EMSPAC-Long Island Chapter  

Nassau and Suffolk Joint Statement

Nassau and Suffolk Counties on Long Island are populated by an estimated 2.7 million people. There are 181 Fire Departments total, in both counties. 175 fire departments are made up of all volunteer members, with only six (2 of the six in combination) being career departments. There is also a total of 33 Volunteer Ambulance Corps. There are 200 NCPD EAB EMS, and around 1,000 EMS workers at Northwell.

Long Island has 126 fire districts, each with facilities to house equipment and firefighters. Just imagine 4-6 pieces of fire apparatus and at least 2 ambulances at each, some with much more. That’s probably more apparatus than there is in the city.

Things are completely different from the City. There are way more fire house based EMS. There are many paid per diem medics. Some dual FF-EMS are in IAFF. There are way more VACs, including many that also partially pay medics. 

Long Island is more conservative in some ways and in many ways opposed to unions. In other ways, Long Island is very libertarian, with very different systems for each town and village deploying EMS. There is heavy reliance on firehouse-based EMS and volunteer EMS.

A group of NCPD-EAB, Northwell, and Firehouse-based EMS in Nassau and Suffolk have been quietly working to bring the EMSPAC organization to Long Island’s approximately 10,000 EMS MOS. We have tried for some time to launch new EMSPAC initiatives specific to the Long Island EMS systems. Over 40% of Nassau Calls are managed by the NCPD-EAB, 40% by Northwell Health, and 20% by VAC/ or Fire House-based EMS. 

In Nassau, there is NCPD-EAP police based EMS; around 250 medics in Nassau are in CSEA Local 830. Northwell is a major hospital employer. It may have as many as 800 non-union EMS. 

Former Hunter is AMR’s new foothold in the NYC area. SCEMS has transport bases in Lynwood and a second due in the Long Beach 911 system. RCA and Ambulanz are large private minimum-wage companies with bases in Nassau and Suffolk. Catholic Health has a substantial IFT operation and in-house emergency. 

Every town/village system is very, very different. Suffolk is always short on volunteers, and more paid posts are coming. The way EMS is deployed between one county and the next varies radically. 

Biggest Nassau EMS employers: Northwell, NCPD EAB, Oceanside FD, Syosset FD, Jericho FD, NYU Mineola.

Biggest Suffolk EMS employers: Brentwood Legion, Huntington, Community, Bayshore Brightwater; Stony Brook EMS is in a state union PEF.

The largest employer is non-union Northwell Health with around 1,000 non-union EMS MOS. Followed by NCPD-EAB with around 250 in the CSEA Local 830. They are a single medic-PD-based system. 

There are around 50 Suffolk County FF/EMS medics in the IAFF. 

The biggest private agencies are SCEMS, Ambulnz at Freeport/Smithtown, Catholic Health, and former Hunter-AMR. AMR BLS is still with Local 22. The biggest hospital-based EMS agencies are Northwell, Stonybrook (which is in PEF), NUMC IFT (which is CSEA) to a much lesser degree, and non-union NYU Winthrop and Sinai South Nassau.

The biggest overall issues are:

1. Professionalizing EMS in Nassau and Suffolk.
2. Competitive Wages & Benefits (although NCPD EAB is top in state)
3. Adding more full-time work (particularly in Suffolk)-Ending the “Suffolk shuffle” (working lots of separate VAC/Firehouse based medic per diems) 
4. Phasing out the slowly dying VAC system, especially in Suffolk.
5. Arbitrary and conflicting fire district rules. (Nassau has 9 battalion areas/Suffolk has 10 )
6. Aspiration for a large singular EMS union 

So far, there has been less Long Island interest in “hardship help”, and more in labor organizing. Also, there is a lot of fear about openly joining EMSPAC at Northwell CEMS. Where x2 1199SEIU union drives have failed, one with a no vote. And in 2025, a CSEA campaign also failed. 

There are a lot of volunteer ambulance groups, most of which also work in paid EMS. Volunteering is a far more normal part of EMS in Long Island. It has been recommended so far that we don’t concentrate on the VAC initially. “As they do not have enough skin in the game, as you are seeing in the city.” As we have seen in the City, the VAC system is dying and, frankly, kind of hostile to the big tent labor populism of EMSPAC. The majority of VAC in both the City and LI are a retirement activity for aging buffs, or a way for rookies to break in: not a critical provider of EMS 911 units, not a reliable resource. Some VACs pay per diem medics and paid FDs that pay medics too. A new law lets VAC & FD based EMS bill. There are big implications for this and for more hiring of EMS. 

Major challenges:

Long Islanders distrust unions. We see them consistently voting down unions at Northwell. We see a lack of success in 1199SEIU gaining traction in Long Island EMS.

Northwell vs. EAB is really a big divide. More so Northwell supervisors vs. the EAB, but uniting these services is seen as a critical strategy on the LI Front. 1199SEIU is not interested in EMS not working for hospitals or Long Island EMS. EMS is an afterthought to them. Northwell workers have passed on 1199 now twice in elections. They rejected a massive CSEA campaign that would have united them with NCPD EAB.

The Suffolk system is disjointed and ununified. There’s no unity; there’s no common system. It’s really an amalgamation of agencies, with some that are really trying and some that are in the Stone Age. It makes getting any sort of large-scale change take forever, and it can be really frustrating.

Long Island EMS want to be firefighters.

The IAFF is mostly in Dix Hills/ Long Beach/Terryville FD. The IAFF is one of the most successful first responder lobbies in America today. We seek an alliance with the largely FF union, which may represent tens of thousands of EMS all over the country and aid us in building bonds with FF. But the IAFF is always FF first, EMS eventually.

Conclusion

Long Island EMS, in general, wants full-time employment, one EMS union/association, an end to arbitrary and stupid fire district rules, and an end to things like the mistreatment of the “EMS Janitor”. Roll back the VAC; replace them with employed FT professionals.

Nassau and Suffolk have been previously broken up into 16 organizing zones based on highways and fire districts. We have only a few official Advocates. We have cut each county North/South/East/ West and are seeking deputies for each Battalion. Then Cut down Route 112.

We have struggled for many years to find a solid way to tie so many different EMS agencies and systems into a solid chapter. What feedback do people have? 

There are 2 standards; one for volunteers, one for paid EMS. If you are an unskilled paid provider you get fired and don’t eat. vs ‘well, ok cool hobby bro’. Each agency treats itself as its own fiefdom. It is hard to get agencies to play together on a good day, let alone on hot button topics like staffing.  Although the fire budget for each district can be in the millions, each shop cries poverty.”