Patient admitted to inpatient hospital following attempted overdose. Prior to hospitalization pt had resided at home with parents since February 2024. Prior to this pt had 18 month stay at Gerard RTC. Pt also had previous stay at North Homes RTC.
Discharge Plan:
RTC
-PCR (referral sent)
-Gerard (referral sent)
-North Homes (referral sent)
-Village Ranch (declined in February due to behaviors, flight risk, animal cruelty)
-Mille Lacs (referral sent)
-Bar None Shelter Plus (need county referral/funding, CMHCM not supporting)
-Leo Hoffman (referral in progress)
Group Home
-CMCHCM assisting with referrals although pt would need to pursue CADI funding prior to county funding
-MnChoices Assessment through Hennepin County for CADI Waiver (request made, scheduling 6 months out, can expedite if placement is found)
Continue with established outpatient providers:
Individual Therapist: Scott Nielson with Melissa Anderson and Associates
Primary Care Provider: Riverwood in MacGregor
Prescriber/Medication Management: Janet Larson with Riverwood Clinic
CMHCM: Alissa Boser with Aitken County (218-838-2405)
Probation Officer: Jacob Leondhardt with Aitkin County (218-927-7231)
Patient presented via law enforcement to the St. Cloud ETC after eloping from mother’s home and found wandering on Highway 10. Initially aggressive/combative with law enforcement. Patient was cleared for discharge but refused to go with mom, because combative and required PRN to calm down. Was kept overnight. Patient’s mom refused to pick patient up once cleared for discharge due to his ongoing aggressive behaviors. CPS is involved and a new report was filed.
Police hold initiated 7/9/24 and CHIPs petition is being pursued. County CPS worker is seeking foster care placement.
Update (7/18)- Court hearing for CHIPs petition. County CPS case worker is continuing to look for foster care placement. Patient will have twice weekly phone calls with his mother.
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.
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
Patient came to our ED on 7/22 after an altercation with mother and mother is refusing to pick pt up. Was previously in ED on 7/12 for same reason. Was reportedly discharged from Nexus East Bethel 7/12. Has been denied by Northwoods, Gerard. Was somewhat successful in the past with day treatment, CM is exploring day treatment options.
Brought to ER after assaultive behavior towards group home staff. Since being in the ER, patient has denied SI/HI and been behaviorally regulated with the exception of one incident after being here for 6 days, and was asked to go to his room to avoid potential problems with other patient’s in the ER and he was upset and got restrained. He’s been up for discharge back to his group home since the day he presented to the ER. The county worker has been main contact with group home and are trying to problem solve ways to support patient at the group home. Ombudsmen involved.
Update 7/10 – patient remains boarded, now on EmPATH unit (observation unit/extension of ER) without aggression or behaviors. County guardian making referrals for placement options including respite, crisis, group home, shelter
On 7/8/24, patient was told he would be spending time with his mother, to which patient had a negative response, causing patient to assault his father and run away. Police located patient at a local middle school just before patient ran across a highway and had to be sedated by EMS due to safety concerns.
Pt has dx that include: reactive attachment d.o., disruptive mood dysregulation disorder, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), ADHD, ODD, OCD, pervasive social communication d.o., with low non-verbal skills, high verbal skills, low memory skills, and average IQ.
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.
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.
