Ancillary Support Service: Children's Mental Health Targeted Case Management

Children’s Mental Health Targeted Case Management involves coordinating and managing mental health services for children and youth to ensure they receive appropriate care and support.

PH-F16-3212

Update 5/16/24: No new information from 5/8 update. Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options. Medical recommendation is locked mental health RTC. Comprehensive assessment (rule 25) recommends Mental Health Residential. Accepted at Nexus East Bethel PRTF- opening midsummer.

Update 5/8/24: Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options.
 
Update 5/01/24: Accepted at Bar None Haven, county funding approved. Missed admissions on 3/20 and 4/30 due to county wanting to complete QI process and having VPA signed in front of a judge before approving placement.

Update 4/25/24: Accepted at Bar None Haven, second opening is now 4/30 and county approved for placement, they are not approving transition on 4/30 wanting a judge to sign the VPA in court and wait the QI process.
Accepted to Nexus East Bethel PRTF, estimated wait list out until August-September.

Update 4/17/24: County funding approved, awaiting open placement at Bar None Haven, previously missed admission due to no funding. Pending acceptance decision at Nexus East Bethel PRTF.

Update 4/3/24: Pt has MA now. CMHCM in process of being assigned and requesting preplacement screening for funding. Denied from Grafton. On waitlist at Bar None Haven, missed admission due to no funding. Pending East Bethel.

Discharge Plan:
Level 6 RTC/PRTF-
Grafton (Referral submitted; Not in network with Prime west, can contract with MA MCO’s and obtain SCA, Denied 2.8.24, re-reviewed, denied)
Nexus East Bethel (Referral submitted; pt will need straight MA; several month waitlist, now has MA so re-reviewing, accepted, admission waitlist til mid-summer)
Bar None Haven (Referral submitted, Tentative admit 3/20-3/21, dependent on county funding, county declining JST screening, requested again, approved)
CMHCM at Beltrami County (Guardian currently in communication with the county, case manager was not being assigned until pt has CD treatment, requested reconsideration)

Notably, Previous services/interventions attempted: Dual Diagnosis IOP, Outpatient therapy, outpatient psychiatry, PCP, CMHCM, CTSS, CD RTCs, Inpatient x3, JDC, previous foster placements.

CMHCM at Beltrami County (Referral completed, services in intake)
INSURANCE- NOW Straight MN MA (was a PRIME WEST MA)
Description: Patient is a 16-year-old Native American female who has a history of depression, anxiety, ADHD, nicotine use disorder, cannabis use disorder, and unspecified trauma. Patient experiences significant impairment(s) in the area(s) of social, emotional, and academical. Patient identifies current supports as her father, sisters, and grandmother. Patient has a history of inpatient psychiatric hospitalization through PrairieCare and Prairie St. Johns.

RMC-F16-4041

16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.

PH-F17-3785

Recommendation is for level 5 Residential Treatment; patient is currently inpatient.

Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.

Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, scheduled admission Tuesday 6/4/24)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)

Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance

PH-F11-3982

The patient presented after expressing homicidal thoughts (threats of aggression) toward her grandmother with whom she lives. Patient was on her way home from school when she pulled her school lvan driver’s arm to the back of the van as she did not want to return home. Patient was then returned to her school where her grandmother picked her up and eventually brought her to the Emergency Department. Since her presentation to the Emergency Department, the patient has not displayed any aggressive behavior. Patient has irritability and emotional outbursts with grandparent(s) and has displayed these behaviors at school as well. Has mostly been pleasant and cooperative in the Emergency Department. Has some attention seeking behaviors when the Emergency Department is busy.

EH8D-F15-4024

Pt is a 15 year old female with a history of unstable placements after having been removed from family care due to physical abuse. She has a history of irritability, impulsivity and mood instability which have led to outbursts, self-harm, aggression and property destruction. She was admitted to the hospital after being discharged from her residential treatment facility due to these behaviors. Patient is requesting medication management for the above listed symptoms while we work with her Hennepin County case manager on placement. She has not had any significant behavioral issues over the past 2 weeks while in the hospital.

RMC-M15-3979

Suspended (5/17) for bringing a knife to school. Went to school on 5/20 with uncle to search locker (items were missing from home-guns, knives, etc.). Pt became agitated and began banging his head on the wall. He also punched his uncle.

