NEW YORK — A debate over whether New York City’s Emergency Medical Service should separate from the FDNY has reignited after a veteran FDNY EMS lieutenant and union leader is calling on the city to break its emergency medical service away from the fire department and create a stand-alone “third 911 service.”
In an article for The Chief Leader, FDNY EMS Lt. Anthony Almojera, vice president of Local 3621 and author of “Riding the Lightning: A Year in the Life of a NYC Paramedic,” argued that paramedics and EMTs “may show up to the same scene, risk the same dangers and respond to the same calls,” yet earn roughly half a firefighter’s salary and receive fewer benefits. The pay gap, he said, “leads to massive attrition” and tells young providers “they are second-class responders.”
| LISTEN: We’re not OK: The What Paramedics Want in 2025 report pulls no punches
“We’re asking to be seen not as an appendage of the Fire Department, but as what we are,” Almojera said. “Healthcare professionals delivering critical services in some of the most dangerous and high-pressure situations imaginable.”
Almojera argues that EMS belongs firmly in the healthcare realm, not in fire suppression or policing. Its core job, he says, is to assess, treat, stabilize, and transport patients and to advocate for them both at the scene and in the hospital. But inside the FDNY, EMS still answers to fire-focused leaders trained in fire science, which limits medics’ career growth and suppresses new ideas in pre-hospital care.
Almojera says an independent EMS agency, run by medical professionals, could update care protocols, launch community paramedicine programs and tackle modern public-health needs.
A stand-alone EMS agency would be nimbler, more accountable, tightly linked to hospitals and mental health partners, and better equipped to deliver patient-centered care.
“We aren’t looking for special favors, only fair treatment,” Almojera said. “See us not as a fire department add-on but as healthcare professionals who provide critical care in the most dangerous, high-pressure situations.”
What’s your take? Should New York City spin EMS off into a third service, or does keeping it under the FDNY make more sense? Share your frontline experiences, concerns about pay and staffing, or ideas for improving pre-hospital care.
