Hannibal Regional gets $15 million state appropriation for Kirksville cancer center, but Kirksville hospital ready to add its own radiation equipment

HANNIBAL, Mo. — Todd Ahrens breathed a sigh of relief Friday afternoon.

More than 170 items were struck from the Missouri state budget on Friday, June 29, as Gov. Mike Parson cut $1 billion from the spending plan passed this year by lawmakers. Parson said in a statement he vetoed earmarked items he believed were loaded into the budget for special projects and organizations without considering the state’s future financial stability.

A $15 million state appropriation to Hannibal Regional to build a cancer center in Kirksville was not among those cuts.

“The word on the street was (Parson) wanted to nix 100 different budget items and save the state a billion dollars within their budget,” said Ahrens, president and CEO of Hannibal Regional Healthcare System. “I knew that our region was large, relatively speaking. I mean, we’re not three-laning I-70 all the way across Missouri, but (the appropriation was) large for a nonprofit entity like us.

“We were sitting on pins and needles until we saw the release from the governor’s office Friday about four o’clock that showed our appropriation was still in there. It was pretty exciting stuff.”

The contract has yet to be written, but Ahrens said he expects the governor’s office to request a 50/50 match from Hannibal Regional. Property has been bought at the intersection of Illinois Street and the alternate U.S. 63 route east of the HyVee on the north part of the city.

Hannibal Regional already has made an impact in Kirksville, buying the Complete Family Medicine clinics in that market seven years ago. 

Ahrens said hospital officials began talking with Sen. Cindy O’Laughlin in November if she would be willing to get the $15 million appropriation in the state budget.

“She was (willing), so we worked with our state representative (Louis Riggs) as well as other important politicians down in Jefferson City, to not only get it in the budget but then work to make sure the governor left it in the budget,” he said.

Work remains to be done before any construction begins on a new facility.

A press release from Hannibal Regional noted Kirksville has lacked life-saving radiation oncology services since the summer of 2022, creating “an undue burden on area residents fighting cancer.”  

“Hannibal Regional, with the support of many partners, identified this critical issue and now with state support will begin efforts to offer this life-saving care in Kirksville,” the release said.

Patients in the Kirksville area who need radiation oncology are typically forced to travel to Columbia, Hannibal or Quincy, Ill., for treatments. Hannibal Regional has been offering radiation oncology services at the Cary Cancer Center in Hannibal since 2003.

“A regimen of treatments for, say, someone with prostate cancer might be every day of the work week for five to seven weeks, depending on the type of tumor you’re dealing with,” Ahrens said. “That becomes a huge burden, an access-to-care issue, because it’s hard for anybody who’s a working man or woman to travel to Columbia, 90 miles each way, for a 10-minute treatment for five days a week for seven weeks. 

“We really thought that, to meet our mission of improving the health of the folks in the Kirksville community, we needed to find a way to bring that service to the community.”

However, a Kirksville hospital appears to have the same idea.

The Missouri Times reported on June 24 that the Northeast Regional Medical Center (NRMC) in Kirksville has submitted a certificate of need (CON) application with the Missouri Health Facilities Review Committee to replace a linear accelerator — which delivers high doses of radiation — that was retired two years ago. The Times said Hannibal Regional Healthcare System filed opposition to NRMC’s efforts, essentially blocking NRMC’s plan to offer advanced radiation cancer treatments in Kirksville.

“We have been preparing to replace the radiation oncology equipment that was previously located on our campus and that was part of the cancer care services offered on our campus for the past 25 years,” Patrick Avila, CEO of Northeast Regional Medical Center, told the Missouri Times. “Our plans would keep local residents close to home for cancer care, and we do not need state funding to make it happen.”

“At worst, Hannibal is attempting to end-run the CON process and improperly ask the legislature to find there is need for another hospital in Kirksville,” said Chuck Hatfield, an attorney for Northeast Regional Medical Center. “That is not the proper role of the body. The law assigns that responsibility elsewhere. And, even if Hannibal were to obtain a CON, appropriating money for private purposes is prohibited by the Missouri Constitution.”

Hannibal Regional officials say they have no plans to build another hospital. The state funding and certificate of need is specific to a cancer center. 

Hannibal Regional also has submitted a certificate of need application. Ahrens said the application must be completed if a hospital spends more than $1 million on a piece of equipment — in this case, the linear accelerator and concrete vault.

If the Kirksville facility is not licensed as an inpatient hospital or long-term care facility, it would not need a certificate of need, Lisa Cox, spokeswoman for the Department of Health and Senior Services, said in an email sent to the Missouri Independent.

The CON process will determine if Kirksville has an unmet need and how it should be serviced. 

“We hope (the application) will be heard in the coming couple of months, give or take, and they’ll approve our project,” Ahrens said. “I know you guys are familiar with (a similar process in) Illinois because of issues right there in your community.”

The Illinois 4th Circuit Court of Appeals ruled in February for Blessing Hospital in its suit against the Illinois Health Facilities and Services Review Board, The Illinois Department of Public Health and Quincy Medical Group. Blessing filed the suit in 2022 after the Review Board approved QMG to build a 27-bed hospital at the Quincy Town Center. 

“I want to make sure there’s clarity around that CON issue, just like you all had in Quincy,” Ahrens said. “Regulatory and bureaucracy issues like that can make things difficult. It’s not a sure thing. We still have work to do to get it approved.”