We are joined today by Councilmember Flickinger, Councilmember Ramirez, Councilmember Alcorn, and staff from Councilmember Evan Shabaz's office, Councilmember Thomas's office, Councilmember Castillo's office, Mayor Pratem Cassak Satum's office, Councilmember Carter's office, and virtually Councilmember Plummer's office.

Did I miss anyone?

I think I got everyone.

All right, we have one presentation today by the Houston Fire Department, and we're excited for that presentation.

If you want to come on out, and you can either sit or stand with stand.

All right, perfect.

Martin is and we're also joined by staff from Councilmember Martinez's office.

Alright, we ready?

We are ready.

All right, good morning.

Um I'm Christine Langis.

I'm a district chief paramedic with Houston Fire Department.

I'm gonna have Ashley Mackey, engineer operator paramedic, and Tim White over here, uh Senior Captain Paramedic, who have been my really big boots on the ground with getting this program set up.

Um I want to thank you for the opportunity to introduce to you a new division within the Houston Fire Department, the Proactive Needs Division.

The top five departments in the country have expanded their EMS paramedic roles with some sort of mobile integrated health program to help their communities at large, and we, the Houston Fire Department, want to do that.

The assistant fire chief of EMS Matt White wants a robust program to help Houstonians, your constituents, the Houston Fire Department, and the city at large.

My responsibility is to oversee the development.

And the next slide, please.

Um team.

From our medical director, Dr.

David Peirce with Oversight, through support of our fire chief, all the way down to uh everybody else that's on the team, Nefertari, Jeff, Thomas, Ashley, Mike, Siobhan, and Sundown.

We are a small team, but we are mighty.

We wear multiple hats at EMS.

Everyone has played an integral part and continues to play an integral part in this division's development from data analysis, MOU development, meeting with outside entities for collaboration, and constituent phone calls and home assessments.

Next slide.

We identify sociological needs, improve access to care, and reduce the number of 911 calls through proactive consumer-centered solutions.

Next slide.

HFD Proactive Needs Division has four areas that we're working on.

And the first one that we're really focusing on is the residential high utilizers.

These are the individuals who have called 911 more than eight times in a year.

We want to be able to optimize their quality of life through linkage to care.

Down the road, we're going to start looking at commercial establishments, both private and public that have a high 911 usage.

We want to be able to identify opportunities for improvement and educate these entities about the call volume that they generate.

The event assessment.

This happens when we have severe weather, whether it's a hurricane freeze or snow, and it will happen when OEM gets stood up.

We will form assessment teams.

So when we get dispatched to a call, the apparatus may get on scene, and instead of it being a sick person, they just need a ride to the shelter.

So instead of staying online and being on held hold with 311 to get the ride set up, they'll call a specific number that's associated with us, and we'll input the information for Z Trip in it's a quick turnaround.

They're back in service, and we get a ride for your constituents to go to the shelter.

And then last but not least, and this is down the road, um, is actually a mobile integrated health program.

And then last but not least, and this is down the road, um, is actually a mobile integrated health program, um, and it can go a variety of directions, but that's going to be up for discussion here in the future.

Next slide.

Our goals identify, collaborate, empower, advocate, prevent, and decrease.

All of our goals are interconnected, and they're all required to be effective.

Identify.

Our IT experts use image trend software to gather and extrapolate data to ascertain patient needs, call volume amounts, and other statistical data that's needed.

Collaborate.

We seek meet and collaborate with outside entities to assist Houstonians.

We partner with public and private entities to deliver a full spectrum of services.

Empower.

We empower your constituents to take an active role in their health and wellbeing.

Advocate by accompanying them to doctor's appointments, verifying insurance, planning and setting goals, and calling on our partners in care for additional resources so that your clients can be seen and heard.

Prevention.

Part of the solution is health maintenance.

We provide ongoing outreach to ensure that a quality of life is continued.

And additionally, in the end, we get decreases in the uses of city resources and budget, wear and tear on HFD vehicles, and hospital resources will happen.

