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NYC EMS workers have been separate and unequal to all other city service workers for years — in wages, in benefits, and in working conditions.

New York City · 2026

In 2026

3,500EMS volunteers
4,000FDNY EMTs, medics & officers
2,500Voluntary hospital EMS
6,000Commercial EMS
16,000Members of service
5,500+Total calls a day
$1,200–1,650An ambulance bill
8EMS unions

Separate and unequal

NYC EMS workers have been both separate and unequal to all other city service workers for years in terms of wages, benefits and working conditions. Another challenge is the awkward segregation of the workforce into distinct sectors with competing leadership.

New York City's 16,000 EMS workers are divided into four deployment models with different funding channels, varying benefits, uniform colors, vehicle colors, conditions and levels of prestige — FDNY 911 Municipal, Voluntary Hospital-based, Private Sector and Community Volunteers.

We need to be compensated in parity with police officers and firefighters. We need leadership to bring the disparate sectors of the field together with a common purpose, and political action to resuscitate this field. For decades we have been there at critical moments of loss and terror, laying down our lives for our patients and their families.

A revenue-generating service

Compared to firefighters and police, EMS is highly revenue-generating. While saving lives, EMS is also a multi-million-dollar industry. Every billable ambulance ride brings the City, private ambulance companies or hospitals between $500 and $4,000. That is why over a dozen private ambulance companies compete for multi-million-dollar contracts in this city. The biggest eight are Seniorcare, Citywide, Empress, Hunter, RCA, Midwood, Assist and Ambulunz.

The pay disparity

Starting NYPD salary is $42,500, rising within 5½ years to $85,292, with the possibility of additional overtime income. FDNY firefighters begin at $43,904 and after 5½ years with fringe pay make $110,293.

Entry-level pay for an FDNY EMT is $39,386–$47,016, up from a pre-pandemic $35,000. It reaches $59,534 after five years and $76,472 after twenty. Entry pay for the first five years — a period in which 70% of FDNY EMS quit — works out to between $16.50 and $19 per hour.

When 14-year FDNY EMT veteran Yadira Arroyo was killed on the job — run over by her own ambulance — she was raising five children on $48,142.

New-hire transport EMTs begin at minimum wage, $17.00 per hour, only recently up from $15.00, and rise around $0.50–$1.00 per year. Voluntary hospital-based EMTs start between $22 and $33 per hour and rise around $1 a year.

Entry-level FDNY paramedics make $53,891–$60,796 to start, up from $48,287 pre-pandemic, reaching $75,872 at five years and $92,635 after twenty.

Another way to think about this: after twenty years of service, a paramedic earns below what a firefighter makes after five. An EMT after five years earns about half what a police officer makes in 5½.

An entry-level voluntary hospital paramedic makes between $38 and $54 per hour with less security and fewer benefits, except in higher-income neighborhood hospital garages like those serviced by New York-Presbyterian, Northwell or Mount Sinai. An entry-level private transport paramedic makes $28 to $35 per hour with no job security or benefits at all.

Front-line troops

EMS workers are the front-line troops in medical and public health emergencies that are dangerous, uncontrolled and always unpredictable — where reinforcements do not always arrive, where ambulances flip, where crews are assaulted daily, and where a virus lurks.

Firefighters and police officers participate in some EMS operations, but often as auxiliary actors. Firefighters protect property. Police enforce the law. By intent and volume, lifesaving is not the main objective of either. They are “the bravest” and “the finest.” When it comes to lifesaving, we are the best.

FDNY EMS manages around 66% of the daily 911 call volume, and voluntary hospital EMS over 33% of citywide total volume — averaging about 5,000 calls a day and 1.5 million a year. Combined with private companies and community volunteers handling interfacility and non-emergent work, estimated daily volume in NYC reaches 8,000+ calls.

We do a lot for this city. We take great risks and we save and prolong lives. We need proper masks, proper wages and proper unity. We need the EMS unions to unite around public policy, advocacy and member assistance. We need to remind people of the hypocrisy of dubbing a group “New York's Best” while paying retail wages. Without joint action we are divided and powerless as a lobby.

We therefore move to establish an effective, transparent and democratic mechanism to rapidly advance the conditions of all EMS workers.
EMSPAC founding meeting · May 17, 2020 · The Bronx, New York
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