Recommendation is for level 5 residential treatment.
Patient arrived at inpatient from ED due to an increase in suicidal ideation with plan. Patient’s legal guardian is Goodhue County. He currently lives with a foster family. This is his 5th psychiatric inpatient hospitalization. He has done PC PHP 3 times, receives outpatient mental health services, and did CIBS program.
Discharge Plan:
RTC: (will need county funding)
-Gerard (Referral sent)
-North Homes (Referral sent)
-Nexus Mille Lacs (Referral sent)
Referred for Trauma informed therapy and CTSS.
Continue with established outpatient providers:
CMHCM: Fernbrook Family Center
PCP/Medication Management: Allina Health
Guardian Ad Litem: Goodhue County
County Guardian: Goodhue County
This child has been on the HUB previously as MCR-10-283.
Patient was admitted to Prairie Care Residential on 11/8/22 but was transferred to Prairie Care’s inpatient psychiatric hospital on 11/10/22 due to aggression. Patient remains on the Northwoods Residential wait list. There will be additional residential treatment waitlist’s the patient can be added to, once they turned 11 on 1/16/23. Patient remained psychiatrically hospitalized at Prairie Care until she was discharged on 1/5/23 with the recommendation of returning to community-based treatment. Adopted but adoptive parents surrendered her to Goodhue County.
In protective custody of Goodhue County. Trauma hx, was at SERCC and became dysregulated. Virtual DA schedule for today.
From crisis bed to ED. will not willingly return. Lives with adoptive parent but now CHIPS petition. Goodhue County. Needs foster care vs residential.
Patient is presenting to the ED for the following concerns: physical aggression, abuse or neglect, worsening psychosocial stress. Patient has been with his foster family for a week. He has been displaying sexualized behaviors, aggressive behaviors like throwing furniture, hitting, trying to light paper towels on fire on the stove top, sharing that he wants to die and self-injure. Patient was in a previous foster home and prior to that he was with his Grandma. Per foster mom, there was “interfamily torture” and the kids were sexually abused. Patient demonstrates inappropriate sexualized behaviors
History of DMDD and ODD with worsening of extreme violent outbursts since March without known trigger or stressor. Kicked out of PHP due to aggression, sent to SERCC and brought here from SERCC after an aggressive event. Family concerned about home safety.
Pt has had 4 psychiatric hospitalizations, PHP twice, and outpatient services. Needing RTC and bridging plan. >Discharge from PC Inpatient is 5/11 at 1400, will discharge home until RTC.
Discharge Plan:
RTC-
Avanti (Referral made, declined for admission due to history of aggression)
North Homes (Referral made, 6-8 week waitlist)
Village Ranch (Referral made, pending acceptance)
Gerard (referral made; pending acceptance)
Northwood (referral not made; waitlist over 6 months)
Newport Academy (referral not made; insurance not accepted)
Grafton (CMHCM making referral; though likely doesn’t meet criteria due to no ASD/ID/DD diagnosis)
CRTC (referral placed)
Interim Plan:
Consider PCR (referral not made; insurance not accepted though possibility for a county contract- connecting county worker and PCR)
Continue Psychiatry at Nystrom and Associates
Continue Probation services at Goodhue County
Continue CMHCM at Fernbrook
Establish Family therapy at Nystrom and Associates.
Establish CADI worker at Goodhue County
update as of 6.22.23 – Denied acceptance at CRTC due to aggression and lack of buy in
