Patient came to ED on 7/19 from Nexus East Bethel PRTF after swallowing a foreign object. Was in our inpatient unit from 7/15-7/19 and discharged for only hours before returning. Reports that repeat behavior was pt seeking to be removed from program. Nexus PRTF is not accepting pt back at this time and Mom is unable to have pt return home. Sending referral to Nexus YCT to assist with placement.
County: Olmsted
MCR-F14-2438
Ran away from home (resides with grandma) & stole from Scheels and air pods from a stranger Was tracked by air pods owner who confronted the patient at Red Lobster. Pt assaulted the mother of this individual. History of trauma & SA Kicked out of multiple schools brought gun to Willow creek & threatened to pistol whip classmate. Attempted treatment at Fountain Centers. Restraint chair multiple times.
Declined from Heartland Girls Ranch, Family/Foster Home is not an option due to behaviors, SERCC/Vonwald- patient has been to in the past and has either eloped or been kicked out of the program due to fighting. Trisha will follow up with PORT and Hunter’s Place. These are both sheltered care so similar to Vonwald but in a different geographic area. Neither of these are locked facilities which is also a concern.
Parents unwilling to take her home. Care conference with the county occurred after a week in the ED. Just starting the QRTP process.
MCR-F13-2434
This child was previously on the HUB as MCR-F13-2165.
Returned 3/21/23 to Mayo ED after discharging to home on 1/9/23. Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self harm. when he goes to Mayo, he claims that its a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 days at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldnt meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
Seeking ideas for other options for keeping him safe. Consider Gerard? Prairie Care? (have both turned him down). Jennifer Butler working on this case. suggestions to mitigating risk? clear all things from units, reintroducing slowly when able. Mayo has been able to mitigate risk with using paper crafts, crayons, etc. Haven’t had an ingestion for a few months – has a sitter a Mayo though as he’s on a medical unit. Functional behavior analysis? Hasn’t had one, due to instability. Hopefully he will have one soon. *** Discharged to home on 4/3/23 with 24/7 PCS care.
MCR-M17-2426
This child was previously on the HUB as MCR-M17-2128. Originally admitted 10/12/23, and discharged 11/17/22 to CD group home and eloped within 24hours. Brought back to ED after being found ODing on 12/4/22. Eloped on 12/30 and returned 1/6; attempted to elope again on 2/4 but successfully stopped.
Chemical dependency (fentanyl and meth), suicidal statements when intoxicated. On MI/CD Civil Commitment. Needs locked CD or dual diagnosis residential treatment. County Attorney pressing charges, which may help with JDC placement options.
MCR-M12-2422
Autism spectrum disorder and ODD, mother struggling with her own mental health issues and just started a day program. Multiple ED and SERCC presentations for physical aggression at home, typically triggered by conflict with mom. Completed PrairieCare PHP in September/October. SERCC declining due to lack of benefit and property destruction, Von Wald shelter has him on a wait list but no anticipated discharges. Only recently opened YBH case so in process of having worker assigned, no options for out of home placement. On wait list to start day treatment, perhaps week of 2/13, but he and mom can’t tolerate being in the same room together without escalating to yelling and throwing things. When not with mom, he is calm and engaged in crafts all day long. Care conference with mom and YBH intake 1/24 and 1/27 with a planned discharge 1/30 but mom refusing to take him home because of her concerns about his escalation in her care even in the hospital. Olmsted County CPS has screened out and does not have resources to offer.
MCR-M13-2218
Significant trauma history, aggression. Paternal grandmother has DOPA but feels unsafe with him at this time. His legal guardian is his mother who relocated to Oklahoma.
MCR-F13-2165
Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self-harm. when he goes to Mayo, he claims that it’s a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 ays at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldn’t meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
MCR-M16-2136
Twin brother adopted from Ecuador at age 11. DD, operate at about 5-6 year old. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers: no MA, waiver or declined due to DD or aggression. DC from Chileda due to behaviors.
MCR-M16-2149
Twin brother adopted from Ecuador at age 11. DD, operate at about a 5-6 year level. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers; no MA, waiver or declined due to DD or aggression. Discharged from Chileda due to behaviors. The family wants to keep him at home, but is intimidated by how big and aggressive he’s become.
MCR-M17-2128
Chemical Dependency (fentanyl and meth) suicidal statements when intoxicated. ED boarded 9/20/22-10/5/22 when brought from CRU for making suicidal statements. Placed at PORT group home in Bemidji, eloped in less than 24 hrs. presented to ED 10/12 after being hit in the head with machete. Surgically cleared, mayo filed for MI/CD commitment. Olmsted currently deciding between CHIPs commitment or family court to obtain court ordered CD tx. Needs locked CD or dual dx residential. Discharged to CD group home and eloped within 24 hours. dropped off at Mayo after OD. proceeding with commitment.