In 1991 Harris County Emergency Services District #1 was formed through a majority vote of the property owners within its district. This was done to ensure that adequate funding was available for EMS within the proposed service area. Taxpayers voluntarily approved a 10 cents per one hundred dollar tax on their property to properly fund the service.

After utilizing contract services for the first seven years, HCESD-1 moved in August of 1998 to assume control of the operations which would allow the ESD to more closely monitor standards and provide a higher level of accountability for the tax monies that are spent.

On June 1, 2011 HCESD-#1 discontinued operations as an EMS provider and contracted EMS with the Harris County Emergency Corps.