Tompkins County EMS Evaluation: Addressing a Fragmented System

CGR Principal Paul Bishop presented the findings and recommendations of our recent Tompkins County EMS Evaluation to the Legislature’s Public Safety Committee. The project identified that EMS in Tompkins County is not a cohesive system of care but is driven by distinct service models and historical political decisions across various agencies.

This fragmentation is evident in service delivery: several smaller communities support their EMS with tax dollars, while the City and Town of Ithaca rely on a private, fee-for-service provider. Despite these challenges, the County’s Rapid Medical Response (RMR) program has been successful in filling a critical first-response gap in rural areas.

CGR’s recommendations focused on improving EMS across several key areas, most notably suggesting the County consider deploying a safety net ambulance service to back up and stabilize existing providers. Following the presentation, the committee engaged in extensive discussion regarding the future vision for EMS and appropriate next steps.

For more information about this work, please contact Paul Bishop. 

November 17, 2025 CGR Briefs Edition