County: Douglas

PH-F12-3437

Update 5/14/24: Patient discharged home to the care of her guardian with outpatient supports to bridge Day Treatment.
 
Update 5/10/24: Patient tentatively scheduled to discharge home on 5/14/24, with outpatient supports to bridge PHP at Amberwing.
 
Update 5/6/24: Douglas County CPS is navigating PHP and Day Treatment with the guardian for aftercare. PHP waitlist is approximately 3 weeks and guardian still needs to obtain insurance coverage. Douglas County CPS will be closing out their case on 5/10/24 due to a lack of immediate safety concerns as evidenced by the guardian willing to take the patient home.

Update 4/30/24: Guardian is making statements of wanting the patient to return home. Patient was declined from foster placements in Wisconsin, and family placement is not an option either. Douglas County, WI, CPS, working with the guardian on a transition plan home, including Day Treatment and Outpatient Therapy. Patient remains at the hospital.

Update 4/24/24: Parent still not willing/able to take pt home. County involved and navigating alternative living arrangement/placement. DC rec is PHP.

Update 4/17/24: Parent still not willing/able to take pt home. County involved and navigating alternative living arrangement/placement. DC rec is PHP.

Update 4/3/24: Parent still not willing/able to take pt home. County involved. DC rec is PHP, openings available at PC PHP when patient is able.

Patient was admitted from Essentia Health in Duluth after attempting to run away from home. Pt has conflict w/ dad & has made HI statements toward him (burning him, switching meds out so he will OD). Pt also has a Hx of inappropriate sexual behavior with older men & on the internet.

Historically, patient lived with extended relatives for the first 11 years of her life due to mitigating circumstances that did not allow biological parents to meet her needs. Patient then went to live with her biological mom and was then sent to live with her dad, as mom was unable to meet patient needs. Patient has been with dad for about 1 month now, and he has indicated that he cannot meet her needs either, and declines for the patient to return home.

Discharge Plan:
PrairieCare Recommends:
Establish PHP; county coordinating with Amberwing, estimated 3-week waitlist

Establish Individual and Family Therapy:
-Insight Counseling in Duluth; referral made
-SOAR Services in Superior, WI; referral made
-Nystrom and Associates in Duluth; referral made

Establish PCP
Establish CMHCM (Open with Kalley Rustad at Douglas County CPS for long-term supports, closing case 5/10)
Establish CLTS (Referral made to Douglas County, CPS also coordinating)

Estimated length of stay:
Seven to ten treatment days; patient is medically ready for discharge; pending Douglas County, WI, establishing aftercare with the guardian. Guardian is now willing to take the patient home.

MHF-M17-3499

Update: Has been accepted at CABHH but discharge there has been delayed due to pts not discharging from their facility.

Pt was at North Homes, then was in Fairview’s inpatient unit for 35 days. Was going to return to North Homes from there, in transport there on 3/27 pt attempted to overdose on pills stating he didn’t want to go back to North Homes and was brought back to Fairview ED where he is currently boarding. Prior to being at North Homes he was at CABHH. County team have referred to Nexus Mille Lacs- long wait and Passageways. Hospital referred to Nexus YCT.

MCR-M16-378

16 year old, county ward, who has been at Gerard Academy for 1.5 months and had escalating SI in the context of conflict with peers at Gerard and then ultimately learning that father’s parental rights were terminated. Long previous history of neglect and possible abuse, multiple family members with substance use disorders. At Gerard was leaving the facility and finding sharps to potentially harm himself with. Initially was recommended for inpatient psychiatric care, but declined by all facilities due to history of aggression or behavioral issues in those facilities previously. Eventually acute SI resolved while boarding in the ED, but as plans have been made to work on return to Gerard, he has repeatedly stated he does not want to go back there and will hurt himself or others if he does. His case manager reports that similar statements have arisen repeatedly in the past as placement facilties start to challenge him and seem to serve the function of avoiding difficult emotions. Currently trying to work with Gerard staff and case manager to help him safety plan for a return to Gerard.