Patient is a 15-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient has had five previous inpatient hospitalizations through Abbott Northwestern and PrairieCare since April of 2022. Patient has had two admissions to PrairieCare partial hospitalization programming, and one admission to Anthony Louis Center RTC.
Establish PRTF:
-Nexus East Bethel (CMHCM sent referral, PC also sent a referral, declined for admission 04/16 due to believing PT needs a higher level of care- CABHH)
-Northwoods (Not a viable option due to insurance and 2 year waitlist)
-Grafton (Not a viable option due to patient not meeting admission criteria)
-Leo Hoffmann Center (Not a viable option due to patient not meeting admission criteria- only accept biological males)
Pt came to us 11/18/24 after an altercation at her ongoing GH in which she physically aggressed against another youth. Its reported that youth plans to press charges. She is not allowed to return to that GH, but that provider is working to see if they can set up a new setting for this pt, both temporary and ongoing. Team also has another GH they are looking into for her. This kiddo boarded with us previously, prior to discharge to her last GH, 9/24-11/1 of last year. Dakota County currently has custody. She is also open to CMH and waiver.
Patient is a 16 yo male with history of DMDD, ADHD, GAD, and MDD. Patient has a history of at least 8 inpatient hospitalizations in the past seven years and has also participated in multiple outpatient programs. Stressors include family conflict, housing insecurity, and school.
Presented to ED for verbal agitation, physical aggression, significant behavior chance, suicidal ideation. Patient has also been engaging in SIB. Aggression has been ongoing for over a year and has intensified. Aggression comes on suddenly/does not seem to be predictable. Mom feels she has no control. Has an IEP for low IQ and learning difficulties. Refuses medications. Strained relationships with mother, father, and older siblings. Patient reports not having many close friends. Has engaged in lots of community and outpatient treatment options including individual therapy, family therapy, case management, school counseling, child protection, primary care, psychiatric medication management, day treatment. Has been hospitalized before at PrairieCare.
Presents from home. Patient is known to our facility having previously boarded. Patient lives with aunt and uncle. There are issues with their relationship, and it has been increasingly difficult for aunt and uncle to manage, and they do not want patient to return home.
Patient presented to the ER after an unprovoked stabbing of a sibling in the middle of the night requiring emergency surgery and then proceeded outside in the cold without weather appropriate clothing. Patient has chronic aggressive behaviors towards caretakers and other children.
Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.
Kiddo boarded in our ED from 11/18/24-12/18/24 after being discharged from JEC Miller GH. JEC Miller took her into a temporary placement in an apartment setting while County worked toward another permanent placement. On 1/19/25 she returned to our ED after ingesting glass and was sent to our medical floor, where she is currently boarding. County team is looking into placement options- primarily crisis respite. On CADI. Working on Nexus YCT referral to assist with placement coordination.
On 11/14/24 the patient’s foster parents brought him to HCMC APS after he was discharged from Children’s Hospital St Paul because of his aggressive behavior. When in APS the patient began hitting his foster mom and becoming increasingly agitated. Security had to assist in transporting the patient to an emergency department bed, where he was then put into restraints for his and others safety. He was given sedative medications, IM.
The patient has been in foster care since he was 7 years old. He was physically and emotionally abused by his biological mother. He has been hospitalized at Fariview inpatient pediatric psych for a year, where he was then transferred to a residential treatment center. He has been with his current foster parents since August 7th, 2024.
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
