Recommendation for level 5 QRTP or level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Ten-year-old female patient with a history of in utero exposure and early childhood trauma and attachment concerns, with a historical diagnosis of FASD-Alcohol-Related Neurodevelopment Disorder (ARND). Patient presents with emotional dysregulation, violent threats and aggression, as well as passive suicidal ideation. Patient has been hospitalized multiple times and participated in several outpatient services.
Discharge Plan:
RTC (recommendation letter sent to CMHCM who is requesting county screening meeting)
-Nexus Gerard (referral sent, reviewing, will hear back week of 9/2)
-Northwood (referral submitted, next opening end of year, will review for acceptance at that time)
-North Homes (declined due not have staffing to meet needs related to aggression, SW requested reconsideration; declined 8/21)
PRTF (PRTF eligibility form sent to DHS 8/16)
-Nexus East Bethel (referral submitted w/PRTF eligibility approval 9/4)
-Grafton (referral submitted w/PRTF eligibility approval 9/4)
Bridging with Day tx
-Catholic Charities (referral pending although may not consider d/t RTC rec, IEP sent, 8 person WL)
Current Providers:
Med Management- Mayo Clinic
CM- Dakota County
CADI waiver- Dakota County contracted provider
CTSS
Pt presented with mother to ER after taking 30 tablets of 650mg Tylenol arthritis to end her life. She has multiple superficial cuts to her right thigh. Last inpatient treatment in May 2024. Pt states she had argument with couple friends and one friend told another things and now that friend was mad at her or does not like her. This upset her enough to want to end her life.
12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.
A 16-year-old female presented to the ED after being away from her group home placement for about 2 weeks. She is a ward of the state and is currently boarding in the ED due to her complex social and mental health history, increased risk of elopement, and the care team’s challenges in developing a safe discharge plan. Referrals are pending.
This pt discharged from our ED on 8/6 after being here since 7/22, went to a Beacon crisis home for approx 24 hours and returned to the ED again on 8/7, after aggressive behavior. Previous number was MHF-M12-4418. Also boarded in our ED in April 2024 for 20 days, and at different hospital in June. Hennepin County has temp custody and he is on DD waiver. Currently looking at a CRS home that requires exception bed approval through DHS, Grafton, remains on the MCCP crisis pool list, and judge is making determination if returning to Mom may be an option. Has been to Zane crisis, Beacon crisis, VOA Bar None, and done PHP with FV.
Pt came to our ED on 8/10 from Grandparents home who were providing foster care and there was an altercation. Grandparents are refusing to take pt back. Hennepin County CPS/ICWA have temp custody. Pt not appropriate for IP due to fecal incontinence and struggles with communication. County is looking for DD waiver CRS and doing a MNchoices assessment on 8/16.
Pt came to our ED on 8/9 from parents home after an altercation. Parents are refusing to pick pt up. They report pt is involved in some gang activity and verbal and physical aggression toward them at home. Has been to 3 residential programs, and multiple placements Northwoods, Gerard and Bar None. He continues to exhibit behaviors in all settings. County does not feel another residential would be beneficial as the last 3 haven’t improved behaviors. Therapist is currently working on IQ testing but unsure if that can be completed in the hospital. Team is looking at starting MNchoices process to get waiver options.
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
Came to us 7/22 via EMT after aggression and property destruction at hotel crisis respite, provider wont take pt back. Previously boarding in our ED 4/5 to 4/25, with somewhat frequent ED visits between. Has previously been to VOA Bar None. Hennepin County has custody and our team was struggling with reaching the CPS worker yesterday/this morning- going to continue reaching out for further plan/details.
Recommendation is for level 5 RTC – patient is currently inpatient.
14-year-old Male from ED. Patient got in a fight with their father and ran away from home. Patient has had several other inpatient hospitalizations and has completed a partial hospitalization program with PrairieCare. In alignment with CMHCM, seeking RTC level of care. At this time parents do not feel they can have the child return home. Referrals have been sent to Gerard Academy and Nexus Mille Lacs.
Patient insured by UCARE MA PMAP.
Pt has the following outpatient supports:
Individual Therapy
Psychiatry
PCP
CMHCM
