Counties Oppose EMS Mandates in State Budget

Regional leaders seek solutions not new mandates on local taxpayers 

For two years, counties have called attention to a growing crisis facing emergency medical services (EMS) in many communities across the state. Increasing wait times, a lack of volunteers, and inadequate reimbursements have devastated many EMS agencies, leaving residents vulnerable in times of medical emergencies.  

After failed attempts to reach a compromise with Governor Hochul and State Legislators, the New York State Association of Counties (NYSAC) is calling on state leaders to reject any language in the state budget that would establish a new mandate on all counties to develop individual EMS plans with oversight under a Statewide EMS council. This new mandate would add layers of cost and complexity to an already overburdened EMS system.

Since the unveiling of the SFY 2026 Budget proposals, counties have sought to amend language contained in Part R of the Health and Mental Hygiene budget bill to provide counties with the flexibility to support local EMS systems based on each communities’ need, rather than a one-size-fits-all state mandated approach.

NYSAC Executive Director Stephen Acquario said, “While counties have led the charge to enact reforms that would bring down costs for providers and give counties the flexibility to address their communities’ needs, the current system works at the local level, where EMS providers and towns convene with each other to address provision of service within a geographic area. In certain instances, these jurisdictions approach counties to assist with gap coverage and "fly cars" are often made available by counties to assist where possible.  What is missing is simple, a financing vehicle to assist in the provision of EMS services, such as an optional and broader county, town, city and village EMS taxing jurisdiction.

“Unfortunately, the language contained in this year’s budget brings a sledgehammer where a scalpel is needed. Instead of providing counties with the flexibility to establish taxing districts to help community partners address gaps in coverage, it imposes additional mandated programs on counties that history has proven simply raise the cost of living for local taxpayers.

“The Governor and State Legislature need to go back to the drawing board and work with all levels of local government to develop a proposal that addresses the root causes of the EMS crisis and provides counties with flexible tools to support local partners while not imposing new mandates on local taxpayers.”

Counties are calling on State Lawmakers to reject these proposals and focus on a more workable plan designed to bolster existing EMS systems, not replace them with a new state mandate on counties and local taxpayers. 

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Media Contact: Mark LaVigne| mlavigne@nysac.org | 518-465-1473 x206