Five months after Dutchess County launched a $2 million multipronged initiative to address mounting failures in Emergency Medical Services — driven by declining volunteerism, rising costs, and poor insurance reimbursement — rural towns like Pine Plains and Milan continue to cope with delayed ambulance responses and unanswered calls.
As part of the county’s effort to address ongoing issues with EMS, on Jan. 1, Empress, an ambulance service based in Poughkeepsie, began providing supplemental emergency coverage to all towns within the county’s 825 square miles by dispatching three vehicles: two basic life-support ambulances and one advanced life-support fly car (a non-transport EMS vehicle). The coverage— at a cost of $ 1.47 million, three-fourths of the initiative’s budget — is not intended to replace community emergency services; ambulances are sent only when local EMS is unavailable.
Acting Commissioner of Emergency Response William Beale presented the first-quarter data on the new program to the County Legislature’s Public Safety Committee on May 8. The statistics showed that Empress EMS vehicles were dispatched 544 times, with 60% of those calls going to high-volume areas in southern Dutchess, including Beacon, East Fishkill, Fishkill, and Poughkeepsie. Almost half of all supplemental dispatches were cancelled en route, as local units had already arrived.
Meanwhile, some northern towns with only volunteer squads received county ambulances just a handful of times — Milan and Pine Plains twice (in 45 emergency calls) and Stanford three times (in 71). “Southern Dutchess County gets the ambulances,” said Stanford Fire District Chairman Dennis Smith, a 55-year veteran firefighter. “They don’t like to come this far. The answer should be that we get the ambulances even though we don’t have the call volume. People’s health is dependent on it; we can’t wait any longer.”
Dutchess County Legislator and committee member Chris Drago (D-19) was also dissatisfied. “We need to ensure that the supplemental EMS program is actually delivering equitable service across the county, not just propping up gaps in higher-density areas,” he said. “If we’re spending taxpayer dollars to close the response-time gap, then rural towns like Pine Plains and Milan … need to be part of that solution, not left behind.”
The program’s objective, according to Beale, is to decrease the call response time for life-threatening (Priority 1) emergencies, such as a heart attack or an overdose, to under nine minutes — the national benchmark associated with higher survival rates — with 90% reliability. “Priority 1 call response times over 15 minutes and ‘inability to respond’ [no EMS vehicles available] should approach 0%,” he said.
According to the National Highway Traffic Safety Administration (NHTSA), Priority 2 calls are urgent but not immediately life-threatening, like broken bones, and arrival should be within 12 minutes; Priority 3 calls are for minor injuries that may require transport to the hospital (16 minutes); and Priority 4 are nonemergencies,, like a tick bite, and could often be handled by telemedicine (three hours).
Even with the supplemental service, response times continue to be slow, according to the report. Only 67% of the 30 municipalities that have EMS answered Priority 1 calls under nine minutes,and 9% didn’t answer at all. These times were unchanged from 2024, and 5% better than in 2023.
Beale said the reasons that some Priority 1 calls don’t get answered is because “no volunteer EMTs are available, no units [emergency vehicles] are available, and no secondary units are available, either.”
EMS response times
According to data provided by the Dutchess County Department of Emergency Response, the towns that performed best were those that pay for professional ambulance services 24/7. For example, Millbrook, which has a contract with Northern Dutchess Paramedic (NDP), responded to Priority 1 calls in less than nine minutes 85% of the time, and attended 97% of all calls.
Stanford contracted with NDP four years ago, at an annual cost of $750,000. Now only 1% of all calls are missed (compared to 43% in 2023), though the response time is the slowest in the county: under nine minutes for Priority 1 calls only 17% of the time.
Pine Plains and Milan are struggling. Both have strictly volunteer rescue squads and while they have hand-shake agreements with NDP to provide backup service, contracted clients like Millbrook and Stanford take priority.
Although their 2025 response times have significantly improved since 2023, Pine Plains answered only 29% of Priority 1 calls under nine minutes (up from 11%), and Milan, only 24% (up from 7%). Additionally, the two ranked among seven towns with the poorest no-show records: Pine Plains was unable to respond 25% of the time, and Milan 30% of the time. (Both missed 39% of calls in 2023.)
Brian Walsh, the 10-year veteran Chief of the Pine Plains Fire Company, said the number of unattended calls is actually lower: Many times the department fly car is the first on the scene. “The vehicle gets our EMT there right away, so they can start patient care before the ambulance arrives,” he explained. “But we only get credit [for the call] if the ambulance shows up.” (According to the NHTSA, non-transport fly cars can be key in early medical intervention, but national metrics are strictly based on ambulance response times.)
Walsh added that some calls have to be missed: “If we are attending an emergency and a Priority 4 comes in, we may not be able to attend.”
Despite the statewide decline in the EMS workforce, the number of EMTs serving Pine Plains has increased. “People want to help: Last year we had eight volunteers, now we’re up to 12,” Walsh said. “This is one reason why our times are improving.” Additionally, NDP is dispatched simultaneously with Pine Plains EMS for Priority 1 calls.“They have floating units to help those of us without contracts,” he said. “They are backfilling for us, and doing a great job.”
Peggy Coons, 32-year veteran officer with the Milan Rescue Squad and active volunteer EMT, said there are about a dozen EMTs in the squad, up three from last year. “But I know the county wants us to get there more quickly. I get that,” she said. “I see a contract with NDP coming soon if we continue to use them all the time. I can’t blame them, if they’re taking 75% of the call.”
Smith added, “We are digging into the numbers to understand this. Overall, NDP has made a big difference. Right now we only have three volunteer EMTs with one in training, and that’s not enough. We can’t afford not to have a paid ambulance, even though it’s expensive.”
Other County strategies to fix EMS
In addition to the supplemental ambulance initiative, Beale said the county offered $20,000 grants in September 2024 for life-saving equipment like the LUCAS automatic chest compressor, installed in fly cars. Only 10 Dutchess County communities were awarded grants — none in the Pine Plains Central School District. “Some agencies in the county said they didn’t hear about this opportunity, and now are interested,” Beale said. “Because of the confusion, County Executive [Sue Serino] is considering offering another grant opportunity.”
Beale said the county is also working to recruit EMTs: Local fly cars are being wrapped with advertisements promoting EMS careers and scholarships. “It’s our landing page for all things EMS right now,” Beale said. A public education campaign to reduce the numbers of inappropriate 911 calls is also in the works: “We’ll use billboards, handbills and social media. People don’t realize how limited the county EMS resources are. We can’t use ambulances for Priority 4’s any more.”
Finally, the county will advocate for state and federal funding. But there has been a recent setback: EMS was not recognized as an essential service in Gov. Kathy Hochul’s 2025-26 budget. State Sen. Michelle Hinchey (D-41) told the Herald that the Essential Service bill she co-sponsored passed the Senate unanimously in 2024. “But the State Assembly hasn’t moved it forward,” she said. “Without that designation, EMS continues to be treated as optional making it harder for providers to secure funding, plan long-term, and stay afloat — especially in rural areas.”