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Should NYC split EMS from FDNY? Pay, staffing and patient care are on the line

A push to return EMS back to its own agency is gaining momentum amid response times, pay parity demands and warnings from FDNY leadership that a breakup could add cost and complexity

NEW YORK — For nearly three decades, New York City’s firefighters and paramedics have worked under the FDNY umbrella. Now, a renewed effort to spin EMS off into its own agency is gaining traction.

EMS leaders, citing severe staffing losses to FDNY firefighting ranks, are pushing hard for the split, according to PIX 11.

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Supporters say it could improve patient care, while critics warn it could drive up costs, PIX 11 reported.

“We’ve doubled the call volume, we haven’t doubled the workforce,” Union Vice President and EMS Lt. Anthony Almojera testified before city council members on Nov. 13.

Almojera supports reverting to the pre-1996 model by separating the uniformed services, arguing New Yorkers would be safer under an independent EMS agency. His plan calls for roughly 5,000 to 8,000 members, pay parity with firefighters and enough equipment to keep ambulances running 24/7.

Achieving pay parity remains the top concern, as EMTs currently earn an average of about $60,000 a year, roughly half the salary of firefighters.

Council Member Justin Brannan is sponsoring legislation to split EMS from the FDNY, framing it as a step toward fair pay and fewer side jobs for frontline medics. Advocates say the current EMS workforce is too small, contributing to average 12-minute response times.

“Almost 70 percent of calls are medical emergencies, but barely 20 percent of the FDNY budget goes to EMS,” Brannan said.

Outgoing FDNY Commissioner Robert Tucker acknowledges response time challenges tied to limited resources but opposes the bill, warning that a breakup could add inefficiency and redundancy.

It’s an age-old constant question — should EMS be its own agency, separate from fire? Why or why not?



EMS1 readers respond

“While many advocate for EMS salaries to match those of firefighters, parity is unlikely due to the distinct nature of their roles. EMS professionals are medical providers, akin to LPNs, RNs and PAs, and their compensation should reflect this. Rather than comparing themselves to firefighters, EMS pay should be aligned with industry standards for medical professionals in similar positions, ensuring fair compensation for their expertise and responsibilities. Pay parity with firefighters isn’t the right comparison; EMS roles are distinct and deserve compensation reflecting their medical expertise.”

“It’s time the city recognizes EMS value. We have been disgustingly underpaid, underfunded, unappreciated. Working 80 hours a week just to stay afloat is asinine. Numbers showed EMS only gets approximately 18% of budget but 70% of work is done by EMS. It’s time to stop funding million dollar kitchens for fire houses and start giving parity to EMS.”

“I don’t know anything about FDNY and FDNY EMS. I am a firefighter/EMT with 29 years in a large metro city. I worked for a surrounding county EMS for 15 years, 12 as a paramedic. The problem nationwide is a failure of imagination, period. Regardless of who runs EMS, they fail to understand the problem that they are up against. In my experience, one of the largest problems within the overall problem, is the EMS deployment model. A variation on the definition of insanity is to continue to do the same thing you have always done but expect different results. EMS problems are not going to fix themselves. It takes visionary leadership. Leadership with imagination.”

“Everything depends on cost, not what makes people happy or the delivery of goods/patient care; it’s what the savings is; sad but true.”

“I consider the issue moot. Folks, this issue is more than 25 years old. Personally, the unions screwed over the workers. Do the union representatives still get compensation by the unions as well as NYC?”

“Splitting the agency would create redundancies and additional costs. They would still lose personnel to fire regardless. Fixing the pay disparity gives them a fighting chance at retention.”

“Absolutely, EMS is the new frontier and the need is outpacing fire service needs.”

“EMS was used to keep FDNY intact by raising response numbers and increasing diversity. Medicine was never a consideration. If EMS can’t be its own agency, it should be a division of NYCDOHMH. EMS is an important part of public health. Our EMS practitioners must be financially compensated so they can work one job and live in NYC.”

“Fire and EMS are 2 different jobs and SHOULD NOT be under one umbrella!”

“A combination department makes sense if the resources, personnel, and demands are all reasonably limited. New York City is not the place for that. FDNY has left EMS to wither away while they spend money on everything else a fire department has to do.”

“No, I always wanted to be an EMT and for the fire department. I don’t want to be a firefighter and never had the desire to be one. All I ever wanted is to be an EMT but if I can’t be a part of FDNY then I won’t be one. To me FDNY is a part of me and I as a 6 year veteran will not be a part of it if I’m not part of the FDNY family.”

“Yes, we are the stepchildren of the FDNY, and they treat us like 2nd-class citizens. We need pay parity for EMS members to stay and not have to work multiple jobs. The cost of living in NYC is out of control and is only getting worse.”

“Definitely split and equal pay is a must. Most FDs started EMS because of revenue and being bored most of the time.”

“Yes it should and the fire budgets need to be cut back and the money from the cut back of the fire department budget goes to EMS to staff properly!”

“Absolutely! Fire wants to play with hoses; that is their thing, not patient care and that often shows as less-than-optimal care from fire-based medics. For FDNY, they used EMS increased bargaining power for fire and threw EMS under the bus from the beginning.”

“The majority of hospital-based EMS agencies are running in the red! Partly because Medicaid and Medicare don’t pay the cost of prehospital care, the cost of medical equipment is outrageous and the cost and maintenance of vehicles is unsustainable! So what is going to change? The only thing that will change is the ease at which FDNY Fire was ‘promoting’ EMTs and paramedics, 300 at a time! This is what devastated FDNY EMS, poor leadership on both sides!”

“I think EMS should definitely be its own entity. Double the budget for EMS!”

“I think it’s much better for EMS to be with fire. I’ve worked in two agencies, one with fire and one in a separate location. Being in the same location, fire support is incredible and amazing and always there! When you’re separated sometimes you have fire support and sometimes you don’t.”

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Bill Carey is the associate editor for FireRescue1.com and EMS1.com. A former Maryland volunteer firefighter, sergeant, and lieutenant, Bill has written for several fire service publications and platforms. His work on firefighter behavioral health garnered a 2014 Neal Award nomination. His ongoing research and writings about line-of-duty death data is frequently cited in articles, presentations, and trainings. Have a news tip? He can be reached at news@lexipol.com.