A school nurse called 911 three times for a 14-year-old boy who was suffering a stroke, his mother told the City Council on Oct. 20.
By the time an ambulance reached St. Francis Preparatory School in Fresh Meadows on Sept. 28, she had already driven him to the hospital herself.
“He was slurring his words. His speech wasn’t clear,” Jennifer Daly of Howard Beach testified via Zoom. “I called his cardiologist and I said, ‘We have to get him over to the hospital. What do I do?’ She said, ‘Wait for the ambulance.’ I said, ‘I cannot wait for the ambulance.’”
Daly reached NewYork-Presbyterian/Queens hospital at 9:52 a.m., she said. Her son, Kevin, was later transferred to Morgan Stanley Children’s Hospital in Manhattan.
FDNY EMS Chief Paul Miano, during the City Council’s hearing on response times hosted jointly by the Committees on Fire and Emergency Management and Hospitals, called it “a tragic incident.”
The call was passed from NYPD dispatch to EMS dispatch, Miano explained, and was entered in the system to say Kevin had an “unknown condition” because EMS never spoke with the caller to triage it, so it was not made a priority.
Miano said 911 was handling more than 100 calls above normal that morning.
“Our life-threatening, our most serious calls … do not hold,” Miano said. “Those calls are immediately dispatched out as soon as an ambulance is available.
A report by City Comptroller Mark Levine released Oct. 16 found that the average response time to life-threatening emergencies rose 3 minutes, 50 seconds, or 41.2 percent, to 13 minutes, 9 seconds, from fiscal years 2015 to 2026, which City Council Speaker Julie Menin (D-Manhattan) at the hearing said “is just wholly unconscionable.”
Over that same period, life-threatening medical emergencies grew 22.9 percent, while the paramedic workforce stayed about the same size.
Pay is part of it. An EMT’s first-year salary is $43,932, compared with $54,122 for a firefighter, and is the lowest of any city first responder or uniformed title.
EMT salaries also climb more slowly. From hiring date through year five, salaries rise 56 percent, compared with 94 percent for firefighters. After five and a half years, an EMT’s base salary is $68,700, compared with $105,146 for a firefighter, a gap of more than $35,000.
Local 2507, which represents EMTs and paramedics, has been without a contract since July 29, 2022. Current EMT and paramedic salaries do not reflect a new deal, which would bring retroactive raises, the report says.
More than 500 EMTs left their jobs in fiscal year 2026, or 19.5 percent of average headcount.
The comptroller’s report did not specify the number of hires, but said there were 2,540 EMTs at the end of that year.
Also in fiscal year 2026, 58 percent of EMT departures left to be firefighters. The median EMT has 3.8 years with the title, compared with 8.1 years for firefighters.
FDNY Chief of Department John Esposito said at the Council hearing that 358 EMTs and 63 paramedics left to become firefighters in 2026, adding that the department is “responding to more calls with fewer ambulances.”
“It’s a positive outcome for the city to have firefighters with EMS and paramedic level medical training, but it also has a severe impact on EMS staffing in the short term,” Esposito said.
“You cannot train your way out of a workforce crisis when you refuse to address why people are leaving,” testified Michael Greco, president of Local 2507.
Training costs for new EMTs rose 300 percent between fiscal 2015 and 2026, from $15 million to more than $62 million, the report found.
Menin at the hearing said that low pay has driven “rising attrition and low recruitment, which of course perpetuates this understaffing issue.”
“We all know at the end of the day what we need first is more money for our EMTs,” said Councilmember Joann Ariola (R-Howard Beach), who chairs the Fire and Emergency Management Committee.
She called for giving EMTs uniformed first responder and civil service status so they can “rise up in the ranks.”
The city classifies EMTs as civilian employees, the comptroller’s report notes.
Closing the gap would be costly. If EMS pay rose to firefighter levels, with the full pattern of raises uniformed workers received, the Comptroller’s Office estimates the net cost at $1.23 billion across fiscal years 2023 through 2027, after accounting for $163 million already in the city’s financial plan.
The report cautions that pay parity “alone is unlikely to substantially lower emergency response times,” though better pay and retention “could ease operational pressures.”
Esposito said the union is negotiating with the city’s Office of Labor Relations and the department is “hopeful that a resolution to the next contract will provide a recruiting boost.”
Ariola believes “we are at a precipice of change” when it comes to EMS pay.
“I don’t think there’s ever been a time when more people were looking at the pay levels of our EMS personnel, and I think that this will spur the change we need,” Ariola said.