TOMPKINS COUNTY, N.Y. — When there’s an emergency, and someone needs immediate medical attention, it’s often a volunteer arriving on scene, racing against the minutes that are potentially the difference between life and death. 

This is especially true in rural and even suburban communities, where Emergency Medical Technicians (EMTs), paramedics, and ambulance drivers are often the second, unpaid professions of neighbors.

But less and less people are stepping in to keep those emergency medical services (EMS) that communities have long relied on the labor of volunteers to keep running, says Michael Sitley, Tompkins County’s Director of Emergency Response.

The decline in volunteer EMS is happening not just in upstate New York, he said, but also in places like the suburbs and cities of Northern New Jersey, where Stitley started his career working as an EMT. 

“It’s absolutely a national issue […] and it’s impacting the rural communities even harder,” he said

While it’s become clear is that there are gaps in Tompkins County’s emergency response services,  but there’s a plan to address it. 

The county government is considering investing in EMS service that would support community based volunteer, and volunteer-professional hybrid ambulance companies. This could mean hiring a staff of paramedics, or EMTs, but that much is not yet determined. 

In its 2023, budget the county is considering adding just over $110,000 to its yearly spending to create the position of an EMS Program Manager. The program manager would begin the process of narrowing down where the gaps of service are in Tompkins County, then determining what level of service the county should invest in to close those gaps. 

“We already know we need it. What we don’t know is how much we need,” said Stitely. 

Stitely said that the gaps are certainly concentrated in the southern part of Tompkins County, such as in the Towns of Danby and Caroline, the latter of which saw its volunteer ambulance service close its doors in 2015.

At the very least, Stitley confirmed that county resident can at least expect a fly car or an EMS vehicle, which is used not for transporting patients to the hospital, but to quickly dispatch an EMS professional to where they’re needed. 

The Program Manager will also be responsible for establishing a training pipeline to help bring more volunteers into the community based EMS force, augmenting their staffing.

“What I want to do is everything I can to help support community based services, whether volunteer or not, to make sure that they have the proper tools so they can continue to grow without having some of this pressure on them,” said Stitley. 

Many issues abound in the EMS profession. For one, salaries for EMTs and paramedics fall far short of parity with other emergency service professions, which Stitely cited as one of the major causes that drive workers away from the profession. According to the US Bureau of Labor Statistics, the median salary for EMTs and Paramedics in 2021 was $36,930, or a wage of $17.76. Firefighters made a median salary of $50,700 in 2021, and police made a median of $66,020.

New York State also does not consider EMS an “essential service.” The state legislature began considering changing that classification in its last session. Without being deemed an essential service, municipal governments aren’t required to provide EMS, and EMS workers don’t have access to the kind of health and pension benefits other emergency responders like firefighters do. 

Stitley gave a presentation to the Tompkins County Public Safety Committee on Thursday about what he wanted the Program Manager to accomplish. The presentation included other counties that have moved to invest in their own EMS, like Schuyler, Chautauqua, Essex, and Wayne counties. 

Committee Chair, Tompkins County Legislator Rich John, who filed the budget item for the EMS Program Manager, said, “I think this is probably the most important decision we’re making” this budget season.  “This is an area we have not been involved with, this is a significant advance in the responsibilities of the county,” said John.

Tompkins County, Stitley emphasized, does have strong community-based EMS in the likes of Dryden, Lansing, Groton, and Trumansburg. Bang’s Ambulance in Ithaca, a for profit ambulance service, is also able to cover calls from around the county. “I believe that we have fantastic EMS in this county, and we’re blessed compared to what other counties are going through,” said Stitely. 

But the time to intervene and begin supporting these services is now, he said. If volunteer emergency response company’s shutter, they’re probably not coming back. “Once you lose it, you lose it forever.”

Jimmy Jordan

Jimmy Jordan is a general assignment reporter for the Ithaca Voice. Questions? Story tips? Contact him at jjordan@ithacavoice.com Connect with him on Twitter @jmmy_jrdn