But in New York City, city leaders are having a hard time recruiting and keeping paramedics and EMTs on the job. That's due to one thing -- low salaries and benefits.
This March marks 25 years since the Emergency Medical Service joined forces with the FDNY. The then FDNY Commissioner, Thomas Von Essen, played a key role in making the merger happen.
"We did a much better job of getting them better equipment, better training," former Commissioner Thomas Von Essen said. "But we never paid them back for what we promised in the merger would be that they would become equal, hopefully over a period of time."
The merger helped keep fire houses open at a time when fires were decreasing in the city. The plan was supposed to also bring paramedics better pay and benefits.
The EMS workers are still waiting for that to happen 25 years later. They start out getting paid around minimum wage at $35,000 a year.
"We work hand in hand with them yet we aren't recognized or compensated for it," Local 2507 President Oren Barzilay said.
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The starting wage is lower than EMS workers are paid in cities like Minneapolis ($47,110), Chicago ($49,070) and Olympia Washington ($79,360.)
"I feel bad, I lost track of it you know I've been doing a lot of other things these past twenty years," Von Essen said.
The FDNY EMS Local 2507 union president said the lower pay makes it difficult to recruit new paramedics and keep the ones they have.
They typically leave after three to four years on the job. Only about 100 workers have more than 20 years of experience out of the 4,500 on the force.
"Most people use those jobs as a stepping stone, until they find something better and they leave," Barzilay said.
It's a profession where medical experience matters and timing matters as well. The union's negotiating its new contract with a cash strapped city in the middle of a pandemic.
"There are ways of getting creative you just have to sit down and want to do it," Von Essen said.
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Even with mayoral support it hasn't happened yet. There are only a few months left for the current administration before a new one takes over. The former commissioner said he would like to see the changes he started in the 90s come full circle in his lifetime.
"I'm not even saying they should be brought up to parity with police and firefighters but they need to start it, if they would've started it 20 years ago it would've happened by now," Von Essen said. "There's ways of helping them raise that starting salary and helping retain them if they really want to but they have to want to do it."
The union has been negotiating the new contract since the beginning of 2020. They've been working without a contract since 2018.
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