Supporting our Heroes: EMS Worker Protections

New York City’s Emergency Medical Service is made up of 13,000 Emergency Medical Technicians (EMTs), paramedics, and other first responders who are key frontline workers keeping our City safe. Often first to the scene, our EMS workers manage everything from gunshot wounds to baby deliveries, serving all New Yorkers in life or death situations. EMS workers are also one of the most diverse groups in city services, with higher percentages of women and workers of color. 

For too long, EMS workers have not received sufficient salary and benefits, being treated as secondary first responders relative to police officers and firefighters. If this past year has shown us anything, it is how crucial EMS is to saving the lives of New Yorkers. In December 2019, 911 received five calls that were tagged as “fever/cough”. By March calls spiked to nearly 6,000 calls. By April, first responders were fielding over 27,000 “fever/cough” calls. 

Working conditions during the pandemic became unmanageable. Many EMS workers worked upwards of 80 hours a week, and were forced to rush to COVID-19 patients without proper PPE or support. Many EMS workers felt they could not go home for fear of putting their loved ones at risk. Because of EMS worker shortages, these frontline workers were told to keep working,  even if they had been exposed to COVID-19 as long as they were asymptomatic. The desperation caused by these working conditions, and the stress of the pandemic, led some EMS workers to take their own lives. One paramedic who works for the FDNY claimed it was more death than many EMTs have seen in their entire careers. After a year of tragedy, EMTs and paramedics can no longer be taken for granted. Andrew Yang hears and sees the needs of EMS workers and commits to making real change in their work conditions, particularly in calling for parity among all first responders. 

Andrew Yang’s Strategy to Reform NYC’s Emergency Medical Services

Improve EMS Pay, Benefits, and Recognition.

Many leaders have recognized the need to increase EMS salary and benefits. The City Council passed a resolution in May, 2020 calling for EMTs and paramedics to be paid comparably to firefighters and police officers. Unfortunately, we have seen no change. “The salary of an FDNY EMT starts around $35,000 and rises to $50,000 over five years. By comparison, an entry-level firefighter starts at $45,000 and within five years will earn over $100,000 annually, not including overtime. But the bulk of the FDNY’s roughly 1.5 million 911 calls are answered by EMS, data show.”

A Yang Administration would support universal standards of pay equity for all first responders that would need to be matched by private employers, and quality benefits, particularly access to mental health care professionals, that will allow EMS workers to do their job to the best of their ability. Specifically, a Yang Administration will:

• Launch a COVID-19 First Responders Relief Fund utilizing state and federal relief funds to support first responders affected by the pandemic. 
• Ensure wage and benefit parity among city-employed EMS workers, fire fighters, and police officers.
• Advocate at the state level for increased sick and maternity leave protections for EMS employers, and a requirement that EMS employers provide an option for affordable health insurance for all employees.
• Annually acknowledge first responders on National First Responders Day and meet with EMS workers to personally thank them for their service. 
• Publicly encourage more local businesses to provide discounts to first responders.

Improve Access to Mental Health Resources and Health Insurance.

Even before the COVID-19 pandemic, the stress of working in EMS negatively impacted the mental health of many workers. A 2018 report by the Substance Abuse and Mental Health Services Administration noted that depression and PTSD affect approximately 30% of first responders, and that 37% of EMS workers have contemplated suicide – nearly 10 times the rate in the general population. These already astonishing numbers were only worsened by the COVID-19 pandemic. With 5,000 medical calls coming in a day to the FDNY EMS, up 25% from last year, President Barzilay says there will be at least one traumatic event a day. EMTs are also being attacked more than ever this year. If the trend continues, it will result in a 43% surge in the number of first responders assaulted.

FDNY-employed EMS workers have access to counseling sessions with a licensed therapist and an FDNY-run peer counselor program. The need for mental health therapy this past year was notable; FDNY saw a 25% increase in member participation in counseling sessions. In contrast, EMS workers employed by private businesses faced the same conditions without the same mental health resources. Andrew Yang is committed to ensuring that all EMS workers have access to high-quality mental health resources, including by:

• Provide on-call clinical psychologists available to EMS workers and other first responders.
• Requiring any EMS employers contracting with the City to provide mental health resources to employees free of charge.
• Supporting local EMS employers applying for FEMA grants and other funding opportunities related to wellness programs and mental health.
• Encouraging partnerships between local EMS, Fire, and Police agencies related to mental health, including the sharing of federal financial resources and the creation of cross-department counseling groups. 

Expanding Required Training and Support.

Due in part to insufficient pay and benefit structure of EMS, many experienced employees leave after a few years in search of better opportunities, creating high turnover. There was also a shortage of EMTs after the FDNY gave 900 EMTs the option to become firefighters, an offer which was difficult to turn down given the higher salary, leaving a gaping hole in the EMS force. For these reasons, NYC has a relatively young and inexperienced EMS workforce managing the worst crisis the city has faced in recent history. To improve the strength of our EMS workforce, NYC must upgrade required training programs and collaboration between agencies. NYC must also create pathways for career development and incentivizes for EMS workers to stay in the force. Andrew Yang supports further research and investment into a robust training program, including:

• Encouraging a two-week field test training for new EMTs, allowing them to shadow more experienced workers and receive on-the-job training and mentorship.
• Requiring annual de-escalation and mental health response training in collaboration with NYPD. This will augment broader efforts at the City level to shift appropriate mental health-related 911 calls away from police to trained health care providers.
• Encouraging local EMS employers to provide better opportunities for clinical advancement, including providing scholarships for high-achieving employees to pursue high levels of licensure training and other education grant programs, tuition assistance and job security while pursuing advanced training.
• A Yang administration will also work with New York State to streamline recertification procedures and reduce barriers to advancing from EMT-B licensure to intermediate and paramedic licensure.

Increasing Number of Available Medical Control Doctors.

EMS workers must occasionally consult an on-call medical control physician when providing complex care or care falling outside of standard operating protocols. While this precaution can increase the quality of pre-hospital care, it can also result in serious delays in treatment and potentially in unnecessary deaths.

With 62 hospitals in New York City, there is only one guaranteed online doctor available at any given hour of the day. One doctor to serve the thousands of EMTs rushing around the city trying to save lives. Any death that stems from these wait times is avoidable and New Yorkers need to feel confident and comfortable that our systems work seamlessly to avoid any unnecessary deaths. Andrew Yang will ensure that there are a minimum of 3 online doctors on call 24/7 in each borough or central call line to help EMTs execute their job well.