TWENTY YEARS LATER: Integrating Services In The New York City Fire Department
One would think a fire department's chief responsibility is to fight fires.
But when a New Yorker sees a firetruck heading down the street with its
lights flashing and siren sounding, the odds are less than one in five that
the firefighters are headed to a fire; it is more likely that they are
responding to a medical emergency.
Medical emergencies have outnumbered fires since the municipal ambulance
service, known as the Emergency Medical Service (EMS), merged with the New
York City Fire Department (FDNY) in 1996. But the merger was not
accompanied by a fundamental transformation of the organization and staffing
of the FDNY. As a result, the FDNY does not efficiently address its most
common job: responding to medical emergencies.
The FDNY leadership has recognized this major challenge. Its 2015 Strategic
Plan established a goal of integrating fire and EMS services to enhance
emergency medical service. The measures they are taking in pursuit of this
goal are constructive, but incremental; bolder actions are essential for
This policy brief documents the increased volume of medical emergencies and
highlights the continued allocation of most of the department's resources to
firefighting despite the declining role of that function. This brief
provides three strategies, spanning from short term to medium and long term,
for addressing the mismatch.
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