The University of Chicago Medical Center has received approval from a review board for a $269 million expansion proposal that includes an adult trauma center.

Parts of the plan had been criticized in an April report by the Illinois Health Facilities and Services Review Board, which said the projected cost was about $18 million too high and may outpace the local need for more medical/surgical and intensive care beds.

Those concerns were outweighed by testimony from residents of Chicago’s South Side, which hasn’t had an adult trauma center since 1991, when the center in Michael Reese Hospital closed.

“What took you so long?” said board member Joel Johnson, according to the Chicago Tribune.

The university, which closed its adult trauma center in 1988, proposed offering those services again as part of a larger expansion that includes a new cancer center.

“Our community needs and deserves equal access to quality healthcare, and we are now one giant step closer to being able to offer that access,” said University of Chicago Medical Center President Sharon O’Keefe in a statement.

Even nearby hospitals spoke in support of the expansion before the board, with executives saying overcrowding in the university’s current facilities—which were said to be 100 percent occupied for 172 days in 2015—prevent their hospitals from transferring patients to the University of Chicago when more complex care is required.

“Members of the communities we serve should always feel confident that they can get the care they need, when they need it,” said Tim Caveney, president and CEO of South Shore Hospital, according to the Tribune.

While the board’s decision clears the way for construction to begin, the hospital will still need approval from the Chicago Trauma Network, the Illinois Department of Public Health and the Region XI EMS System to become a Level 1 trauma center.  

The university expects the new emergency room to be open by the end of 2017, with the trauma center following in the first quarter of 2018. The entire project, including the cancer treatment center, is scheduled to be completed in 2022.