The Emergency Medical Services (EMS) in New York City are struggling to meet the rising demand for ambulance services as the workforce dwindles. In 2025, the FDNY EMS can only respond to two-thirds of the actual 911 call volume. This situation stems from inadequate compensation for emergency medical technicians (EMTs) and paramedics, leading many to leave the profession. As the City, hospitals, and private sectors fail to address these compensation issues, the demand for services continues to increase.
The current workforce consists of approximately 15,500 EMTs and paramedics, who respond to around 5,500 911 calls daily. Of these, 4,500 are represented by the FDNY EMS Union Locals 2507 and 3621. These unions are currently in stalled contract negotiations with the City, highlighting the ongoing struggle for fair pay and working conditions. Many EMS workers earn a mere $18.94 per hour, which many view as insufficient for the high-risk nature of the job.
Despite the challenges, EMS services generate significant revenue. In Fiscal Year 2024, EMS reported revenues of $367 million, primarily from ambulance rides billed at rates ranging from $1,385 for Basic Life Support (BLS) to $1,692 for Advanced Life Support (ALS). Additional charges for mileage and oxygen supply can further increase these costs.
The work environment for EMS personnel is fraught with challenges. Many face daily violence, including assaults and other forms of aggression. The psychological toll is significant, with many workers experiencing hypervigilance and mental exhaustion. This constant state of alertness is exacerbated by long hours and the high-stress nature of responding to emergencies.
Walter Adler, a veteran paramedic and President of the EMS Public Advocacy Council, emphasizes the urgent need for change. He highlights that low wages and poor working conditions are driving experienced professionals out of the field. “Low wages equal long hours equal physical and mental deterioration,” he states, underscoring that EMS is a job requiring serious recognition and investment, not just a calling.
The expectation from the public is that EMS should be a reliable component of public safety. Yet, the current system is fractured and under-resourced. The City Council and the mayor must recognize the critical role EMS plays in saving lives and the essential need for a budget that reflects this reality.
Adler calls for a reevaluation of how EMS is treated within the broader context of public health and safety. “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,” he argues.
As negotiations continue, the pressure mounts for city officials to address these systemic issues. The reality is clear: without adequate support and compensation, the EMS workforce will continue to shrink, jeopardizing the health and safety of New Yorkers who rely on these critical services.