Private ambulance chief says Houston permit rules prevent out-of-state paramedics from transporting patients

A private ambulance chief told the City Council on Feb. 4 that a city ordinance dating from 2011 restricts paramedics and EMTs who hold out-of-state licenses from driving ambulances in Houston and is creating delays for critically ill patients.

Andre Ruby, who identified himself as chief of a large private ambulance service operating in the Houston area, said the ordinance requires paramedics and EMTs to obtain a City of Houston driver permit and, practically, a Texas driver's license. He said the rule led to tickets of $385 for crews who lack the city permit and that roughly 30% of his staffing comes from out of state.

Ruby described an incident in which a 28-year-old cardiac-arrest patient, intubated and being moved to a facility, was delayed while crews were stopped at a receiving facility and an inspector questioned the credentials of a paramedic holding a non-Texas driver's license. He asked councilmembers either to waive the local permit requirement for out-of-state workers or to allow out-of-state licenses to qualify based on certified driving records.

Councilmember Kamen and Mayor Pro Tem said they would follow up with the bureau chief of the health department and have staff contact Ruby to discuss the ordinance and possible administrative fixes. Kamen clarified that the matter concerns private hospital-to-hospital transports and other permitted private transports rather than 911 response by the Houston Fire Department.

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Council members asked the health department bureau chief to review the ordinance's operational impact and directed staff to follow up with the company to explore options for permitting that do not impede patient transfers.