But the administrator of the existing county-wide service said they can expect a fight.

Carter County Ambulance Service currently handles all ambulance calls within the county. If applications from Grayson and Olive Hill are approved at the state level, their fire departments will be allowed to operate ambulances when the CCAS can't respond.

``What we're wanting to do is not a competition, but a back up," Olive Hill Fire Chief Rod Stephens said.

Gary Stevens, the administrator at CCAS, said that may be the case, but if the state approves each group's application, known as a certificate of need, they will be in position to open full fledged ambulance services of their own.

He vowed to fight them.

``My position is if we have a deficiency in ambulance service we need to upgrade, we don't need to add services to supplement," Stevens said.

Fire officials in both cities insist they're not out to harm Stevens' operation, they just want to be in position to better serve their residents. The department's rescue squads already respond to the same calls so, they argue, why shouldn't they be able to take the next step of transporting the patients they treat.

Dennis Midkiff, a paramedic who also serves as a captain with Grayson Fire and Rescue, said more than half of his department's call volume in recent months are mutual aid assists to the ambulance service.

``We don't want to compete, we just want to transport," he said. ``We want to provide service in times of emergency," he said.

Patients from the county must be taken elsewhere, since there is not a hospital located there.

Stephens said each patient transport takes an ambulance out of the county for at least two hours, sometimes longer.

The state's Cabinet for Health Services are currently in the preliminary review stage. If the applications are contested, as is expected, they will hold a public hearing in an attempt to establish whether need for the services exists.

A final decision could be reached as early as December.

To operate their service Midkiff said his department would rely on four trained paramedics and twice as many emergency medical technicians. Olive Hill has about the same number available to them.

This is not the first challenge CCAS has faced.