Patient presented from Prairie Care PHP due to aggression and dysregulated behaviors. PHP unwilling to accept patient back, mother unwilling to take home at this time and cites need for RTC. No RTC referrals made currently. Patient needs support in short term placement while outpatient team supports long term plan and placement. Has been in the ED 4 other times. Back and forth from ED to home. No letter of rec. for residential at the moment. Working on it. There is a case mgr, working on a care conference currently.


1/18/24. No placement at this time. Waiting for a waiver to open up more funding sources. Denied at respite/shelter due to behaviors

Patient presented from Aspen House shelter due to aggressive behavior and property destruction. Patient is unable to return to shelter. Mother refusing to discharge home. County looking into shelter options and foster care placement


Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.


Came after being found in the street by a passerby who administered Narcan. Was incoherent, EMS brought her in to HCMC ED. Long history of trauma. Sexually abused in preschool by her father, who is incarcerated currently. Has been vulnerable to sexual exploitation. Her engagement with anyone in the community is a pathway to a friendship. Dakota County financial responsibility. Working with DaK. case mgr. Had an incident at school (interaction with the principal and had some sort of physical contact with him, charged with assault), so now has a probation officer. No aggression noted at hospital. Wonderful family support. Had been living with aunt. Will just walk out and engage with strangers who do not have her best interest in mind. When DA is complete will be looking for placement for her. community placement. Has been at CRTC and VOA. Working on getting all the info to understand her full picture. DRug screen was negative. Unsure if chemical abuse is dependent? She will use substances if someone offers it to her, socially.


Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.


Aggression, Child looks difficult on paper.


Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, and significant behavioral change. Per patient’s mom, patient has been struggling for several years with anger and aggression, but this past month things have been escalating. Patient got upset at home, threw things, and punched his mom in the face. Patient’s mother called the police. Patient was in Riverside’s inpatient unit 3x in 2020. Patient was referred to PHP, and attended a 3-week PHP at Children’s Hospital. At the completion of the 3-week PHP, patient was recommended for additional treatment in a residential/inpatient setting. Patient has previous mental health diagnosis of PTSD, ADHD, DMDD, anxiety, and depression. Patient has a mental health CM and a psychiatrist.


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


Diabetes, non-compliance, new substance use, looking at Jarvis, CHIPs placement.

DC’d to foster care 9/7/2022


Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.