Orcas Fire Chief Mike Harris wants a sure thing.

When life-saving medical treatment is needed within minutes, not hours, and the Eastsound airport is a whirling whiteout of snow or fog, there aren’t many options.

Which is why Harris has suggested that Orcas Fire consider buying its own emergency response vessel.

“Since the board decided to pay off the bond early, almost all capital budget items will be axed, especially the large ones,” Harris said. “I support that. But in the big picture, a boat is needed by Orcas now and will be needed even more later. It is simply a concept whose time will come eventually. I’m presenting it so that the board is aware of the need. It is also a chance for me to gauge their support.”

If Airlift Northwest or San Juan’s Island Air Ambulance can’t bring in a helicopter or airplane to take a patient to the mainland, emergency responders now call the Navy or the Coast Guard to lend a lift. But even daring military pilots get grounded by weather sometimes.

The next possibility is the county sheriff’s boat the “Guardian,” a last resort for speedy transport to a mainland hospital. But Orcas emergency responders never know when the sheriff’s boat will be out of commission when patients are in desperate straits.

“When you have an option of last resort, you’d better make sure you can count on it,” Harris said. “We’ve already called for the boat at least twice (over the last year) and it’s been busy. While it’s good to know that resource is so useful that it’s in use a lot, it raises an alarm flag; how do I make sure my citizens can get that option of last resort consistently?”

Division Chief Mik Pryz reports that Orcas Island EMS used the “Guardian” nine times in 2009, 12 times in 2008 and eight times in 2007.

Sheriff Bill Cumming says it was used for five medical transports from Orcas, six from San Juan and three from Lopez over the last twelve months.

“Two years ago at Christmastime, from Dec. 15 to Jan. 30, there was a really bad winter storm,” Cumming said. “We did 27 medical evacuations (from the county) within that time period.” He said the Guardian is unavailable “very infrequently.”

“I cannot even imagine what would have happened to dozens of people over the years that we would not have been able to get off the island without the ‘Guardian,’” said San Juan EMS chief Jim Cole. “It’s a very expensive option (at $1000 per trip) but absolutely lifesaving. It’s a risky one, usually in some pretty bad weather situations with low visibility, high waves and high winds. We don’t take it lightly.”

Harris’s first step was presenting the Orcas Fire board of commissioners with a budget proposal for a boat to be used for emergency medical response. The proposal was for $250,000, a ballpark number.

“That’s about what the sheriff’s boat cost,” said Harris. “It’s very possible that it could go up from there if the boat is going to be both a fire boat and a transport vessel. I’m fully aware that … the biggest part of the program cost is the maintenance and repair; the cost of a waterborne transport system would be huge.”

Cumming said the county pays, on average, between $17,000 and $20,000 per year on maintenance and repairs.

“Some years it is less, some years it is more,” he said.

Harris said he’s open to other ideas besides Orcas Fire purchasing its own boat.

“I’m not married to the idea,” he said. “We’re taking this approach – we want plenty of time to gather the data. Trust me, someone is going to come up with a blindingly simple (solution).”

He said captains would need to be Coast Guard certified volunteers. Another idea he mentioned was finding commercial captains with boats who might be interested in getting their ambulance certification.

With a hospital coming to Friday Harbor soon, Cole said he anticipates an increased need for medical transport to move patients around the county.

“If we had two ambulance boats here in the county, that’s more ability to serve our residents and get them to the mainland,” he said. “I would certainly applaud and encourage and lend whatever support we could… It would be a way of keeping you out of the skies on windy nights.”