The resolution also reaffirms the commission's decision to convert the county-owned 25-bed San Juan County Hospital in Monticello from an acute care facility to an urgent care clinic when the new Blanding hospital opens.

The San Juan Hospital will not be affected until the nine-bed Blue Mountain Hospital is operational, a process that could take up to two years, said commission Chairman Lynn Stevens. But once the change takes place, San Juan Hospital will function solely as a clinic, stripping the facility of its ability to keep patients overnight.

"If they move us to urgent care clinic and we remain at that, we would definitely not be able to go forward," said San Juan Hospital CEO Duncan Lyman in an interview Monday evening. "That would be the death of our hospital."

Stevens explained to the crowd of about 50 people who attended Tuesday's public hearing that for the new Blue Mountain Hospital to qualify for guaranteed loan insurance through the U.S. Department of Housing and Urban Development (HUD) - a necessity, Stevens said, for the nonprofit Blue Mountain Hospital Corp. to go forward with the facility - there cannot be another critical access hospital within 35 miles of Blanding.

The San Juan Hospital in Monticello is about 15 miles away. The hospital was granted critical access hospital status from the state about two months ago and is waiting for federal designation, which allows the facility to receive Medicare reimbursement at a higher rate.

The commissioners said Monday that they believe the commission can find a way to keep both hospitals open, but Stevens said he cannot guarantee that will happen.

He said once HUD issues the loan guarantee insurance, "they step back. So the San Juan Commission could reverse the vote at a later date after HUD has insured" the Blue Mountain project, but for now, he said, the commission must pass the resolution and get HUD guarantees, "so this doesn't appear to be only a sham."

Many residents from Blanding and the southeastern part of the county voiced strong support for the Blue Mountain Hospital, saying the facility is needed to provide health care for the entire county.

Some residents of Monticello said they do not want to see the county hospital close and asked for assurances from commissioners that they will work to keep both hospitals open and functioning as full service facilities.

Monday's vote follows a contentious Oct. 2 meeting in which San Juan Commissioner Bruce Adams charged that Commissioner Manuel Morgan should recuse himself from voting on the hospital issue because Morgan serves as a member of both the Blue Mountain Hospital board and the Utah Navajo Health Systems Board, and receives an annual salary to serve as the tribal liaison for the Navajo Health Systems Board. In 2005, according to the agency's federal disclosure statement, Morgan received $55,000 for the liaison job.

Morgan, who has been a staunch supporter of the Blanding hospital, said during an emotional speech Monday that the Blue Mountain Hospital is necessary to provide services to residents of extreme southern San Juan County, particularly those who live on the Navajo reservation, who otherwise are underserved or have no health care services available at all.

"As native Americans, we've never had the opportunity to be involved in health care until five years ago when we set the stage to be involved," he said, referring to the Navajo Health Systems' support for the Blue Mountain Hospital. "I'm here to represent all the county, and to make decisions that will benefit all the county."

Stevens opened the public hearing by reading a statement that castigated Adams for raising the allegations, characterizing them as a "shameful, vicious, unresearched, unsubstantiated and inappropriate attack on a fellow team member." He called for Adams to publicly apologize to Morgan and "to represent the people who elected you by voting in favor" of the resolution.

Stevens also chastised some members of the public who, he said, "emphasized their points with insults, foul language, and disrespectful tones." He likened public reaction at the Oct. 2 meeting to "a pack of wolves seeking destruction of one target of prey - Commissioner Morgan."

Adams apologized to Morgan for "causing harm to your character or to you personally," and said his intent was only to point out the possible legal ramifications of Morgan's participation in the vote.

After the meeting, Adams said the commission has wasted enough time consulting attorneys regarding whether Morgan's work constitutes a conflict of interest.

Several attorneys have offered differing views on the issue, and Adams said it is time to move forward with the county's business.

"I don't want to rattle the sabers, I don't want to bloody anybody's nose anymore, and I don't want mine bloodied anymore either," Adams said. "I want to see positive progress toward good health care in this county."

lchurch@citlink.net