County: Hennepin

CH-F11-3461

Update 6/26/24: Patient doing well and has made improvement with emotional dysregulation. No longer recommending PRTF level of care. Interview with Divine House occurred last week.

Update-5/30/24- Patient has had severe decompensation in part due to child protection concerns along with prolonged hospitalization and has been in the BICU for aggression, self harm, and seeking/securing items to self harm with. It is now recommended that she be placed in a PRTF.

11 year old presented to the ER after discharging from residential for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care or a home with younger children. This patient struggles with low insight, poor boundaries, antagonizing behavior, and justifies her behaviors. We attempted to obtain psychological testing though patient was not cooperative and refused. Medications are stable. She continues to display oppositional behaviors at times.

MHF-F13-4168

Pt came into our ED on 6/13 after a verbal altercation at home with mom, where she left the house and walked to the police station who called crisis and brought pt to ED. Mom is refusing to pick up. Its reported pt was in residential treatment until April 2024, and prior to that was in PHP through Fairview. Mom reports that Case Manager is looking into residential treatment again however we have been unable to reach the CM and their offices are closed the rest of this week. Unsure if there is a recommendation for residential or county approval for that LOC.

MHF-F14-3744

Discharging today 6/20 to group home

Came to our ED solely due to not having another placement. Has boarded in our ED in the past. Was previously at Bar None Shelter plus where she assaulted others and was taken to JDC. Was in JDC for a week when a judge ordered her to be removed, so CPS brought her to the ED as they had no other place to go. CPS is searching for group home placement as that is what the County’s juvenile screening team deemed the appropriate level of care.

MHF-M17-4109

Update: Discharging today 6/20 to hotel crisis respite

Came to the ED this time on 6/9, after refusing to do chores and punching a wall and tree. Dad is refusing to pick up. Was previously in our ED 5/4-5/18 and 5/25-5/28, returned home with Dad both of those times. Case Manager is looking for waiver paid placement, and has been for over a month. Had interview with potential provider 6/12- they are potentially going to do a variance for him to live in adult home if accepted (he’s 3 months from 18). At baseline has some auditory hallucinations, ongoing aggression- primarily verbal, occasionally property, along with some suicidal ideation.

MHF-F16-4103

Came to ED on 6/2 after a fight with her guardian, Grandma. Grandma reported she has run away in the past and had made comments related to SI. Grandma refused to pick up and then flew to another state, notifying us she did not know when she would return. We tried to refer to shelter programs, but struggled due to Grandma’s unwillingness to work on reunification post shelter placement. CPS has now opened and will be pursuing temp custody, once they have that they will pursue placement options.

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.

HCMCH-M16-3905

Update: O5/16, Central Pre-Admission denied the patient’s placement in CABHH, appealing this decision. Comprehensive Home Care (Respite Provider) accepted him moving date TBD.
Update: 5/15 referred to CABHH he previously denied on 3/29 along with residential and respite placement.
16 y/o M with hx of intellectual disability, poor distress tolerance, and maladaptive patterns to get needs met. Presents with chronic behavioral pattern of acting out to get needs met. Pervasive behavioral patterns in the community result in unsafe behaviors, high utilization of ERS, loss of placements, and exacerbating attachment struggles. He was d/c from respite placement through Twin Cities Home Care on 5/14 due to aggression and impulsive behaviors.

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.

MHF-F14-3886

Came to ED on 5/09/24 via police after increase in suicidal ideation. Pt reports being bullied at her group home, was at Divine. Divine is not allowing pt to return. No physical aggression, continues to have suicidal ideation without attempts. County is working on Group Home placements- wait listed at North Crow, has explored shelters, foster cares- denied by those. Referral was made for MCCP crisis bed and working on hotel crisis respite referrals, as well as CRS homes.

MHF-F11-3813

Patient came to the ED on 5/4 after running away from her foster care. Patient reports she does not want to return to that foster care. County is guardian and CPS/ICWA worker is exploring shelters, denied from Dignity House and Passageways, still waiting to hear from Brittney’s Place. Elopement is main behavioral concern currently, pt did not like the foster care she was in. Not suicidal or violent according to foster parent.