In 2025, residents of New York City are experiencing longer wait times for ambulances, primarily due to a significant decline in the workforce. The Fire Department of New York Emergency Medical Services (FDNY EMS) is currently only able to respond to approximately two-thirds of the volume of 911 calls. This shortage is largely attributed to inadequate compensation for emergency medical technicians (EMTs) and paramedics, who are leaving the field in increasing numbers.
The city’s emergency medical services face a rising demand while the number of available providers continues to diminish. Contract negotiations between the city and the FDNY EMS Union Locals 2507 & 3621, which represent about 4,500 EMS workers, are stalled. This group constitutes around 66% of those serving the 911 ambulance service in New York City. The remaining 33% of EMS personnel primarily work in hospitals, represented by the 1199SEIU union.
Ambulance services generate substantial revenue, with FDNY EMS reporting $367 million for Fiscal Year 2024. Each ambulance ride is billed between $1,385 for “Basic Life Support” (BLS) and $1,692 for “Advanced Life Support” (ALS), with additional charges for mileage and oxygen. Despite this financial viability, many EMTs and paramedics earn only $18.94 per hour, prompting workers to seek opportunities in fire suppression or other fields.
The working conditions for EMS personnel contribute to a challenging environment. The daily risks include potential assaults, with reports of physical violence becoming increasingly common. These incidents foster a climate of hypervigilance, as EMTs and paramedics must remain constantly alert to the threats they face. Many members of the workforce are grappling with mental health issues, including post-traumatic stress disorder (PTSD), stemming from their exposure to trauma and violence on the job.
Walter Adler, a seasoned paramedic and President of the Emergency Medical Services Public Advocacy Council (EMSPAC), emphasizes the urgent need for improved working conditions and compensation. “The city must recognize that public expectation demands a reliable ambulance service,” Adler stated. He argues that the city’s failure to invest in a uniformed EMS service undermines public safety and the well-being of EMS personnel.
Despite the challenges, the value of EMS services is undeniable. Across the nation, over 1-2 million EMTs and paramedics save countless lives daily. Yet, the reality of their work often goes unacknowledged. Many individuals in the public do not fully understand the toll that working in this field takes on mental health and personal well-being.
The city’s leadership must take action to address these issues. With a growing disconnect between the demands of the job and the support provided to emergency responders, the viability of EMS services is at risk. As negotiations continue, it is crucial for city officials to prioritize the welfare of those who serve on the front lines of emergency response.
In light of the ongoing challenges, the city is called to reconsider its approach to EMS staffing and compensation. The expectation for prompt emergency responses is clear, and the resources allocated to this essential service must reflect that reality. As the demand for ambulances increases, it is essential for city leaders to ensure that those who answer the call are supported and valued.
