agency? What model do you think works best and why?
EMS1 readers respond:
“Generally speaking, most of the issues that EMS agencies experience are foundationally caused by low reimbursement for the services that we provide. We are stuck in a payment model that started in the 1970s and hasn’t changed much. We are still listed in the federal procurement system that CMS uses as “suppliers” and not “providers”. EMS is no longer run by funeral homes and law enforcement, which had a “load and go” mentality and were no better than a cab ride in many instances. We now have a rolling ICU that costs half a million dollars with highly trained and skilled paramedics and EMTs. We need to be reimbursed based on what we provide in 2026, not 1975. Once that happens, the conversations surrounding how to recruit and retain could be more robust. As it stands now, most conversations surrounding recruitment and retention are how to “rob Peter to pay Paul” by moving budgets around just to be able to keep the lights on in many agencies, especially rural locations where property and sales tax struggle to cover even 50% of the budget.”
“As a former NYC-EMS paramedic, either system can work! What needs to be addressed is pay parity. The EMS workforce is smaller than the FD workforce yet, they handle 3 to 4 times more workload.”
“Make the pay equal to nursing registered nursing salaries and you would see a boom in retention.”
“EMS has been under valued for a very long time. We did it to ourselves because we love to help people so much that we gave away our services for free through volunteering. EMS is the newest member of the public safety team and we are required to complete more continuing education to maintain our certifications than other members of the team. EMS is not recognized by the general public as an essential service until they have a medical emergency. Then it is in our best interests to explain to the patient and their family what EMS is, what we do and where we are in the public safety system. Educating the voting public to the fact that EMS Providers are leaving the field because they can not afford to be underpaid is our best option. EMS should be included in LODDB at the National level too. A great start for the new commissioner! I hope she keeps pushing for EMS parity. THIS SHOULD GO NATIONAL!”
“I would question the wisdom of deploying a single crew member to a scene by themselves, Medic or EMT. My concern would be for responder safety and for Pt diagnosis/interventions. Isn’t that why we all deploy as a team?”
“I have been in EMS for 50 years. While a lot of patient care technologies have improved, the treatment of EMS workers has not. The problems for FDNY-EMS personnel is nothing new to me. The reality is a lot of firefighters regard EMS as “scut” work and the EMS workers as the same. Until EMS is regarded, and receives, equal pay, benefits and a public safety pension, nothing will ever change. But that means the hiring criteria must be the same as it is for police and firefighters.”
“Separate- However, EMS/PD/FD should train together and work together.”
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