CentraCare - Coordinated Care Clinic

About This Location

CentraCare - Coordinated Care Clinic is a collection of population health initiatives where CentraCare is partnering to improve the health of the community: partnering with purpose.

Coordinated Care Clinic

The Coordinated Care Clinic is an innovative primary care clinic designed for patients with complicated medical, mental health and social needs that can result in frequent hospitalization. This clinic provides a multidisciplinary team who delivers patient-centered care that includes:

  • Primary care
  • Mental health
  • Addiction services (specializing in opioid addiction management)
  • Medication Therapy Management
  • Outreach services
  • Social and community resource management
  • Post-incarceration continuation of care

This clinic is available to patients by professional referral only including medical professionals, faith community members, law enforcement, human service providers, or other community professionals. Referrals to Coordinated Care Clinic can be made by calling 320-656-7195.

*Additional support: Patients 18 years of age and older with a mental illness have the opportunity to engage with Central Minnesota Mental Health Center (CMMHC) at Coordinated Care Clinic. Patients can work together with a Care Navigator and Certified Peer Specialist to find appropriate community resources for mental health and social needs (ex: transportation, housing, insurance, and more). This unique partnership between Coordinated Care Clinic and CMMHC ensures patients can get their needs assessed in one place.

Correctional Care

CentraCare - Coordinated Care Clinic partners with local law enforcement to provide health care for incarcerated individuals. The program provides high quality, cost-effective and comprehensive care that is available to inmates at the jail facilities and in the CentraCare - Coordinated Care Clinic upon discharge.

“CentraCare is pleased to be able to provide medical care, integrated behavioral health, medication therapy management, social services and more for patients who are incarcerated. CentraCare - Coordinated Care Clinic is a natural extension of our comprehensive, community-based medical services,” explained Medical Director Dr. David Frenz, a primary care physician with special expertise in addiction care and behavioral medicine.

For More Information:


  • Briana Eriksson, APRN, CNP
  • Catherine Standfuss, APRN, DNP
  • Lori Korte, LPCC, MA
  • Zachary Dorholt, LPCC, MS
  • Dr. David Frenz, Medical Director
  • Katy Kirchner, RN, MPH, Director
  • Heather Qunell, RN, Manager
  • Lori Laudenbach, MA, LPCC, Psychotherapist

Community Collaboration

Central MN Chip

The Community Health Improvement Partnership (CHIP) is a collaboration between CentraCare, Benton County, Sherburne County, and Stearns County to partner in community health efforts. Members of the partnership include participants who will provide a broad range of perspectives, represent a variety of groups, sectors, and activities within the community, and bring the necessary resources and enthusiasm to the table. One of the activities of CHIP is to complete the Community Health Needs Assessment (CHNA) as a group.

CHIP also includes partners working on mental health in the community. In the St. Cloud area, the CHIP includes the Community Multidisciplinary Team (CMDT) and Community Action Team involving CentraCare - Coordinated Care Clinic, CentraCare - St. Cloud Hospital Emergency Trauma Center, jail, local law enforcement, social services, public health, probation, community-based mental health, Veteran’s Affairs, and NAMI. These group functions to coordinate care for active utilizers in the community with the goal of reducing recidivism and making an impact on individuals with mental health concerns.

Chronic Opioid System Management

Thousands of patients in health care receive opioid analgesics for chronic pain, generally in primary care. Since 2013, CentraCare has been improving pain management and opioid prescribing system-wide. In our continued efforts, CentraCare is implementing the Federation of State Medical Boards’ Guidelines for the Chronic Use of Opioid Analgesics throughout primary care clinics. This practice guideline outlines a comprehensive care model that ensures provider support and patient safety.

CentraCare - Coordinated Care Clinic has dedicated, centralized “opioid” nurses to serve as a system resource to support frontline providers and provide critical linkages between clinic care coordinators and system resources such as pain medicine consultations, mental health services and addiction treatment. The nurses utilize tools that can predict opioid overdose, opioid-related side effect burden, and as well as other validated tools and make recommendations for the primary care providers.

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