Emergency Medical Workers Deserve Pay Equity

New York Times Editorial Board

Paramedics and E.M.T.s are just as professional as firefighters and should be compensated accordingly.

By The Editorial Board

The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op-Ed section.

  • Sept. 21, 2019

Christell Cadet says she had been on the job as a paramedic for the New York Fire Department for just weeks in 2012 when the ambulance she and her partner were in came under gunfire during a call in Harlem, forcing them to peel away.

Paramedics and emergency medical technicians in New York learn to be prepared for anything: rushing into burning buildings to give aid to firefighters; braving active shooters to reach the wounded; enduring assaults by patients — particularly those addicted to opioids, who are sometimes confused or event violent after being revived with the anti-overdose drug naloxone.

“I love what I do,” Ms. Cadet says. “But it’s stressful.”

This is the job of the roughly 4,100 E.M.T.s and paramedics of the F.D.N.Y. The job is getting tougher in New York, where medical calls, not fires, now make up most of the Fire Department’s responsibilities. In 2018, more than 80 percent of the 1.7 million incidents to which the department responded were medical, according to department officials. The same year, the more than 11,000 firefighters and officers of the F.D.N.Y. responded to 40,784 fires, including 1,983 so-calledserious fires, like apartment fires or fires that spread to several buildings.

Firefighters across the country also perform the duties of paramedics and E.M.T.s. But in New York, paramedics and E.M.T.s are a separate work force within the F.D.N.Y. Though they are all skilled workers employed by the same city agency, the difference in pay and benefits is striking.

The base salary for an E.M.T. is $50,604 after five years on the job. That base rises to $65,226 for paramedics, who receive more training and perform advanced lifesaving procedures like intubation. Though the pay is comparable to private ambulance services, it is significantly less than what the city’s firefighters earn. After five years on the job, a firefighter’s base pay is $85,292.

The benefits are also different. Firefighters have unlimited sick pay, for example, while paramedics and E.M.T.s — who regularly come into contact with sick patients — have 12 days of paid sick leave every year.

The unions that represent E.M.T.s and paramedics have fought to close the gap, pointing to the growing workload and arguing that they face some of the same dangers as firefighters.

On Sept. 4, Local 2507 and Local 3621 of District Council 37, along with the E.M.S. Superior Officers Association, filed a complaint with the United States Equal Employment Opportunity Commission, charging that the disparity was also a matter of racial and gender discrimination. Their evidence: Nearly 78 percent of the department’s firefighters and officers are white, and nearly 99 percent of them are male. The F.D.N.Y.’s emergency medical services are far more diverse: About 41 percent are white, 28 percent Hispanic, 21 percent black and 5 percent Asian. More than one in four Emergency Medical Services workers are female.

Labor and civil rights attorneys say a discrimination case would most likely depend on the ability of the E.M.S. unions to show that their jobs are sufficiently similar to that of firefighters to justify similar pay. The case could be strengthened by the department’s history of discriminatory hiring practices. In 2014, the city agreed to give $98 million in back pay and benefits to minority firefighter applicants to settle a class-action suit that argued the F.D.N.Y.’s hiring practices discriminated against racial minorities. In the late 1970s and early 1980s, New York was forced to allow women to become firefighters after Brenda Berkman, an applicant who had been rejected, successfully sued the city.

Mayor Bill de Blasio, whose administration has been in contract negotiations with the unions representing E.M.T.s and paramedics for more than a year now, has dismissed the idea that the disparities are discriminatory, saying the work is simply different than that of firefighters. City officials said giving similar or equal pay to paramedics and E.M.T.s could cost the city some $450 million annually. Cutting down on overtime pay at the Fire Department — which amounted to more than $340 million in fiscal year 2019, which ended in June — may help.

Firefighters do have different jobs. There are far fewer structural fires in New York than there once were, but that doesn’t make the job of fighting them any less hazardous. Firefighters are more likely to die on the job than paramedics and E.M.T.s. Since 2009, nine firefighters have died in the line of duty in New York City, compared with one member of the E.M.S. The figures don’t include firefighters and E.M.S. workers who have died of illnesses related to toxic air in the Sept. 11 attacks.

Yet as the department’s role in emergencies changes, and it becomes a significant provider of medical care, the salary and benefits of its E.M.S. workers must also evolve.

As Ms. Cadet’s experience shows, in addition to a rising workload, paramedics and E.M.T.s regularly encounter hazards similar to those faced by the police and firefighters. A 2013 University of Maryland study, using data from the Department of Labor, found that the injury rate of E.M.T.s and paramedics is three times higher than the national average for the general population. In March, James Booth, the E.M.S. chief at the time, said during testimony before a City Council committee that assaults on paramedics and E.M.T.s by the public had increased by nearly 50 percent between 2015 and 2018, from 79 to 117.

Such conditions, along with the disparity in pay and benefits, have prompted hundreds of E.M.T.s and paramedics to become firefighters in recent years. They get preferential treatment in hiring, and since 2013, 1,533 of them have become firefighters, according to city officials. The move is considered a promotion, and has helped improve racial diversity in the city’s firefighting force. But it has also left the ambulance service with fewer and less-experienced emergency medical personnel.

In large part because of this shortage, E.M.S. workers regularly work lots of overtime — 1.2 million hours of overtime in 2018, up from 893,000 in 2008, despite the addition of 1,000 workers over the past decade, according to city data.Mayor de Blasio’s administration seemed to acknowledge this fact when it said in an annual performance report last week that it planned to increase the sizes of its incoming E.M.T. and paramedic classes. The announcement came alongside the news that dispatch and travel time of ambulances to life-threatening medical emergencies in the city had increased by nearly 30 seconds. “Despite the department’s aggressive efforts to hire additional E.M.T.s and paramedics,” city officials wrote, the number of ambulances in service every day fell to 460 in fiscal year 2019, compared with 472 the previous year.

Many E.M.S. workers say they rely on overtime to make ends meet anyway, because of the low pay and the high cost of living in New York. Shakeria Tate, an E.M.T., said she works a double shift about twice a week. Ms. Tate has two children, and when she works her grandmother watches her 9-year-old daughter, Ms. Tate’s youngest. “I have to make sure I can pay the bills,” she says.

But Ms. Tate said that though she enjoys the job, the work can be grinding. “I’ve been in active shootings. I’ve been hit by patients,” she said. “The public really doesn’t know what we do. We’re not just taxi drivers. We’re here to help you live.”

New York’s emergency medical workers should be paid salaries and benefits far closer, if not equal to, the city’s firefighters. That’s what’s owed the tiny force of people providing New Yorkers with critical medical care in their hour of need.

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