February 5, 2023

In spite of unknowns, Chisholm clinic hurtles toward reality – Duluth News Tribune

CHISHOLM — Expected to break ground in spring and open in fall, key details remain unknown for a new health clinic and separate child care center planned along U.S. Highway 169.

The project features several partners, figures to meet community needs, and has the clout of Essentia Health behind a large part of it.

It’s also not something upon which Essentia was willing to go it alone.

“This is an innovative approach we are taking to bring together health and human services in a common space,” said Tammy Kritzer, Essentia Health senior vice president of regional operations.

So, while the regional hospital forges ahead to replace an outdated clinic shuttered in 2021, partners are scrambling to fill voids.

Earlier this month, the St. Louis County Board heard a report about how the county had yet to fill its committed-to 1,500 feet of space in the new 5,000-square-foot clinic. Range Mental Health Center, the report said, had withdrawn its interest in the space.

“We’ve found ourselves back in a spot where we do not have someone at the table with us potentially looking at filling some of the space we have,” deputy administrator Brian Fritsinger told the board Feb. 8.

Despite the gaps — including roughly 3 acres of land still to be transferred as a donation from a 7-acre Delta Air Lines parcel containing a call center — the project hurtles toward reality.

Mike Jugovich.jpg

Mike Jugovich

“I would like to see us stay the course,” said Commissioner Mike Jugovich, the former Chisholm mayor who first proposed the county’s involvement in the project. 

“We’ve been mired down in COVID,” said Commissioner Keith Nelson, of Virginia. “Nobody wants to make a major move because everybody is in the same state of uncertainty.”

As the county pledged to fill 1,500 square feet with mental health or similar services, Essentia committed to 1,500 feet of clinic space. An additional 2,000 feet of space also remains unclaimed.

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Gary Meader / Duluth News Tribune

The city of Chisholm, which is leading the project, confirmed there is no business yet named for the remaining 2,000 square feet, and told the News Tribune it is in the process of selecting a developer, and does not yet have total costs.

“This is a great opportunity for the city of Chisholm, and I am excited to see the project move forward,” City Administrator Stephanie Skraba wrote in an email. “We hope to have (more) information by the end of February and move forward with the project in the spring.”

Kritzer explained how the process has unfolded across the past 18 months, starting with an agreement from all parties “that it was imperative some form of health care service be in Chisholm in order to keep care as close to home as possible.”

“That’s one of our founding values,” Kritzer said of Essentia, while describing clinic space featuring exam rooms, a laboratory and telehealth technology. There will be some form of primary care service, with physicians from clinics in Hibbing and Virginia likely cycling through Chisholm. Specialty service will be conducted using new technology.

Tammy Kritzer.jpeg

Tammy Kritzer

“We do anticipate standing up telehealth capability,” Kritzer said. “So if patients do need a consult they can do it in their own community via new technology and telehealth capability.”

Kritzer finished by saying the Chisholm model is new for Essentia, a departure from free-standing solo provider clinics of the past. But recruiting physicians to fill clinics in a town of 5,000, like Chisholm, is not as manageable as it once was.

“We knew we needed to change the model,” Kritzer said.

Essentia and the county agreed to sign long-term leases to leverage funding for the project.

A separate child-care facility adjacent to the clinic is part of what brought the Iron Range Resources and Rehabilitation on board.

Chris Ismil said the IRRR is prepared to help fund site preparation, but the city, awaiting the land, has yet to apply.

Ismil, community development representative at IRRR, called child care a top priority for the agency.

“Child care is instrumental in a local work force being healthy or not healthy,” Ismil said. “If you don’t have available child care slots you can’t attract a work force or expand an existing business.”

A child care provider has been identified, Ismil said — “someone who wants to open and run a facility” — but added it was still in a “pre-planning” phase.

Regarding the county, the question of how to fill space it was committing to first came up in February 2021, when the board voted unanimously to support the idea. At the time, Duluth commissioners asked pointed questions about the project, and were described as “naysayers” by Nelson.

A year later, the question of how to fill 1,500 feet of space in a new clinic remains unanswered.

The deputy administrator, Fritsinger, said timing was a “major concern,” given the county has no commitment to a facility opening in the fall.

“We’re trying to move forward in a fairly expeditious manner,” he told commissioners earlier this month.

The plan all along has been to fill the space with a mental health or substance abuse component. One hurdle to date has been prospective rents, which Fritsinger quoted ranging from $23.75-$24.50 per square foot — equating to roughly $3,000 per month.

“I can tell you that cost is extremely high,” Nelson said, noting commercial rents as low as $13 per square foot found in other parts of the Iron Range.

In the end, the commissioners seemed to believe the county would be able to find a provider to fill its space. Its partners seemed confident, too.

“There is immense need on the Iron Range and in the Arrowhead region,” Kritzer said. “I’m not concerned they won’t come through on their end of the bargain. I’m very confident.”