With all these combined, we will be part of the top five fire departments in the nation with a community paramedicine mobile integrated health program.

Next slide.

So these are numbers.

So the gray bar shows the total incidents for year, which combines fire and EMS.

Blue is strictly EMS incidents.

Green are the fire incidents.

And you can see between 2019 and 2020, we had a little decrease due to COVID, and then come 2022 on up, it's just exponentially gotten greater, and it's going to continue to get greater.

Ashley.

Aside from that, you may wonder why fire incidents are green.

That's because fire prevention is working.

That is an actual good thing, and that's why the numbers are low.

With what we have going on, they'll continue to be low even with the outbreak and increase in fires.

However, the EMS incidents are on a rise, of course, and not to sound doomsday, but an estimated 1.7 million people are supposed to lose coverage.

Aside from that, we have, for example, Memorial Herman nursing home closing down.

We have different free clinics closing down, things like that.

So it's getting tighter.

However, we do have a wonderful opportunity to assist the constituents.

And but if you could please just take note of the numbers, they are on a rise.

Okay, go ahead.

So just uh by the numbers infographic, we have identified about 18 over 1,800 uh high utilizers of 911, and that inclusion criteria is they dial 911 eight times or more per year.

Um that year is a 365-day period year.

Um we have a mighty team of 12, now 13.

Um, they do have their, we all have our own positions and duties, so this is in addition to our own duties.

Uh, and also this staggering statistic about one in 10 calls received by OEM is a high utilizer.

So that right there shows the need for this team and program.

Um, also the main thing is all city council districts are affected.

Um there's there's no one that is left out.

So we are working on it.

So thank you all for being here and looking at this.

Next slide.

Yeah, yep.

So, couple of success stories.

Um, Miss L, just to we are HIPAA, we want to make sure we're HIPAA compliant.

Miss L is someone who is ongoing, just to show you on the right, the call volume in 2024 was pretty high, 55 times.

When you think about it, how many times do we as constituents call 911?

It's not that many.

However, this person is called 911 55 times in 2004.

2025, it dropped down to 22, and then once we intervened, so far it's been zero.

And that's because we have walked her through her care, what she needs, as well as doctors' appointments to get her on a better road to longevity.

So we had we advocated for her at Memorial Herman.

We switched her over from the planned um sub insurance to actual traditional Medicare.

And after that, she was able to actually get the approval to get the her surgery, which was a spinal laminectomy.

She got that done.

She since went to rehab rehabilitation center, and she was doing well.

She has had a setback.

So we do have a 90-day model that we use.

However, it's not we don't cut them off at 90 days.

Once you sign up as a client, you're always a client.

So if we see that the call volume goes up, or you identify or they identify a need, then we will continue to help.

So it's not 90 days, you're done.

That's not how it goes.

So next slide.

Ums B.

So the way that we discover these clients is either through our data analytics or through the HFD responding units.

They'll send us an email to say, hey, this person needs help.

And what we'll do is we'll go and identify a need through our data analytics on the back end, and then we will go out, make contact with the patient or client at that point.

If they want to sign up, which so far we have a hundred percent sign up rate, um, then we'll sign them up and get them started to see what they need and address everything.

So this was a 16-year-old pediatric patient.

Um she has been through some traumatic things, and while she was at school, we actually co-responded with um the Harris Center.

Um the Harris Center um has a psychologist on staff, so we responded with her to the location, spoke with the mother, and by the end of that day, she was set up with a program.

Okay, she was set up with the program that will bring treatment to her door.

So she did not have to go, she doesn't have to go to um a location, you know, she can sit and be comfortable and actually talk about what she's going through.

Since then, she's now thriving, she is now um doing really well in school, and that one time you see down at the bottom, the post PCNT support.

That one time she actually was routed to 988.

She's dealing with mental health issues, and she was actually she actually called the correct number for her situation.

So um, and got help right then and there.

So it's a positive thing.

We we go, we don't go for perfection, we go for betterment.

So um, since then she's doing well.

Next slide.

