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New York City Council
Oversight - Ambulance Response Times
Read summaries and jump into the video at the segment start.
Council staff welcomes attendees to the joint Fire and Emergency Management/Hospitals hearing, asks that electronics be silenced, and instructs anyone wishing to testify to see the sergeants at arms. Staff tells the public not to approach the dais and invites the chair to begin.
Chair Joann Ariola calls the joint oversight hearing to order, acknowledges members present and co-chair Mercedes Narcisse, and states the committees will examine ambulance response times and Intro 990. She explains the bill would use Notify NYC to alert residents to extended ambulance wait times.
Ariola says that over the summer 700 calls were held in the EMS system due to staffing shortages. She argues Intro 990 would let New Yorkers know when help is not moments away and requires emergency notifications when FDNY EMS has more than 25 pending ambulance dispatches.
Ariola thanks EMTs, paramedics, and firefighters for delivering critical emergency medical care and responding to more than 1.6 million medical calls annually. She says EMS workers face stressful conditions, long hours, and are vastly underpaid despite their life-saving work.
Ariola says the city has struggled to provide timely emergency medical care despite publishing response-time data and reallocating resources. She notes FDNY response times have consistently increased over the past decade, especially for life-threatening incidents.
Ariola says she expects FDNY testimony to explain rising response times and cover dispatching, staffing, and ambulance maintenance. She also calls for broader discussion of pre-hospital emergency resources, interagency coordination, and reversing the trend before thanking staff and yielding to Narcisse.
Chair Mercedes Narcisse apologizes for her delay and introduces herself as chair of the Committee on Hospitals and a registered nurse. She says delayed ambulance response and prolonged emergency department waits are urgent challenges facing New York City.
Narcisse says New York City has 49 hospital emergency departments, including 11 operated by NYC Health + Hospitals, serving more than 8.5 million people. She reports that from 2022 to 2025 H&H patients waited an average of 12.8 hours to transfer from the emergency department to an inpatient bed.
Narcisse says staffing shortages, hospital closures, and barriers to primary care caused by federal Medicaid cuts have intensified pressure on the emergency system. She warns that temporary fixes will not help New York City.
Narcisse says she is committed to finding long-term solutions rather than temporary fixes and recounts a family forced to drive their child to the hospital after a long ambulance wait. She says every resident deserves timely emergency care regardless of zip code, income, race, gender, immigration status, or background.
Narcisse says the committees look forward to hearing from FDNY, emergency management, and other representatives about changes since the 2024 hearing and feedback on pending legislation. She thanks committee staff, says the city must lead by example, and calls health care a human right.
Ariola says the committees will give a courtesy to Jennifer Daly before swearing in the panel. She explains Daly is the mother of Kevin, a 14-year-old who had a medical episode at school and whose nurse called 911 three times without an ambulance arriving.
Jennifer Daly testifies remotely that her son Kevin arrived at St. Francis Prep feeling faint and weak, and the school nurse called 911 as his symptoms worsened. She says after multiple 911 calls and no ambulance, her husband advised their daughter to give Kevin aspirin, and she drove him to New York Presbyterian in Queens where he was diagnosed with a stroke.
Ariola thanks Daly for sharing her story and says her daughters' preparation and her husband's medical knowledge likely saved Kevin's life. She reassures Daly that she was not neurotic but a great mother.
Narcisse thanks Daly for saving her child's life and acknowledges her husband's FDNY background. She explains the school nurse could not administer medication without a doctor present, making the family's intervention especially critical.
Ariola notes that Council Members Maloney, Wong, and Brooks-Powers have joined and introduces the panel: Dr. Josh Motzquist from Health + Hospitals and FDNY Chiefs John Esposito, Paul Miano, and Denise Werner. Council staff administers the oath to affirm truthful testimony.
FDNY Chief of Department John Esposito testifies that response times are increasing and unacceptable, and says addressing them is a top priority for him, the fire commissioner, and the mayor. He cites declining ambulance in-service hours and rising life-threatening call volume, saying FDNY is responding to more calls with fewer ambulances.
Esposito says decreased ambulance hours are significantly driven by staffing changes, including 358 EMTs and 63 paramedics who left EMS to become firefighters in 2026. He says the department staffs up before promotions but the effect on EMS staffing remains severe.