EH8D-F10-3962

Pt has been living in the Residential Services-Jewel Group home for over a year. They gave a 60 day termination of service due to their inability to manage her escalating behaviors (last day of services 6/25/24). They have 2:1 staffing for her. These behaviors include harm to self, or others, striking out, choking herself, throwing things and threatening to kill herself and others. She had been attending TSA day treatment until March after an altercation with a peer. She is currently at a 4th grade level and has an IEP. She was brought to the Welia Mora ED on 5/9 and 5/10 as well as Children’s ED on 5/14 looking for “other placement” and was discharged due to not meeting criteria for inpatient hospitalization.

PH-F17-3791

5/20/24: Patient discharged from inpatient and admitted to PCR.

5/8 update: Patient scheduled for admission to PrairieCare Residential on 5/20/24 at 10:00am.
5/6 update: Patient is currently awaiting an RTC bed through PrairieCare Residential in Maple Grove. Patient has been approved for 3rd pathway funding through Hennepin County. Due to patient behaviors seeming to increase, other options are being explored for aftercare as denials are a possibility. Parents do not feel safe with the patient coming home.

Discharge Plan:
Residential Treatment:
-PrairieCare Residential; intake 5/20/24 at 1000

Other RTC Referrals:
-Nexus Gerard; referral made
-North Homes; referral made, declined due to FAS and IQ
-Avanti Center for Girls; referral made, declined due to aggression and peer conflict

Outpatient Providers:
Establish CMHCM; opened with Soreya Jama through Hennepin County, 3rd pathway funding approved

Establish/Continue CTSS with Samira through Nexus FACTS
Continue Therapy with Mary Midler at Great Lakes Neurobehavioral Center in Edina (weekly)
Continue PCP with Dr. Megan Reilly at Partners in Pediatrics in Plymouth
Continue Psychiatry with Gerard Balan at Plymouth Psych Group
Continue IEP Case Management with Yvette Zeese at Wayzata High School
Continue Neurological Services with Dr. Catalfamo at Noral Neurological Clinic in Bloomington

ADMISSION NOTE: Patient was admitted due to acute safety concern and was unable to contract for safety at home. Pt was in PHP in the past and family was monitoring her 24/7 at home as instructed. Pt became irritated that she is constantly being watched and ended up having altercation with her mother because she was instructed by her mother to change outside of her bedroom because the mother was unable to see her. Pt ended up leaving and went to her grandmother’s house which is next door while mom followed her, pt went straight to the kitchen grabbed a knife and start threatening to stab herself. Mother was able to wrestle the knife out of her hands and called EMS. Pt has a history of depression, anxiety, epilepsy, and fetal alcohol syndrome.

PH-F14-3891

Update 5/23/24: Patient accepted to Heartland Girls Ranch with scheduled admission Wednesday 5/29 – county funding was approved.

Patient presents to inpatient from the ED due to an increase in SI. This is her third psychiatric inpatient hospitalization. She has done PHP twice and engaged in outpatient mental health services.

Discharge Plans –
RTC: (JST funding meeting on 5/17)
-Avanti Center for Girls (referral under review)
-Nexus Gerard (referral under secondary review)
-North Homes (pt is on waitlist – 4-6 weeks out)
-Village Ranch- Annandale (pt is on waitlist – end of June)
-Heartland Girls Ranch (referral under review)

Continue with established outpatient providers:
– Therapist: Mayo Clinic Health Systems Austin
– Family Therapist: Albert Lea
– Medication Management: Mayo Clinic Austin
– Case Management: Freeborn County
– Occupational Therapist: Mayo Clinic Rochester

PH-F16-3692

Update 5/09/24: Patient discharged from inpatient to home with outpatient supports in place while awaiting admission to RTC. Admission to Avanti RTC tentative 6/4/24

Update 5/08/24: Patient is accepted to Avanti Center for Girls RTC. Tentative admission date is 6/04/24.
Update 5/01/24: Patient is accepted to Avanti Center for Girls RTC. Estimated opening early-mid May. County funding approved for placement.
Update 4/24/24: Patient is accepted to Avanti Center for Girls RTC. Estimated opening early-mid May.

Patient is a 16-year-old female who presented to inpatient from ED due to increase in SI and suicide attempt. She has had 6+ psychiatric inpatient hospitalizations. She has had two residential 35/45-day evaluations as well as a history of participating in outpatient mental health services.

Discharge Plans:
RTC:
-Gerard (Referral sent & received, wait list out until September or later)
-North Homes (declined due to previous programming experience)
-Avanti Center for Girls (Accepted, opening early-mid May)

CMHCM: Carlton County