Miss S.

Um, she was having trouble walking.

She when we when we showed up to her door, she was on oxygen and she was smoking.

So of course, we were just like, hey, that's not a good thing.

So what we did was we uh got her into a smoking cessation program.

She also um had insufficient food.

So uh the church without walls gave us a hundred dollar gift card.

We were able to buy the run one ingredient food items like flour to make you know, crust and bread, sugar to you know, mix with the flour to make things.

So um it lasted her two weeks.

Her brother um was also in issue, had an issue, so um, we got him job support as well through Texas Workforce Commission.

So even though we're dealing with a patient or a client, if there's someone else in need, we will help them as well.

Next slide.

So these are currently all our partners in care.

We're working with them to um bring the services that your constituents need to them.

And hopefully it will grow.

Next slide.

And that's pretty much it.

Thank you for your time.

Anyone have any questions?

Thank you so much for the presentation, all of the great work you do.

Um we were joined at the beginning of the presentation by our vice chair um councilmember Jackson, Councilmember Davis, and Councilmember Huffman and staff from Councilmember Keaton's office.

And we do have quite a few council members in the queue.

First, uh Councilmember Vermeer.

Uh thank you, Madam Chair, and thank you all for the presentation.

I think it's a great idea to reach out to those folks who are calling 911 the most frequently and see what you can do to help and reduce the number of 911 calls.

I'm curious to know, and I may have missed it during the presentation.

So if I have a medical emergency and I need to be transported by ambulance, um I'm gonna get billed for that, and hopefully I've got insurance.

I'm curious to know when you intervene like this uh for the folks who are frequent callers, um, is is there a charge?

And if so, who who pays for that?

No charge?

No charge.

Okay, okay, great.

Uh also um on this slide that had the fire department run volumes.

Um, you know, relative to EMS calls, the number of fire incidents is is very low, but it has risen um since 2020.

Uh in 2020, there were 43,000 uh plus, and last year uh it was up to 59,000.

And I was just wondering if you uh had any uh thoughts on the reasons for the increase in fire incidents.

Can answer that one morning again, seeing Captain uh Fire Department.

Uh when we look at the the fire, if you could just speak into one of the microphones.

We look at the fire increased calls, it's not just fire itself, it's always a breakdown in um uh fire alarms, uh gas leaks.

Uh that's increased both the actual fire itself.

Uh if you look at the percentage rate, it's 88%, maybe to 12% of fires.

Fires used to break down, maybe it was like five or six percent of actual working fires that we actually have in the city.

Uh everything else again breaks down to fires on the fire alarms, uh gas leaks, as uh Ms.

Mackey says that's why you see that increase, but not actual working fires.

So so do you think the increase has been largely due to alarm alarm calls then, not fire?

Not fire, no.

More alarm calls again, like gas leaks again, and that's what we attribute that to.

All right.

Um let me ask you as well.

Uh the EMS numbers and the fire numbers, they include calls that are made uh out to the toll road.

Calls on the toll roads.

We typically don't respond.

Do we respond on the party?

So yes.

Yes, we do.

Depending on the all right.

And do you happen to know how many uh what percentage of those calls listed on the slide would be toll road calls?

I do not have that answer, but we can report that.

Yeah.

Okay.

So uh, and last thing I want to touch on is um when we look at this dark blue column for EMS incidents, 357, almost 358,000 in 2024.

On those incidents, did a fire truck go out as well as an ambulance.

Most of the time, yes, because we do have a tiered response.

So yes, sir.

Okay, I can't give you specific numbers, sorry, but um most of the time.

Can we get to the point where we we don't have to send a fire truck out on these EMS calls, do you think?

We would love to get to that point, but that's something that obviously requires further discussion in I sort of part of dispatch, um, it's hard to come up with an answer.

Okay.

So do you any of you have any thoughts on how we might do that?

Any thoughts?

Take concerted effort.

Thank you, Bernard.

We're just gonna bring the whole station up here and uh we'll we'll get you the answer one way or the other.