Esposito says 19 hospitals have closed since 2003, forcing ambulances to travel farther and reducing hospital-run ambulance contributions to the 911 system. He notes the system is about two-thirds municipal FDNY units and one-third hospital-run units, and says any lost tours add stress.
Esposito says FDNY must replace members who left EMS for firefighter positions or due to wages and schedules, and recruitment has become harder since COVID-19. He says the EMT union is negotiating with the city and hopes a contract resolution will boost recruiting.
Esposito describes steps already taken, including paramedic response units, a centralized resource coordination center, and a borough-based command structure. He says these changes aim to get more ambulances into service and allow chiefs to tailor responses to local conditions.
Esposito says FDNY is working with hospitals to reduce diversion and has asked hospital partners to add 911 ambulances, with three agreeing so far. He cites Staten Island hospitals agreeing to accept mental health patients and says FDNY invoked the state mutual aid agreement and welcomes volunteer units.
Esposito says FDNY is reviewing all EMS members in non-frontline positions and redeploying EMTs, paramedics, and officers to operational roles during lean staffing. He says two deputy chiefs were reassigned from offline positions to provide field guidance and supervision.
Esposito says FDNY is replacing its off-the-shelf scheduling program with a bespoke system and is testing artificial intelligence to improve ambulance deployment decisions. He says FDNY continues working with the Office of Technology and Innovation to update the EMS CAD system.
Esposito discusses telemedicine, alternative transport, treat-in-place, and 911-to-988 programs as ways to avoid lengthy transports. He says callers overwhelmingly expect hospital transport, so these programs will require lengthy public education before significant use.
Esposito says FDNY will work night and day to improve response times and appreciates the committee's attention. He says FDNY understands Intro 990's intent but believes the likely volume of notifications may not provide useful information, while remaining open to discussion.
Esposito says EMS had an incredibly busy year with code blue cold periods, FIFA World Cup visitors, America 250 events, and the International Naval Review. He praises EMS members for professionalism and life-saving work and offers to take questions.
Ariola asks why an ambulance never arrived for Jennifer Daly's son Kevin after he showed signs of a stroke. Esposito calls it unacceptable, and Chief Paul Miano says the 911 system was experiencing more than 100 extra calls; the call was classified as unknown and an ambulance arrived after the patient had already left for the hospital.
Speaker Julie Menin thanks the committees for holding a life-saving hearing and says New York City faces a crisis in its EMS teams. She says EMS responds to 1.6 million calls with only about 4,500 members, and low pay has led to attrition, recruitment problems, and workers living in shelters or cars.
Menin describes a 16-year-old in her district who was badly hurt during a basketball game and received no EMS despite five separate 911 calls and a firehouse next door. She says a parent called a private ambulance after 30 minutes and FDNY called back nearly three hours later to ask if an ambulance was still needed.
Menin says the Mayor's Management Report shows an average response time of 13 minutes and 0.9 seconds, which she calls unacceptable. She notes brain cells begin to die after four minutes without oxygen and urges the city to pay EMS workers a living wage.
Ariola thanks Speaker Menin and says the core issue is that EMS workers cannot survive on $18 an hour, leading to retention failures. She says the mayor's office must negotiate a competitive contract and not kick the can down the road.
Menin responds to FDNY testimony by saying the city council wants to raise wages but the administration and FDNY are the ones who can actually solve the crisis. She says she does not understand perpetuating the situation when lives are at risk.
Miano says the Wagner Middle School call was triaged as an injury, a lower-priority category, and several ambulances were dispatched. He says those ambulances were preempted and redirected to life-threatening emergencies, and fire engines are not dispatched to injuries.
Ariola returns to Kevin Daly's case and asks how often the system holds more than 100 calls and why critical calls are classified as unknown. Miano says call volume is up and staffing is down, and Werner explains the call came through the overflow position as an unknown condition because no call takers were available.
Ariola asks whether FDNY also has a low headcount for EMS dispatchers. Miano says EMS headcount includes everyone in the service, including field, dispatch, instructors, and medical affairs, so there is no specific separate headcount for dispatchers.
Ariola says Intro 990 would let families know if an ambulance is not coming so they can make other arrangements sooner. Esposito says FDNY should continue discussing the issue but worries Notify NYC could confuse or frighten the public and discourage necessary calls.
