Time to Let FDNY EMS Stand on Its Own
The writer, a paramedic/EMS lieutenant and a union vice president, says it is time for EMS to become its own independent emergency response agency.
| 25 Aug 2025 | 01:28
Anthony Almojero, responding to an incident, feels EMS should be independent from the fire department since their jobs when responding to an emergency are so different. Under FDNY, he said EMTs are underpaid and often unappreciated. (
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Anthony Almojera, a lieutenant in the FDNY’s Emergency Medical Services, said the importance of EMTs as first responders was hammered home during the COVID-19 crisis, which was the subject of his harrowing 2022 book. He says EMS should be an independent first-responder agency. (
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Lt. Anthony Almojero (far right) and his EMS crew, station 40 in Brooklyn. (
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Lt. Anthony Almojero’s book about working as an EMT through the COVID-19 pandemic was published by Harper Collins in 2005. (
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Police, FDNY, and EMS often respond to the same incidents—as in this report of a person on the subway tracks at Union Square—but the jobs are vastly different, and an EMS lieutenant who is also a union official says EMS should be split off from FDNY and stand as its own independent agency. (
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When New Yorkers dial 911, they expect help—fast, skilled, and lifesaving. Whether it’s a fire, a shooting, a cardiac arrest, or a mental health crisis, lives often hang in the balance of seconds. Yet for too long, the city’s emergency medical services—FDNY EMS—have been treated like a sidenote instead of a pillar of the city’s emergency response infrastructure. It’s time to change that. It’s time for EMS to separate from the FDNY and become its own independent agency: a true third 911 service.
The idea of a third service is not radical. Across the country, many cities recognize EMS as a distinct and vital public safety entity alongside police and fire. New York, ironically the city that never sleeps, remains asleep on this issue, keeping EMS under the shadow of the Fire Department. But the challenges EMS faces today aren’t just a result of budgetary neglect or political inertia; they’re rooted in a structural problem. You cannot fix a broken system while keeping EMS trapped in someone else’s house.
FDNY EMS is staffed primarily by EMTs (emergency medical technicians) and paramedics—workers who are highly trained, deeply experienced, and often the first healthcare providers a person will ever encounter. Yet they are the lowest paid and most overworked of the city’s emergency responders. An FDNY firefighter and an EMS paramedic may show up to the same scene, risk the same dangers, and respond to the same calls. But one makes nearly double the salary of the other and receives far more comprehensive benefits. Why? Because one wears bunker gear and the other wears an EMS patch. This is not the fault of the firefighters themselves. The fault lies solely with the management of New York City and the FDNY.
This disparity is not just unfair—it’s dangerous. It leads to massive attrition. It breaks morale. It tells every young EMT or paramedic in New York City that they are second-class responders. And in a city where medical calls vastly outnumber fires, that message undermines the very fabric of public health and safety.
EMS is healthcare. It is not fire suppression. It is not law enforcement. The mission of EMS is unique: assess, treat, stabilize, transport, and also advocate for patients and their families not only on scene but at the hospitals we deliver them to. But under the FDNY, EMS is often viewed through the lens of firehouse priorities. This has created a system where operational decisions are made by leadership trained in fire science, not emergency medicine. Where career advancement for EMS professionals is capped. Where innovation in pre-hospital care is stifled by a culture that doesn’t fully understand or value it.
Creating a stand-alone EMS agency would allow for a leadership structure that reflects EMS’s mission—led by medics, clinicians, and administrators who understand the science and practice of emergency care. It would empower EMS to modernize its protocols, pursue community para-medicine programs, and engage in public health initiatives that align with 21st-century needs.
Every New Yorker should care about this. Because when EMS is underfunded, understaffed, and undervalued, response times rise. Quality of care suffers. And people—especially in marginalized communities where EMS call volumes are highest—pay the price. An independent EMS agency would be more nimble, more accountable, and more focused on delivering patient-centered care. It could better partner with hospitals, mental health services, and public health departments. It could build a more resilient, responsive system from the ground up.
We’re not asking for special treatment—we’re asking for fair treatment. We’re asking to be seen not as an appendage of the Fire Department but as what we are: healthcare professionals delivering critical services in some of the most dangerous and high-pressure situations imaginable.
The pandemic laid bare what EMS has always been: frontline, essential, and heroic. But heroism without structure is not sustainable. The only way to fix the cracks in this system is to build a new foundation. Let FDNY EMS stand on its own. Let it be the third 911 service New York City so desperately needs. Our lives—and yours —depend on it.
Anthony Almojera is an FDNY EMS lieutenant, vice president of Local 3621, the Uniformed EMS Officers Union, and author of Riding the Lightning: A Year in the Life of a NYC Paramedic. This article was originally published in The Chief.
“The idea of a third service is not radical. Across the country, many cities recognize EMS as a distinct and vital public safety entity alongside police and fire.” — FDNY EMS lieutenant Anthony Almojera