Um so uh to to what EO Mackey was uh mentioning, we have a tiered response, and so there are certain search circumstances where um the way that it's dispatched will depend on uh both proximity and availability of resources.

So if an ambulance is being used for a transport, and then we also have tiered response within the ambulances, right?

So we have ALS and BLS.

Uh ALS is advanced like advanced life support, BLS is basic life support.

They have different capabilities um within their expertise and the resources available on the apparatus.

And so um there are circumstances where let's say it's uh uh motor vehicle accident, and um the fire truck may get there first um as part of the response, and they can begin um EMS support.

They can because all of our firefighters are EMTs as well.

And so they can begin basic level care uh and then it's possible that maybe they just had a banged up knee, maybe they just needed you know a band-aid or something like that, and they don't even need an ambulance.

So that's part of why we have the the mixed uh dispatch protocol like that that includes both uh EMS and fire to these EMS calls because everyone is uh cross-trained to a certain level and they can triage the cases because uh and I know Dr.

Purse is here in the audience, he can tell you all about the uh resource management.

Our our ambulances go into what's called resource management, which is when we have 20 percent or less availability for response, we do that every single day.

Um we are at a situation where and that's really the the crux of what this Proactive Consumer Needs team is about is to lower the number of uh resources that are required, right?

So uh these whether it's through the uh consumers that we're talking about today or the next phases where we start looking at uh uh commercial properties and things like that.

It's all this whole program is designed to reduce the impact on resources.

And so we do that in several different ways through the dispatch model through the Proactive Consumer Needs team and and many other things.

All right.

Thank you for that, Brent.

Councilmember Alcorn.

Thank you, Chair, for bringing this.

This is really interesting, and I'm really so glad that we're doing this.

We've been hearing about these frequent flyers for a long time, and and you're being very proactive about how to how to handle them.

I'm as always I'm interested in the money, and it's probably how how long have y'all been doing this?

I don't think we're quite at a year.

So you don't really have the data, Dr.

Pearce yet to tell me how much money we're saving on all on um not going out to all these calls, but that's the ultimate goal, and again to Councilmember Ramirez's point to to save on the the resources.

And and and truthfully, if if somebody in my house having a heart attack, I don't care if a fire fire fire engine.

I want the closest person to come.

So that's why fire fire engines come, people get mad about it, and it does cost more, but until we have a million more ambulances or a lot more ambulances, their fire engines are gonna have to come.

Uh but but this is a great way of of getting to that.

So um to the extent you're able to quantify, you know, what this is saving, I would be interested in seeing data to that to that effect.

Um if you have any yet, or if uh yeah, as as as you operate longer, um that's certainly important.

And on the commercial side, you're you're just kind of starting that aspect?

Yes.

And just okay.

So we hear often about um nursing homes who are called, you know, that you have to go a jillion times to to break the nursing homes just to really lift somebody out of off the floor.

Yes.

Um I'm assuming you're you're gonna tackle that in this that through this program.

Let's correct.

Okay, great.

And and do you have to be trained and and and educated, I guess, on a lot of the insurance matters?

You're so you're becoming insurance specialists, it sounds like no, not so far.

Um all we do is call the 800 number.

A lot of times these are Medicare and Medicaid recipients, CMS.

Okay.

So we can call, and once we call and get authorization, um, we call with the client right there.

So they can give that authorization right then.

And so then we call to say, hey, what what do you what is this client have?

Like do they have transportation to and from the doctor?

Is that something that's okay?

So you're basically sitting on the phone trying to figure it out for them and doing that job for them.

Um which is time consuming, as we all know when we've ever anybody that's called an insurance company.

So thank you for that.

And there is a call, although you're saving on on one side, it is it is a cost certainly to the department.

What about how much time is allocated?

I mean, you you all are doing your regular jobs at your other at your stations, and then how much time is allocated.

So all of us here are assigned to EMS headquarters, which is at 500 Jefferson.

So you're not at a stage station.

But we all have multiple responsibilities for EMS on that floor, and this is in addition to what we already do in the first time.