Ariola asks how EMS call takers are scheduled and what number of held calls the system can safely handle. Miano says call takers are staggered based on historical volumes, and he explains that the system prioritizes high-acuity calls and redirects ambulances rather than using a fixed safe hold number.
Ariola asks for the average number of calls on hold. Miano says the number is too dynamic to reduce to a single figure because it varies hour to hour and moment to moment, and the system holds lower-acuity calls while responding to life-threatening emergencies.
Ariola notes Kevin Daly's case was life-threatening but went into the system as unknown after four calls. Miano says FDNY disputed none of that and reviewed the assignment minute by minute, and Werner says they are improving communications between NYPD and EMS.
Ariola asks how often mutual aid is used and when hospitals can divert certain ambulance patients. Miano says volunteer agencies help when available, while hospital diversions are evaluated by an EMS officer and may be limited to certain patient types or services.
Ariola asks about engine companies responding to medical emergencies, including a firehouse near the school in the speaker's example. Esposito says CFR engine companies are assigned only to segment one, two, or three life-threatening calls; they cannot transport and are not sent to lower-acuity injuries.
Miano explains that ALS ambulances are staffed by paramedics who can provide advanced cardiac care, medications, and airway management, while BLS ambulances are staffed by EMTs. He describes paramedics as bringing the emergency room to the patient.
Ariola reiterates the need for a living wage and uniformed first responder status, then asks whether two paramedics are needed for ALS and what happens if staffing is low. Miano says two paramedics are needed for effective advanced life support, and Esposito says fire companies must stay with patients until an ambulance arrives.
Narcisse asks about the engine company near a school and whether it could rush a child to the hospital. Esposito says the engine was not assigned because the call was not life-threatening, and even if sent it could not transport and would be tied to the scene.
Narcisse agrees with Ariola that retention is a problem rooted in inadequate pay, saying EMS workers leave for nursing or other jobs. She also says the city must educate residents not to call 911 for non-emergencies and discusses how lack of insurance drives emergency room use.
Narcisse asks H&H about current emergency department wait times and the time to transfer admitted patients to inpatient beds. Dr. Josh Motzquist says the median time to first provider is 29 minutes and the average emergency department-to-bed time is about 270 minutes.
Narcisse asks whether wait times vary by hospital and which H&H hospitals have the longest and shortest waits. Motzquist says he does not have all hospital-level data but notes variation by time of day, capacity, admissions, and discharges, and cites Lincoln Hospital as seeing about 37 patients per hour at peak.
Narcisse asks about emergency room staffing and whether provider-in-triage models have been sustained. Motzquist says staffing is variable and facilities use different models; provider-in-triage can speed initial care but does not always improve throughput.
Narcisse asks where patients await inpatient beds and how H&H handles space constraints and hallway crowding. Motzquist says it is facility-specific, that ideally no patient waits in hallways, but H&H will use hallway and other spaces when necessary.
Narcisse asks about patients leaving against medical advice and the most common reasons for emergency visits. Motzquist says left-without-being-seen data is around 2%, common complaints include chest pain, belly pain, and shortness of breath, and mental health calls are complex with B-HEARD and 988 partnerships.
Narcisse asks whether H&H has seen increased emergency department volume or hospital admissions. Motzquist says volume has been increasing since 2020, with over 1.1 million emergency department patients across 11 facilities in 2025, and higher-acuity cases have increased significantly.
Narcisse says many problems require educating patients on preventive care and connecting them to clinics and community resources. Motzquist agrees and describes spending much of his clinical time educating patients about their diseases and appropriate care options.
Narcisse asks whether patient needs have become more acute or complex and what operational challenges contribute to long waits. Motzquist says care is increasingly complex, with laboratory, imaging, and medication processes adding time, especially at high-volume facilities.
Narcisse asks what strategies H&H is pursuing to reduce overcrowding and shorten wait times. Motzquist cites virtual express care, where some 911 calls are transferred to H&H for virtual evaluation and treatment, sometimes diverting an ambulance from being dispatched.
After Ariola yields to members, Council Member Vickie Paladino says the council fought for EMS pay parity in the fiscal 2027 budget and warned about losing experienced personnel. She asks how many ambulance tours are out of service; Miano says the system averages over 90 off-service ambulances per day, overwhelmingly due to staffing.
