When Fire Chief Chris Rea speaks about his staff, he speaks of members of a family and of members of a platoon—two distinct roles a career firefighter must learn to inhabit if he or she is to be cut out for the job.
“There are four different families here,” Rea says. “Four platoons. Each platoon works one 24-hour shift, with three days off in between.”
On call, at the ready, in-house at the central station at 25 East O’Reilly, waiting around for action, much of the job can be downtime—looking for busywork, conversation or private pursuits—but there’s no predicting when it will whiplash. Summoned by a dispatcher, in less than a minute, with no warning, one will be out on the road, racing through traffic while the sirens flash and scream.
Car accidents and health scares occur more frequently than fires. Since the 1980s, Kingston firefighters have made themselves useful by providing first-responder emergency services wherever they’re needed.
That skill set has become even more germane since the city of Kingston opted to run its own ambulance service out of the firehouse. Empress Ambulance purchased Kingston’s previous privately provided ambulance service, Mobile Life Support Services, and six months later tried a service fee hike of over $500,000. Kingston declined.
Starting off with three ambulances, Rea has since grown his fleet to five. Most recently, he purchased a brand-new Type 3 Wheeled Coach ambulance with a $263,000 state grant secured by Sen. Michelle Hinchey.
“Right now we have three ambulances that are out every day,” Rea said. “An additional two are for if something breaks down or for additional calls.”
By the end of today, he’ll also have a fly car—an SUV that, while it can’t provide transport, can provide advanced life support (ALS) equipment.
The fly car is the result of the fire department agreeing to participate as one of six anchor agencies providing coverage to surrounding municipalities that may lack sufficient resources, per the newly adopted Ulster County Emergency Management Plan, which is scheduled to begin Oct. 1.
“If they need ALS assistance out there—whether it be Hurley, Bloomington, Rosendale, Esopus, all that area—we’ll go out to them if we’re available. But at no time will the city ever be left without one ALS ambulance, at minimum, available to a city resident.”
Chief Rea puts the number of ambulance calls at around 12 a day, and with the garage for the ambulances basically in the center of Kingston’s 7.5 square miles of land, Rea says the ambulances arrive at their location within three minutes, on average.
When Kingston began providing the ambulance service, a source of concern was whether the compensation afforded by Medicaid and private insurance agencies would be enough to keep the operation afloat. By July 2025, Comptroller Tuey was reassured by the revenues coming in.
“The last time I reported, I had mentioned that we’re on pace to the $1.5 million budget. Over the last five months, we’re at $175,000 a month, and this most recent month was over $200,000.”
Tuey cautiously speculated that revenues could generate $1.9 million by the end of this year, and $2 million in 2026.
The paramedics
Joe Miller, a veteran of 20 years’ service in the Kingston Fire Department, sits next to Matilda, last name not shared, hired in February, who sits next to Emma Post, who was hired in June of last year. Deputy Chief Chris Hyatt arrives last to round out the group. Hired in 1996, Hyatt’s been a member of the platoon and family since then, and he’s in charge of the EMS program.
“We’re all paramedics,” says Matilda, “but we’re all firefighters as well. We’ve all gone through the academy.”
While EMTs can put a patient on the monitor, take the vitals, do the EKG to check their heart, check glucose, give Narcan, do CPR and defibrillate, intubation and other invasive procedures are the domain of paramedics—as is the intravenous administration of certain classes of drugs: anti-seizure medication, anesthetic, opioids.
“We also can administer morphine,” says Miller, “but paramedics don’t carry it anymore.”
In the first year the ambulance program was road-tested, the Fire Department responded to 4,462 medical emergencies.
“You can never really predict what you’re walking into anytime you come to work,” Post says. “You kind of have to be prepared for everything.”
Gunshots and stabbings featured in September, sure, but statistically it’s more likely to be a cardiovascular issue or an overdose, a car crash or other more mundane accidents they are responding to.
Miller did remember “a year-and-a-half stint” during the pandemic when there was a higher-than-normal frequency of shootings.
“Just the frequency of them—it’s like, what is going on? Is it the phases of the moon?” Miller said. “Like drug overdoses, they come in waves. We’ll go for a time period where we don’t have any, and then we’ll get a week-long stint where we’ll get a couple every day.”
A paramedic’s life is lived between high-frequency, low-acuity incidents and low-frequency, high-acuity incidents. Any moral element behind the injury is beside the point. The paramedics aren’t paid to judge the cause of an injury.
“We all try to leave our emotions and judgments at the door. We look at the mechanism of how it happened—whether it was, you know, a car, versus a weapon, versus bodily force,” Miller says. “We have to treat a person that just shot a police officer the same as that police officer that was shot. We can’t make a distinction—they’re somebody that’s injured. No matter who they are, we are there to help them.”
