More than a year after Dutchess County launched a $2 million-a-year supplemental ambulance service to rescue its struggling emergency medical services, newly released fourth-quarter 2025 data shows that rural towns in Northern Dutchess — including Milan and Pine Plains — remain seriously underserved. County Legislator Chris Drago (D-19) and a handful of Milan officials, have suggested one way to improve coverage: Capitalize on the expertise and the ambulance fleet of the state’s biggest integrated health network, Northwell Health.
Under a possible pilot program for Northern Dutchess, each town would still be responsible for a basic life support ambulance, but Northwell would supply advanced life support vehicles. BLS ambulances, staffed by EMTs, provide essential noninvasive care like oxygen or defibrillation; ALS ambulances, staffed by paramedics, can handle critical emergencies with invasive procedures, like intubation and intravenous medication.
Drago first met with representatives from Northwell Health Center for EMS (CEMS), the state’s largest nonprofit ambulance service, in December. 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.
“I heard that Northwell had a substantial EMS footprint in New York City and Long Island,” he said, “I wanted them to hear what our EMS challenges are in Northern Dutchess, and find out their plans, too. They are eager to consider a public-private partnership with the county. But if it’s too much for Northwell to support the whole county right away; let’s pilot it out for Northern Dutchess.”
Northwell Health CEMS assistant vice president Jonathan Washko, who is the lead in all discussions with Dutchess County, signaled that he is open to the proposal: “A system-wide solution is needed, not an independent solution, so every town doesn’t have to pay $1 million for EMS. Municipalities don’t each need their own ambulance.”
Washko added that because New York is a home rule state, each city and village can adopt local laws and manage their internal affairs. “Which means that every town has its own […] EMS, which makes things complicated, a patchwork quilt of services,” he said.
In January, Drago arranged a roundtable with Northwell Health CEMS and Dutchess County officials, including William Beale, the commissioner of the Department of Emergency Response. “Soon after that meeting, Beale gave Northwell a tour of the county 911 call center,” Drago said, “And they’ve met with him several times since.”
At the Public Safety Committee meeting of the County Legislature on March 5, Beale said, “My priority here as Northwell Health [grows] is, do they have any available EMS assets? Can we create a system where Northwell’s [ambulances] can be on-shifted into our existing dispatch system? It may take some time, as their current focus is interfacility transport [from hospital to hospital].”
To answer some of those questions, Northern Dutchess town officials and EMS leaders will hold an information-gathering session with Northwell representatives at Milan Town Hall on March 19. Milan has created a six-person ad hoc committee to “address immediate, short-term EMS needs as we all work with the county and state on longer-term solutions,” Town Supervisor Bill Jeffway said in his invitation to the session. “We believe there may be potential in looking at this as a shared services opportunity.”
According to fourth-quarter 2025 data, Milan ranks last in the county among 31 municipalities, 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 — slower than last year’s time of 14 minutes, 42 seconds. (The national benchmark for on-site arrival is less than 9 minutes.)
Pine Plains showed minimal improvement, unable to attend calls 23% of the time as compared to 24% in 2024; but the squad shaved nearly three minutes off its arrival time, averaging 12 minutes, 52 seconds this year, compared to 15 minutes, 31 seconds in 2024.
In January 2025, the county contracted with Empress EMS, a Poughkeepsie-based ambulance provider, to provide supplemental emergency coverage. Since then, Empress has deployed three emergency vehicles including a rapid-response ALS fly car and two BLS ambulances, one of which was upgraded to an ALS ambulance in October. Southern Dutchess has reported modest response-time gains, but progress in the northeast part of the county has been limited.
The majority of supplemental ambulances answered calls in Southern Dutchess, where population density and call volume is higher. Both Milan and Pine Plains had a total of 13 dispatches each, but more than half did not arrive, cancelled en route or simply unavailable.
Beale said the supplemental program will not change in 2026: “It is only a stopgap measure to provide critical EMS response to residents while longer-term solutions can be developed. It can’t be successful unless municipalities have a primary [BLS] service.”
Another potential EMS fix is in limbo: state legislation directing all counties to develop a comprehensive emergency medical services plan. Gov. Kathy Hochul signed one bill in December, but it was amended in January and awaits her approval.
Drago believes the pilot program can help. “We should act now as towns are starting to talk to Empress about renewing EMS contracts,” he said. “And I’ve heard that since Empress took over Northern Dutchess Paramedics, the handshake agreements are likely going away. Northwell will give Empress competition, and competition is good.”