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New FDNY EMS chief faces massive attrition and call for pay equity

The FDNY has appointed a veteran paramedic and longtime EMS leader to oversee citywide EMS operations amid ongoing staffing and pay challenges

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FDNY Chief of EMS Operations Paul Miano.

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By Thomas Tracy
New York Daily News

NEW YORK — A seasoned 26-year “street doctor” veteran who led city emergency medical technicians and paramedics in north Brooklyn during the height of the COVID pandemic has been tapped to be the next head of EMS Operations, the FDNY said Friday.

As one of his last acts in office, Fire Commissioner Robert Tucker appointed Chief Paul Miano as Chief of EMS Operations.

| MORE: EMS1 readers respond: Frontline views on FDNY-EMS split

Miano will replace retired Chief of EMS Michael Fields, who held the post since 2023.

“Chief Miano has spent his entire professional career working in FDNY EMS, and he brings passion, expertise, and a will to protect his members that is unmatched,” Tucker said in a statement. “Under his leadership, FDNY EMS is in strong, capable hands, and it will continue to keep our members safe, and deliver top-notch pre-hospital care to those who need it most.”

As Chief of EMS Operations, Miano will oversee more than 4,000 city EMTs, paramedics, officers and civilian employees and will be responsible for overseeing operations, planning and strategic initiatives.

Miano joined EMS in 1999 as an emergency medical technician in Brooklyn. Two years later he completed his paramedic training and became a HazMat paramedic.

He quickly moved up the ranks, helping to develop the Marine Paramedic program. He is also credited for creating response procedures for potential Ebola cases in 2014.

Miano served as Brooklyn North Commander during the height of the COVID-19 pandemic and also served as Brooklyn and Staten Island borough commander until his promotion to assistant chief in 2023.

His promotion comes as EMS endures massive attrition, attributed to EMT and paramedic pay being far lower than other city first responders’ compensation.

Last week, Local 2507, the union that represents city EMTs, put out a radio spot demanding that Mayor Adams make good on his campaign promises and grant wage equity to EMTs and paramedics before he leaves office.

EMS is facing a 70% attrition rate over the wage disparity, the union said.

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