13 Investigates: HFD short on available ambulances 84% of 2022

HOUSTON, Texas (KTRK) -- Randy Kubosh was getting his second round of chemotherapy at a treatment center in Memorial City when his sister-in-law saw him go into cardiac arrest.

"She said I was shaking. My eyes rolled back in my head, and I laid back, and they started doing CPR, and put oxygen on me," Kubosh recalled. "It lasted a long time. I was - I flatlined. I was dead."

Kubosh said he's thankful he was already in a medical setting, with nurses and doctors who could get his heartbeat and consciousness back during his health crisis on Sept. 1. Without those health professionals, Kubosh said he worries about what could have happened.

13 Investigates found Kubosh's heart stopped just minutes after city records show Houston Fire Department EMS went into what it calls resource management, meaning fewer than 35% of the department's ambulances were available for new calls citywide.

Our investigation found that HFD staffing is down, response time is up, and the department's ambulances are increasingly busy, even as it implements rules to deal with it.

"The slow response time could be a matter of life or death for someone," Kubosh said.

We analyzed data for every day in 2022 and found HFD was low on ambulance availability and went into resource management at some point during 84% of the days, so far, this year.

During 30% of every hour in 2022, HFD dropped into the resource management designation.

"At that time, a certain number of things begin to happen to try and figure out where our fleet is being utilized, what's their status right now, and how can we get them back into the available status to make emergency runs," HFD Assistant Chief Matthew White, who oversees EMS, said.

The firefighter's union calls it a crisis.

"Do we really think that it's acceptable in the city of Houston, in the fourth largest city, the third largest municipal fire department, to gamble on people's lives because we don't want to tell the truth about the resources within the Houston Fire Department?" Houston Professional Fire Fighters Union President Marty Lancton said.

Since 2018, the volume of Houston EMS calls is up 14%, but city records show firefighter staffing dropped by 9%. While HFD tries to make it up with overtime, that's not guaranteed.

The department says that regardless of whether or not they're short-staffed, ambulances get staffed first.

Still, city data shows that since 2018, the time it takes for the first HFD unit to arrive at an EMS call has grown by 90 seconds.

"That is absolutely something you never want to see. In our world, seconds matter. When somebody has a heart attack, or a stroke, or they're in a bad car wreck, or they're stuck in a fire, do you think that they want to wait 90 more seconds? This isn't a joke. These are people's lives," Lancton said.

White said the department goes into resource management most weekdays, usually from 9 a.m. to 6 p.m., when the population is the largest, causing most of the calls to come in.

He said resource management is a tool the department uses to actually keep ambulances on the street.

"The goal isn't necessarily to get out of EMS resource management. The goal is to have our units available to make the runs. By staying in EMS resource management, that's how we accomplish that," White said.

Whenever HFD goes into resource management, White said that alerts everyone in the department, allowing meetings to be canceled, administrative tasks curtailed, and stable patients left in the care of hospital ERs.

HFD statistics show ambulances waiting to drop patients off at Houston hospitals causes delays and contributes to putting the department into resource management.

13 Investigates analyzed HFD data and found it takes an average of nearly 37 minutes to drop off a patient and get ambulances back in service.

When HFD goes into resource management, the wait time becomes shorter because department rules allow firefighters to leave patients at ERs quicker.

"When the resource management ... announcement goes out, units know. You'll have EMS supervisors check out hospitals. If there's a particular hospital with a long wait time, they can go to the hospital, start returning units to service (and) working with the hospital staff (to see) what patients can we get into one of your wheelchairs or onto a chair in the waiting room," White said. "We have protocols where if the patient meets a certain criteria at that time, they can call their supervisor, even if they're not there, and leave the patient in the waiting room. We do announce that to the hospital."

A city-funded study seven years ago said HFD needed to add transport units, build three more stations and maintain more than 3,600 firefighters. A year later, a union study suggested even more growth.

But years later, with far more calls, none of them have been added.

He said the department cannot simply add more capacity during peak hours. Instead, he said, HFD is planning to add paramedics in SUVs around the city to help address the issue. The so-called 'squad' program is one HFD moved away from years ago but is now bringing back.

In Kubosh's case, HFD records obtained by 13 Investigates show it took a standard HFD ambulance 18 minutes to arrive that day. A fire engine, with a paramedic on board as part of a special program, arrived 36 minutes later.

The department disputes that timeline, saying the first engine was on scene in five minutes, offering another document for the same call.

The department's nearest advanced life support ambulance was dispatched 37 miles away in Kingwood and was waved off before it ever arrived.

Kubosh's brother, Michael Kubosh, is a City of Houston council member and said he didn't realize how often HFD's EMS services were low on ambulances until there wasn't one available for his brother during his time of need.

The hospital was less than a quarter of a mile away from Randy Kubosh, yet the nearest advanced life support ambulance was in Kingwood.

"It just doesn't make sense to me. The problem is we're relying on those EMS and ambulances to take our patients and our family members to the hospital or to make sure that they're there in a critical care moment," Councilman Kubosh said. "I have a voice, a vote, and a seat at the table, and I can speak up, and that I will do."

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