IRON MOUNTAIN — An affiliation agreement has been completed that makes Dickinson County Healthcare System part of Wisconsin-based Marshfield Clinic Health System, setting the stage for a $26 million capital commitment by Marshfield over the next five years, including construction of a new cancer center in Iron Mountain.

“The future of health care for our community and our region is now more capable and more secure than ever,” DCH CEO Chuck Nelson said in news release announcing the agreement was in place. “We will move local and regional health care to even higher levels of quality and accessibility by expanding locally based services, providers and locations.”

DCH and Marshfield Clinic signed a definitive agreement in January, which received unanimous approval from the DCH Board of Trustees.

Marshfield will start incorporating its care and operational support system into all Dickinson hospital and clinic locations, Nelson said. The process will take several months.

The agreement creates a regional hub for nonprofit Marshfield in the Upper Peninsula. There will be a focus on expanding locally provided outpatient surgeries, supporting DCH’s pediatric team within Marshfield Children’s Hospital, and growing DCH’s primary care provider team. Integrating Marshfield Clinic’s team and resources will also enhance emergency services.

The hospital and clinics’ names and branding will be announced in the coming months as the incorporation process is finished.

Dr. Susan Turney, Marshfield Clinic Health System CEO, said it’s crucial that rural areas such as Dickinson County have local access to quality health care.

“Our integrated approach allows us to offer the full continuum of health care and services in communities that truly need it,” Turney said. “Patients and rural residents deserve access to excellent care how, when and where they want to receive it, and we are proud to deliver on this promise to the Upper Peninsula.”

The new cancer center will bring a full spectrum of oncology services to the region. The center will build on DCH’s previous multi-million-dollar capital expenditures, including a highly advanced linear accelerator. The center will provide radiation treatment and nuclear medicine technology for cancer diagnostics and allow patients to receive treatments closer to home.

Thursday’s news release did not disclose financial details of the closing. Officials previously confirmed there will be no liability for Dickinson County going forward. Under the agreement, hospital facility operations will be turned over to Marshfield, with input and oversight from a local advisory board.

In a memo to the Dickinson County Board of Commissioners, which authorized the Marshfield affiliation Dec. 6, DCH attorney Michael Celello summarized some key issues:

— For the first three years post-closing, any labor force reductions must by approved by the local advisory board. The board will be comprised of five to seven members, including some current members of the hospital board, a representative of Marshfield, a physician and one or two local community or business leaders. DCH employees will transition to become Marshfield employees.

— The advisory board, for a period of 10 years, must approve any decision to discontinue or substantially diminish any core service lines or the closure of a medical practice. The board will also be responsible for monitoring the hospital’s operational functions and financial performance as well as the development of strategic business and other plans.

— Dickinson Hospital Foundation will be given $1 million over a five-year period while also serving as an “enforcer” of the affiliation agreement. A subcommittee of the foundation will be charged with making sure Marshfield meets its $26 million capital commitment and related promises. The subcommittee will consist of the chief administrator officer of the new operation — likely Nelson — and several current members of the hospital board.

— Marshfield is taking responsibility for pension funding. No dollar amount has been disclosed, but when a DCH sale to Bellin Health of Green Bay, Wis., was proposed in March 2018, roughly $40 million of the planned acquisition was expected to go toward making the DCH pension plan whole. Two months later, however, Bellin terminated the agreement.

Administrators of the Marshfield and DCH health systems said Thursday they are optimistic about the future of health care across the region.

“As the only physician-led health care organization in the U.P., Marshfield Clinic Health System is ideally positioned to help lead discussions that benefit the wellbeing of the Upper Peninsula overall,” Nelson said. “This is an exciting time.”

Operating a 49-bed, general medical and surgical hospital in Iron Mountain, DCH has more than 70 physicians and 700 employees. It provides a broad range of acute care, including inpatient, outpatient, diagnostic and specialty services. It also has primary care clinics in Iron Mountain, Kingsford, Norway and Bark River as well as Florence, Wis.

DCH has functioned as a Michigan municipal health facility corporation under Public Act 230. According to attorney Celello, with a Marshfield agreement completed, P.A. 230 will no longer be applicable.

The original Dickinson County Memorial Hospital opened in 1951 on Woodward Avenue in Iron Mountain. The hospital has received no taxpayer support since moving to its current facility on U.S. 2 in 1996.

Marshfield Clinic was incorporated under Wisconsin law in 1916 and operates as a charitable corporation with all of its assets held in a charitable trust. It is one of only a few large independent nonprofit medical clinics in the United States. It has more than 1,400 providers, comprising 170 specialties, health plan, and research and education programs. Primary operations include Marshfield Clinic, nine Marshfield Medical Center hospitals, Marshfield Children’s Hospital, Marshfield Clinic Research Institute, Security Health Plan, and Marshfield Clinic Health System Foundation.