In 2025, New York City is facing extended delays in ambulance response times, primarily due to a significant shortage of Emergency Medical Technicians (EMTs) and Paramedics. The city’s Emergency Medical Services (EMS) is currently only able to handle two-thirds of the actual 911 call volume. This trend is attributed to inadequate compensation for a highly stressful and risky profession, prompting many workers to leave for better opportunities.
The ongoing contract negotiations between the City and the FDNY EMS Union Locals 2507 and 3621, representing approximately 4,500 EMS workers, have stalled. These workers make up about 66% of those serving the 911 ambulance service in New York City. The remaining workforce is largely based in hospitals and represented by the 1199SEIU union. This situation highlights a growing disconnect between the increasing demand for medical response services and the dwindling supply of trained personnel.
According to the Emergency Medical Services Public Advocacy Council (EMSPAC), the financial strain on the EMS workforce is palpable. Many EMTs are reportedly earning as little as $18.94 per hour, despite the critical nature of their work. The lack of financial incentives has led to a workforce that is increasingly disengaged, with many treating their positions as temporary stepping stones to roles in fire suppression.
Financially, the EMS does generate significant revenue, with an expected $367 million in revenue for the 2024 Fiscal Year. Each ambulance ride is billed at varying rates, from $1,385 for Basic Life Support (BLS) to $1,692 for Advanced Life Support (ALS), along with additional charges based on mileage and oxygen use. Despite these earnings, the compensation for the workforce does not reflect the value they provide.
The physical and mental toll of working in EMS is severe. Many EMTs and Paramedics face daily exposure to violence, with frequent instances of assault reported. The emotional burden is compounded by the nature of their work, which often involves responding to traumatic incidents, such as domestic violence and drug abuse. The cumulative effects of such experiences can lead to conditions similar to post-traumatic stress disorder (PTSD).
Walter Adler, a veteran paramedic with over 22 years of experience and President of EMSPAC, emphasizes the need for better recognition and support for EMS workers. He points out that the public expects timely medical assistance, yet the current budget allocations do not reflect this necessity. “Where there is blood, risk, death, and a lot of money being made, it cannot be justifiable to pay EMTs and Paramedics $19 per hour,” Adler stated.
The Taylor Laws, which restrict public sector workers from striking, further complicate the situation. Many EMS personnel feel trapped in their positions, unable to advocate for better working conditions without the risk of losing their jobs. As a result, an entire workforce is finding it increasingly difficult to remain in a profession that demands so much but offers so little in return.
The city must recognize the essential role that EMS serves in public safety. As response times lag and the workforce shrinks, the focus should shift to addressing these critical issues. The public’s expectation for timely ambulance services must be met with a corresponding commitment to invest in the workforce that provides them.
