The Olive Hill Fire Department stands to gain the most because volunteers would run its service.

According to its certificate of need application filed with the Kentucky Cabinet for Health Services, the department expects to make 900 emergency and 225 non-emergency runs annually.

The department estimates those runs would bring $337,500 in revenue for 2001 and $364,500 for 2002. Total operating expenses for each year would be only $20,000.

Olive Hill Fire Chief Rodney Stephens said the department based those numbers on an application the state approved for Advanced Care Transport and Training, a former Carter County ambulance service which went out of business in 1998.

The department might have to revise those numbers down a bit, he said.

Any money the service earns would go back into the fire department budget to buy more equipment or provide more service, Stephens said.

The department already extricates patients from auto wrecks and stabilizes them — everything an ambulance service does except take them to the hospital, Stephens said.

``We do all this for free for them now," Stephens said, referring to the Carter County Emergency Ambulance Service.

The fire department does this because Carter County EMS sometimes doesn't have an ambulance immediately available, Stephens said.

If the state allows it to start an ambulance service, the Grayson Fire Department expects to make 1,375 emergency runs per year, according to its certificate of need application.

The department bases this figure on runs it and neighboring ambulance services have handled when Carter County ambulances were tied up, the application says.

The department expects to earn $406,450 in 2001 and $443,300 in 2002 from ambulance runs. But with a paid staff, after covering expenses, it would only have $2,500 left in 2001 and $12,500 in 2002.

Members of the Our Lady of Bellefonte Grayson Outreach Center wrote a letter supporting Grayson's application, as did Dr. Sanjiv Gupta of Grayson.

Both letters told of times when critical patients had to wait for transportation to the hospital because Carter County was unavailable.

Fire department emergency medical technicians can hold patients, but can't transport them until Carter County EMS becomes available, Dr. Henry Adkins wrote.

``This seems illogical and perhaps even dangerous," wrote the Grayson doctor.

Carter EMS Administrator Gary Stevens has said he will oppose the Olive Hill and Grayson applications.

Stevens successfully opposed Paramedic Emergency Ambulance Service Inc.'s application in February to expand into Carter County.

PEASI had wanted to do only non-emergency runs, but a state hearing officer ruled that PEASI had overestimated the need.

People should not look at the situation as a competition for patients, Olive Hill's Stephens said, because all the services involved would be taxpayer supported.