Kiddo was just boarding with us 1/9/25 – 2/19/25, prior to that was in residential in FL for almost 2 years. Discharged to treatment GH 2/19 and had been doing fairly well there. Was supposed to start school yesterday and refused. GH staff gave her the option of going to school or back to the hospital and she chose the hospital so was brought back to our ED. Staff are saying that pt cant return without being willing to go to school. Pt reports that the school scares her because it has locked doors and they do holds.
County: Ramsey
MHF-F15-5270
Kiddo came to our ED on 2/11 from Rebound after altercation. Rebound initially stated they would not take pt back then, but we have not received confirmation if they are terminating. She had been there for 2 weeks, and prior to that was in JDC. Court determined she was incompetent for charges that led to JDC. County has temp custodianship but Mom still remains involved ongoing and makes decisions/signs. No waiver currently.
MHF-M16-5234
Kiddo came to us on 2/2 following suicidal behaviors. Plan was originally for inpatient however while waiting for bed he stabilized in the ED and became a boarder on 2/10. Was in SUD residential treatment, but they are declining to have him return, explaining that his needs are more mental health based than what their program can provide. He has a tentative acceptance at a residential program, just waiting for them to process more paperwork and identify a discharge date. Currently under temp custodianship with Ramsey County but Mom is involved ongoing.
PH-F14-5154
Psychiatric history of Major Depressive Disorder, Generalized Anxiety Disorder, and Oppositional Defiance Disorder. Patient has two prior inpatient psychiatric hospitalizations in October 2024 and December 2024. Patient has a history of partial hospitalization programming in October 2024. Patient presented to PrairieCare through the ED following a suicide attempt and increasing behaviors at home. The current recommendation is for residential or PRTF..
MHF-F13-5110
Kiddo was brought into our ED on 1/9/25 by her County Case Manager. She was in residential treatment at Deveruex in FL for over a year, she then aggressed, and was charged with assault so was brought to a JDC for 21 days in FL. After that time was up, she was ordered back to MN and the County had no placement so she was brought to the ED. Ramsey County currently has custody. Their goal is a long term group home with 2:1 staffing, but are needing somewhere for pt to go in the interim. Our team tried to refer to Nexus YCT for placement assistance, but the County worker refused that service. She has been declined by Gerard and North Homes RTCs. She currently is eligible for waiver placements but a waiver worker won’t be assigned until placement is found, so the Child Family Svs worker is doing all referrals, for MH and waiver placements. County is currently refusing hotel crisis as an option.
MHF-M7-4555
Came to the ED on 8/27 after behaviors at home of head banging and screaming. Mom has refused to pick pt up thus far, wanting medications prescribed before she is willing to do so. Our psychiatrist has been trying to work with Mom on potential medication changes, but there has not been an agreement thus far. CPS has opened a case and is investigating, and Nexus YCT intake was yesterday. Patient is primarily non-verbal. Mom is reporting he needs residential treatment, but there is no professional recommendation for that at this time and due to age and autism diagnosis, options would be very limited. Mom has connected with Chelida in WI. Pt has DD waiver with in-home services, as well as Washburn ready to come out at discharge.
CH-M11-4450
Patient presented to the ER via law enforcement for homicidal ideation towards his foster family (maternal aunt) and biological brother and had threatened them with a knife. Was removed from his biological home in June due to neglect, abuse, domestic abuse, substance use in the home. Patient with dissociative episodes and resorting back to small child like behaviors.
CH-M11-4380
Patient endorses homicidal ideation towards his sibling. Increasing behaviors at home. PHP (Clara’s House) attempted and will be discharged with recommendation of high level of care (residential). Patient has significant trauma after extensive physical abuse from biological mother and likely operates at a much younger age. Patient was removed from his mother’s custody by Ramsey County CPS in May 2024. Aunt is foster care provider.
PH-F10-2765
Update 2/22/224- Admission to Grafton tentatively scheduled 2/28/24, can discharge interim pending availability.
Update 2/15/24- waiting admission to Grafton end of Feb- date pending- can discharge home interim, pending availability.
Pt is medically cleared for discharge- parents informed county they need to pursue crisis respite for patient.
Discharge Plan:
Residential treatment referrals-
Grafton PRTF (Accepted, next opening tentative end of February)
Northwood Children’s (Referral not sent d/t insurance)
Nexus-East Bethel (Denied d/t not in 6th grade)
Nexus-Gerard (Denied d/t functioning for programming)
Avanti Center (Referral not sent d/t patient’s age)
VOA-Bar None (Referral not sent d/t patient’s age)
Heartland Girls’ Ranch (Referral not sent d/t patient’s age)
Nexus-Mille Lacs (Referral not sent d/t male only programming)
North Homes (Referral not sent d/t patient’s age)
Newport Academy (Referral not sent d/t patient’s age and insurance)
PrairieCare Residential (Referral not sent d/t insurance)
Village Ranch (Referral not sent d/t patient’s age)
Northwest Passage (Referral not sent d/t patient’s age)
Dakota Boys & Girls Ranch (Referral not sent d/t not ND resident)
Rogers Behavioral Health (Referral not sent d/t insurance)
Plan to bridge until residential availability:
Cradle of Love (Accepted, pending county funding)
Northwood Children’s Shelter (CM placing referral)
Kindred Care (CM placing referral)
MCCP Crisis Respite (CADI CM placing referral)
Trauma focused/attachment therapy (Referrals to be placed by CM)
Continue with established outpatient providers:
Ramsey County CADI- (Shakir Consulting Services)
Ramsey County CMHCM- B
PCP- (Entira Vadnais Heights)
OT- Fairview
CTSS- (Nystrom & Associates)
PCA/companion care 3x/week
ADYC-M14-1768
Update: 1/19/24 Pt. still looking for placement.
15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.
Because of experiences, client is chemical dependent on marijuana, perks, and opioids.