Houston Needs to Add 10 Fire Stations, 65 Ambulances and 12 Companies as City Grows, Report Shows

Jun. 12—Houston Fire Department is responding to more emergencies than it has resources to efficiently handle, according to a new analysis that found rising demand has left the department falling short of national response standards.

The report, presented to Houston City Council's Public Safety Committee on Tuesday, revisits longstanding concerns about whether HFD has enough personnel, stations and ambulances to meet growing demand for emergency services.

The report by the International Association of Fire Fighters examined city data and found the average number of daily incidents increased 34% for fire calls and 21% for medical calls from 2018 to 2024.

The study recommended Houston build 10 new fire stations, place a new fire truck and crew at each one, add two ladder trucks, and staff 65 additional ambulances.

"These aren't demands," said Houston Professional Fire Fighters Association President Marty Lancton, who helped present the report. "It is a conversation that's saying we have to invest in and grow a department that is in high demand and continually runs more calls every year."

The report also found the department continues to fall well short of national response-time standards. National standards call for the first emergency unit to arrive within four minutes to 90% of incidents. Houston met that benchmark on 29% of incidents in 2023 and 2024, according to the report.

The department's medical workload has also increased. During the study period, more than half of the department's ambulances and medic units were unavailable when new medical emergencies came in, far above the recommended 30%.

Mayor John Whitmire's office but did not respond to a request for comment, and has not responded to requests for comment from the Houston Chronicle since August.

Whitmire's office previously told KTRK-TV the report does not reflect departmental reorganizations and audits conducted after he took office in 2024.

Whitmire and the firefighters union that year reached a deal to end a contract stalemate that had dominated city politics for nearly a decade. The agreement included $650 million in back pay and raises over the life of a five-year contract.

That agreement improved recruitment and retention, Lancton said, but he argued the department still needs a plan to improve services over time.

"You can't keep doing more with less," Lancton said. "You have to have a roadmap for it."

A decade of studies

The recommendations revive issues raised in previous studies of the fire department.

A 2016 FACETS Consulting report commissioned by the city found HFD was missing national response-time objectives and recommended expanding the department's ambulance fleet and adding fire stations in the Meyerland, Northline and Minnetex areas.

Then-Mayor Sylvester Turner criticized the report at the time, saying its recommendations would require additional spending. The union's new analysis says Houston has added only five peak-hour ambulances since the 2016 report, despite continued growth in call volume.

A separate 2018 report took a different approach, recommending broad changes to city government to cut spending and raise revenue. Among its suggestions were reducing the number of fire stations, hiring civilians for some duties now done by classified firefighters, and requiring firefighters to work longer schedules.

While some recommendations such as raising ambulance fees were adopted, many of the larger proposals — including calls for additional stations and ambulances — were never fully implemented.

District-wide recommendations

The new report tailored its recommendations by city council district.

District D would receive the largest investment, with four new fire stations and 12 additional ambulances. District H would receive two new stations and nine ambulances. Districts A, G, J and K each would receive one new station.

Other districts would receive additional ambulances or ladder trucks but no new stations. District B, for instance, would receive nine ambulances but no new station. District C would receive two ambulances and one ladder truck. 

The report also recommended improving dispatch protocols and increasing use of Houston's Emergency Telehealth and Navigation program, known as ETHAN. The program allows some 911 callers to consult physicians through telemedicine rather than being transported to an emergency room.

Serving a patient through ETHAN rather than making a hospital trip saves roughly 50 minutes for the responding unit, the report found. But ETHAN patients declined from 2,805 in 2018 to 1,330 in 2024.

Lancton attributed the drop to inconsistent funding, physician availability and program support during previous mayoral administrations. He said the city has reinvested in ETHAN and is pursuing a community health initiative aimed at reducing repeat 911 calls from people who need help navigating health care or social services.

Mike McEvoy, a former EMS official in New York, said telemedicine diversion programs can reduce strain on ambulance systems but often face barriers, including reimbursement issues, patient skepticism and reluctance from paramedics who may initially believe the process takes longer than a hospital transport.

McEvoy said paramedics often come to see the benefit once they compare time spent with a patient on scene to the time crews can lose waiting at hospitals to transfer patients.

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