The Bastrop County ESD #3 was approved by the citizens of Bastrop County in November 2024.    Prior to the formation of the District, Commissioners Court managed a contract with Acadian Ambulance for the provision of emergency ambulance service.   The objective of the election was to provide a source of funding to enhance the provision of EMS to meet the needs of the growing community and increasing call volume.    The ESD Board would also provide a Board of industry and community leaders to oversee the service contract and work with Acadian's leadership to evaluate and improve care to the community.

Bastrop County Commissioner's Court appointed the initial Board members and the inaugural Board meeting was held on January 9, 2025.    

In May 2025, Bastrop County Commissioners Court voted to assign the Acadian contract to the ESD.   Acadian and the ESD worked diligently to extend the contract through at least October 2026.   The new contract creates a collaborative oversight model, with a new approach to response times and implements a set of nationally endorsed, evidence-based clinical performance standards.   The ESD and Acadian will review performance data monthly, looking for opportunities to continually improve the system.