An ordinance approving and authorizing suspension of Section 4.9 of the City of Houston Code of Ordinances to authorize the operation of certain emergency stroke ambulances by members of the Houston Mobile Stroke Consortium (Consortium).
Specific Explanation:
The Director of the Houston Health Department (HHD) and the Chief of the Houston Fire Department (HFD) request the City Council approval and authorization of an ordinance authorizing the suspension of Section 4.9 of the City of Houston Code of Ordinances to authorize members of the Consortium to operate emergency stroke ambulances for the purpose of pre-hospital diagnosis and treatment of stroke patients.
A mobile stroke unit is an ambulance that is equipped with a CT-scanner and trained staff who can diagnose and provide acute stroke treatment at the emergency site. In 2014, Houston was the first City to have a Mobile Stroke Unit (MSU) in the United States. This was made possible through a clinical trial titled, “Pre-Hospital versus In-Hospital stroke treatment: a Multicenter Randomized prospective Trial” conducted by the University of Texas Health Science Center at Houston and the City of Houston Emergency Medical Services. The trial validated the presumption that pre-hospital stroke treatment based on an ambulance that includes all diagnostic tools required for pre-hospital thrombolysis, can significantly decrease the delay between a 911 call and therapy decision and administration of thrombolysis (a life-saving procedure that dissolves blood clots in vital organs such as the heart and brain) in eligible acute ischemic (blood flow blockage) stroke patients.
The Consortium was established to provide guidance for MSUs throughout the 7-county metro area (Harris, southern Montgomery, eastern Fort Bend, northern Brazoria and Galveston, and western Liberty and Chambers) with the goal of coordinating all Houston area MSU operations, research and education including overseeing staffing, licensing, equipping, quality control, scheduling and other day-to-day MSU operations. The Consortium will include all community stakeholders including the medical directors of all EMS agencies, and the stroke directors of all community stroke centers.
Chapter 4 of the Houston Code of Ordinances pertains to ambulances and Section 4.9(a) provides the following:
“The operation of emergency ambulances on the streets of the city for the furnishing of emergency ambulance service is hereby declared to be a governmental function of the city to be performed by the fire department in accordance with the terms of this chapter. It shall be unlawful for any person or persons, other than members of such fire department in its classified civil service, while driving emergency ambulances operated by the fire department, to furnish or to attempt to furnish emergency ambulance service or to operate or drive or cause to be operated or driven any ambulance on the streets of the city for the purpose of furnishing emergency ambulance service.”
Because the MSU clinical trial resulted in better health outcomes for individuals that were treated by MSUs, Houston Fire Department EMS and HHD fully support the suspension of Section 4.9 to enable the MSUs to operate for the health and safety of the Houston community.
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Stephen L. Williams, M.Ed., M.P.A. Fire Chief Samuel Pena
Houston Health Department Director Houston Fire Department