In mid-April, I wrote a commentary in CT Mirror urging the Connecticut Office of Health Strategy (OHS) to approve the Certificates of Need for two revolutionary new proton therapy cancer treatment centers in Wallingford and Danbury.

Proton therapy is an up-and-coming form of radiation that is rapidly growing across the USA and around the world, but it is not yet available in Connecticut. The closest proton facilities are currently in Boston and New York City, and these centers are operating at peak capacity, turning away patients on a consistent basis. The need for in-state proton therapy is abundantly clear.

Drew Crandall

Due to high staff turnover, the coronavirus, and other internal factors at OHS, the approval processes for both proton therapy centers experienced multiple delays, twists and turns over a lengthy 2-1/2 year period. Throughout this process, I have been outspoken about my enthusiasm for both proton therapy centers. It has never been an issue of either/or.

I was elated when, shortly after my April commentary, a major victory was scored for proton therapy when OHS approved the Connecticut Proton Center in Wallingford, a joint venture of Yale New Haven Health and Hartford Health Care.

However, my enthusiasm was dampened when OHS subsequently denied the certificate for Danbury Proton. As a result, Danbury Proton filed a Petition for Reconsideration with OHS on July 29. Thus far, OHS has not been receptive to constructive conversation about this situation, and has until today to respond. Their denial, and passivity in resolving any issues, doesn’t make any sense.

The approved Wallingford facility will have enough of a patient base within Connecticut’s largest two health systems to keep it operating at full capacity. That begs the question: What about the many patients in Connecticut and adjacent portions of New York and Massachusetts who will not be served?

The aggregate need for proton therapy in this densely populated region is far greater than what the Wallingford facility will be able to handle. Why would OHS intentionally create a monopoly that cannot meet the patient need, and cause the rationing of this life-saving care? By OHS’ recognized Wallingford calculations, this rationing will send at least 500 cancer patients a year searching for treatment slots in other states. It doesn’t make any sense.

OHS agreed that proton therapy is cost-effective for the Wallingford facility, but not for Danbury Proton. They determined that a smaller Wallingford demographic is financially feasible, but that Danbury Proton’s significantly larger demographic of 17 million people is not. How can that be?

Danbury Proton has pointed to the financial assessments of independent consultants and investment bankers who have significant experience with other proton therapy centers and deem the project to be financially feasible. The denial doesn’t make any sense.

OHS would prefer that Danbury Proton be a multi-institutional arrangement. As an independent provider, Danbury Proton will be available to all health systems’ patients, excluding none. The center will even welcome Hartford Health Care and Yale New Haven Health patients who reside in western Connecticut. Does OHS want Danbury Proton to choose institutions with which to affiliate, and exclude others? The CON denial doesn’t make any sense.

OHS would prefer that the new equipment be in a medical school or other teaching or research facility. However, Danbury Proton’s clinicians are global pioneers and leaders in proton therapy research, and plan to continue and expand this research in the new Danbury facility. Danbury Proton also clearly stated its intent to partner with regional medical schools, noting the request by the New York Medical College to place interns at Danbury Proton. Danbury Proton’s world class research team will be a huge asset and advantage to Connecticut. The CON denial doesn’t make any sense.

From a sheer economic development perspective, the Danbury Proton facility will be an investment of over $80 million, with no state funds requested or required. The project is already “shovel-ready,” with approvals from the City of Danbury, Danbury Municipal Airport and the Federal Aviation Administration. Architecturally, the facility is a highly creative, eco-friendly use of land that has limited utility because it is in a runway approach zone.

The project will create over 100 good-paying construction jobs for two years, over 30 high-paying permanent medical and administrative jobs with annual cumulative payroll of over $3 million, over 500 indirect jobs, an estimated $600,000 in annual City property tax revenue and $130,000 in annual State taxes. Because of its unique, high-tech nature, once Danbury Proton is built and operational it will remain planted in Danbury for years to come. Patients, family and friends will be visiting Danbury, spending time and money in the area during treatment.

At the moment, Connecticut is the only state in the USA to deny a certificate for a proton therapy cancer treatment center. It doesn’t make any sense. Now is the time for OHS to talk to Danbury Proton, resolve any lingering issues, and approve the application so proton therapy can flourish. We’re halfway there. Let’s finish the job.

Drew Crandall is community engagement director for Danbury Proton.