New York City's emergency medical services (EMS) workers, who make life-or-death decisions daily, remain among the lowest-paid first responders in the city, with a years-long fight over wages and pay parity now testing the young administration of Mayor Zohran Mamdani.
Oren Barzilay, the recently retired president of FDNY EMS Local 2507, after 31 years in the service, now advises young New Yorkers: "Don't come here. You are only going to hurt yourself." His reversal stems from what he believes is the city's failure to pay those who risk their lives to save others. "After 31 years, I am stuck at $59,000," he said.
Low pay amid high stakes
Natasha Villaruel, a 36-year-old paramedic born in Jamaica and raised in Brooklyn, described the pressure of responding to 911 calls. Within about 20 seconds of arriving, she must assess a patient's breathing, skin color, and ability to speak. "Within 20 seconds, you have to make a life decision," she said.
More than 4,500 EMS workers respond to over 1.9 million medical and fire emergencies each year across the city's five boroughs, serving a population of over 8.58 million. Yet an FDNY EMT starts at $39,386 a year, barely above the city's minimum wage. After five years, an EMT can earn roughly $59,534, while a firefighter with similar experience makes up to $105,146—nearly double. Many EMS workers struggle to make ends meet; Villaruel noted that colleagues live in shelters, receive vouchers, or rely on food stamps.
Longer response times, growing attrition
The average ambulance response time rose from 11 minutes and 21 seconds in fiscal year 2025 to 13 minutes and 9 seconds in fiscal year 2026, according to the Mayor's Management Report. Meanwhile, the number of active EMS responders statewide fell 17.5% between 2019 and 2022, per the New York State EMS workforce report. Union leaders attribute the exodus to low wages. "We have a tremendous attrition problem. People are leaving," said Anthony Almojera, an FDNY EMS paramedic lieutenant and vice president of Local 3621.
For patients, delays can be life-altering. "Time matters a lot," said Dr. Shreya Kashyap, a second-year neurology resident at Mount Sinai. For acute stroke patients, every delay increases the risk of permanent brain damage. "There's this phrase that's very popular in neurology education: 'time is brain,'" she said.
Political and contractual battles
Brooklyn councilmember Sandy Nurse, who has supported raising EMS compensation, said: "EMS workers, frontline emergency management workers, make very, very low wages." In 2024, Nurse co-sponsored bills to establish a standalone Department of Emergency Medical Services, aiming for better wages and mental healthcare. Her progressive caucus also secured $1 million for an EMS mental health pilot program.
Barzilay blames city hall, particularly labor contract offices, for the decades-long failure to achieve pay parity. Nearly four years after the last contract, the Mamdani administration says negotiations are underway but declined to disclose details. "Contract negotiations are currently underway with the EMS union, and we remain fully committed to good-faith bargaining at the table," said Kenneth Londono, communications director for the mayor's office of labor relations, adding that the administration values EMS members' life-saving work and hopes for a "fair and sustainable outcome" for workers and taxpayers.
Barzilay remains skeptical: "No. Not as of yet." Almojera is more hopeful, noting that negotiations haven't formally commenced but that "we're just talking." He sees the appointment of Lillian Bonsignore as fire commissioner—a 31-year EMS veteran—as encouraging: "Making her commissioner is acknowledging that the Fire Department is mostly EMS. She knows exactly what we do. She's one of us." Villaruel is less optimistic: "I feel like politicians are politicians. They tell you what you want to hear. And then when it's time for the work to be put in, everyone is blind and deaf." Bonsignore's office did not respond to a request for comment.
For Villaruel, the work itself isn't the problem. "It's not like they don't like the job. It's the pay that's the problem. Who doesn't like saving people?"
