More than 40 town officials and emergency service leaders from eight rural Northern Dutchess municipalities converged on Milan Town Hall on Thursday, March 19. The information-gathering session with Northwell Health executives — themselves current or former EMTs — marked an important step toward a potential pilot program that could bring vital ambulance coverage to the region.
Milan Supervisor Bill Jeffway said his Town Board’s ad hoc committee on EMS originally sought a meeting with Northwell to support Milan’s all-volunteer rescue squad — but then he talked to County Legislator Chris Drago (D-19). “[He] helped us think of this more in terms of a regional opportunity to collaborate.” he said. “Part of this is understanding what Northwell has to offer.”
Northwell Health Center for EMS (CEMS) is one of New York’s largest nonprofit ambulance services. Since its merger with Nuvance Health last April, Northwell has managed Vassar Brothers Medical Center in Poughkeepsie, Northern Dutchess Hospital in Rhinebeck, and Sharon Hospital in Connecticut. The agency currently keeps two ambulances in Dutchess, which it uses for interhospital transport.
“Northwell is a new player in [our area],” Drago told attendees. “They need to hear from you about how EMS is set up in your towns, and what some of your challenges are. And you need to hear how they’re running it in Long Island and New York City. Hopefully we can get a pilot program in northern Dutchess sooner than later.”
Drago has been advocating this initiative, in which each town would be responsible for a basic life support (BLS) ambulance, but Northwell would supply advanced life support (ALS) vehicles. (BLS ambulances are staffed by EMTs, and give essential noninvasive care like oxygen or CPR; ALS ambulances, operated by paramedics, provide invasive procedures, like intravenous medication and intubation.)
Fourth-quarter 2025 data released early this month ranks Milan last in the county among 31 municipalities: The town’s EMS was unable to respond to life-threatening Priority 1 calls 39% of the time, unchanged from 2024. On-site arrival times also ranked last, averaging 15 minutes, 5 seconds. (The national benchmark is less than nine minutes.) Pine Plains missed calls 23% of the time as compared to 24% in 2024; its average on-site arrival time was 12 minutes, 52 seconds this year.
Dutchess County contracted Empress EMS in January 2025 to provide supplemental BLS and ALS ambulances, as well as a rapid-response ALS fly car. Although this has led to improved response times in Southern Dutchess, progress has been slow in the northeastern region.
Many meeting participants — fire chiefs, rescue squad captains, and elected officials — frankly shared their town’s EMS challenges and addressed the reasons for slow response times, such as staffing shortages, spiraling costs, or the impact of low rural population density on call volume.
West Clinton EMS Supervisor Todd VanBuskirk reported ongoing staffing shortages, despite offering paid EMT positions. Joe Drago, a member of the town’s Fire Commissioners Board, said, “Many of our districts have handshake agreements for ALS, [which was] promised to remain in effect until the fall. So many of us are under the gun to get coverage by the end of year.” (Northern Dutchess Paramedics in Rhinebeck provided uncontracted backup for a handful of towns, including Milan, Clinton, and Pine Plains. Empress acquired the agency in October, putting these informal arrangements in limbo.)
Stanford Fire Commissioner Tim Gifford voiced concern about the cost effectiveness of their ambulance service: “We went to a paid BLS unit about five years ago. It’s a very expensive unit [currently $768,000 annually], and it doesn’t really do enough volume to merit our situation.”
North East Supervisor Christopher Kennon, whose town shares a $1.3 million EMS provider contract with Amenia and Dover, had similar worries. “We have an ALS unit that our town pays a great deal for,” he said. “It sits most of the day unused with less than one call per day. I’m wondering how we move from this static system?”
Northwell’s CEMS vice president Alan Schwalberg said, “The cost is too high if you’re only doing 911. This is why you pay Empress $1 million.” He added that by balancing costly emergency responses with lucrative nonemergency tasks, like interfacility and critical care transfers, Northwell has been able to provide all necessary services and achieve financial stability.
The agency’s assistant vice president, John Washko, explained that the primary driver of its EMS system’s effectiveness is the use of predictive data analytics — technology that can predict call volume and high-risk locations and times. “The bottom line is that we need data from your county to figure out how many ambulances are needed and where they should be located,” he said. “Then we could come back and say, OK, these five communities should come together instead of each one having an ambulance. Our goal is to do things better, faster, cheaper, and do no harm.”
Both officials underscored the need for a public-private partnership between Northwell and local municipalities to meet EMS demands. “We want to be a partner, not a vendor,” Schwalberg said.
Drago will expedite county data-sharing with the Northwell team. “Then they can assess how many towns are needed to come together to have critical mass to actually do a pilot,” he said.
Pine Plains Town Supervisor Brian Walsh commended Northwell’s presentation.“It seems like [Northwell] wants to work with volunteers, and not just push them out,” he later told the Herald. “They should meet with [town EMS providers] — not elected officials— and hear the ins and outs of what it’s like to be in a rescue squad. It will help them make more accurate decisions.”
Jeffway considered the meeting a success. “There were many frontline people here who needed to look [Northwell officials] in the eyes and believe that they knew what they were talking about,” he said. “That happened.”