§ 209-b. Emergency rescue and first aid squads. 1. Emergencies. a.
The authorities having control of fire departments and fire companies
may organize within such departments or companies emergency rescue and
first aid squads composed of firefighters who are members of such
departments or companies. Such squads, so organized, may render services
in case of accidents, calamities or other emergencies in connection with
which their services may be required, as well as in case of alarms of
fire. Whether or not such squads have been organized, any firefighter
may render service in case of accidents, calamities or other emergencies
in connection with which the services of firefighters may be required,
as well as in case of alarms of fire, unless he or she shall have been
duly ordered not to render such service by the authorities having
control of the fire department or company of which he or she is a
member. If a request for emergency service is made by, or originates
from a doctor or peace officer, acting pursuant to his or her special
duties, or police officer, and there is any doubt as to whether an
emergency exists, the judgment of the doctor or officer that there is,
in fact, an emergency may be accepted as conclusive by such squad, or
the firefighter responding, or who has responded to such call. The
person designated to receive calls for such emergency services, for the
purpose of dispatching such squads or firefighters, shall determine in
the first instance from the information furnished to him or her whether
an emergency exists and his or her decision, if in good faith, as to
whether or not there is an emergency shall be final in relation to
dispatching such squads or firefighters. Any such preliminary
determination shall not be deemed to authorize the rendition of services
if, upon arriving at the place to which dispatched, it is found that
there is no emergency.

b. The governing board of any city, town, village or fire district
which has a fire department but which has not authorized such fire
department to render emergency ambulance service, may contract for the
furnishing to it of emergency ambulance service with another city, town,
village or fire district which has in its fire department an emergency
rescue and first aid squad duly authorized to render emergency ambulance
service. Before any contract to furnish emergency ambulance service is
entered into, the consents of the fire department, the fire company and
the emergency rescue and first aid squad to furnish such emergency
ambulance service shall be obtained. Each consent shall be evidenced by
a copy of a resolution certified respectively by the secretary of the
fire department and fire company and by the officer then in command of
the emergency rescue and first aid squad.

2. General ambulance service. a. The governing board of any city, town
which has a fire department, village or fire district which has in its
fire department an emergency rescue and first aid squad composed mainly
of volunteer firefighters, by resolution, may authorize any such squad
to furnish general ambulance service for the purpose of (1) transporting
any sick, injured or disabled resident or person found within the city,
town, village or fire district to a hospital, clinic, sanatorium or
other place for treatment and care and returning any such person
therefrom if still sick, injured or disabled and (2) transporting any
sick, injured or disabled resident of the city, town, village or fire
district from a hospital, clinic, sanatorium or other place where such
person has received treatment and care to any other place for treatment
and care or to such person's home whether such hospital, clinic,
sanatorium or other place where such person has received treatment and
care is within or without the city, town, village or fire district or
the territory listed on the ambulance service certificate or certificate
of registration as the usual territory within which the ambulance
service operates.

b. The town board of a town which does not have a fire department but
in which there is a fire corporation located outside any village, fire
district, fire alarm district or fire protection district, by
resolution, may authorize the emergency rescue and first aid squad of
such fire corporation to furnish general ambulance service for the
purpose of (1) transporting any sick, injured or disabled resident or
person found within the area described in the certificate of
incorporation of the fire corporation to a hospital, clinic, sanatorium
or other place for treatment and care and returning any such person
therefrom if still sick, injured or disabled and (2) transporting any
sick, injured or disabled resident of such described area from a
hospital, clinic, sanatorium or other place where such person has
received treatment and care to any other place for treatment and care or
to such person's home whether such hospital, clinic, sanatorium or other
place where such person has received treatment and care is within or
without the area described in the certificate of incorporation of such
fire corporation or the territory listed on the ambulance service
certificate or certificate of registration as the usual territory within
which the ambulance service operates.

c. The governing board of a city, village or fire district which by
law is authorized to contract to have fire protection furnished for any
district or area thereof by the fire department or fire company of
another city, town, village or fire district, or a town board on behalf
of a fire protection district or fire alarm district, may include in any
fire protection contract a provision for the furnishing of general
ambulance service by the emergency rescue and first aid squad of the
fire department or fire company which furnishes such fire protection.
Such general ambulance service shall be for the purpose of (1)
transporting any sick, injured or disabled resident or person found
within the contract district or area to a hospital, clinic, sanatorium
or other place for treatment and care and returning any such person
therefrom if still sick, injured or disabled and (2) transporting any
sick, injured or disabled resident of such contract district or area
from a hospital, clinic, sanatorium or other place where such person has
received treatment and care to any other place for treatment and care or
to such person's home whether such hospital, clinic, sanatorium or other
place where such person has received treatment and care is within or
without the contract district or area or the territory listed on the
ambulance service certificate or certificate of registration as the
usual territory within which the ambulance service operates. The city,
town, village, fire district or the fire department or fire company
thereof which is authorized to furnish such fire protection pursuant to
contract shall have power to contract to furnish such general ambulance
service.

