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.
Ancillary Support Service: Family Resource Stabilization
Family Resource Stabilization services provide families with resources and support to help them stabilize their living situations and address various challenges they may be facing.
HCMCECC-M13-3482
**Contact department: HCMC Acute Psychiatric Services (APS) 612-873-9300
13 y.o. male boarding in ED. Brought in by adoptive mother after running away from home 3 times. Multiple suspensions from school (including currently) for fighting. Mother unwilling to bring patient home. Physically assaulted mother after he was brought back home. Went to Uncle’s house and left via window. Has been making passive comments indicating suicidal ideation and not having any sense of danger- getting into cars with strangers. Significant increase in challenges since he began going through puberty about 6 months back.
Copied from ED note:
“Collateral from mother and family:
Foster mother took in his sister first, took him as well at 16 months old. States that when he first came to live with her he would eat out of the trash, and from bowls on the floor like a dog. Took several months to correct this. Patient was then returned to his paternal grandmother in chicago, but was only there for two months. Foster system asked mother to adopt him and keep him with his sister. Some school issues, briefly on IEP. Mother was kindergarten teacher.
In the past 6 months, since hitting puberty and undergoing a growth spurt, patients behaviors have been worsening. In Nov of 23 patient attempted to start a fire in his bedroom. He has been in a plethora of fights at school. Is currently suspended. Believes that everyone hates him. Since January he has been making comments to family about ending his life. Reportedly had knife in his room at one point. 3x running away from home. 1st time was not far and he came home quickly. 2nd he made his way from north Minneapolis to S St. Paul, and was with a complete stranger for approximately 9 hours. Family reports that patient refuses to speak about this time. Was acting strangely after he returned. 3rd was yesterday after he became angry and physically assaulted mother. Was found by police (allegedly engaging in burglary?) Was brought to uncles house per request of mother, as he had been quite belligerent with her earlier. Patient normally behaves well with uncles, but today he waited until he was unsupervised and climbed out of a ground floor window to run away again.”
Not appropriate for inpatient pediatric medical floor. Boarding in HCMC Emergency Department. HCMC Acute Psychiatric Services do not feel patient needs an inpatient psychiatric admission. Family and NEXXUS advocate not comfortable with discharge unless plan for significantly increased outpatient support. No formal diagnoses. Has been completely compliant and appropriately behaved since presenting to the ED 32+ hours prior.
MHF-F15-687
Patient is presenting to the ED for the following concerns: substance use, intoxication, anxiety. Patient was at WINGS treatment center for substance abuse/mental health from 10/17/23-10/28/23, before eloping. Patient was living on the streets, and staying with friends, before going to her aunt’s house. Patient was then picked up by her guardian/grandmother and brought to the ED.
Patient has a history of elopement and substance abuse.
Patient attended Prairie Care’s PHP program in June 2022, but was discharged due to behavioral problems.
Patient was in FV inpatient unit from 3/10/23-3/16/23 when she eloped while being transported to FV residential treatment program.
Patient was readmitted to the inpatient unit on 3/17/23 where she remained until admission to FV residential treatment could be arranged.
Patient was discharged from treatment due to behaviors and ran away from home, when she was found and brought back to FV ED on 4/24. where she remained until eloping on 5/28.
Patient has been accepted to Oshki Manidoo treatment center, and will admit once a bed opens up.
PH-F15-1621
Updated 10/23/23: DC home to in home therapy through CIBS. Still no county funding for QRTP
Updated 10/19/23: Still no county funding for QRTP. Discharge home 10/23 or 10/24 with in home therapy through CIBS.
Update 10/12/23: Still no county funding. Likely moving forward with CIBS at Gerard, will likely discharge next week home.
Update 10/5/23: Gerard admission pending 10/11 now. County funding remains pending. Pt declined from CD RTC noting Mental Health long term RTC.
Update: 9/7/2/3 Gerard admission tentative 9/20, pending county funding.
Update: 8/31/23 Approved for Gerard admission week of 9/18, pending county funding. Also accepted at NorthHomes, 3-6 month waitlist.
SI since the 4th grade, history of trauma, living in cars/shelters, history of CD use.
Discharge Plan:
Primary DC recommendation is RTC*:
Gerard (accepted; pt is next on list for placement; openings week of September 18th)
North Homes (accepted; 3-6m waitlist)
CRTC (referral placed; admissions paused due to staffing)
Avanti (referral not placed; facility not accepting referrals)
*QRTP/RTC County Funding needed as pt has a UCARE PMAP Plan:
Dakota County CMHCM: Referral Placed
-Mother lives in Dakota County and father lives in Rice County (pt will reside with mother following hospitalization, mother provided consents)
-Le Suer County and Scott County CMHCM previously referred to: Cancelled Referral due to Family Moving