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.