Dec 20, 2025
[Albany] — New York’s emergency medical services continue to face funding issues after Governor Kathy Hochul vetoed Senate Bill S1515. This bill aimed to help municipalities create more reliable funding for local EMS systems. For many communities, it was a practical step toward fixing a system that has struggled for years only made worse by the COVID-19 pandemic.EMS agencies across New York share common challenges. They are dealing with rising call volumes, difficulties in hiring and keeping paramedics, aging ambulances, and wages that often fall short compared to nearby healthcare and public safety jobs. Local leaders have repeatedly stated they need better options to fund EMS like police and fire services are funded. This bill was aimed to help bridge that gap.
“We’re deeply disappointed to hear that the Governor vetoed such an important funding mechanism. EMS systems are desperately seeking funding to provide better clinical care to patients and improve working conditions for staff,” said Robbie MacCue, co-founder of the EMS Leadership Academy. “Local governments must remember they can create specialty improvement districts to fund EMS delivery, however these operate closer to lighting & sewer districts not fire districts. They can also break the property tax cap to do what’s right for their constituents. Where you live shouldn’t determine whether you live, or if paramedics should earn a livable wage.”
The veto is especially frustrating since the Governor has previously supported EMS. She signed direct-payment legislation in recent years that closed a long-standing loophole insurance companies used to avoid paying ambulance providers. In 2024, legislation passed that allowed ground ambulances to carry and administer prehospital blood, a significant improvement in trauma care, but it still lacks proper funding. While this law exists, regulations from the State Division of EMS are still pending and are expected by fall 2026.
In 2025, the Governor and Legislature passed meaningful EMS reform as part of the “Rescue EMS” initiative. One major bill, S7501A/A8086A, requires counties to work with regional EMS councils to develop detailed EMS plans. These plans must address service gaps, staffing shortages, funding challenges, and system coordination. While this planning effort is a step forward, it fell short of what many providers had hoped for: a clear “essential service” designation and a dedicated funding stream similar to what police and fire departments receive.
State Senator Shelley Mayer has been a strong advocate for better EMS legislation. The issue has gained attention through the documentary Honorable but Broken: EMS in Crisis, created by Rich Difenbach and Bryony Gilbey. The film highlights what EMS professionals and municipal leaders already know: communities depend on EMS every day, but the system is held together by inconsistent funding and goodwill.
With the veto of S1515, local governments must now take action using existing tools. Improvement districts, budget overrides, and local investment choices remain options, even when they are politically challenging. For EMS leaders and advocates, the message is clear: the work isn’t over. The discussion about sustainable EMS funding must continue at both the local and state levels.
