Bravest burning millions
Study: Cut fire trucks, boost ambulances
The city could more wisely spend the $1.1 billion it costs to provide emergency medical services, a budget watchdog group says, in part by reducing the role fire engines play in responding to 911 calls — and then considering whether it really needs all of its engine companies.
In a new report, the Citizens Budget Commission recommends ultimately reducing the number of engine companies, which for years has been a political nonstarter.
The suggestion comes as the Fire Department, which is responsible for responding to medical emergencies, has seen a steady uptick in the number of calls — responding to 1.5 million in 2017, up 36% since 2000. At the same time, the number of fires in the city has decreased. But while EMS work makes up 84% of the department’s workload, it accounts for just 30% of its budget, the report’s author, Mariana Alexander, a research associate at the Citizens Budget Commission, said.
“The Fire Department has adequate resources to do its job, and it’s about reassessing how those resources are allocated to match its workload,” she said.
Fire engines are only supposed to be dispatched to the most serious medical calls, when time is of the essence — because they can often arrive faster than ambulances. But that quick arrival doesn’t always translate into much help.
While the engines can reduce response time, firefighters can’t provide the same level of care an ambulance crew can. And the engines are much more expensive to staff — with “five or six people on a fire truck, and they’re all paid a lot more than your average EMT or paramedic.”
“Sending a fire engine doesn’t necessarily reduce your workload, because the ambulance is still needed to transport,” Alexander added.
Staffing each fire engine costs the city an average of $7.2 million a year — compared with $2.2 million a year on average for an ambulance to make three tours a day.
“If you closed one fire engine company, you could fund 10 additional ambulance tours each day,” she said.
But closing fire engine companies has been a political third rail for years — Mayor de Blasio even got himself arrested protesting the idea under his predecessor’s mayoralty.
“It would politically be a very heavy lift for the Fire Department to do,” Alexander acknowledged.
FDNY spokesman Frank Gribbon said the engines are dispatched to life-threatening calls such as cardiac arrest, an unconscious person, or someone choking, in addition to responding to fires.
“Engines also respond to fires and other emergencies, and we do not advocate nor support closing any of them, as the report seems to suggest,” Gribbon said.
Reducing the role of fire engine companies isn’t the CBC’s only suggestion — it also called for mounting public campaigns to reduce unnecessary requests for ambulances and reducing the focus on response time for minor issues while beefing up the ability to quickly respond to more serious ones.
“Many of the incidents that the Fire Department are responding to are not genuine emergencies. These are incidents that either medical care is not needed at all or urgent medical care is not needed,” Alexander said.
The FDNY said it has been working with other city agencies to try to steer people to other forms of medical treatment when appropriate.
“We share the CBC’s concern about unnecessary or inappropriate requests for ambulances — and have been working closely with NYC Health & Hospitals, Greater N.Y. Hospitals Association. and the city health care networks that are participating in the Medicaid DSRIP program to ID appropriate alternative pathways for these patients to receive care,” Gribbon said.