And if you could put an an hours per week um on this project, about what would that be?

And if you could put an an hours per week um on this project about what would that be well, our IT subject matter expert um spends about 10 to 12 hours a day outside of work.

I know there's only 24 hours in a day, but um he spends about 10 to 12 hours working on that.

Um as far as data goes, the analytics, we spend about eight to ten hours a day in addition to our regular ship.

Well, is that then you're into overtime or what what's how's going on?

This sounds like a 24 hour operation.

I mean, I'm just trying to get a handle on, you know, we're saving money, big money on the resource side.

Right.

When you when you cut down from 55 to zero calls.

Um so it's probably nominal compared to that.

But I I do want to have a better understanding of kind of what um what uh additional expense or whatever this might be um personnel wise.

I think I mean obviously we're in need of more people to uh tackle what we're doing.

Um like I said, we're small and mighty.

Um we're gonna do what it takes to get this done.

Uh we don't get overtime for the extra hours we put in, but um we do hopefully allow our people to take comp time if they put extra hours in that you know I want to leave an hour early.

I'm gonna let you do that.

Um but yeah, the data analytics has I'll just say it's kind of a nightmare.

Yeah to set up the uh formula to run this the the data um that could take several hours just to run it, and then to have to break it down into what pieces we want.

It's just very time consuming.

Okay.

And what's your timeline on getting to those that last the the mobile applications and the other stuff you're trying to do?

The four steps.

Yeah, it's gonna be dependent on the staffing and how quickly we can you know we still have some stuff we're trying to get set up um just within the program itself to be successful.

Um we're waiting on other people to finish their parts.

Okay.

Um so another couple years maybe okay.

Thank you very much.

Sure.

Councilmember Division.

Thank you, Madam Chair.

Thank you for your presentation.

Uh excellent uh, you know, social input from the the fire department to the community.

I had a friend uh long time classmate, grew up in the same neighborhood there in third ward.

I think that's near fire station, is it 25 off of Leland and in that area?

Yeah.

We grew up together, Elmo Dallas Board, and he was one of the firefighters that led the program with furnishing um smoke uh detectors, Captain White, you know exactly Elmo, and it was a phenomenal program.

Um so are you is the fire department continuing that uh program, sp particularly with senior citizens.

That was the whole focus of that, and I would be interested to know if that's ongoing.

Yep.

So the Get Alarm Houston program is still in uh part of the fire department.

It is uh we get we get the fire the smoke departments uh the smoke detectors from Kitty is the name of the company, K I D D E.

And um that's run through our public affairs division.

Okay, we do that both for uh traditional smoke alarms.

So anyone who uh owns their home uh and is you know that they they need help getting that.

We there's the very, very low threshold.

You just express the need and we'll come out and we'll take care of it for you.

Um and then there's also if you have uh um hearing issues, if you have a disability for to where a traditional smoke alarm wouldn't uh alert you.

We have smoke alarms for the deaf and hard of hearing that are that include things like strobe lights and bed shakers, and those are all available if you go to uh Houston Fires website, Houston TX.gov slash fire, uh you can go on there and there's a form to fill out and we'll come out and install them for you.

Good, good.

Well, I certainly will keep up on that because I like to know if the ratio is, you know, if it's annually, how many uh smoke detectors that you're putting in the homes and hopefully we could use that to work with the fire department with many of the organization groups to to advocate that over pool pits or community organizations.

I can email you uh the numbers from the most recent fiscal year.

We can if you want to get involved in that and kind of do some outreach for us, we're we're more than willing to.

I love it.

All right, but thank you.

Also, the team has um use get alarmed as well.

Uh Councilmember Flickinger.

Uh we went to a house there and actually installed smoke alarms in one of the homes of the um 1855 that we've identified.

So um it works.

It's pretty quick, and um it's there.

Councilmember Flickinger.

Thank you, Madam Chair.

Thank you for the presentation.

Um I actually went out to a home with uh two of these people here about two months ago, I think.

