News Release - City Releases Fitch Report, Plans to Explore Investments in EMS Services and Negotiate AMR Contract

City of Rochester

News Release


(Saturday, Feb. 17, 2023) – Mayor Malik D. Evans announced today that the City has begun exploring plans to invest in enhanced emergency medical services for City of Rochester residents. The planned investments align with recommendations from Fitch Solutions, as outlined in a report the City released today.  

The report, commissioned in November 2021 after an extensive RFP process, evaluates the City’s EMS system utilizing five years of historical data from 2017 to 2021. It provides the City with an assessment of the current EMS system, perspectives on contractual compliance performance objectives, and a comparative analysis with similar communities. In addition, the report includes an evaluation of seven alternative EMS models for the City’s consideration.

“Fitch’s evaluation has presented our team with an objective perspective of our current emergency medical response system,” said Mayor Evans. “We have already begun identifying ways to add to and maximize our current resources to improve emergency health services to city residents.”

The City contracts with American Medical Response (AMR), which provides ambulance service within city limits. In addition, the Rochester Fire Department (RFD) provides basic life support services for the most acute medical calls (25 to 30 percent of all calls) until an AMR ambulance crew arrives to continue life support and transport the patient to a hospital. 

City leadership has reviewed and intends to follow several of the recommendations outlined in the report, including maintaining the current unsubsidized EMS model; better aligning turnout time performance with best practices; beginning response time for staging calls only after a scene is declared clear to enter; enabling computer-aided dispatch (CAD) adjustments; and changing the approach to measurement to reduce manual effort, increase transparency, and increase oversight for compliance.

“These adjustments are clinically appropriate not only in light of the current demands for and realities of emergency medical services, but also because they will positively impact patients,” said City EMS Medical Director Dr. Jeremy Cushman. “And the additional investments that the City is exploring will further ensure stable and reliable emergency medical response for Rochester well into the future.”

Dr. Cushman joins City leadership, including representatives from the Rochester Fire Department, Mayor’s Office, Emergency Communications Department, Office of Management and Budget, and Law Department, in identifying and exploring additional EMS investments, including expanding RFD basic life support treatment capabilities; increasing community education and engagement; expanding the successful Nurse Navigator program; improving access to mental health services; and investing in advance life support, first-response squad vehicles for RFD use and personnel to staff those vehicles.

“Some of these investments will take years to come to fruition, and will require significant budgetary commitments,” Mayor Evans explained. “But we are committed to doing what it takes to ensure Rochester residents receive the highest quality emergency medical care possible.”

In addition, the City is in contract discussions with AMR while it continues an investigation into an incident in which a city resident in medical distress was removed from an AMR ambulance. AMR’s current contract expires in November 2024 and contains renewal options that could maintain the relationship through 2026.


The Administration of Mayor Malik D. Evans strives to create a safe, equitable and prosperous Rochester by inspiring hope and delivering opportunity for everyone. Guided by the Administration’s Mission, Vision and Values and the principles of the “Rochester 2034” comprehensive plan, City employees are committed to providing exceptional customer service, transparent stewardship, and collaborative leadership to foster a vibrant community that empowers personal, professional and generational growth for all who live, work or play in the city of Rochester.