Council Member Lynn Schulman notes she is the only council member who worked for EMS and asks whether response time is measured point-to-point. Miano says response time is calculated from the 911 call until the ambulance arrives on the scene, not until providers reach the patient.
Schulman asks how many EMS calls are routed to FDNY fire companies and whether FDNY is planning for new housing and population growth. Esposito says fire companies routinely handle about 1,000 CFR medical runs per day and that FDNY is looking at technology and AI to guide resource placement.
Council Member Selvena Brooks-Powers says response time stops when the ambulance arrives, but for isolated communities the clock runs until hospital arrival. She asks FDNY for full 911-to-hospital time by council district and why Queens saw a drop in calls reached within 10 minutes; Miano says he will look for the data.
Brooks-Powers asks whether 911 callers are told how soon help should be expected. Esposito says call takers do not know ambulance status and it would take work to share dispatch information, but he agrees FDNY should work with the council on that.
Council Member Harvey Epstein asks whether ambulances are GPS-tracked and whether any of that information is public-facing. Miano says ambulances are tracked internally to dispatch the closest unit, but there is no public interface and no way for callers to get updated ETA information.
Epstein asks H&H about expanding the SHOW homeless outreach program, the Bridge to Home program, and B-HEARD mental health response. Motzquist says he is not familiar with some details but will follow up, and notes H&H works with 911, FDNY, and NYPD on B-HEARD.
Council Member Gale Brewer asks about calls that are not true emergencies and how to educate the public on alternatives. Miano says people often believe arriving by ambulance gets them seen faster, but triage is based on condition, and FDNY uses telehealth and education to divert appropriate calls.
Brewer asks about ambulance and fire support in Hudson Yards and complains about siren noise from hospitals. Esposito says FDNY previously placed a rapid response vehicle in Hudson Yards and will review response times, and says sirens are required when going through intersections against traffic signals.
Brewer asks for the elevator pitch on what needs to be addressed, citing pay, lack of ambulances, and traffic. Esposito says staffing is the overwhelming issue and that EMS must become a career, which depends on fixing pay.
Council Member Pierina Ana Sanchez recounts a 90-year-old neighbor who fell and was cared for by NYPD for 25 minutes before an ambulance arrived. She asks how often NYPD arrives before EMS and how often police transport patients; Esposito says FDNY does not record that but knows it happens anecdotally.
Sanchez asks about the training NYPD officers have when responding to medical emergencies and how EMS workers feel about police filling in. Esposito says FDNY does not know what training NYPD has, while Miano says NYPD complements EMS and that the agencies train together.
Ariola asks when the EMS CAD dispatch is created and whether it is done with NYPD, and why an unknown condition is treated as low priority. Werner says the incident enters through NYPD first, and Miano says a computer-aided triage system determines call type; unknown is the highest of the low-acuity types.
Ariola notes FDNY has about 4,500 budgeted EMS personnel but fewer than 4,100 on staff. Esposito says recruitment is challenging nationwide, FDNY has 163 EMT trainees at Fort Totten and about 150 in paramedic classes, and it continues testing and recruitment.
Ariola asks step by step what happens when no EMS call taker is available. Werner says NYPD releases the call to an EMS overflow position with a code, and the call taker enters the incident based on that code; if no call taker is available, it still goes to overflow.
Ariola asks about the pilot program placing EMTs at hospitals to speed handoffs. Miano says the hospital liaison unit was ceased at the end of May after showing only a small reduction in hospital turnaround time, and those members were returned to ambulances.
Ariola asks whether Kevin Daly's call was ever categorized as high priority; Miano says it remained unknown and FDNY is working with NYPD to close communication gaps. Ariola also asks about the Comptroller's report on ambulance tours, and Miano says the two numbers compared are physical ambulances versus daily tours.
Narcisse asks whether engine companies can refuse medical attention for patients and whether people should call volunteer or private ambulances. Esposito says only EMTs and paramedics can perform an RMA, and Miano says callers can call community volunteers directly, but 911 dispatches the closest appropriate ambulance.
Narcisse asks what incentives beyond pay could help retain EMS workers. Miano says members deserve respect and acknowledgment, and the city can support quality-of-life efforts like providing Thanksgiving meals to EMS stations.
