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Report: New York State 2023 Evidence Based EMS Agenda for Future

9 Feb 2023 6:46 AM | Matt Zavadsky (Administrator)

Fantastic report by a very diverse group of Technical Expert Panel members!

Congratulations to Ryan Greenberg and the team for putting this together!

This report is a must read for not only EMS Leaders, but more importantly, elected officials and other policy makers.

Although this is for the State of New York, you can insert pretty much any state not these findings (and recommendations), as virtually all have similar issues with EMS delivery in their state.  This report could be a blueprint for other states to engage in to address their challenges.

The preamble pretty much sums up the ‘current state’, and a few of the more compelling recommendations from the report are shown below.

The New York State [Insert your state here] EMS system has markedly deteriorated over the past several years due to declining volunteerism, lack of public funding to cover costs of readiness, inadequate staffing, rising costs, insufficient insurance reimbursement, rising call volumes, a lack of performance standards, poor understanding of the EMS system by elected officials and the public, NYS home rule, and lack of transparency and accountability for EMS agencies.

New York State's emergency medical services (EMS) are in trouble.

Multiple ambulance services have closed their doors over the past several years, and many who remain open are unable to respond to emergency calls in any consistent fashion.

Originally established as a transportation provider, EMS has developed over time to encompass healthcare, public safety, disaster response mitigation, and public health.

Today, EMS is an unanticipated (and often unfunded) safety net provider of pre-hospital healthcare, to all patients regardless of their ability to pay for services.

Link to view and download the report:


The report’s key recommendations start on page 10 – some notable that are worth highlighting:

  • Increase the number of certified EMS providers in New York State by 10,000 by 2025.
  • Engage stakeholders to address the decreasing pool of EMS providers to include pay disparities between EMS and other emergency services (Fire and Law Enforcement), benefits, longevity, mental health, work hours, access to EMS education and migrating from certification to licensure.
  • Incentivize implementation of tiered EMS response systems, using Certified First Responders (CFRs), Basic Life Support (BLS) ambulances, Advanced Emergency Medical Technician (AEMT) staffing, and Paramedic staffed response units.
  • Establish, implement, and enforce agency performance standards. Develop standardized, reasonable, measurable, and reportable response reliability, clinical quality/outcome, customer service and provider engagement/satisfaction expectations and standards with performance-based incentives, such as subsidies, contract incentives, and other impactful inducements to perform. Measures should be transparent to the public and standardized across the state for comparative purposes.
  • Create statutory changes that establish and define EMS as an essential service in New York State and mandate that the service's beneficial stakeholders pay their fair share of the costs of funding it, including the cost of maintaining continuous readiness and reimbursement for any pre-hospital care that is rendered, including the actual cost of transportation.
  • Amend New York State law to recognize EMS certifications as professional licenses regulated by the Department of Health and issued by the Commissioner.

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