The city of Fair Oaks Ranch will enter a contract with Bexar County Emergency Services District No. 4 for emergency medical transport services.

This contract follows the upcoming expiration of a contract with Acadian Ambulance Service, which is expiring at the end of April. The contract with Bexar County ESD 4 will be effective April 1.

The overview

According to the agenda, the proposed $6,125 monthly payment to ESD 4 is a budgeted expense for fiscal year 2024-25. This payment is identical to the prorated portion of the expiring agreement with Acadian.

This proposal outlined provisions for Medical Intensive Care Unit-level ambulance services, operational response times, service expectations and financial arrangements.


For residents, this means that the ESD will be responsible for ambulance services alongside services currently provided.

What they’re saying

Council member Laura Koerner raised concerns on March 6 about the services being provided when compared to the previous contract with Acadian.

Koerner asked whether the services in the new contract with the ESD would result in an increase in services provided by the ESD, since the city already contracts with the district for fire-related services.


ESD Fire Chief Craig Ramon explained that the ESD has added 12 positions to staff the ambulance positions, which provides two people per ambulance.

Ramon said the city will still get the same services provided that were included in the other contract, as well as the two additional people with the ambulance service.

“We are not rolling with the same people, we have added four people per shift with those ambulances to respond with those first responders that have always come before,” he said.