Narcisse says she and the speaker will work to provide holiday meals to EMS stations and thanks Miano for the idea. Miano invites council members to visit EMS Station 58 and says broader citywide acknowledgment would help morale.
Narcisse asks about the hospital liaison officer program from the 2024 hearing and its results. Miano says FDNY expanded to 13 hospitals, but because the impact on response times was limited, the members were reallocated to the field; conversations with hospitals about triage continue.
Narcisse asks how the April 2025 closures of Mount Sinai and Beth Israel affected patient volume and capacity. Motzquist says it is hard to measure causally, but Bellevue has seen a moderate increase in emergency visits and its ambulance turnaround is below the city average.
Narcisse asks whether H&H measures NYC Care's effect on avoidable emergency visits and how many New Yorkers are enrolled. Motzquist says H&H does not currently have data on that and will follow up with enrollment figures.
Narcisse asks about psychiatric emergency services and the LEADS substance-use program. Motzquist says H&H treated 33,400 unique psychiatric emergency patients and 56,600 visits in 2025, and LEADS encounters rose to 30,400 with over 6,500 referrals and 3,600 naloxone kits distributed.
Narcisse calls Bridge to Home a great program for patients with mental illness and says she wants to keep people out of emergency rooms and off the streets. She says supportive housing and programs like SHOW should be expanded.
Ariola asks what specific gaps are being addressed in NYPD and FDNY dispatch communications. Werner says they are improving methods for sending and receiving messages, and Ariola requests that all call transcripts related to Kevin Daly be sent to committee counsel.
Ariola says street redesigns and closures increase response times and cites a Cortelyou Road project where the local firehouse objected. Esposito says FDNY submitted the firehouse's feedback to DOT but does not have veto power; Ariola says Local Law 6 requires that input and she will follow up.
Narcisse asks about the 2024 commitment to educate New Yorkers on urgent care and non-emergency options through PSAs. Esposito says FDNY has not instituted that yet, and Narcisse says she wants to collaborate on it.
Narcisse asks whether FDNY tracks how many calls crews determine do not need emergency care or transport. Miano says EMS does not tell people they do not need care; if a patient wants transport, EMS provides it, and refusal is handled through an RMA.
Council Member Lincoln Restler thanks FDNY for candor about the staffing and compensation crisis and asks about recruitment efforts and timelines. Esposito says FDNY is partnering with schools and colleges but faces a nationwide recruitment problem, and the current EMS Academy class has 163 recruits graduating in mid-December.
Narcisse shares a brief tribute to Healthy Humor, a company bringing laughter to children suffering from cancer and other illnesses in hospitals. She says she wanted to recognize the clowns who do that work and wish the children well.
Council Member Shirley Aldebol asks how long recruitment-to-hire takes and what FDNY is doing to retain EMTs and paramedics. Miano says EMS should be a career, not a stepping stone, and FDNY is working on quality-of-work-life issues while the city and unions negotiate pay.
Ariola asks whether FDNY is aware of how many collective bargaining meetings EMS unions have had with the mayor's office. Esposito says he does not know the number but is told there are positive actions.
Narcisse asks what incentives besides pay FDNY offers and how it addresses mental health and wellness. Miano cites tuition reimbursement, the FDNY Foundation, the EMS Help Fund, union assistance networks, peer support, and counseling services.
Brewer asks what percentage of EMS workers come from the military, whether a 911 education app still exists, and what happened to a National Science Foundation grant on response times. Esposito says he will look into the app, veteran percentage, and grant status.
Ariola says the hearing has produced productive discussion and that EMS workers need compensation, uniformed first responder status, civil service status, and promotional exams. She thanks the panel and dismisses them, saying the mayor inherited the problem but must now solve it.
Ariola opens the public hearing portion, reminds attendees to observe decorum, and says the witness table is reserved for testifiers. She says speakers will have two minutes and written testimony can be submitted to the sergeants at arms or by email within 72 hours.
Michael Greco, president of Local 2507, says he is angry and frustrated because New Yorkers are waiting too long for ambulances. He cites Comptroller data showing life-threatening ambulance response times up more than 41% since fiscal 2015 and more than 500 EMTs leaving in fiscal 2026, and recounts delayed responses including a 14-year-old stroke patient.
