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 meaningful progress. 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. Download the report