When Lillian Bonsignore was announced as newly elected New York Mayor Zohran Mamdani’s choice for FDNY commissioner, the news elicited some intense emotions.
Despite a 30-year EMS career, most recently as the department’s EMS Chief of Operations, during which Bonsignore oversaw the response to the COVID-19 pandemic, opponents of her appointment lodged their complaints. They claimed she was a diversity, equity and inclusion (DEI) hire, or that her lack of firefighting experience disqualified her for the position.
In a post on X.com, Elon Musk even made the startling claim that “people will die” under her direction.
But, as Bonsignore herself points out, her background is not unusual for someone in the top spot of the FDNY.
“I’m the 37th commissioner in the department’s 160-year history,” she said in an interview with EMS1. “Two-thirds of those fire commissioners had no firefighting experience; 100% did not fight fires when they were commissioner.”
Bonsignore’s career history and FDNY leadership experience suggests her detractors were uninformed. And, less than a month after she was sworn in as commissioner on Jan. 6, 2026, she made headlines again — and gained support from industry rank and file — after a full-throated endorsement of raising EMS pay to match their firefighter counterparts.
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“I’m not here to fight fires,” she said. “I’m not even here to start IVs. I’m here to guide the fire department into the next few decades.”
When ‘for love of the job’ isn’t enough
During a “State of the FDNY” breakfast on Feb. 5, 2026, Bonsignore directly connected dwindling EMS recruitment and retention to current EMS compensation levels.
“EMS are the lowest-paid first responders in the city, and that is unacceptable,” she told the gathering. “The people staffing the ambulances deserve to be able save the lives that need them and still support their families in the city that they love.”
While former FDNY Commissioner Laura Kavanagh also voiced her support for EMS pay parity, Bonsignore’s early career history matches the lived experiences of today’s field providers, connecting her support to the rank and file.
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“I can talk firsthand about what it’s like to live on an EMS salary,” she said. “Now sitting here as commissioner, the majority of my career I had to work three to four jobs in order to support my family.”
In the past, departments may have relied on the idea that “EMS is a calling” to justify and encourage acceptance of a lower income. However, that’s no longer an option, Bonsignore said.
“We’re in a position now where EMTs and paramedics are leaving their positions within the first five to seven years,” she said. “It’s hard to support a family on the salary that EMS makes.”
That’s not to say people aren’t still called to work in EMS; but it’s no longer enough to keep people in the career field.
“People need to make money and support themselves,” Bonsignore said. “We’re already out of that era when it was the love of the job that kept you; when people like me were willing to work four jobs and give up time with our children and families just to stay in a job we loved. Those times are gone.”
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The FDNY’s ‘next 50 years’
Bonsignore’s career experience includes two of the most large-scale incidents to impact the FDNY in the last 30 years — the Sept. 11 terrorist attack that brought down the World Trade Center towers and the 2020 pandemic that saw call volumes rise to the same levels as seen amid the panic in 2001.
That background, coupled with her prerogative to tap into the collective knowledge of past department leaders, allows for a historical analysis of the FDNY’s past to shape the present and launch the organization into the future.
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Creating a stable, responsive EMS system
Expanding the FDNY’s support for and approach to EMS is at the top of Bonsignore’s list, starting with continued attention to the issue of EMS pay parity.
“We’re seeing significant decreases in recruitment and we’re having more trouble retaining providers,” she said. “In this role, it’s all about modernizing and preparing; that’s really our mission. With EMS, obviously, we have to right the ship on this one.”
And changing the metaphorical ship’s course will require looking at EMS operations from a new angle — one that considers the impact of current salary levels on recruitment, retention and future planning.
“I have the awesome responsibility to sit at the highest level of the most recognized and greatest fire department in the world,” Bonsignore said. “If I’m not honest with the administration or society about where our EMS end of this business is headed, I would be doing them a disservice.”
Though, as commissioner, she has no direct impact on union discussions regarding salary or benefits; in her mind, raising awareness is half the battle: “Just speaking about it does pay off. It drives these conversations. I know there are people who left EMS for a job that pays higher they may not love as much. So, it’s just time that we take this on,” Bonsignore said.
In her opinion, the department’s current staffing issues will begin to negatively affect the city’s residents if something is not done to address the inequality.
“It’s time we take on these very difficult problems of pay parity and turn our EMS system into something that is equally respected and equally embraced as first responders,” she said. “It’s unacceptable for somebody who saves lives for a living to not be able to support their own families.”
Modernizing firehouses across the city
Bonsignore is also focused on investing in rebuilding and expanding FDNY infrastructure throughout the city.
“We have to prepare ourselves for the coming decades,” she said. “When we look at fire and EMS comparatively, fire has 100 more years on EMS; it’s a toddler compared to the fire service. But, the FDNY’s been around a long time, and a lot of our buildings and firehouses are over 100 years old and require repair.”
That investment should also consider the technological needs of the future, Bonsignore said.
“The mission is about setting ourselves up for the next 50 years, which means embracing technology and trying to be on the ground level of a growing city,” she said.
Considering the area’s recent housing expansion, “we must make sure we’re considering the resources needed to care for the people in these additional housing areas. We need firehouses, we need EMS stations, we need additional resources,” Bonsignore said.
Bolstering community & recruitment outreach
In addition to personnel and infrastructure investment, Bonsignore also wants to make the work of FDNY members more visible, appreciated and appealing to residents.
“We’re in emergency services, which means people really only see us when things are going wrong,” she said. “We want to be seen when things are going right. We want our communities to know that our jobs — our very existence — is to keep them safe, healthy and their lives and property protected. And we want to do that through education, through outreach.”
And, just like their EMS counterparts, Bonsignore hopes to move fire service recruitment beyond the family trees of their current or former employees.
“There’s always been this bloodline push into the fire department — people who have made this industry their lifestyle, and their kids grow up knowing this as a career path. But there are lots of people in our city who don’t know that; they don’t know about this extraordinary job where they can have a career that’s 25, 30 years long.”
Bonsignore counts herself as one of those New Yorkers back in the day with no knowledge of what a career in emergency services could look like — until her childhood pediatrician encouraged her to take an EMT class. Now, 31 years later, she’s sitting at the top of the organization she once considered a simple summer job.
“I want to pay that forward,” Bonsitnore said of her career beginnings. “I want young women and men out there to know there’s a path for them and they, too, can become commissioner of the greatest fire department in the world.”
‘When you save one life, you save a generation’
Despite early criticism of her appointment, Bonsignore sees her role as telling the story of emergency response in New York City — less simply sharing the novelty of the career field and instead focusing on its influence.
“We have to shift our narrative a little and talk about the impact of our presence,” she said. “We both save and change lives. And when you save one life, you save a generation of people because those are birthdays, weddings, births. You create an environment where you can impact an entire family with your presence, your abilities, your skills.”
That ability to impact others and show up in hard times is what brought Bonsignore out of retirement and what drives her to speak up on the issues that mean the most to those risking their lives for the city’s residents.
“I’m not here to rewrite our history; I’m here to secure our future,” she said. “How could I say no to such a wonderful opportunity? To represent these people is the greatest honor of my life.”