Greco says FDNY may be training as many EMTs as it can, but the city is losing more EMTs and paramedics than it can replace. He says the problem is retention caused by EMS being devalued, underpaid, and under-resourced, and he compares EMT and firefighter salaries after five years.
Greco says Local 2507's lawsuit is about whether the city recognizes EMS as essential public safety personnel. He calls fair compensation an investment in people who answer 911 calls and urges a fair contract, competitive pay, and equitable treatment.
Ariola asks the union panel whether collective bargaining meetings have occurred with the mayor or OLR and how many. Greco says bargaining started two years ago, has stalled, and this year there have been no traditional bargaining meetings; he says conversations are positive but under confidentiality.
Vince Variale, president of the Uniformed EMS Officers Union Local 3621, says New York City faces a present crisis threatening lives. He cites the Mayor's Management Report and Comptroller report, and says cardiac arrest survival rates have fallen from a high of about 35% to 16%.
Variale says low wages and high response times stem from FDNY failing to treat EMS as a co-equal uniformed branch. He says EMS responds to 1.6 million calls with about 25% of staffing while fire handles about 500,000 calls with 13,000 personnel, and EMS receives about 16% of the FDNY budget.
Variale says EMS cannot be expected to shoulder the solution and that anything short of co-equal treatment is a band-aid. He asks the city to ensure EMS members are treated as equals to fire operations and to provide pay and benefits comparable to firefighters to improve recruitment and retention.
Variale says EMS captain, deputy chief, and division chief became civil service titles in 2019, but the city and department refused to recognize them. He says the union won a lawsuit on eight counts, quoting the judge that the city violated EMS members' constitutional rights, yet no civil service exams have been scheduled.
Anthony Almojera, vice president of Local 3621, says EMS has no more time and reads daily snapshots showing 68 to 138 ambulances out of service each afternoon. He says as he spoke there were 112 ambulances off service and 51 calls holding, with many over three hours.
Almojera describes a Staten Island woman who waited two hours and 47 minutes, suffered heat stroke, and died, and a Long Island City woman with an open compound leg fracture who waited three hours on a hallway floor. He says these are not spreadsheets but resources New Yorkers cannot count on.
Almojera cites a shooting where NYPD transported the wounded man and a South Bronx heart attack patient who died after a two-hour wait. He says EMS is no longer failing but has failed, not because of EMTs and paramedics, but because dedication cannot replace staffing and ambulances.
Almojera says 47 members have reached out since 2020 saying they want to commit suicide and 14 members have died by suicide among those who reached out. He says EMS is not asking for applause but for resources and accountability when patients wait hours or die.
Restler asks Variale to clarify the survival rate statistic and what the decline means. Variale says the rate fell from about 35% to 16%, citing a Penn State study that experienced EMTs or paramedics with six or more years improve survival rates, and says losing veteran providers hurts outcomes.
Greco says EMS responds to about 80 cardiac arrests a day, or 29,000 a year, so a drop from 37% to 16% survival means about 4,000 fewer people survive annually. Restler calls this the most compelling point of the hearing and says policymakers must solve for it.
Almojera says FDNY is now losing officers to the fire class, taking experience out of EMS. Greco says it costs $45,000 to train an EMT and $100,000 to train a paramedic, and that the city has spent millions training people who leave for other services.
Ariola calls the next panel: Valerie Guardino and Logan Clark from the New York City Independent Budget Office. The panel is seated and invited to begin.
Logan Clark of IBO says the Mayor's Management Report shows end-to-end response times for life-threatening emergencies have increased by nearly three minutes since FY22 to more than 13 minutes. He says call volume increased 5% since 2022 but is down from its 2024 peak, while daily ambulance operating hours fell nearly 10%.
Valerie Gudino says EMS staffing has had substantial volatility from FY22 to FY26, with higher attrition among EMTs than paramedics and supervisors. She says the timing of the firefighter promotional exam creates recurring periods of high EMS attrition just as new classes are brought in.
Joseph Ranieri of the Regional EMS Council of New York City says EMS has a true retention problem and strongly opposes replacing two paramedics with one paramedic and one EMT. He says paramedics rely on each other for clinical judgment in complex cases like cardiac arrest.
Ranieri says pay parity is at the top of the retention problem and EMS workers need better work-life balance, clear career paths, and incentives. He says EMS providers are people, not machines, and should not be pushed to squeeze out extra calls without recovery time.
