CAIRO, Ill. -- This poor Southern Illinois city will soon be a small step closer to having a local hospital for the first time in 16 years. But many difficult steps remain.

A local health-care official who has long been trying to build a hospital here will sign a contract in the next couple of days to draw up design plans, the official said Friday.

But Fred Bernstein, executive director of a health-care center, said many obstacles must be overcome before a hospital can be built, including securing the money to pay for it and determining whether it could survive financially.

Bernstein has received about $240,000 from federal and state sources to hire a design firm to draw plans for a "critical access" facility, which is a mini-hospital with emergency room and 16 patient beds.

The city's 3,600 people, many of whom are unemployed or have low incomes, have had to travel 31 miles to Sikeston, Mo., to reach the nearest hospital since city's hospital closed in 1986. It now stands empty and shrouded in weeds in this city at the southern tip of the state.

Bernstein hopes to have a new hospital elsewhere in the city up and running in two years, he said.

That depends on getting federal funding by next year to build it, something that a spokesman for Rep. Jerry Costello, D-Belleville, a past proponent of the plan, now says is far from certain.

"Whenever you're going after an appropriation, it's not easy, particularly when we're in a budget situation we're in now," Costello's spokesman, David Gillies, said Friday. "We'll continue to work with Mr. Bernstein," he said.

Before anything is built, another contractor will determine whether the mostly low-income residents of the city could support such a facility financially, Bernstein said.

The company will likely make that determination by July, based on the design plans that Bernstein is commissioning now, he said.

And although he said he thinks it can work, he doesn't want to raise the hopes of many who have been waiting and hoping for a local hospital for a long time.

"If the numbers come in on the negative side and suggest it wouldn't be financially feasible, it's not something we can move forward on," he said. "But I think we can accomplish anything we set our minds to."