d. Before any authorization is granted under paragraphs a and b of
this subdivision, or before any contract to furnish general ambulance
service is entered into pursuant to paragraph c of this subdivision, and
before any public hearing is conducted as herein provided, the consents
of the fire department, the fire company and the emergency rescue and
first aid squad to furnish the general ambulance service shall be
obtained. Each consent shall be evidenced by a copy of a resolution
certified, respectively, by the secretary of the fire department and
fire company and by the officer then in command of the emergency rescue
and first aid squad.

e. Before authorizing general ambulance service under paragraphs a and
b of this subdivision the governing board of a city, town, village or
fire district shall conduct a public hearing. Before the governing board
of a city, town, village or fire district enters into a contract for
fire protection which contract, for the first time for a specific
district or area, provides for the furnishing of general ambulance
service pursuant to paragraph c of this subdivision, it shall conduct a
public hearing in the manner required by law, if any, for the entering
into of a fire protection contract therefor, but if a public hearing is
not required in any such case, then the public hearing shall be held as
herein provided and the procedure for publishing notice under this
paragraph shall be applicable. Notice of such hearing shall be published
at least once in a newspaper or newspapers having general circulation in
the city, town, village or fire district, or, in the case of contracts,
in the fire alarm district, fire protection district, or other contract
area. In all cases the notice of hearing shall, in general terms, (1)
describe the general ambulance service which is proposed to be
furnished, (2) describe the area to be served, (3) state the names of
the fire department, fire companies and emergency rescue and first aid
squad affected, (4) state the time and place within the city, town,
village or fire district, or, in the case of contracts, the fire alarm
district, fire protection district, or other contract area, where such
hearing will be held and (5) state that all persons residing within the
area to be served, all persons, firms and corporations owning real
property within the area to be served, and all persons, firms and
corporations whose business interests or employment would either be
benefited or adversely affected, whether or not a resident or owner of
real property within the area to be served, shall have the right to be
heard in person or by representative at the public hearing. Such notice
shall be published at least ten days prior to the date fixed for the
hearing.

f. After the hearing and after considering the statements made at the
hearing the governing board shall determine whether authorizing the
furnishing of general ambulance service, or the entering into of a
contract for general ambulance service, is in the public interest. If
the governing board determines that it is in the public interest to
authorize the furnishing of general ambulance service, or to enter into
a contract for general ambulance service, it shall adopt the resolution
authorizing the same and within ten days thereafter cause a certified
copy of the resolution and the determination on which it is based to be
filed in the office of the clerk of the county or counties in which the
city, town, village or fire district is located. The consents required
by paragraph d of this subdivision shall be filed with such resolution
and determination.

g. The determination of the governing board in relation to the
furnishing of general ambulance service shall be subject to review in
the manner provided in article seventy-eight of the civil practice law
and rules provided that application has been made therefor within thirty
days from the date of the filing thereof. Such determination shall
become final and conclusive and the resolution shall become effective at
the expiration of such thirty days or, if application for review be
made, upon the final determination thereof.

h. When general ambulance service is authorized pursuant to this
subdivision, the emergency rescue and first aid squad shall answer all
calls and demands for such service to be furnished to sick, injured or
disabled persons entitled thereto, subject to such rules and regulations
as shall be prescribed by authorities having control of such squad, and
subject at all times to the emergency needs of the fire department and
any limitations upon such service specified in a fire protection
contract. Such rules and regulations may establish limitations on the
distances which may be traveled outside the area to be served in order
to reach hospitals, clinics, sanatoriums or other places where care and
treatment is to be or has been furnished.

i. Any action taken pursuant to this subdivision may be rescinded by
resolution of the governing board which has taken such action. The term
"resolution", as used in this subdivision two, means resolution,
ordinance, act or local law.

j. The provisions of this subdivision two shall apply to all cities,
towns, villages and fire districts, except where the provisions of a
general or special law expressly prohibit the rendition of general
ambulance service by an emergency rescue and first aid squad of the fire
department thereof.

3. Transportation of persons. Squads and persons authorized to render
service pursuant to this section shall transport sick, injured or
disabled persons only in vehicles owned by or under the control of a
city, town, village, fire district, a fire department or a fire company
unless ordered or permitted to transport such persons in other vehicles
by the authorities having control of the fire department or fire company
of which he is a member.