Narcisse thanks Ranieri and says she agrees that the city must invest in EMS at frontline and support levels. Ranieri says even online medical control is often staffed by a single physician, showing how far behind the city is in supporting EMS.
Narcisse calls several public witnesses, including DeCourtney Williams, Jack Chapman, Walter Adler, Christian Lopez, James Kerr, and Andrew. She asks them to say their names and begin from one corner of the panel.
Paramedic Christian Bear Lopez says he testified in March and returned because problems remain, citing FDNY EMS Lieutenant Nelson Cito who died after a six-minute ambulance arrival but no one answered. He says EMS needs sustainable wages, career development, and educational pathways, and asks why the council has not assessed an independent EMS department.
Gerardney Williams, an Army veteran and paramedic, describes starting in East 86th Street and responding to East Houston Street and 121st Street with 25-minute ETAs. He says fire, police, and MTA workers all wait for ambulances, and hospitals are pulling ambulances out of the 911 system because they are not profitable.
Andrew Freena, a former EMT and current PA, says the FDNY chief says life-threatening jobs are not held, but paramedics across all boroughs arrive under 10 minutes only 26% of the time. He says pay parity would cost a small fraction of the city budget and asks why the issue remains unsolved.
Walter Adler, a hospital-based paramedic and president of the EMS Public Advocacy Council, says it is painful to watch FDNY EMS bleed members. He says hospital-based EMS is not a competing force and that the different pay systems are by design.
Adler says the city must reduce call volume by 10%, reclaim EMS members who went to fire, and reduce CFR use when not necessary. He also calls for ending the fire promotional pathway, public education on 911 overuse, and a serious conversation about an independent EMS department.
Jack Chapman of 1199 says EMS starting salaries around $40,000 are not competitive in New York City and lag behind firefighters, driving attrition. He says ALS call volumes have increased while hospitals remove voluntary ambulances, and ALS units are often sent to calls BLS units could handle.
Stephen Northmore, a FDNY EMS rescue medic, recounts a cardiac patient waiting 40 minutes for an ambulance, a patient with three broken limbs waiting 50 minutes, and a child waiting 30 minutes while a fire company was on scene. He says these cases show the system is out of time.
Northmore says the city's line of credit from EMS workers has run out and the situation was willed into existence by officials who ignored warnings. He says every other fix has been tried except fair pay, which is the wound bleeding EMS of personnel, morale, and experience.
James Carr, former executive director of NYC EMS, says response time is a symptom of broader problems the fire department cannot solve alone. He recommends a mayor-directed EMS improvement and modernization task force bringing together FDNY, OMB, OLR, labor, H&H, and hospitals to produce an implementation plan within 90 days.
Ariola thanks the in-person public panel and says there has never been such focus on EMS failure. Narcisse tells Stephen Northmore that the chair is a fighter and that the committees will follow up, not just listen.
Ariola concludes the in-person Q&A panel and transitions to virtual panelists. She explains that staff will unmute each witness when their name is called and the sergeant at arms will set the timer.
Tyler Weaver says his 24-year-old son Nikos Costello suffered cardiac arrest in the Bronx in 2023 and waited 20 minutes for an ambulance, leading to severe brain damage and death. He says cardiac arrest revival rates have dropped from 20% to 16% and response times have returned to early 1980s levels.
Retired NYPD communications member Cheryl Bernard says increasing population, hospital closures, and retirements all affect response times, but DOT's bus lanes, bike lanes, and street thinning are a major problem. She describes an ambulance unable to pass due to a protected bike lane and warns against giving the public ETAs.
FDNY EMT Christopher McKagan, a 27-year veteran, takes issue with the statement that EMS has failed and says the city government has failed EMS. He says he trains new EMTs who leave for transit or court officer jobs because pay is too low and warns that retirements will take more ambulances out of service.
Chowdhury Hassan Mahmood, an FDNY technology specialist, says FireCAD crashed three times in six months and he faced retaliation after reporting defects. He says the new EMS CAD is being built by Accenture under a $20.66 million no-bid sole-source contract and asks the committee to demand milestone accountability, independent certification, and protection for civil servants.
Ariola thanks all who testified, committee staff, and sergeants at arms, and says written testimony can be submitted by email within 72 hours. She confirms no one else wishes to testify and declares the hearing ended.