That commitment includes the homeless and the emotionally or psychologically disturbed. For the first group, the issues most frequently are hygiene and a lack of regular medical checkups, wherein chronic problems like emphysema or diabetes have been at work, ravaging their bodies. Instead of practicing preventive health care with a doctor, they end up in the emergency room for treatment.
For the second group, Chief Rea says the addition of a mobile mental health ambulance to the department’s emergency response team has been a game-changer. Responding with a basic life support ambulance and accompanied by a fire department EMT, the clinician will often talk to the person as long as it takes to establish whether they’re stable enough to avoid transport.
“If it’s okay to leave them home and it was—they were just kind of having a bad day—well, that’s one thing,” Hyatt says. “But if we honestly believe that they’re going to harm themselves or others, then you have to go to the hospital.”
Called a 941, New York’s Mental Hygiene Law allows an officer to take an individual into custody.
“We don’t have enough inpatient facilities to take care of what we have here,” Miller continues. “The night before, it was so busy to the point where the psych ward was full and they were housing, I want to say, like eight or 10 patients in the ER waiting for beds.”
Besides not being able to control the injuries they will see in the course of a shift, or the state of the people they try to help, neither can the paramedics choose the setting—which can be dangerous. Nine times out of 10, the police have arrived to control the variables and clear the path for the medical professionals to do their job. But sometimes that’s not the case.
The area down Broadway by the Radio Kingston Park has become synonymous with a certain level of chaos.
“Over the winter, 80 Elmendorf Street was designated as a county warming shelter,” says Miller. “So those folks had a place to stay warm, get a meal, so on and so forth. And we would go there a lot. And a lot of them have some psychiatric issues that again, go undiagnosed, untreated—but it affects them and everybody around them.”
When spring came to Kingston, the warming shelter closed and those people migrated to the general area near Radio Kingston Park.
“Before the warming center shut, they’d be on the rail trail under the bridge. From our perspective, when we hear a call come out, we’ll listen to the dispatch information, what it is. But when we hear where it is, we know it’s highly likely that we’re going to be going there for a member of that population, at that location.”
“Even if the police say the scene is safe, you always should be alert and aware of the scene,” Post says. “I consider the scene as never safe.”
Post says it could be that someone is having an issue or is injured, but other people on the scene may not like that person. The whole situation can escalate very quickly.
“And everybody starts yelling and screaming, and then they start fighting with the cops, and the cops are trying to keep them back—and this is happening while you’re trying to help somebody.”
Sometimes the best thing to do is to get into the ambulance and get out of the situation. This strategy dovetails nicely with the overall strategy of speed: fast response, fast stabilization of the situation, fast transport. It’s all supposed to happen in a flash.
“All I hear back from the community is how quick you’re here,” Rea says. “How quick, you know, they took my mother. She’s gone from the doorway of the room before I could blink. And you’re already doing your things and you’re already going to the hospital.”
Rea smiles. “That’s what I want to hear.”
Prior to doing it all in-house—excepting the private company transport and the hand-off at the hospital—Rea says the firefighters already did 80 to 90 percent of the job.
“Before, we would show up with the fire trucks and then we’d have to wait for the ambulance. Now we’re transporting the patients, now we’re caring for the patients, now there’s more follow-through. The ambulance is at your house faster. We’re off the scene quicker. You’re at the hospital quicker. We’re back in service quicker. So it really has functionally enhanced the system.”
According to the Medical Examiner’s Office, out of the 222 people who died in Ulster County in 2023, a portion of those died in Kingston. For those not already in a hospital when they passed, still alive when the ambulance arrived, there are times when they have tried everything they possibly could, and still a patient succumbs to their condition or injuries.
“You can sit there in your brain and go over it 18 million times—how you did the call and how it affected you—but without saying it out loud, it’s not really getting it out of your system and putting it out there.”
This is when the platoon switches to family. They talk it out around a kitchen table and debrief themselves. For those issues that are particularly troublesome, Hyatt says—like a bad car wreck or a pediatric patient, one of those low-frequency, high-acuity situations—there are outside critical incident stress debriefing teams that are called in.
“Everybody that was involved in the incident is ordered to be here,” Hyatt says. “We sit and we go around the room and we’ll talk about the evolution of the incident, what was done, what could have been done. People talk about what they went through.”
No two perspectives agree exactly. Every scene of an emergency is seen from the perspective of the job each individual must do. And yet, while there must be an element of adrenaline at work, none of the paramedics say they looked at their job as if they were cheating death.
“I feel more so that we’re just keeping people alive,” Post says. “Doing the best we can to provide the best care we can.”
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