3-a. Mutual aid. a. The governing board of any city, town which has a
fire department, village or fire district which has in its fire
department an emergency rescue and first aid squad composed mainly of
volunteer firefighters, may, by resolution authorize any such squad to
enter into one or more mutual aid agreements as defined in subdivision
twenty of section three thousand one of the public health law, and/or to
contract with ambulance services as defined in subdivisions two and
three of section three thousand one of the public health law to provide
services when the emergency rescue and first aid squad is unavailable.

b. The town board of a town which does not have a fire department but
in which there is a fire corporation located outside any village, fire
district, fire alarm district or fire protection district may, by
resolution, authorize the emergency rescue and first aid squad of such
fire corporation to enter into one or more mutual aid agreements as
defined in subdivision twenty of section three thousand one of the
public health law, and/or to contract with ambulance services as defined
in subdivisions two and three of section three thousand one of the
public health law to provide services when the emergency rescue and
first aid squad is unavailable.

* 4. Fees and charges authorized. (a) Subject to the restrictions set
forth in paragraph (d) of this subdivision, emergency and general
ambulance service, including emergency medical service as defined in
section three thousand one of the public health law, authorized pursuant
to this section may be furnished without cost to the person served;
provided, however, that the authorities having control of a fire
department or fire company that have authorized such fire department or
fire company to provide such service or services may fix a schedule of
fees or charges to be paid by persons requesting such service or
services. The authorities having control of a fire department or fire
company may provide for the collection of fees and charges or may
formulate rules and regulations for the collection thereof by the fire
department or fire company. When fees and charges are authorized
pursuant to this subdivision, the fees and charges collected shall be
disbursed in accordance with a written contract entered into between the
authority having control of a fire department or fire company and the
fire department or fire company itself. If the authorities having
control of a fire department or fire company have authorized such fire
department or fire company to fix a schedule of fees or charges to be
paid by persons requesting such service or services, and seek
participation in and reimbursement from the medical assistance program,
the authorities having control of a fire department or fire company
shall adhere to any medical assistance enrollment and billing
requirements applicable to such services prior to receiving
reimbursement. The acceptance by any firefighter of any personal
remuneration or gratuity, directly or indirectly, from a person served
shall be a ground for his or her expulsion or suspension as a member of
the fire department or fire company.

(b) Notwithstanding the provisions of paragraph (a) of this
subdivision, a basic life support service which establishes a schedule
of fees for service shall enter into a contract with a provider or
providers of advanced life support services to provide such advanced
life support services. Such contract shall at a minimum establish the
fees for advanced life support services and the means by which said
provider will be reimbursed when the ambulance service bills for
emergency medical service.

(c) An emergency and general ambulance service, including emergency
medical service as defined in section three thousand one of the public
health law, authorized pursuant to this section which does not issue a
bill for its services and which requests an Advanced Life Support (ALS)
intercept from another ambulance service furnishing service in an area
that is designated as a rural area by any law or regulation of the
state, or that is located in a rural census tract of a metropolitan
statistical area (as determined under the most recent Goldsmith
Modification), shall pay the ambulance service providing the ALS
intercept an ALS Rural Intercept Fee at rates negotiated between the
providers of such services. In the absence of any agreed upon rates, the
service receiving such ALS intercept shall pay the service providing the
ALS intercept for such services at the usual and customary charge, which
shall not be excessive or unreasonable.

(d) An emergency and general ambulance service, including emergency
medical service as defined in section three thousand one of the public
health law, authorized pursuant to this section to fix a schedule of
fees or charges to be paid by persons requesting such service or
services, may apply such fees and charges only within such service's
primary response territory as assigned and evidenced by a valid
ambulance service certificate issued by the commissioner of health
pursuant to section three thousand five of the public health law, on or
before January first, two thousand twenty-two.

(e) An emergency and general ambulance service, including emergency
medical service as defined in section three thousand one of the public
health law, authorized pursuant to this section shall not directly issue
a bill for its services to any uninsured recipient of such services.

* NB Effective until April 9, 2026

* 4. Fees and charges prohibited. Emergency and general ambulance
service authorized pursuant to this section shall be furnished without
cost to the person served. The acceptance by any firefighter of any
personal remuneration or gratuity, directly or indirectly, from a person
served shall be a ground for his or her expulsion or suspension as a
member of the fire department or fire company.

* NB Effective April 9, 2026

5. The term "emergency", as used in this chapter, or in any other law
of general application, in relation to the operations of fire
departments, includes, unless a contrary intent is clearly expressed or
indicated, the search for persons and the search for, and attempts to
recover or the recovery of, bodies of persons even though it is posible
or is known that all hope of life is gone.