And uh it was one of the frequent flyers, and uh was uh a little shocked at uh kind of the lack of initiative they were taking to take care of themselves.

Uh so I I think this this really helps.

And it was also uh this kind of stemmed out of a meeting that I had with the the fire department uh probably about a month before that, where we were initially looking at uh some equipment that was a little different than Nashville is loop using, uh some smaller fire trucks on an F 650 chassis, uh, rather than the huge fire trucks that we've got, and they were able to save money with that.

And that's when they started talking about uh the number of lift assists that they go out to.

And that number was through the roof.

Um to Councilman Alcorn's point, a lot of it was at these senior living centers.

Um, you know, where they don't want to uh actually lift up their customer, essentially themselves.

Um so, and then I guess they actually said that uh there's corporate directive from some of these senior senators, uh senior centers not to actually assist these people, which kind of blows me away that they would have one of their residents lying on the floor.

Um, you know, I I can certainly see if there's a medical reason not to lift them.

I I don't understand if if that's not the issue and they just need assistance up.

But yeah, they would really like to see the numbers on that and and how many of the people actually ended up needing medical attention afterwards versus how many of them just needed assistance getting up.

Um, you know, I think we certainly should look at uh some kind of charge for that, even if it's nominal, uh, to where you know maybe people will take a little initiative on their own to get back up rather than having the the fire department have to come out and make calls.

I think this whole initiative is fantastic.

Uh if you know obviously we're we're tapped with resources, uh constantly trying to get more resources.

I mean, it's been a huge effort with the recruiting, so anything you can do to reduce the volume obviously impacts the demand on your resources as well.

So thank you very much, and and please keep up the good work.

Thank you.

Just to clarify, um, nothing against nurses.

I'm a nurse, but um in the nursing homes, if a patient falls, they do not have the capability to see what's going on inside.

It could be a brain bleed that suffered and they can't see what's going on.

So they do they may need to go to the hospital.

They are limited in what they can do and what they can see at their level.

So it is understandable that they would transport the patient out.

But it's the amount.

Everybody same thing.

It's the amount of times.

The higher the amount, it doesn't mean that they're not doing what they're supposed to do.

However, it's a bigger problem with medical across the board.

Everyone is short staffed.

So it puts us in a juxtaposition to try to figure out how to best serve the community while you know making sure our resources are still intact and not having to go into resource management every day.

So it's not that they're not doing what they're supposed to do.

They are short staffed.

No, I understood.

And that's why it'd be great to get the data as to how many of the lift assists actually require medical transport.

Vice Chair Jackson.

Thank you, um Chair, and thank you all for the presentation.

Great presentation.

Thank you for the great work that you're doing.

Um I think every department should have navigators um navigating people, connecting people to resources.

So I'm happy to hear um that you all are doing this.

Um I'm gonna give a shout out to Tim, Ms.

Tim White.

Um District B represent.

Um so just one question, you probably don't have the answer to it, but it goes into the the data.

Um I know HPD have similar situations to where they're getting frequent calls and they have to go out to a call, and that takes them away from the real work.

Uh and so as you look at your frequent callers, and I know when person called 911, sometimes HPD have to um show up to some of these calls.

And so I'm just curious what percentage of the frequent calls require an additional department to show up.

And so um I know you don't probably know how the numbers, but does this really look at how it's impacting um other departments like HPD?

Um that's one of the complaints is slow response with them, but they're dealing with unnecessary calls, and so um, yeah, just curious to know that.

But again, thank you for all your work, and yeah.

Looking forward to it.

Thank you for that.

We will look into that and get no one else is in the queue.

Thank you so much for the presentation and all the great work you do.

Thank you, Dr.

Peirce, also for being here today.

Um, we will move on to our public speakers.

Um, first up, Dominic Mazoc.

I don't see him here.

Was there anyone else here that wanted to speak?

All right.

Um, next public safety committee meeting will be on Tuesday, September 9th at 10 o'clock a.m.

We stand adjourned.

Thank you, everyone,